2023-09-27-GAUWPro_Partner__Engineering_.pdf

ANY PROPRIETOR/PARTNER/EXECUTIVE

OFFICER/MEMBER EXCLUDED?

INSR ADDL SUBR

LTR INSD WVD

PRODUCER CONTACT

NAME:

FAXPHONE

(A/C, No):(A/C, No, Ext):

E-MAIL

ADDRESS:

INSURER A :

INSURED INSURER B :

INSURER C :

INSURER D :

INSURER E :

INSURER F :

POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY) (MM/DD/YYYY)

AUTOMOBILE LIABILITY

UMBRELLA LIAB

EXCESS LIAB

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY

DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)

AUTHORIZED REPRESENTATIVE

EACH OCCURRENCE $

DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence)

MED EXP (Any one person) $

PERSONAL & ADV INJURY $

GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $

PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT

OTHER: $

COMBINED SINGLE LIMIT

$(Ea accident)

ANY AUTO BODILY INJURY (Per person) $

OWNED SCHEDULED

BODILY INJURY (Per accident) $AUTOS ONLY AUTOS

HIRED NON-OWNED PROPERTY DAMAGE

$AUTOS ONLY AUTOS ONLY (Per accident)

OCCUR EACH OCCURRENCE

CLAIMS-MADE AGGREGATE $

DED RETENTION $

PER OTH-

STATUTE ER

E.L. EACH ACCIDENT

E.L. DISEASE - EA EMPLOYEE $

If yes, describe under

E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below

INSURER(S) AFFORDING COVERAGE NAIC #

COMMERCIAL GENERAL LIABILITY

Y / N N / A

(Mandatory in NH)

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN

ACCORDANCE WITH THE POLICY PROVISIONS.

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.

THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS 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(S), AUTHORIZED

REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.

IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) 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).

COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:

CERTIFICATE HOLDER CANCELLATION

© 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03)

CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)

The ACORD name and logo are registered marks of ACORD

6/1/2023

License # 0M63276

(951) 368-0700 (951) 368-0707

26620

Partner Assessment Corporation dba Partner Engineering & Science, Inc.

2154 Torrance Blvd., #200 Torrance, CA 90501

20443 19489 35289

A 1,000,000

X X SP004650022022 9/27/2022 9/27/2023 300,000

$25,000 Deductible 25,000

1,000,000 2,000,000 2,000,000

1,000,000B

X X 6081763112 9/27/2022 9/27/2023

5,000,000C X X 03098032 9/27/2022 9/27/2023 5,000,000

D

X 6081763143 9/27/2022 9/27/2023 1,000,000 Y 1,000,000

1,000,000 A Professional E&O SP004650022022 9/27/2022 Each Claim/Aggregate 1,000,000 A Pollution Liability SP004650022022 9/27/2022 9/27/2023 Each Occ./Aggregate 2,000,000

Contract Number: CTR065801

The State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees re included as Additional Insured with regards to General Liability and Auto Liability, per attached policy forms. Waiver of Subrogation applies in favor of additional insured with regards to Workers Compensation, General Liability and Auto Liability.

Excess Policy is a follow form.

30 Days Cancellation Notice, except for 10 day non-payment of premium.

Arizona Department of Environmental Quality 1110 W. Washington Street Phoenix, AZ 85007

PARTASS-01 ASHUNN

Gallant Risk and Insurance Services, LLC 4160 Temescal Canyon Rd. Suite 214 Corona, CA 92883

Axis Surplus Insurance Company Continental Casualty Company Allied World Assurance Company (U.S.) Inc The Continental Insurance Company

Follow Form X

9/27/2023

X X

X

X

X

X X

X X

X

Includes copyrighted material of Insurance Services Office, Inc with its permission

CG 20 01 04 13

SPP 2001 04 (04 14) Page 1 of 1

Endorsement No.

Effective Date: 09/27/2022@12:01 a.m. Standard Time at the address of the Named Insured Policy Number: SP004650-02-2022 Insured Name: Partner Assessment Corporation Issuing Company: AXIS Surplus Insurance Company Additional (Return) Premium: $0 If the Endorsement Effective Date is blank, then the effective date of this Endorsement is the Inception Date of the Policy.

PRIMARY AND NONCONTRIBUTORY OTHER INSURANCE CONDITION

This endorsement modifies insurance provided under the following:

SPECIALTY PACKAGE POLICY

The following is added to SECTION VI, COMMON CONDITIONS, Paragraph 9, Other Insurance. It 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 is a Named Insured under such other insurance; and

(2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured.

CG 24 04 05 09

SPP 2404 09 (04 14) Page 1 of 1

Endorsement No.

Effective Date: 09/27/2022@12:01 a.m. Standard Time at the address of the Named Insured Policy Number: SP004650-02-2022 Insured Name: Partner Assessment Corporation Issuing Company: AXIS Surplus Insurance Company Additional (Return) Premium: $0 If the Endorsement Effective Date is blank, then the effective date of this Endorsement is the Inception Date of the Policy.

WAIVER OF TRANSFER OF RIGHTS OF RECOVERY

AGAINST OTHERS TO US

This endorsement modifies insurance provided under the following:

SPECIALTY PACKAGE POLICY

SCHEDULE

Name Of Person Or Organization:

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

The following is added to Paragraph 12.

Subrogation of Section VI – Common Conditions:

We waive any right of recovery we may 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.

Where required by written contract in force prior to any claim.

SPP 0180 (Ed. 07 20) Page 1 of 2

Endorsement No. 27

Effective Date: 09/27/2022 @12:01 a.m. Standard Time at the address of the Named Insured Policy Number: SP004650-02-2022 Insured Name: Partner Assessment Corporation Issuing Company: AXIS Surplus Insurance Company Additional (Return) Premium: $0 If the Endorsement Effective Date is blank, then the effective date of this Endorsement is the Inception Date of the Policy.

DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT ENDORSEMENT

(GENERAL LIABILITY COVERAGE)

THIS ENDORSEMENT MODIFIES THE POLICY. PLEASE READ IT CAREFULLY.

This endorsement modifies the SPECIALTY PACKAGE POLICY

Schedule of Designated Construction Projects:

Where required by written contract in force prior to any claim.

A. For all damages which can be attributed only to ongoing operations under Section I - Coverage A shown in the schedule above:

1. A separate Designated Construction Project Limit applies to each Designated Construction Project, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations

2. Except for damages because of Bodily Injury or Property Damage included in the Products Completed Operations hazard, the Designated Construction Project Limit is the most we will pay for the sum of all such damages, regardless of the number of:

a. Insureds;

b. Claims made or Suits brought; or

c. Persons or organizations making Claims or bringing Suits.

3. Any payments made for such damages under Section 1 - Coverage A shall reduce the Designated Construction Project Limit for that Designated Construction Project. Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Designated Construction Project Limit for any other Designated Construction Project shown in the Schedule above.

4. The limits shown in the Declarations for Each Occurrence and for Damage to Premises Rented to You continue to apply to a Designated Construction Project. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Designated Construction Project Limit.

5. The Designated Construction Project General Aggregate Limit is the most we will pay for the sum of all damages under the Designated Construction Project Limit described in Paragraphs 1. and 2. above.

Regardless of the number of construction projects or Designated Construction Projects covered under this policy, the most we will pay under the Designated Construction Project General Aggregate is $5,000,000.

SPP 0180 (Ed. 07 20) Page 2 of 2

If no amount is entered above, the most we will pay under the Designated Construction Project General Aggregate Limit is $5,000,000.

B. For all sums which the insured becomes legally obligated to pay as damages under Section 1 - Coverage A to which this insurance applies and which cannot be attributed only to ongoing operations shown in the Schedule above:

1. Any payments made for such damages shall reduce the amount available under the General Aggregate Limit or the Products-Completed Operations Aggregate Limit, whichever is applicable; and

2. Such payments shall not reduce any Designated Construction Project General Aggregate Limit.

C. When coverage for liability arising out of the Products-Completed Operations Hazard is provided, any payments for damages because of Bodily Injury or Property Damage included in the Products-Completed Operations Hazard will reduce the Products-Completed Operations Aggregate Limit, and shall not reduce the General Aggregate Limit or the Designated Construction Project General Aggregate Limit.

D. If the applicable Designated Construction Project has been abandoned, delayed, or abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project.

E. The provisions of SECTION IV – LIMITS OF INSURANCE AND DEDUCTIBLE not otherwise modified by this endorsement shall continue to apply as stipulated.

All other terms and conditions of this Policy remain unchanged.

CG 20 10 04 13

SPP 2010 13 (02 14) Page 1 of 2

Endorsement No.

Effective Date: 09/27/2022@12:01 a.m. Standard Time at the address of the Named Insured Policy Number: SP004650-02-2022 Insured Name: Partner Assessment Corporation Issuing Company: AXIS Surplus Insurance Company Additional (Return) Premium: $0 If the Endorsement Effective Date is blank, then the effective date of this Endorsement is the Inception Date of the Policy.

ADDITIONAL INSURED – OWNERS, LESSEES OR

CONTRACTORS – SCHEDULED PERSON OR

ORGANIZATION

This endorsement modifies insurance provided under the following:

SPECIALTY PACKAGE POLICY

SCHEDULE

Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

A. Section III – Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for Bodily Injury, Property 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 for the additional insured(s) at the location(s) designated above.

However:

1. The insurance afforded to such additional insured only applies to the extent permitted by law; and

2. If coverage provided to the additional insured is 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.

B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply:

This insurance does not apply to Bodily Injury or Property Damage occurring after:

1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or

2. That portion of Your Work out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project.

Where required by written contract in force prior to any claim.

All Projects/Locations

CG 20 10 04 13

SPP 2010 13 (02 14) Page 2 of 2

C. With respect to the insurance afforded to these additional insureds, the following is added to Section IV – Limits Of Insurance:

If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance:

1. Required by the contract or agreement; or

2. 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.

CG 20 37 04 13

SPP 2037 13 (06 12) Page 1 of 1

Endorsement No.

Effective Date: 09/27/2022@12:01 a.m. Standard Time at the address of the Named Insured Policy Number: SP004650-02-2022 Insured Name: Partner Assessment Corporation Issuing Company: AXIS Surplus Insurance Company Additional (Return) Premium: $0 If the Endorsement Effective Date is blank, then the effective date of this Endorsement is the Inception Date of the Policy.

ADDITIONAL INSURED – OWNERS, LESSEES OR

CONTRACTORS – COMPLETED OPERATIONS

This endorsement modifies insurance provided under the following:

SPECIALTY PACKAGE POLICY

SCHEDULE

Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

A. Section III – Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for Bodily Injury or Property Damage caused, in whole or in part, by Your Work at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the Products-Completed Operations Hazard.

However:

1. The insurance afforded to such additional insured only applies to the extent permitted by law; and

2. If coverage provided to the additional insured is 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.

B. With respect to the insurance afforded to these additional insureds, the following is added to Section IV – Limits Of Insurance:

If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance:

1. Required by the contract or agreement; or

2. 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.

Where required by contract in force prior to any claim. All Projects/Locations

It is understood and agreed that this endorsement amends the BUSINESS AUTO COVERAGE FORM as follows:

SCHEDULE

Name of Additional Insured Persons Or Organizations

1. In conformance with paragraph A.1.c. of Who Is An Insured of Section II - LIABILITY COVERAGE, the person or organization scheduled above is an insured under this policy.

2. The insurance afforded to the additional insured under this policy will apply on a primary and non-contributory basis if you have committed it to be so in a written contract or written agreement executed prior to the date of the “accident” for which the additional insured seeks coverage under this policy.

All other terms and conditions of the policy remain unchanged.

This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy.

ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY

Policy No: 6081763112 Policy Effective Date: 9/27/22 Policy Page:

Form No: CNA71527XX (10-2012) Endorsement Effective Date: 9/27/2022 Endorsement No:

Underwriting Company: Continental Casualty Company

© Copyright CNA All Rights Reserved.

As per written contract.

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

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.

This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below.

Named Insured: Partner Assessment Corporation

Endorsement Effective Date: 9/27/22

SCHEDULE

Name(s) Of Person(s) Or Organization(s):

As per written contract.

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 contract with that person or organization.

WAIVER OF TRANSFER OF RIGHTS OF RECOVERY

AGAINST OTHERS TO US (WAIVER OF SUBROGATION)

Policy No: 6081763112 Policy Effective Date: 9/27/22 Policy Page:

Form No: CA 04 44 10 13 Endorsement Effective Date: 9/27/2022 Endorsement No:

Underwriting Company: Continental Casualty Company

© Copyright Insurance Services Office, Inc., 2011

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

ANY PERSON OR ORGANIZATION FOR

WHICH THE INSURED HAS AGREED

BY WRITTEN CONTRACT EXECUTED

PRIOR TO LOSS TO FURNISH THIS

WAIVER

The premium charge for the endorsement is reflected in the Schedule of Operations.

All other terms and conditions of the policy remain unchanged.

This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy unless another expiration date is shown below.

WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT

Policy No: 6081763143 Policy Effective Date: 9/27/22 Policy Page:

Form No: WC 00 03 13 (04-1984) Endorsement Effective Date: 9/27/22 Endorsement Expiration Date: 9/27/23 Endorsement No:

Underwriting Company: The Continental Insurance Company

Copyright 1983 National Council on Compensation Insurance.