2024-10-01_Tetra_Tech_CTR056545_GAUWP.pdf
PDF 654 KB Posted
- Attached to
- Master Agreement AZ|CTR056545
- Contract number
- CTR056545
- Issued by
- Arizona
About this file
This document is a Certificate of Liability Insurance for Tetra Tech, Inc., issued by Aon Risk Insurance Services West, Inc. on 09/27/2023. The insurance policy covers multiple lines including Commercial General Liability, Automobile Liability, Umbrella Liability, Workers' Compensation, and Environmental Contractors Professional Liability. The certificate names the Arizona Department of Environmental Quality as the certificate holder, with multiple insurance carriers including American International Group UK Ltd, Allied World Surplus Lines Insurance Co, and Zurich American Insurance Co providing coverage.
The policy covers Contract Number CTR056545 for Water Quality Sampling and Monitoring, with an effective period from 10/01/2023 to 10/01/2024. The insurance provides various coverage limits, including $2,000,000 for General Aggregate, $1,000,000 for Each Occurrence, and $10,000,000 for Umbrella Liability. The policy includes additional insured status for the State of Arizona, its departments, agencies, and employees, with a waiver of subrogation and primary non-contributory provisions. Stop Gap Coverage is provided for Ohio, North Dakota, Washington, and Wyoming. The policy also includes specific endorsements for designated construction projects, locations, and various state-specific subrogation waivers.
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H o ld e r
Id e n ti fi e r
77777 77707
07070 00777
61616 04557
11107 67535
33603 75441
07663 11574
17250 22071
67374 60562
33100 70424
01332 72112
20742 37331
66133 67507
73615 13374
32212 07154
04753 27611
31073 72155
30324 41330
76727 24203
57720 00777
77770 70007
07007
77777 77707
07070 00735
25677 11545
60007 60017
01532 75113
07427 23202
71332 64072
75411 06473
71220 74762
33707 17755
00703 33372
53026 10007
43377 32061
72010 07122
27371 21224
11075 27732
20652 35500
77756 16335
17655 40777
77770 70007
07007 C e rt if ic a te
N o
CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DD/YYYY)
09/27/2023
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).
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.
PRODUCER
Aon Risk Insurance Services West, Inc.
Los Angeles CA Office 707 Wilshire Boulevard Suite 2600 Los Angeles CA 90017-0460 USA
PHONE
(A/C. No. Ext):
ADDRESS:
INSURER(S) AFFORDING COVERAGE NAIC #
(866) 283-7122
INSURED AA1120187American International Group UK LtdINSURER A:
24319Allied World Surplus Lines Insurance CoINSURER B:
16535Zurich American Ins CoINSURER C:
INSURER D:
INSURER E:
INSURER F:
FAX
(A/C. No.): (800) 363-0105
CONTACT
NAME:
Tetra Tech, Inc.
45610 Woodland Road, Suite 400 Sterling VA 20166 USA
COVERAGES CERTIFICATE NUMBER: 570101843977 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, Limits shown are as requested
POLICY EXP
(MM/DD/YYYY)
POLICY EFF
(MM/DD/YYYY)
SUBR
WVD
INSR
LTR
ADDL
INSD POLICY NUMBER TYPE OF INSURANCE LIMITS
COMMERCIAL GENERAL LIABILITY
CLAIMS-MADE OCCUR
POLICY LOC
EACH OCCURRENCE
DAMAGE TO RENTED
PREMISES (Ea occurrence)
MED EXP (Any one person)
PERSONAL & ADV INJURY
GENERAL AGGREGATE
PRODUCTS - COMP/OP AGG
X
X
X
X X
GEN'L AGGREGATE LIMIT APPLIES PER:
$2,000,000
$1,000,000
$10,000
$2,000,000
$4,000,000
$4,000,000
X, C, U Coverage
C 10/01/2023 10/01/2024Y Y GLO181740605
PRO-
JECT
OTHER:
AUTOMOBILE LIABILITY
ANY AUTO
OWNED
AUTOS ONLY
SCHEDULED
AUTOS
HIRED AUTOS
ONLY
NON-OWNED
AUTOS ONLY
BODILY INJURY ( Per person)
PROPERTY DAMAGE
(Per accident)
X
BODILY INJURY (Per accident)
$1,000,000C 10/01/2023 10/01/2024Y Y COMBINED SINGLE LIMIT
(Ea accident)
BAP 1857085 05
EXCESS LIAB
X OCCUR
CLAIMS-MADE AGGREGATE
EACH OCCURRENCE
DED
$10,000,000
$10,000,000
$100,000
10/01/2023UMBRELLA LIABA 10/01/202462785232
RETENTIONX
X
E.L. DISEASE-EA EMPLOYEE
E.L. DISEASE-POLICY LIMIT
E.L. EACH ACCIDENT $1,000,000
X OTH-
ER
PER STATUTEC 10/01/2023 10/01/2024
AOS
WC185708705C 10/01/2023 10/01/2024
$1,000,000
Y / N
(Mandatory in NH)
ANY PROPRIETOR / PARTNER /
EXECUTIVE OFFICER/MEMBER N / A
Y
YN
WI
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
If yes, describe under DESCRIPTION OF OPERATIONS below
$1,000,000
WC254061605
Each Claim03120276 10/01/2023 10/01/2024 Prof/Poll-Claims Made Cov $5,000,000Aggregate
Environmental Contractors and Prof
B Y
SIR applies per policy terms & conditions
$5,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Stop Gap Coverage for the following states: OH, ND, WA, WY. RE: Contract Numbers: CTR056545 - Water Quality Sampling and Monitoring. The State of Arizona, its departments, agencies, boards, commissions, universities and its officers, officials, agents and employees are included as Additional Insured in accordance with the policy provisions of the General Liability, Automobile Liability and Pollution Liability policies as required by written contract. General Liability policy evidenced herein is Primary and Non-Contributory to other insurance available to Additional Insured, but only in accordance with the policy's provisions as required by written contract. A Waiver of Subrogation is granted in favor of Certificate Holder in accordance with the policy provisions of the General Liability, Automobile Liability and Workers' Compensation policies as
CANCELLATIONCERTIFICATE HOLDER
AUTHORIZED REPRESENTATIVEArizona Dept. of Environmental Quality Contracts and Procurement Section Judy A. Junge - CPPB - EV 09 - 0100 1110 W. Washington St.
Phoenix AZ 85007-2935 USA
ACORD 25 (2016/03)
©1988-2015 ACORD CORPORATION. All rights reserved
The ACORD name and logo are registered marks of ACORD
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
required by written contract. Contractual Liability is included under the General Liability policy where required by written contract.
FORM TITLE:FORM NUMBER:
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
ADDITIONAL REMARKS
EFFECTIVE DATE:
CARRIER NAIC CODE
POLICY NUMBER
Aon Risk Insurance Services West, Inc.
NAMED INSUREDAGENCY
LOC #:
570000036654 AGENCY CUSTOMER ID:
© 2008 ACORD CORPORATION. All rights reserved.
See Certificate Numbe
See Certificate Numbe
The ACORD name and logo are registered marks of ACORD
570101843977
570101843977
ACORD 25 Certificate of Liability Insurance Additional Description of Operations / Locations / Vehicles:
ACORD 101 (2008/01)
ADDITIONAL REMARKS SCHEDULE Page _ of _
Tetra Tech, Inc.
WC 99 06 43 Page 1 of 1 (Ed. 01-13) Includes copyright material of the National Council on Compensation Insurance, Inc. used with its permission.
2012 Copyright National Council on Compensation Insurance, Inc. All Rights Reserved.
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 43
BLANKET NOTIFICATION TO OTHERS OF CANCELLATION OR NONRENEWAL ENDORSEMENT
This endorsement adds the following to Part Six of the policy.
PART SIX
CONDITIONS
Blanket Notification to Others of Cancellation or Nonrenewal
1. If we cancel or non-renew this policy by written notice to you, we will mail or deliver notification that such policy has been cancelled or non-renewed to each person or organization shown in a list provided to us by you 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 you. Such list:
a. Must be provided to us prior to cancellation or non-renewal;
b. Must contain the names and addresses of only the persons or organizations requiring notification that such policy has been cancelled or non-renewed; and
c. Must be in an electronic format that is acceptable to us.
2. Our notification as described in Paragraph 1. above 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 you. We will mail or deliver such notification to each person or organization shown in the list:
a. Within seven days of the effective date of the notice of cancellation, if we cancel for non-payment of premium; or
b. At least 30 days prior to the effective date of:
(1) Cancellation, if cancelled for any reason other than nonpayment of premium; or
(2) Non-renewal, but not including conditional notice of renewal.
3. Our mailing or delivery of notification described in Paragraphs 1. and 2. above is intended as a courtesy only.
Our failure to provide such mailing or delivery will not:
a. Extend the policy cancellation or non-renewal date;
b. Negate the cancellation or non-renewal; or
c. Provide any additional insurance that would not have been provided in the absence of this endorsement.
4. We are not responsible for the accuracy, integrity, timeliness and validity of information contained in the list provided to us as described in Paragraphs 1. and 2. above.
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 Policy No. Endorsement No.
Insured Premium $
Insurance Company
POLICY NUMBER: WC 2540616-05
POLICY NUMBER: COMMERCIAL GENERAL LIABILITY
CG 24 04 05 09
CG 24 04 05 09 Insurance Services Office, Inc., 2008 Page 1 of 1
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:
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 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.
GLO 1817406-05
ANY PERSON OR ORGANIZATION THAT REQUIRES YOU TO WAIVE YOUR RIGHTS OF
RECOVERY, IN A WRITTEN CONTRACT OR AGREEMENT WITH THE NAMED INSURED
THAT IS EXECUTED PRIOR TO THE ACCIDENT OR LOSS.
U-GL-1465-D CW (12-13)
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
Additional Insured – Owners, Lessees Or Contractors – Ongoing Operations – Scheduled
Policy No. Eff. Date of Pol. Exp. Date of Pol. Eff. Date of End. Producer No. Add’l. Prem Return Prem.
GLO 1817406-05 10/01/2023 10/01/2024 75272000 INCL
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the:
Commercial General Liability Coverage Part
SCHEDULE
Name of Person or Organization: Location and Description of Ongoing Operations:
Additional Premium:
ANY PERSON OR ORGANIZATION TO WHOM
OR TO WHICH YOU ARE REQUIRED TO
PROVIDE ADDITIONAL INSURED STATUS
IN A WRITTEN CONTRACT OR WRITTEN
AGREEMENT EXECUTED PRIOR TO THE
LOSS, EXCEPT WHERE SUCH CONTRACTOR
OR AGREEMENT IS PROHIBITED BY LAW.
ANY LOCATION OR PROJECT, OTHER
THAN A WRAP-UP OR OTHER
CONSOLIDATED INSURANCE PROGRAM
LOCATION OR PROJECT FOR WHICH
INSURANCE IS OTHERWISE SEPARATELY
PROVIDED TO YOU BY A WRAP-UP OR
OTHER CONSOLIDATED INSURANCE
PRGRAM.
N/A
U-GL-1465-D CW (12-13)
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
A. Section II – Who Is An Insured is amended to include as an insured any person or organization shown in the Schedule of this endorsement, but only with respect to liability arising out of your ongoing operations performed for that insured at or from the corresponding location designated and described in the Schedule.
However, if you have entered into a construction contract with an additional insured person or organization shown in the Schedule of this endorsement, the insurance afforded to such additional insured only applies to the extent permitted by law.
B. With respect to the insurance afforded to any additional insured shown in the Schedule of this endorsement, the following additional exclusion applies:
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 site 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.
All other terms and conditions of this policy remain unchanged.
U-GL-1466-D CW (12-13)
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
Additional Insured – Owners, Lessees Or Contractors – Completed Operations – Scheduled
Policy No. Eff. Date of Pol. Exp. Date of Pol. Eff. Date of End. Producer No. Add’l. Prem Return Prem.
GLO 1817406-05 10/01/2023 10/01/2024 75272000 INCL
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the:
Commercial General Liability Coverage Part
SCHEDULE
Name of Person or Organization: Location and Description of Completed Operations:
Additional Premium:
ANY PERSON OR ORGANIZATION TO WHOM
OR TO WHICH YOU ARE REQUIRED TO
PROVIDE ADDITIONAL INSURED STATUS
IN A WRITTEN CONTRACT OR WRITTEN
AGREEMENT EXECUTED PRIOR TO THE
LOSS, EXCEPT WHERE SUCH CONTRACTOR
OR AGREEMENT IS PROHIBITED BY LAW.
ANY LOCATION OR PROJECT, OTHER
THAN A WRAP-UP OR OTHER
CONSOLIDATED INSURANCE PROGRAM
LOCATION OR PROJECT FOR WHICH
INSURANCE IS OTHERWISE SEPARATELY
PROVIDED TO YOU BY A WRAP-UP OR
OTHER CONSOLIDATED INSURANCE
PRGRAM.
N/A
U-GL-1466-D CW (12-13)
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
Section II – Who Is An Insured is amended to include as an insured any person or organization shown in the Schedule of this endorsement, but only with respect to liability arising out of "your work" at or from the corresponding location designated and described in the Schedule performed for that insured and included in the "products-completed operations hazard".
However, if you have entered into a construction contract with an additional insured person or organization shown in the Schedule of this endorsement, the insurance afforded to such additional insured only applies to the extent permitted by law.
CG 25 03 05 09
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CG 25 03 05 09 Insurance Services Office, Inc., 2008 Page 1 of 2
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):
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 obligated to pay as damages caused by "occurrences" under Section I ---- Coverage A, and for all medical expenses caused by accidents under Section I ---- Coverage C, which can be attributed only to ongoing operations at a single designated construction project shown in the Schedule above:
1. A separate Designated Construction Project General Aggregate 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. The Designated Construction Project General Aggregate Limit is the most we will pay for the sum of all damages under Coverage A, except damages because of "bodily injury" or "property damage" included in the "products-completed operations hazard", and for medical 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".
3. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the Designated Construction Project General Aggregate 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 General Aggregate Limit for any other designated construction project shown in the Schedule above.
4. The limits shown in the Declarations for Each Occurrence, Damage To Premises Rented To You and Medical Expense continue to apply.
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 General Aggregate Limit.
GLO 1817406-05
ANY CONSTRUCTION PROJECT EXCEPT A CONSTRUCTION PROJECT FOR WHICH A
CONSOLIDATED (WRAP-UP) OR SIMILAR INSURANCE PROGRAM HAS BEEN PROVIDED.
B. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under Section I ---- Coverage A, and for all medical expenses caused by accidents under Section I ---- Coverage C, which cannot be attributed only to ongoing operations at a single designated construction project shown in the Schedule above:
1. Any payments made under Coverage A for damages or under Coverage C for medical expenses 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 not reduce the General Aggregate Limit nor 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 III ---- Limits Of Insurance not otherwise modified by this endorsement shall continue to apply as stipulated.
CG 25 04 05 09
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CG 25 04 05 09 Insurance Services Office, Inc., 2008 Page 1 of 2
DESIGNATED LOCATION(S)
GENERAL AGGREGATE LIMIT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Designated Location(s):
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 obligated to pay as damages caused by "occurrences" under Section I ---- Coverage A, and for all medical expenses caused by accidents under Section I ---- Coverage C, which can be attributed only to operations at a single designated "location" shown in the Schedule above:
1. A separate Designated Location General Aggregate Limit applies to each designated "location", and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations.
2. The Designated Location General Aggregate Limit is the most we will pay for the sum of all damages under Coverage A, except damages because of "bodily injury" or "property damage" included in the "products-completed operations hazard", and for medical 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".
3. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the Designated Location General Aggregate Limit for that designated "location". Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Designated Location General Aggregate Limit for any other designated "location" shown in the Schedule above.
4. The limits shown in the Declarations for Each Occurrence, Damage To Premises Rented To You and Medical Expense continue to apply.
However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Designated Location General Aggregate Limit.
GLO 1817406-05
EACH LOCATION, OTHER THAN CONSTRUCTION PROJECTS, OCCUPIED, OWNED OR
RENTED BY THE NAMED INSURED.
B. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under Section I ---- Coverage A, and for all medical expenses caused by accidents under Section I ---- Coverage C, which cannot be attributed only to operations at a single designated "location" shown in the Schedule above:
1. Any payments made under Coverage A for damages or under Coverage C for medical expenses 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 Location 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 not reduce the General Aggregate Limit nor the Designated Location General Aggregate Limit.
D. For the purposes of this endorsement, the Definitions Section is amended by the addition of the following definition:
"Location" means premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway or right-of-way of a railroad.
E. The provisions of Section III ---- Limits Of Insurance not otherwise modified by this endorsement shall continue to apply as stipulated.
Policy No. Eff. Date of Pol. Exp. Date of Pol. Eff. Date of End. Producer No. Add’l. Prem Return Prem.
GLO 1817406-05 10/01/2023 10/01/2024 75272000 INCL
Other Insurance Amendment – Primary And Non- Contributory
U-GL-1327-B CW (04/13)
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Named Insured:
Address (including ZIP Code):
This endorsement modifies insurance provided under the:
Commercial General Liability Coverage Part
1. The following paragraph is added to the Other Insurance Condition of Section IV – Commercial General Liability Conditions:
This insurance is primary insurance to and will not seek contribution from any other insurance available to an additional insured under this policy provided that:
a. The additional insured is a Named Insured under such other insurance; and
b. You are required by a written contract or written agreement that this insurance would be primary and would not seek contribution from any any other insurance available to the additional insured.
2. The following paragraph is added to Paragraph 4.b. 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 written contract or written agreement to provide coverage to the additional insured on a primary and non-contributory basis.
CG 24 17 10 01
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CG 24 17 10 01 ISO Properties, Inc., 2000 Page 1 of 1
CONTRACTUAL LIABILITY - RAILROADS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Scheduled Railroad: Designated Job Site:
(If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.)
With respect to operations performed for, or affecting, a Scheduled Railroad at a Designated Job Site, the definition of "insured contract" in the Definitions sec-tion is replaced by the following:
9. "Insured Contract" means:
a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or or-ganization for damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract";
b. A sidetrack agreement;
c. Any easement or license agreement;
d. An obligation, as required by ordinance, to indemnify a municipality, except in connection with work for a municipality;
e. An elevator maintenance agreement;
f. That part of any other contract or agreement pertaining to your business (including an in-demnification of a municipality in connection with work performed for a municipality) under which you assume the tort liability of another party to pay for "bodily injury" or "property damage" to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement.
Paragraph f. does not include that part of any contract or agreement:
(1) That indemnifies an architect, engineer or surveyor for injury or damage arising out of:
(a) Preparing, approving or failing to pre-pare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifi-cations; or
(b) Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or damage;
(2) Under which the insured, if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of the in-sured’s rendering or failure to render pro-fessional services, including those listed in Paragraph (1) above and supervisory, in-spection, architectural or engineering activi-ties.
GLO 1817406-05
ALL CONTRACTS FOR WORK DONE FOR
RAILROADS AS REQUIRED BY WRITTEN
CONTRACT.
CA 04 44 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1
POLICY NUMBER: BAP 1857085-05 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.
This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below.
Named Insured: TETRA TECH, INC.
Endorsement Effective Date:
SCHEDULE
Name(s) Of Person(s) Or Organization(s):
ALL PERSONS AND/OR 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.
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.
U-GL-1521-B CW (01/19)
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
Blanket Notification to Others of Cancellation or Non-Renewal
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Policy No. GLO 1817406-05 Effective Date: 10/01/2023
This endorsement applies to insurance provided under the:
Commercial 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. 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:
1. Within 10 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, unless a greater number of days is shown in the Schedule of this endorsement for the mailing or delivering of such notification with respect to Paragraph B.1. or Paragraph B.2. above.
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.
U-GL-1521-B CW (01/19)
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
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.
SCHEDULE
The total number of days for mailing or delivering with respect to Paragraph B.1. of this endorsement is amended to indicate the following number of days: *
The total number of days for mailing or delivering with respect to Paragraph B.2. of this endorsement is amended to indicate the following number of days: **
* If a number is not shown here, 10 days continues to apply.
** If a number is not shown here, 30 days continues to apply.
Policy No. Eff. Date of Pol. Exp. Date of Pol. Eff. Date of End. Producer No. Add’l. Prem Return Prem.
BAP 1857085-05 10/01/2023 10/01/2024 75272000 INCL
Blanket Notification to Others of Cancellation or Non-Renewal
U-CA-832-A CW (01/13)
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
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 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;
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:
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;
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 B. of this endorsement.
WC 00 03 13
(Ed. 4-84) 1983 National Council on Compensation Insurance.
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13
(Ed. 4-84)
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 AND/OR 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.
WC 252 (4-84)
WC 04 03 06 (Ed. 4-84) Page 1 of 1
WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY WC 04 03 06
(Ed. 4-84)
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT—
CALIFORNIA
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.)
You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule.
The additional premium for this endorsement shall be of the California workers' compensation pre-mium otherwise due on such remuneration.
Schedule Person or Organization Job Description
ALL PERSONS AND/OR
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
WC 42 03 04 B
(Ed. 6-14) © Copyright 2014 National Council on Compensation Insurance, Inc. All Rights Reserved.
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 42 03 04 B
(Ed. 6-14)
TEXAS WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
This endorsement applies only to the insurance provided by the policy because Texas is shown in Item 3.A. of the Information Page
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, but this waiver applies only with respect to bodily injury arising out of the operations described in the Schedule where you are required by a written contract to obtain this waiver from us.
This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule.
The premium for this endorsement is shown in the Schedule.
Schedule
1. ( ) Specific Waiver
Name of person or organization
( ) Blanket Waiver
Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver.
2. Operations:
ALL PERSONS AND/OR 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.
3. Premium:
The premium charge for this endorsement shall be percent of the premium developed on payroll in connection with work performed for the above person(s) or organization(s) arising out of the operations described.
4. Advance Premium:
WC 43 03 05
(Ed. 7-00)
2000 National Council on Compensation Insurance, Inc.
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 43 03 05
(Ed. 7-00)
UTAH WAIVER OF SUBROGATION ENDORSEMENT
This endorsement applies only to the insurance provided by the policy because Utah is shown in Item 3.A. of the Information Page.
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. Our waiver of rights does not release your employees’ rights against third parties and does not release our authority as trustee of claims against third parties.
Schedule
ALL PERSONS AND/OR 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.
WC 00 03 13
(Ed. 4-84) 1983 National Council on Compensation Insurance.
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13
(Ed. 4-84)
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 AND/OR 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.
POLICY NUMBER: WC 1857087-05
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| 3 - GL - WOS |
| A - GL - AI PNC AGG RR |
| D - Auto - WOS |
| F - GL - NOC |
| G - Auto - NOC |
| H - WC - WOS |
File details come from the government source that posted it. Updated .