CERTIFICATE OF LIABILITY INSURANCE (254) DATE tMM1DDNYYY)
CERTIFICATE OF LIABILITY INSURANCE 06!1412019
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE,. DOMES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed. -
If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT
-_.--
MARSH LISA,INC. NAME:.
TWO ALLIANCE CENTER PHONE No):
3680 LENQX ROAD,SUITE 2400 EMAIL
ATLANTA,GA 30326 ADDRESS:
INSURER.$AFFORDING COVERAGE NAfC 0
-
CN102421774-Atkin-GAWE-118-20 NDC INSURER A:Zurich American Insurance Company 18535
INSURED INSURER a:American Guarantee&Liabili Ins Co 26247
Atkins North America,Inc.
4030 West Boy Scout Blvd.,Ste 70D INSURER C:National Union Fire Ins Co.of Pittsburgh PA 15445
Tampa,FL 33607 INSURER D:
INSURER E:
INSURER F':
COVERAGES CERTIFICATE NUMBER: ATL-004955482.43 REVISION NUMBER: 4
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
-
INSR TYPE OF iNSUt1J'.NGE POLICY EFF POLICY EXP
LTR POLICYNUMBER Mmm MMVOO LIMITS
A X COMMERCIAL GENERAL LIABILITY GLO 0137576-04 10115/2018 10/15/2019 EACH OCCURRENCE $ 2,000,000
F-Y-1 DAMAGE CLAIMS-MADE OCCUR PREMISES/ RENTED-
CLAIMS-MADE $ 1,000,000
Ea cx;c
MED EXP(Any ons person $ 50,000
PERSONAL&ADV INJURY $
......2,000,000
GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000
X POLICY 7 JECDT- El LOC PRODUCTS-COMPIOPAGG $ 4.000,000
OTHER: $
A AUTOMOBILE LIABILITY BAP 0137575-04 10115/2018 10/1512019 COMBINED SIVG—LE-LIMI $ 2,000,000
_._- I Ea aociden ,
X ANY AUTO BODILY INJURY(Per person) $
OWNED SCHEDULED BODILY INJURYPer accident $-_-
AUTOS ONLY - AUTOS. ( )
X HIRED X NON-OWNED PROPERTY DAMAGE
AUTOS ONLY AUTOS ONLY Pee aecident
X. UMBRELLA LIAR X OCCUR AUC 9304209-16 10115/2018 10/15/2019 EACH OCCURRENCE $ 1,000,000
ExcE58.LIAR CLAIMS---MADE AGGREGATE. $. 1,000,000
DED RETENTION$ $
A WORKERS COMPENSATION WC 0137577-045 PER OTH-
AND EMPLOYERS'LIABILITY Y V N X STATUTE ER _
ANYPROPRIETOWPARTNER!EXECUTIVE
OFFICERIMEMBEREXCLUDED? N] NIA E.L.EACH ACCIDENT $ 1,000,000
(Mandatory In NH) E.L.DIS EASE.=EA EMPLOYEE $ 1,000,000
If yes,describe under
DESCRIPTION OF OPERATIONS below i E.L.DISEASE-POLICY LIMIT $ 1,000,000
C Professional Llabilry95808715 04130/2019 04/3012020 Limit:Per Claim 1,000,000
(claims made policy) (See additional page) Annual Aggregate: 1,000,000
DESCRIPTION OF OPERATIONS 1 LOCATIONS V VEHICLES(ACORD 101„Additional Remarks Schedule,may be attached If more apace Is required) --
Re:RFQ#28-19
City of Clearwater itsatf,Its Council,the Community Redevelopment Agency of the City of Clearwater,a Florida governmental agency created pursuant to Pali III,Chapter 163,Florida Statute,its duty appointed
officers,or other public bodies,officers,employees,volunteers,representatives and agents is included as additional insured where required by written contract with respect to general liability and auto liability
coverages. Waiver of subrogation is applicable where required by written contract and subject to policy terms and conditions. This insurance is primary and non-contributory over any existing insurance and limited
to liability arising out of the operations of the named insured subject to policy terms and conditions.
CERTIFICATE HOLDER CANCELLATION
-
City of Clearwater SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Attn:Engineering,RFQ#26-15 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
P.Q.Box 4748 ACCORDANCE WITH THE POLICY PROVISIONS.
Clearwater,FL 33758.4748
-
AUTHORIZED REPRESENTATIVE
of Marsh USA Inc.
ManashlMukherjee ki
0 1888-2016 ACORD CORPORATION.. All rights reserved.
ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID: CN102421774
LOC#: Atlanta
ACOORL> ADDITIONAL REMARKS SCHEDULE Page 2 of 2
AGENCY NAMED INSURED
MARSH USA.INC. Atkins North America,Inc.
4030 West Boy Scout Blvd.,Ste 700
POLICY NUMBER Tampa,FL 33607
CARRIER NAIC CODE I EFFECTIVE DATE:
ADDITIONAL REMARKS
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: 25 FORM TITLE- Certificate of Liability Insurance
Professional Liabilcy:
Professional Liability placement was made by Matsh Canada.Marsh USA has only acted in the role of a consultant to the client with respect to the placement,which is indicated here for your convenience,
ACORD 101 (2008101) C 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
Additional Insured — Automatic — Owners, Lessees Or ZURICH '
Contractors
Policy No. M Date of Poi. Exp. Date of Pol. Eli, Date of End. Producer No. Addl.Prem Return Prem.
GLO 0137576-041 10115/2018 1011512019 1011512018 28235000
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Named Insured: Atkins North America, Inc.
Address(including ZIP Code):
4030 West Boy Scot Blvd., Ste 700
Tampa, FL 33607
This endorsement modifies insurance provided under the:
Commercial General Liability Coverage Part
A. Section 11 —Who Is An Insured is amended to include as an additional insured any person or organization whom you
are required to add as an additional insured on this policy under a written contract or written agreement. Such person
or organization is an additional insured only with respect to liability for 'bodily injury", "properly damage' or "personal
and advertising injury"caused, in whole or in part, by:
1. Your acts or omissions; or
2. The acts or omissions of those acting on your behalf,
in the performance of your ongoing operations or "your work" as included in the "products-completed operations
hazard",which is the subject of the written contract or written agreement.
However, the insurance afforded to such additional insured:
t Only applies to the extent permitted by law; and
2. Will not be broader than that which you are required by the written contract or written agreement to provide for
such additional insured,
B. With respect to the insurance afforded to these additional insureds, the following additional exclusion applies:
This insurance does not apply to:
"Bodily injury", "property damage"or "personal and advertising injury"arising out of the rendering of, or failure to
render, any professional architectural, engineering or surveying services including:
a. The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys,
field orders, change orders or drawings and specifications: or
b. Supervisory, inspection, architectural or engineering activities.
This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the
supervision, hiring, employment,training or monitoring of others by that insured, if the "occurrence"which caused the
'bodily injury' or "property damage", or the offense which caused the "personal and advertising injury", involved the
rendering of or the failure to render any professional architectural, engineering or surveying services,
U-GL-1 175-F CW(04113)
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C. The following is added to Paragraph 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit of Section IV —
Commercial General Liability Conditions:
The additional insured must see to it that:
1. We are notified as soon as practicable of an "occurrence"or offense,that may result in a claim-,
Z We receive written notice of a claim or"suit"as soon as practicable; and
3. A request for defense and indemnity of the claim or "suit" will promptly be brought against any policy issued by
another insurer under which the additional insured may be an insured in any capacity. This provision does not
apply to insurance on which the additional insured is a Named Insured if the written contract or written agreement
requires that this coverage be primary and non-contributory.
D, For the purposes of the coverage provided by this endorsement:
1. The following is added to the Other Insurance Condition of Section IV — Commercial General Liability
Conditions:
Primary and Noncontributory insurance
This insurance is primary to and will not seek contribution from any other insurance available to an additional
insured provided that:
a. The additional insured is a Named Insured under such other insurance; and
b. You are required by written contract or written agreement that this insurance be primary and not seek
contribution from any other insurance available to the additional insured.
Z The following paragraph is added to Paragraph 4,11b. of the Other Insurance Condition of Section IV—Commercial
General Liability Conditions:
This insurance is excess over:
Any of the other insurance, whether primary, excess, contingent or on any other basis, available to an additional
insured, in which the additional insured on our policy is also covered as an additional insured on another policy
providing coverage for the same "occurrence", offense, claim or"suit". This provision does not apply to any policy
in which the additional insured is a Named Insured on such other policy and where our policy is required by a
written contract or written agreement to provide coverage to the additional insured on a primary and non-
contributory basis,
E. This endorsement does not apply to an additionall insured which has been added to this policy by an endorsement
showing the additional insured in a Schedule of additional insureds, and which endorsement applies specifically to
that identified additional insured,
F. With respect to the insurance afforded to the additional insureds under this endorsement, the following is added to
Section III —Limits Of Insurance:
The most we will pay on behalf of the additional insured is the amount of insurance:
1. Required bythe written contract or written agreement referenced in Paragraph A of this endorsement; or
Z Available under the applicable Limits of Insurance shown in the Declarations,
whichever is less.
This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations.
All other terms and conditions of this policy remain unchanged.
U-GL-1 175-F CW(04113)
Page 2 of 2
IncWdss copyrighted material of insurance Services Office,Inc_,with its perinission
Coverage Extension Endorsement ZURICH
Pdicy No, Eff Date of Pol. Exp. Date of Pol, Eff, Date of End. Producer No Add'I Prem
,_ Return Peens.
BAP1 0137575-04 10/15(2018 10/15/2019 1 10(15/2018 18235000
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the:
Business Auto Coverage Form
Motor Carrier Coverage Form
A. Amended Who Is An Insured
1. The following is added to the Who Is An Insured Provision in Section If —Covered Autos U ability Coverage:
The following are also"insureds":
a. Any "'employee" of yours is an "insured"' while using a covered "auto" you don't own, hire or borrow for acts
performed within the scope of employment by you. Any 'employee" of yours is also an "insured" while
operating an "auto" hired or rented under a contract or agreement in an 'employee's" name, with your
permission, while performing duties related to the conduct of your business.
b. Anyone volunteering services to you is an "insured" while using a covered "auto" you don't own, hire or
Morrow to transport your clients or other persons in activities necessary to your business.
c. Anyone else who furnishes an "auto"referenced in Paragraphs A.1.& and Al.b. in this endorsement.
d. Where and to the extent permitted by law, any persons) or organization(s)where required by written contract
or written agreement with you executed prior to any "accident", including those person(s) or organizabon(s)
directing your work pursuant to such written contract or written agreement with you, provided the "accident"
arises out of operations governed by such contract or agreement and only up to the limits required in the
written contract or written agreement, or the limits of Insurance shown in the Declarations, whichever is less,
2. The following is added to the Other insurance Condition in the Business Auto Coverage Form and the Other
Insurance— Primary and Excess Insurance Provisions Condition in the Motor Car-tier Coverage Form:
Coverage for any person(s) or organization(s), where required by written contract or written agreement with you
executed prior to any "accident", will apply on a primary and non-contributory basis and any insurance maintained
by the additional 'Insured"will apply on an excess basis. However, in no event will this coverage extend beyond
the terms and conditions of the Coverage Form.
B. Amendment—Supplementary Payments
Paragraphs &(2) and &(4) of the Coverage Extensions Provision in Section 11 — Covered Autos Liability
Coverage are replaced by the following:
(2) Up to $5,000 for the cost of bail bonds (including bonds for related traffic law violations) required because of an
"accident"we cover. We do not have to furnish these bonds.
(4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a
day because of time off from work.
U-CA-424-F CW(04114)
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Includes copyrighted material of Insurance Serrates Office, Inc ,with its permission.
C. Fellow Employee Coverage
The Fellow Employee Exclusion contained in Section 11 —Covered Autos Liability Coverage does not apply.
D. Driver Safety Program Liability and Physical Damage Coverage
1. The following is added to the Racing Exclusion in Section I! —Covered Autos Liability Coverage-,
This exclusion does not apply to covered "autos" participating in a driver safety program event, such as, but not
limited to, auto or truck rodeos and other auto or truck agility demonstrations.
2. The following is added to Paragraph 2. in the Exclusions of Section III — Physical Damage Coverage of the
Business Auto Coverage Form and Paragraph 2.b. in the Exclusions of Section IV — Physical Damage
Coverage of the Motor Carrier Coverage Form:
This exclusion does not apply to covered "autos"participating in a driver safety program event, such as, but not
limited to, auto or truck rodeos and other auto or truck agility demonstrations,
E. Lease or Loan Gap Coverage
The following is added to the Coverage Provision of the Physical Damage Coverage Sectiom
Lease Or Loan Gap Coverage
In the event of a total 'loss"to a covered "auto", we will pay any unpaid amount due on the lease or loan for a covered
..auto",less:
al. Any amount paid under the Physical Damage Coverage Section of the Coverage Form; and
b. Any:
(1) Overdue lease or loan payments at the time of the"loss";
(2) Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage;
(3) Security deposits not returned by the lessor-,
(4) Costs for extended warranties, credit life insurance, health, accident or disability insurance purchased with the
loan or lease; and
�5) Carry-over balances from previous leases or loans.
F. Towing and Labor
Paragraph A2. of the Physical Damage Coverage Section is replaced by the following:
We will pay up to $75 for towing and labor costs incurred each time a covered "auto" of the private passenger type is
disabled. However, the labor must be performed at the place of disablement.
G. Extended Glass Coverage
The following is added to Paragraph A.3.a. of the Physical Damage Coverage Section:
If glass must be replaced, the deductible shown in the Declarations will apply. However, if glass can be repaired and
is actually repaired rather than replaced, the deductible will be waived. You have the option of having the glass
repaired rather than replaced,
H. Hired Auto Physical Damage—Increased Loss of Use Expenses
The Coverage Extension for Loss Of Use Expenses in the Physical Damage Coverage Section is replaced by the
following:
Loss Of Use Expenses
For Hired Auto Physical Damage, we will pay expenses for which an 'Insured"becomes legally responsible to pay for
loss of use of a vehicle rented or hired without a driver under a written rental contract or written rental agreement. We
will pay for loss of use expenses K caused by:
u- -424-r CW(04414)
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includes copyrighted material of Insurance Services Office,inc,win its permss on
(1) Other than collision only if the Declarations indicate that Comprehensive Coverage is provided for any covered
."auto";
(2) Specified Causes Of Loss only if the Declarations indicate that Specified Causes Of Loss Coverage is provided
for any covered "auto" or
(3) Collision only if the Declarations indicate that Collision Coverage is provided for any covered "auto".
However, the most we will pay for any expenses for loss of use is$100 per day,to a maximum of$3000.
I. Personal Effects Coverage
The following is added to the Coverage Provision of the Physical Damage Coverage Section:
Personal Effects Coverage
We will pay up to$750 for"loss"'to personal effects which are:
(1) Personal property owned by an "insured"; and
(2) In or on a covered"auto".
b. Subject to Paragraph a. above, the amount to be paid for"loss"to personal effects\AMI be based on the lesser of:
(1) The reasonable cost to replace; or
(2) The actual cash value.
c. The coverage provided in Paragraphs a. and b. above, only applies in the event of a total theft of a covered
"auto", No deductible applies to this coverage. However, we will not pay for "loss"to personal effects of any of
the following:
(1) Accounts, bills, currency, deeds, evidence of debt, money, notes, securities, or commercial paper or other
documents of value.
(2) Bullion, gold, silver, platinum, or other precious alloys or metals-, furs or fur garments-, jewelry, watches,
preci ou s or sem i-preci ou s,stones,
(3) Paintings, statuary and other works of art.
(4) Contraband or property in the course of illegal transportation or trade.
(5) Tapes, records, discs or other similar devices used with audio, visual or data electronic equipment.
Any coverage provided by this Provision is excess over any other insurance coverage available for the same 'loss".
J. Tapes, Records and Discs Coverage
1. The Exclusion in Paragraph B.4.a. of Section III — Physical Damage Coverage in the Business Auto Coverage
Form and the Exclusion in Paragraph B.Zc. of Section IV — Physical Damage Coverage in the Motor Carrier
Coverage Form does not apply.
Z The following is added to Paragraph I.a. Comprehensive Coverage under the Coverage Provision of the
Physical Damage Coverage Section:
We will pay for "loss" to tapes, records, discs or other similar devices, used with audio, visual or data electronic
equipment. We will pay only if the tapes, records, discs or other similar audio, visual or data electronic devices:
(a) Are the property of an 'Insured"; and
(b) Are in a covered "auto"at the time of'loss".
The most we will pay for such 'loss" to tapes, records, discs or other similar devices is $500. The Physical
Damage Coverage Deductible Provision does not apply to such 'loss".
U-CA-424-1`CW X04114)
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includes copyrighted material of insurance SeNces Office, Inc.,with its permiswon
K. Airbag Coverage
The Exclusion in Paragraph 13.3.a. of Section III— Physical Damage Coverage in the Business Auto Coverage Fon-n
and the Exclusion in Paragraph B.4.a. of Section IV — Physical Damage Coverage in the Motor Carrier Coverage
Form does not apply to the accidental discharge of an airbag.
L. Two or More Deductibles
The following is added to the Deductible Provision of the Physical Damage Coverage Section:
If an accident is covered both by this policy or Coverage Form and by another policy or Coverage Form issued to you
by us,the following applies for each covered "auto"on a per vehicle basis:
1. If the deductible on this policy or Coverage Form is the smaller(or smallest) deductible,it will be waived; or
2. If the deductible on this policy or Coverage Form is not the smaller(or smallest)deductible, it will be reduced by
the amount of the smaller(or smallest)deductible.
M. Physical Damage—Comprehensive Coverage—Deductible
The following is,added to the Deductible Provision of the Physical Damage Coverage Section:
Regardless of the number of covered "autos" damaged or stolen,the maximum deductible that will be applied to
Comprehensive Coverage for all 'loss"from any one cause is$5,000 or the deductible shown in the Declarations,
vvinichever is greater.
N. Temporary Substitute Autos— Physical Damage
1. The following is added to Section I —Covered Autos:
Temporary Substitute Autos—Physical Damage
If Physical Damage Coverage is provided by this Coverage Form on your owned covered "autos", the following
types of vehicles are also covered "autos"for Physical Damage Coverage:
Any "auto" you do not own when used with the permission of its owner as a temporary substitute for a covered
,.auto"you do own but is out of service because of its:
1. Breakdown;
2. Repair-,
3. Servicing;
4. "Loss"; or
5. Destruction.
2. The following is added to the Paragraph A Coverage Provision of the Physical Damage Coverage Section:
Temporary Substitute Autos—Physical Damage
We will pay the owner for'loss"to the temporary substitute "auto" unless the "loss"results from fraudulent acts or
omissions on your part, If we make any payment to the owner, we will obtain the owner's rights against any other
party.
The deductible for the temporary substitute "auto" will be the same as the deductible for the covered "auto" it
replaces.
C. Amended Duties In The Event Of Accident, Claim, Suit Or Loss
Paragraph a of the Duties in The Event Of Accident, Claim,Suit Or Loss Condition is replaced by the following:
a. In the event of"accident", claim, "suit" or "loss", you must give us or our authorized representative prompt notice
of the "accident", claim, "suit" or "loss". However, these duties only apply when the "accident", claim, "suit" or
"loss" is known to you(if you are an individual), a partner(if you are a partnership),a member(if you are a limited
liability company) or an executive officer or insurance manager (if you are a corporation). The failure of any
U-CA-424-F CW(04/14)
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Includes copyrighted material of insurance SeNces Oce, Inc,vAth its Permission
ffi
agent, servant or employee of the "insured"'to notify us of any""accident', claim,"suit"or'loss"shall not invalidate
the insurance afforded by this policy.
Include, as soon as practicable:
(1) How, when and where the "accident" or "loss" occurred and if a claim is made or "suit" is brought, written
notice of the claim or"suit" including,but not limited to, the date and details of such claim or"suit";
(2) The"insured's"name and address;and
(3) To the extent possible, the names and addresses of any injured persons and witnesses.
If you report an "accident", claim, "suit" or "loss" to another insurer when you should have reported to us, your
failure to report to us will not be seen as a violation of these amended duties provided you give us notice as soon
as practicable after the fact of the delay becomes known to you.
P. Waiver of Transfer Of Rights Of Recovery Against Others To Us
The following is added to the Transfer Of Rights Of Recovery►against Others To Us Condition:
This Condition does not apply to the extent required of you by a written contract, executed prior to any "accident" or
'loss"', provided that the "accident"or"loss" arises out of operations contemplated by such contract. This waiver only
applies to the person or organization designated in the contract.
Q. Employee Hired Autos—Physical Damage
Paragraph b, of the Other Insurance Condition in the Business Auto Coverage Form and Paragraph f, of the Other
Insurance—Primary and Excess Insurance Provisions Condition in the Motor Carrier Coverage Form are replaced
by the following:
For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos"you own:
(1) Any covered "auto"you lease, hire, rent or borrow; and
(2) Any covered "auto"hired or rented under a written contract or written agreement entered into by an "employee" or
elected or appointed official with your permission while being operated within the course and scope of that
..employee's"employment by you or that elected or appointed official's duties as respect their obligations to you.
However, any"auto"that is leased, hired, rented or borrowed with a driver is not a covered "auto".
R. Unintentional Failure to Disclose Hazards
The following is added to the Concealment, Misrepresentation Or Fraud Condition:
However,we will not deny coverage under this Coverage Form if you unintentionally:
(1) Fail to disclose any hazards existing at the inception date of this Coverage Form; or
(2) Make an error, omission, improper description of""autos' or other misstatement of information.
You must notify us as soon as possible after the discovery of any hazards or any other information that was not
provided to us prior to the acceptance of this policy.
S. Hired Auto—World W de Coverage
Paragraph 7a.(5) of the Policy Period, Coverage Territory Condition is replaced by the following:
(5) Anywhere in the world if a covered"auto"is leased, hired,rented or borrowed for a period of 60 days or less,
T. Bodily Injury Redefined
The definition of'bodily injury"in the Definitions Section is replaced by the following:
"Bodily injury" means bodily injury, sickness or disease, sustained by a person including death or mental anguish,
resulting from any of these at any time. Mental anguish means any type of mental or emotional illness or disease,
U-CA-424-F CW(0411 4)
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U. Expected Cr Intended Injury
The Expected Or Intended Injury Exclusion in Paragraph S. Exclusions under Section 11—Covered Auto Liability
Coverage is replaced by the following:
Expected Or Intended Injury
"Bodily injury" or "property damage" expected or intended from the standpoint of the "insured". This exclusion does
not apply to 'bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or
property.
V. Physical Damage—Additional Temporary Transportation Expense Coverage
Paragraph A.4.& of Section III— Physical Damage Coverage is replaced by the following:
4. Coverage Extensions
a. Transportation Expenses
We will pay up to $50 per day to a maximum of$1,000 for temporary transportation expense incurred by you
because of the total theft of a covered "'auto" of the private passenger type. We will pay only for those
covered "autos"for which you carry either Comprehensive or Specified Causes of Loss Coverage, We will
pay for temporary transportation expenses incurred during the period beginning 48 hours after the theft and
ending, regardless of the policy's expiration, when the covered "auto" is returned to use or we pay for its
'loss',
W. Replacement of a Private Passenger Auto with a Hybrid or Alternative Fuel Source Auto
The following is added to Paragraph A.Coverage of the Physical Damage Coverage Section:
In the event of a total "loss"to a covered "auto"of the private passenger type that is replaced with a hybrid "auto" or
"auto" powered by an alternative fuel source of the private passenger type, we MI pay an additional 10% of the cost
of the replacement "auto", excluding tax, title, license, other fees and any aftermarket vehicle upgrades, up to a
maximum of$2500. The covered "auto" must be replaced by a hybrid "auto" or an "auto"powered by an alternative
fuel source within 60 calendar days of the payment of the "loss" and evidenced by a bill of sale or new vehicle lease
agreement.
To qualify as a hybrid "auto", the "auto" must be powered by a conventional gasoline engine and another source of
propulsion power. The other source of propulsion power must be electric, hydrogen, propane, solar or natural gas,
either compressed or liquefied. To qualify as an "auto" powered by an alternative fuel source, the "auto" must be
powered by a source of propulsion power other than a conventional gasoline engine. An "auto" solely propelled by
biofuel,gasoline or diesel fuel or any blend thereof is not an "auto"powered by an alternative fuel source.
X Return of Stolen Automobile
The following is added to the Coverage Extension Provision of the Physical Damage Coverage Section:
If a covered "auto" is stolen and recovered, we will pay the cost of transport to return the 'auto" to you. We will pay
only for those covered "autos"for which you carry either Comprehensive or Specified Causes of Loss Coverage,
All other terms, conditions, provisions and exclusions of this policy remain the same.
U-CA-424,F CW 10404)
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Includes copyrighted material of Insurance Services Office,Inc.,Wth its permission
POLICY NUMBER: GLC 0137576-04 COMMERCIAL GENERAL LIABILITY
CG 20100413
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - SCHEDULED PERSON OR
ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured PersorXs)
Cr Organization(s) Location(s)Of Covered Operations
Any person or organization, other than an architect, Any Location or project, other than a wrap-up or
engineer or suirveyor, to whom you are required to other consolidated insurance program location or
add as an additional insured under this policy under project for which insurance is otherwise
a written contract or written agreement executed separately provided to you by a wrap-up or other
prior to loss, except where such requilrement is consolidated insurance program
prohibited by law.
Information required to complete this Schedule, if not shown above,will be shown in the Declarations.
X Section 11 — Who Is An Insured is amended to B. With respect to the insurance afforded to these
include as an additional insured the person(s) or additional insureds, the following additional
organization(s) shown in the Schedule, but only exclusions apply:
with respect to liability for 'bodily injury", "property This insurance does not apply to 'bodily injury" or
damage" or "personal and advertising injury" "property damage"occurring after:
caused,in whole or in part,by: 1. All work, including materials, parts or
1. Your acts or omissions; or equipment furnished in connection with such
2. The acts or omissions of those acting on your work, on the project (other than service,
behalf; maintenance or repairs) to be performed by or
in the performance of your ongoing operations for on behalf of the additional insured(s) at the
the additional insured(s) at the location(s) location of the covered operations has been
designated above. completed; or
However- 2. That portion of "your work" out of which the
injury or damage arises has been put to its
1. The insurance afforded to such additional intended use by any person or organization
insured only applies to the extent permitted by other than another contractor or subcontractor
law', and engaged in performing operations for a
2. If coverage provided to the additional insured is principal as a part of the same project,
required by a contract or agreement, the
insurance afforded to such additional insured
will not be broader than that which you are
required by the contract or agreement to
provide for such additional insured.
CG 20 10 04 13 Cc)Insurance Services Office, Inc., 2012 Page I of 2
Wolters Kluwer Financial Services I uniform FofinsTm
C. With respect to the insurance afforded to these 2. Available under the applicable Limits of
additional insureds, the following is added to Insurance shown in the Declarations„.
Section III—Limits Of Insurance: whichever is less.
If coverage provided to the additional insured is This endorsement shall not increase the
required by a contract or agreement, the most we applicable Limits of Insurance shown in the
will pay on behalf of the additional insured is the Declarations.
amount of insurance:
1. Required by the contract or agreement" or
Page 2 of 2 Co Insurance Services Office, Inc., 2,012 CG 20 10 04 13
POLICY NUMBER: GLO 0137576-04 COMMERCIAL GENERAL LIABILITY
CG 24 04 05 09
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
SCHEDULE
Name Of Person Or Organization:
Any Person or Organization that requires You to waive your Rights of Recovery, in a written contract or agree-
ment with the Named Insured that is executed prior to the accident or loss.
L Information required to complete this Schedule,if not shown above,will be shown in the Declarations,
The following is added to Paragraph 8. Transfer Of
Rights Of Recovery Against Others To Us of
Section IV—Conditions:
We waive any right of recovery we m ay have against
the person or organization shown in the Schedule
above because of payments we make for injury or
damage arising out of your ongoing operations or
"your work" done under a contract with that person
or organization and included in the "products-
completed operations hazard". This waiver applies
only to the person or organization shown in the
Schedule above.
CG 24 04 05 09 f,-D Insurance Services Office, Inc., 2008 Page 1 of I
Wolters Kluwer Financial Services I Uniform Farm
STV
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13
(Edi 04-154)
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not
enforce our right against the person or organization named in the Schedule. (This agreement applies only to the
extent that you perform work under a written contract that requires you to obtain this agreement from us.)
This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule.
Schedule
ALL PERSONS ANDIOR ORGANIZATIONS THAT ARE REQUIRED BY WRITTEN CONTRACT OR
AGREEMENT WITH THE INSURED, EXECUTED PRIOR TO THE ACCIDENT OR LOSS, THAT WAIVER OF
SUBROGATION BE PROVIDED UNDER THIS POLICY FOR WORK PERFORMED BY YOU FOR THAT
PERSON AND/OR ORGANIZATION OR SCHEDULED AND PREMIUM CHARGE,
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.
(The information below is required only when tNs endorsement is issued subsequent to preparation of the policy.)
Endorsement Effective: 10/16P.018 Policy No.WC 0137577-04 Endorsement No. -
Insured: SNC Lavalin Engineers&Constructors, Inc, Premium
Insurance Company:Zurich American Insurance Company Countersigned by
WC124 (4-84) Page I of 1
WC 00 03 13 Copyright 1983 National Council on Compensation Insurance,inc. Uniform Forms TM
Blanket Notification to Others of Cancellation ZURICH '
or Non-Renewal
Policy No, I Eff. Date of Pol. I Eyp. Date of Pol. Eff Date of End. Producer No. Add']. Prem Return Pre4
BAP0137575-041'011512018 1 _ 10/1512019 10115/2018 28235000 1$-
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the:
Commercial Automobile Coverage Part
A. If we cancel or non-renew this Coverage Part by written notice to the first Named Insured, we will mail or deliver
notification that such Coverage Part has been cancelled or non-renewed to each person or organization shown in a
list provided to us by the first Named Insured if you are required by written contract or written agreement to provide
such notification. However, such notification will not be mailed or delivered if a conditional notice of renewal has been
sent to the first Named Insured. Such list:
1. Must be provided to us prior to cancellation or non-renewal;
2- Must contain the names and addresses of only the persons or organizations requiring notification that such
Coverage Part has been cancelled or non-renewed-, and
3. Must be in an electronic format that is acceptable to us.
B. Our notification as described in Paragraph A. of this endorsement will be based on the most recent list in our records
as of the date the notice of cancellation or non-renewal is mailed or delivered to the first Named Insured. We will mail
or deliver such notification to each person or organization shown in the list:
i. Within seven days of the effective date of the notice of cancellation, if we cancel for non-payment of premium; or
Z At least 30 days prior to the effective date of:
a. Cancellation,if cancelled for any reason other than nonpayment of premium; or
b. Non-renewal, but not including conditional notice of renewal,
C. Our mailing or delivery of notification described in Paragraphs A and B. of this endorsement is intended as a courtesy
only. Our failure to provide such mailing or delivery will not:
1. Extend the Coverage Part cancellation or non-renewal date;
2. Negate the cancellation or non-renewal; or
3. Provide any additional insurance that would not have been provided in the absence of this endorsement.
D. We are not responsible for the accuracy, integrity, timeliness and validity of information contained in the list provided
to us as described in Paragraphs A.and S. of this endorsement,
All other terms and conditions of this policy remain unchanged.
t1-CA-832-A CW(01113)
Page 1 of 1
Includes copyrighted material of insurance Ser-Aces Office, Inc,,wth its permisslon.
Blanket Notification to Others of Cancellation
ZURICH
or Non-Renewal
Policy No Eff. Date of Pot, j- Exp. Date of Pol. Eff. Date of End Producer No. Add'l. Prem Return Prem,
GLO 0137576-04 10/15/20 18 10115/2019 10/15/2018 28235000 s- s-
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under thea.
Cornrnercial General Liability Coverage Part
A. If we cancel or non-renew this Coverage Part by written notice to the first Named Insured, we will mail or deliver
notification that such Coverage Part has been cancelled or non-renewed to each person or organization shown in a
list provided to us by the first Named Insured if you are required by written contact or written agreement to provide
such notification. However, such notification will not be mailed or delivered if a conditional notice of renewal has been
sent to the first Named Insured, Such list:
1. Must be provided to us prior to cancellation or non-renewal;
Z Must contain the names and addresses of only the persons or organizations requiring notification that such
Coverage Part has been cancelled or non-renewed; and
3. Must be in an electronic format that is acceptable to us,
B. Our notification as described in Paragraph A. of this endorsement will be based on the most recent list in our records
as of the date the notice of cancellation or non-renewai is mailed or delivered to the first Named Insured, We will mail
or deliver such notification to each person or organization shown in the list:
1. Within seven days of the effective date of the notice of cancellation, if we cancel for non-payment of premium; or
2. At least 30 days prior to the effective date of:
a. Cancellation,if cancelled for any reason other than nonpayment of premium: or
b. Non-renewal,but not including conditional notice of renewal.
C. Our mailing or delivery of notification described in Paragraphs A. and B. of this endorsement is intended as a courtesy
only. Our failure to provide such mailing or delivery will not:
1. Extend the Coverage Part cancellation or non-renewal date;
Z Negate the cancellation or non-renewal; or
3. Provide any additional insurance that would not have been provided in:the absence of this endorsement.
D. We are not responsible for the accuracy, integrity, timeliness and validity of information contained in the list provided
to us as described in Paragraphs A. and B. of this endorsement,
All other terms and conditions of this policy remain unchanged.
U-GL-1 521-A CW(10/12)
Page 1 of 1
Includes copyrighted material of Insurance Services Office,Inc. ,wth its permission
VYORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 33
NOTIFICATION TO OTHERS OF CANCELLATION ENDORSEMENT
This endorsement is used to add the following to Part Six of the policy.
PART SIX
CONDITIONS
A. If we cancel this policy by written notice to you for any reason other than nonpayment of premium, we will mail
or deliver a copy of such written notice of cancellation to the name and address corresponding to each person
or organization shown in the Schedule below. Notification to such person or organization will be provided at
least 10 days prior to the effective date of the cancellation, as advised in our notice to you, or the longer
number of days notice if indicated in the Schedule below,
B. If we cancel this policy by written notice to you for nonpayment of premium,we will mail or deliver a copy of
such written notice of cancellation to the name and address corresponding to each person or organization
shown in the Schedule below at least 10 days prior to the effective date of such cancellation,
C. If notice as described in Paragraphs A. or B. of this endorsement is mailed,proof of mailing will be sufficient
proof of such notice.
SCHEDULE
Name and Address of Other Person(s)I Number of Days Notice:
O[Uan!zati�ra s):
ANY PERSON OR ORGANIZATION TO WHOM OR TO
V041CH YOU ARE REQUIRED TO PROVIDE NOTICE 30
OF CANCELLATION IN A WRITTEN CONTRACT OR
WRITTEN AGREEMENT
All other terms and conditions of this policy remain unchanged,
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated,
(The information below is required only when this endorsement is issued subsequent to preparation of the policy.)
Endorsement Effective: 10/15/2018 Policy No.: WC-0137577-04 Endorsement No.
Insured:Atkins North America, Inc. Premium
Insurance Company:Zurich American Insurance Company
WC 99 06 33
(Ed. 05-10) includes copyrighted material of National Council on Compensation Insurance, Inc. tai its permission, Page 1 of 1