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Home My WebLink AboutInsurance Certificate: HDR Engineering, Inc. AACORD � ( ( Page i of 2 O 1'� V DATE IMMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 05/20/2026 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND ONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES 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($), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HE}LDER, IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) roust have ADDiTIt?NAL INSURED provisions or be:endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does net confer rights to the certificate holder in lieu of such endorsement($). PRODUCER CONTACT NAME: 6dTGl Certificate Center Towe Willis26 Century WatsonlvMidwest, Inc. PHONE 1-877�-945-7378 FAX 1-888-467-2378 c/o 26 Century Blue) AM E 1: WC'Not: E.O. Box 305191 E-MAIL certificates@wtwco,com Nashville, 2N 372305191 USA INSURER(S) NAICtfi r m�[HERRERA: Liberty Mutual Fire Insurance Company 23035 INSURED_ INaURERB: Ohio Casualty Insurance Company 24074 191 Engineering, Inc. Libert Insurance Corporation 42404 1917 South 67th Street INSURERC: y p -- --- Omaha, ME 66106 PNSURERD:—�----____ _�_._----- --_ INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:W46121258 REVISION NUMBER: 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, LIMITS SHOWN ARE INCLUSIVE OF AMOUNTS REQUESTED BY THE CERTIFICATE HOLDER AND MAY NOT REFLECT POLICY LIMIT AMOUNTS IN EXCESS OF THOSE REQUESTED. 'Next Applicable in WY INSR I ADDLSeNRI I, POLICY EFF POLICY EXP LTR I TYPE OFINSURANCE [NaDPOLICY NUMBER, , MMtDD/YYYY) IFAMIDD,'YYYYI LINTS COMMERCIAL GENERAL LIABILITY EACHOCCURRENCE S 210001000 'DAIJAGE'TORCNTED. ,..CLAIMS-MADE X I OCCUR PREMISES{Ea occurrencO $ 1,040,400 A X}Contractual Liability MED EXP(Any one parson) $ 10,000 Y Y IQ6/01/2426 06/01/2027 P82-641-444950-036 PERSONAL&ADVINJURY S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $ 4,000,000 1 PRO- POLICY I } r JECT LOG PRODUCTS-COMP/CPAGO 4,000,000 OTHER: ; $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 2,0001000 (Ea accident) _ ANY ALTO � BODILY INJURY(Par person) I$ A OD I Y AS2_T4i-44495Q 448 06/01/202606/01/20271 BODILY INJURY(Per accident) $AUTO ONLY SCHEDULED HIRED NON-OWNED r PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY j _(I�er aecid 1 -_----- _---- - IS UMBRELLALIABX OCCUR EACH OCCURRENCE S 5,000,000 EXCESS DAIS IF7 CLAIMS-MADE Y Y EUO(27)57919363 106/01/2026 06/01/2027; AGGREGATE 5 5,000,000 DED 1 X 1 RETENTION$0 WORKERS COMPENSATION I STATUTE !ERH AND EMPLOYERS'LIABILITY YIN ( I C ,ANYPROPPIETORIPARTiJER;'EXECIJTIVE I )EL.EACH ACCIDENT $ 1,000,000 ?OFFICER/MEMBER EXCLUDED? I4e N/ Y WA7-64D-444950-016 06/01/2426j06/01/2027 1.00fl,004 :(Mandatary in NH) I E.L.DISEASE EA EMPLOYEE $ It yes,doscrabe under 1,000,000 DESCRIPTItJN OF OPERATIONS below i E.L.DISEASE POLICY LIMIT I DESCRIPTION OF OPERATIONS r LOCATIONS!VEHICLES(ACORD 101,Additional Remarks Schedute,maybe attached It more space is required} Certificate Holder is named as Additional Insured on General Liability, Automobile Liability and Umbrella/Excess Liability on a Primary, Non-contributory basis where required by written contract. Waiver of Subrogation applies on General Liability, Automobile Liability, Umbrella/Excess Liability and Workers Compensation where required by written contract and as permitted by law. Umbrella/Excess policy is follow .form over General Liability, Auto Liability and Employers Liability. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. City of Ashland, Public Works Department AUTHORIZED REPRESENTATIVE Attn: Scott Fleury 20 East Main Street f Ashland, OR 97520 ~,'l }f< t 9988-2025 ACORD CORPORATION. All rights reserved. ACORD 25(2025/12) The ACCORD name and logo are registered marks of ACORD SR ID: 29951702 BATCH; 4455719 8056: 2 of 10 AGENCY CUSTOMER IC: LOC#: ADDITIONAL REMARKS SCHEDULE Rage 2 Of 2 AGENCY NAMED INSURED Willis 'Towers Watson Midwest, Inc. SEE, Engineering, Inc. 1917 South 67th Street POLICY NUMBER Omaha, HE 68106 See Page 1 CARRIER NAIC CODE See Page 1 See Page 1 EFFECTIVE DATE:See Page 1 ADDITIONAL REMARK THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER:BER: 25 FORM TITLE: Certificate of Liability Insurance Re: City of Ashland WTP Phase 2 Final Design 10193663. Additional Insureds: City of Ashland, Oregon, its elected officials, officers and employees. ACORD 101 (2000101) tit 2008 ACORD CORPORATION. All rights reserved. The ACORD name and Ingo are registered marks of ACORD SR ID: 29951702BATCH: 9455719 CEF.T: w96121258 8056: 2 of 10 Policy u b r: 2-6 1 950.036 THIS CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED LOCATION(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Location(: 1l locations owned by or rented to the Named Insured Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. For all sums which the insured becomes legally b. Claims made or"suits"brought; or obligated to pay as damages caused by "occur- c. Persons or organizations making claims or rences" under Section 1 —Coverage A, and for all bringing"suits". medical expenses caused by accidents under Section I — Coverage C, which can be attributed 3. Any payments made under Coverage A for only to operations at a single designated "loca- damages or under Coverage C for medical tion"shown in the Schedule above: expenses shall reduce the Designated Loca- tion General Aggregate Limit for that desig- �. A separate Designated Location General Hated '"location". Such payments shall not re- "location", Limit applies each designated duce the General Aggregate Limit shown in °'location"", and that limit t is equal to the the Declarations nor shall they reduce any amount of the General Aggregate Limit other Designated Location General Aggre- gate Limit for any other designated "location" . The Designated Location General Aggregate shown in the Schedule above. Limit is the most we will pay for the sum of all 4. The limits shown in the Declarations for Each damages under Coverage A, except damag- Occurrence, Damage To Premises Rented To es because of "bodily injury" or "property You and Medical Expense continue to apply, damage" included in the "products-completed However, instead of being subject to the operations hazard", and for medical expenses General Aggregate Limit shown in the Decla- under Coverage C regardless of the number rations, such limits will be subject to the appli- of: cable Designated Location General Aggre- a. Insureds: gate Limit. CG 25 04 05 Og Q Insurance Services Office, Inc,, 2008 Paged 02 8068: 3 of 10 B. For all sums which the insured becomes legally C. When coverage for liability arising out of the obligated to pay as damages caused by "occur- "products-completed operations hazard" is pro+ nen om" underGeoUnn | —Covero�e . and for all vid d. any payments for damages because of medical expenses caused by accidents under "bodily injury" or "property damage" included in Section | — Coverage C, which cannot be at- the "products-completed operations hazard" will tributmd only to operations eda single designated reduce the Products-completed Operations /\g- "|uoetion''shown in the Schedule ebowe-, gregmte Limit and not reduce the General Ag- 1. Any payments made under Coverage A for greQate Limit nor the Designated Location Gen- damages or under Coverage C for medical era| Aggregate Limit. expenses shall reduce the amount available D. For the purposes of this endorsement, the Defi- under the General A0Qnegsda Limit or the nit1ons Section is amended by the addition of Prod uote-oomp|eted Operations Aggregate the following definition: Limit, whichever ia applicable; and "Lonat|on" means premises involving the same nr � 2, Such payments shall not reduce any Desig- connecting |ots, or premises whose connection is � natedLooedon General Aggregate Limit. interrupted only by a sheet, roadway, waterway � or right-of-way of railroad. E. The provisions of Section |I| — Limits Of Insur- ance not otherwise modified by this endorsement shall continue to apply amstipulated. Page 2 of 2 Oc |nsurance Services Office, |nc., 2O08 CG258405 09 Policy Number: T82-641-444950-036 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Project(s): All construction projects not located at promises owned, leased or rented by a Named Insured Information required to complete this Schedule, if not shown above, will be shown in the Declarations, A. For all sums which the insured becomes legally 3. Any payments made under Coverage A for obligated to pay as damages Caused by "occur- damages or under Coverage C for medical rences" under Section I —Coverage A, and for all expenses shall reduce the Designated Con medical expenses caused by accidents under struction Project General Aggregate Limit for Section I — Coverage C, which can be attributed that designated construction project. Such only to ongoing operations at a single designated payments shall not reduce the General Ag- construction project shown in the Schedule gregate Limit shown in the Declarations nor above: shall they reduce any other Designated Con- t. A separate Designated Construction Project struction Project General Aggregate Limit for General Aggregate Limit applies to each des- any other designated construction project ignated construction project, and that limit is shown in the Schedule above. equal to the amount of the General Aggregate 4. The limits shown in the Declarations for Each Limit shown in the Declarations, Occurrence, Damage To Premises Rented To 2. The Designated Construction Project General You and Medical Expense continue to apply. Aggregate Limit is the most we will pay for the However, instead of being subject to the sum of all damages under Coverage A, ex- General Aggregate Limit shown in the Decla- cept damages because of "bodily injury" or rations, such limits will be subject to the appli- 1.property damage" included in the "products- cable Designated Construction Project Gen- completed operations hazard", and for medi- eral Aggregate Limit. cal expenses under Coverage C regardless of the number of: a. Insureds; b. Claims made or"suits" brought; or c. Persons or organizations making claims or bringing "Suits". CG 25 03 05 09 (D Insurance Services Office, Inc., 2008 Page I of 2 0 8056: 4 of 10 B. For all SLIMS which the insured becomes |eOmUy C. When coverage for liability arising out of the obligated to pay as damages caused by "occur- "products-completed operations hazard" is po+ rences" underSeotien | —Coverage A, and for all v1ded, any payments for damages because of medical expenses caused by accidents under "bodily injury" or "property damage" included in Section I — Coverage [' which cannot be at- the "products-completed rati hazard" will tribuLed only to ongoing operations at e single reduce the Products-completed Operations AU- designated construction project shown in the gregote Limit, and not reduce the General Ag- Schedu|eabove� gregate Limit nor the Designated Construction 1. Any payments made under Coverage Afor Project General Aggregate Limit. damages or under Coverage C for medical D. If the applicable designated construction project expenses shall reduce the amount available has been abandoned, de|ayed, or abandoned under the General Aggregate Limit or the and then reetaded, or if the authorized contract- Products-completed Operations Aggregate ing parties deviate from p|ans, blueprints, de- Limit, whichever is applicable,- and signs, specifications or timetables, the project will 2. Such payments shall not reduce any Desig- still be deemed to be the same construction pro- nated Construction Project General A0gre- jez1. gate Limit. E. The provisions of Section i|| — Limits Of Insur- ance not otherwise modified by this endorsement shall continue to apply aestipulated. � � Page 2mf 2 K0 Insurance Services Office, |nc. 2OO@ CG 25Q3 05 09 POLICY NUMBER: TB2-641-444950- COMMERCIAL GENERAL LIABILITY 036 CG 20 10 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided Linder the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A Section 11 — Who Is An Insured is amended to 1. All work, including materials, parts or include as an additional insured the person(s) or equipment furnished in connection with such organization(s) shown in the Schedule, but only with work, on the project (other than service, respect to liability for "bodily injury", "property maintenance or repairs) to be performed by or damage" or "personal and advertising injury' on behalf of the additional insured(s) at the caused, in whole or in part,by: location of the covered operations has been 1. Your acts or omissions; or completed; or 2. The acts or omissions of those acting on your 2. That portion of "Your work" out of which the behalf-, injury or damage arises has been put to its in the performance of your ongoing operations for intended use by any person or organization the additional insured(s) at the location(s) other than another contractor or subcontractor designated above, engaged in performing operations for a principal as a part of the same project. However: C. With respect to the insurance afforded to these 1. The insurance afforded to such additional additional insureds, the following is added to insured only applies to the extent permitted by Section III —Limits Of insurance: law, and If coverage provided to the additional insured is 2, If coverage provided to the additional insured is required by a contract or agreement, the most we required by a contract or agreement, the will pay on behalf of the additional insured is the insurance afforded to such additional insured will amount of insurance: not be broader than that which you are required 1. Required by the contract or agreement-, or by the contract or agreement to provide for such additional insured. 2. Available under the applicable limits of B. With respect to the insurance afforded to these insurance; additional insureds, the following additional whichever is less. exclusions apply: This endorsement shall not increase the This insurance does not apply to "bodily injury" or applicable limits of insurance. property damage" occurring after; SCHEDULE Narne Of Additional Insured Person(s) Location(s) Of Covered Operations Or Organization(5): Any person or organization with whom you have agreed All locations as required by a written contract or through written contract, agreement or permit to provide agreement entered into prior to an"occurrence" or additional insured coverage offense Information required to complete this Schedule, if not shown above, will be shown in the Declarations, CO 20 10 12 19 ®r- Insurance Services Office, Inc., 2018 Page 1 of I 8066: 5 of 10 POLICY NUMBER: TB2-641444Q5O- COMMERCIAL GENERAL LIABILITY 086 CG 20 37 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDIT��0�� N��N�� LESSEES �� IONAL�� 0�� v�'� V��~�-��, ��~��_�� v~�H � �� COMPLETED CONTRACTORS v�/�� x �~�m�� ~~ ��mxwv u�� n �� OPERATIONS ox~�� This endorsement modifies insurance provided Linder the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART A Section || — Who Is An Insured is amended to El With respect to the insurance afforded to these include as an additional insured the person(s) or additional insuredm, the following is added to organization(s) shown in the BmbedV|e, but only Section III —Limits OfInsurance: with respect to liability for "bodily injury" or If coverage provided to the additional insured is "property donnoge" omueod, in whole or in Pah, by required by a contract or agreement, the most we 'Wur vvorV' at the location designated and will pay on behalf nfthe additional insured is the described in the Schedule of this endorsement ammuntofinsuranoe� performed for that additional insured and included in the"prnducts-oomp|etmd operations hazard" i, Required by the contract or agreement, or Hm*evec 2 Available under the applicable limits of 1 The insurance affnnjad to such additionalinsurance, insured only applies to the extent permitted vvhiohevar |s |ess�d by . law; and This endorsement shall not increase the applicable 2 If coverage provided to the additionallimits|a . required by e contract or ogn*ement 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. � SCHEDULE Name Of Additional insured Person(s) � (]r{}rganizet|om(s): Location And Description Of Completed Operations � Any person or organization howhommrho which you are Any location where you have agreed,through written, � required to provide additional insured status inawritten contract, agreement, or permit, to provide additional contract, agreement or,permit except where such insured coverage for completed operations contact or agreement|s prohibited, Information required to complete this Schedule, if not shown above, will be shown in the Declarations, CE]20 37 12 19 (—c�Insurance Services Office. Inc., 2018 Page 1 of I aos* 5 mlo | Policy Number TB2-64144495O-036 Issued by Liberty Mutual Fire Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ |T CAREFULLY. PRIMARY AND NONCONTRIBUTORY— OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRDDUCTS»COW1PLETEO OPERATIONS LIABILITY COVERAGE PART The following is added to Section IV—Conditions 4. Other Insurance and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured isa Named Insured under such other insurance; and (2) You have agreed prior to a loss, that this insurance would be primary and would not seek contribution from any other insurance available tuthe additional insured. (3) This insurance is excess over any other insurance available to the additional insured for which it is also covered as on additional insured by attachment cfen endorsement to another policy providing coverage for the same''occunenoe" claim . � / � _ LD24153 0016 @o2V18Liberty Mutual Insurance Page iofi � includes copyrighted material of Insurance Services Office, Inc,,with its permission. ' 8056: 6 ^ mm POLICY NUMBER:TB2-541-444950-0 5 COMMERCIAL GENERAL LIABILITY CG 244 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PANT ELECTRONIC DATA LIABILITY COVERAGE PANT LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS SCHEDULE Name Of Person(s)Or Organ i atlon(a)e As required by written contract or agreement. Information required to com fete 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 m Conditions: We waive any right of recovery against the person(s) or organization(s) shown in the Schedule above because of payments we make under this Coverage Part. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person(s) or organization(s) prior to loss. This endorsement applies only to the person(s) or organization(s) shown in the Schedule above. G 24 04 1219 @ Insurance Services Office, Inc.,2018 Page 1 of 1 8056: 6 of 10 POLICY NUMBER: AS2-641-444950-046 COMMERCIAL AUTO CA 20 48 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. SCHEDULE Name Of Person(s) Or Organization(s): As required by written contract Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.1. of Section 11 — Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I — Covered Autos Coverages of the Auto Dealers Coverage Form. CA 20 48 10 13 @insurance Services Office, Inc., 2011 Page I of I 8056, 7 of 10 Policy Number: --14 V',::tl�-,- 4 Issued by: L HuL uai F1.cr I ri-lur2Irlc,- THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED - NONCONTRIBUTING This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIERS COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement,the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s)or organization(s)who are"insureds"under the Who Is An Insured Provision of the Coverage Form, This endorsement does not alter coverage provided in the Coverage form, Schedule Name of Persoms) or Organizations(s): Illy._ t I H r,11 l I 1-t L -1 h r) r;;�A F I t FL Regarding Designated Contractor Project: V Each person or organization shown in the Schedule of this endorsement is an"insured"for Liability Coverage,but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form. The following is added to the Other Insurance Condition: If you have agreed in a written agreement that this policy will be primary and without right of contribution from any insurance in force for an Additional Insured for liability arising out of your operations, and the agreement was executed prior to the "bodily injury" or "property damage", then this insurance will be primary and we will not seek contribution from such insurance, AC 84 23 0811 @ 2010, Liberty Mutual Group of Companies. All rights reserved, Page 1 of 1 Includes copyrighted material of Insurance Services Office,Inc., with its permission. 8066: 7 of 10 POLICY NUMBER: AS2-641-444950-046 COMMERCIAL AUTO CA 04 44 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement, SCHEDULE Narne(s) Of Person(s) Or Organ ization(s): Any person or organization for whom you perform work under a written contract of the contract requires you to obtain this agreement from us but only if the contract is executed prior to the injury or damage occurring. Information required to complete this Schedule, if not shown above, will be shown in the-Declarations.. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident' or the "loss" under a c ontract with that person or organization. CA 04 44 10 13 Q Insurance Services Office, Inc,, 2011 Page I of 1 8056: 8 of 10' 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 Where required by contract or written agreement prior to loss. Issued byliberty insurance Corporation For attachment to Poky No VVA7,,64D-444950-016 Effective Date 06101/2026 PreMILIM S Issued to:HDR Engineering, Inc WC 00 03 13 Oc 1983 National Council on Compensation Insurance, Inc. Page 1 of 1 Ed. 4/11/1984 8056: 8 of 10 Policy Number TB2-641-444950-036 Issued by Liberty Mutual Fire Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION OR MATERIAL REDUCTION IN COVERAGE TO THIRD PARTIES This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FART MOTOR CARRIER COVERAGE PART GARAGE COVERAGE PART TRUCKERS COVERAGE PART EXCESS AUTOMOBILE LIABILITY INDEMNITY COVERAGE PART SELF-INSURED TRUCKER EXCESS LIABILITY COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART COMMERCIAL LIABILITY— UMBRELLA COVERAGE FORM Schedule Name of Other Person(s)/ Emali Address or mailing address, Number Days Notice: Grganizati n(s); As required by written contract or As required by written contract or 3 written agreement written agreement A. If we cancel this policy for any reason other than nonpayment of premium, or make a material reduction in coverage, we will notify the persons or organizations shown in the Schedule above. We will send notice to the email or mailing address listed above at least 10 days, or the number of days listed above, if any; before the cancellation becomes effective, In no event does the notice to the third party exceed the notice to the first named insured. B. This advance notification of a pending cancellation or material reduction of coverage is intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the policy. All other terms and conditions of this policy remain unchanged. LIM 99 04 03 14 02014 Liberty Mutual Insurance.All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. 8056; 9 of 10 E I'; Policy Number AS2-641-444950-046 Issued by Liberty Mutual Fire Insurance Company THIS ENDORSEMENT CHANGES T E POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION OR MATERIAL REDUCTION IN COVERAGE TO THIRD PARTIES This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE PART MOTOR CARRIER COVERAGE PART GARAGE COVERAGE PART TRUCKERS COVERAGE PART EXCESS AUTOMOBILE LIABILITY INDEMNITY COVERAGE PART SELF-INSURED TRUCKER EXCESS LIABILITY COVERAGE. PART COMMERCIAL GENERAL LIABILITY COVERAGE PART EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART COMMERCIAL LIABILITY— UMBRELLA COVERAGE FORM Schedule Name of Other Person(s) d Email Address or mail address: Number Days Notice: Organization(s): As required by written contract 30 or written agreement A. If we cancel this policy for any reason other than nonpayment of premium, or make a material reduction in coverage, we will notify the persons or organizations shown in the Schedule above. We will send notice to the email or mailing address listed above at least 10 days, or the number of days listed above, if any, before the cancellation becomes effective. In no event does the notice to the third party exceed the notice to the first named insured. B. This advance notification of a pending cancellation or material reduction of coverage is intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the policy. All other terms and conditions of this policy remain unchanged. LIM 99 04 03 14 0 2014 Liberty Mutual Insurance.All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. 8056: 9 of 10 NOTICE OF CANCELLATION TO THIRD PARTIES A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or organizations shown in the Schedule below. We will send notice to the email or mailing address listed below at least 10 days, or the number of days listed below, if any, before cancellation becomes effective. In no event does the notice to the third,party exceed the notice to the first named insured, B. This advance notification of a pending cancellation of coverage is intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the policy, Schedule Name of Other Person(s)t Email Address or mailing address: Number Days Notice: Organ lzation(s): As required by written 30 contract or agreement All other terms and conditions of this policy remain unchanged. Issued by Liberty Insurance Corporation For attachment to Policy No,WA7-64D-44495MI6 Effective Date 06101/2026 Premium$ Issued to HDR Engineering,Inc. Endorsement No. WC 99 20 75 (D 2016 Liberty Mutual Insurance Page I of i Ed. 1210112016 8056: 10 of 1 8056: 10 of1C