2025-06-01 HDR GAUW.pdf

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Attached to
Master Agreement AZ|CTR074224
Contract number
CTR074224
Issued by
Arizona

About this file

This document is a comprehensive Certificate of Liability Insurance issued by Liberty Mutual Fire Insurance Company for HDR Engineering, Inc., with the Arizona Department of Environmental Quality listed as the certificate holder. The insurance policies cover multiple liability categories including Commercial General Liability, Automobile Liability, Umbrella Liability, and Workers Compensation. The insurance is provided through multiple insurers, including Liberty Mutual Fire Insurance Company, Ohio Casualty Insurance Company, and Liberty Insurance Corporation, with policy effective dates from 06/01/2024 to 06/01/2025.

The insurance certificate relates to a specific contract (CTR074224) for Capacity Development/Technical Assistance to Small Public Drinking Water Systems, with a solicitation number of BPM006379. The policies provide various coverage limits, including a $2,000,000 general aggregate limit, $2,000,000 for commercial general liability, a $5,000,000 umbrella liability limit, and $1,000,000 for workers compensation. The insurance includes additional insured provisions, waiver of subrogation, and primary and non-contributory status as required by written contract. The certificate indicates that HDR Engineering is providing technical assistance services to small public drinking water systems, with insurance coverage designed to protect both the company and the contracting agency.

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Text version

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN

ACCORDANCE WITH THE POLICY PROVISIONS.

INSURER(S) AFFORDING COVERAGE

INSURER F :

INSURER E :

INSURER D :

INSURER C :

INSURER B :

INSURER A :

NAIC #

NAME:

CONTACT

(A/C, No):

FAX

E-MAIL

ADDRESS:

PRODUCER

(A/C, No, Ext):

PHONE

INSURED

REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES

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.

OTHER:

(Per accident)

(Ea accident)

N / A

SUBR

WVD

ADDL

INSD

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.

$PROPERTY DAMAGE

BODILY INJURY (Per accident)

BODILY INJURY (Per person)

COMBINED SINGLE LIMIT

AUTOS ONLY

AUTOSAUTOS ONLY

NON-OWNED

SCHEDULEDOWNED

ANY AUTO

AUTOMOBILE LIABILITY

Y / N

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY

OFFICER/MEMBER EXCLUDED?

(Mandatory in NH)

DESCRIPTION OF OPERATIONS below If yes, describe under

ANY PROPRIETOR/PARTNER/EXECUTIVE

E.L. DISEASE - POLICY LIMIT

E.L. DISEASE - EA EMPLOYEE

E.L. EACH ACCIDENT

ER

OTH-

STATUTE

PER

LIMITS(MM/DD/YYYY)

POLICY EXP

(MM/DD/YYYY)

POLICY EFF

POLICY NUMBERTYPE OF INSURANCELTR

INSR

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

EXCESS LIAB

UMBRELLA LIAB $EACH OCCURRENCE

$AGGREGATE

OCCUR

CLAIMS-MADE

DED RETENTION $

$PRODUCTS - COMP/OP AGG

$GENERAL AGGREGATE

$PERSONAL & ADV INJURY

$MED EXP (Any one person)

$EACH OCCURRENCE

DAMAGE TO RENTED

$PREMISES (Ea occurrence)

COMMERCIAL GENERAL LIABILITY

CLAIMS-MADE OCCUR

GEN'L AGGREGATE LIMIT APPLIES PER:

POLICY

PRO-

JECT LOC

CERTIFICATE OF LIABILITY INSURANCE

DATE (MM/DD/YYYY)

CANCELLATION

AUTHORIZED REPRESENTATIVE

ACORD 25 (2016/03)

© 1988-2016 ACORD CORPORATION. All rights reserved.

CERTIFICATE HOLDER

The ACORD name and logo are registered marks of ACORD

HIRED

AUTOS ONLY

Willis Towers Watson Midwest, Inc.

c/o 26 Century Blvd P.O. Box 305191 Nashville, TN 372305191 USA

HDR Engineering, Inc.

1917 South 67th Street Omaha, NE 68106

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.

Arizona Department of Environmental Quality Attn: Ana Machiche 1110 W. Washington St.

Phoenix, AZ 85007

10/24/2024

1-877-945-7378 1-888-467-2378 certificates@wtwco.com

Liberty Mutual Fire Insurance Company 23035

Ohio Casualty Insurance Company

Liberty Insurance Corporation

24074

42404

W35846588

A

2,000,000

1,000,000

10,000Contractual Liability

2,000,000

4,000,000

4,000,000

Y Y TB2-641-444950-034 06/01/2024 06/01/2025

A

2,000,000

06/01/202506/01/2024Y Y AS2-641-444950-044

B 5,000,000

Y Y EUO(25)57919363 06/01/2024 06/01/2025 5,000,000

WA7-64D-444950-014

C Y

1,000,000 No 06/01/2024 06/01/2025

1,000,000

1,000,000

367447226640182SR ID: BATCH:

WTW Certificate Center

ACORD 101 (2008/01)

The ACORD name and logo are registered marks of ACORD

© 2008 ACORD CORPORATION. All rights reserved.

THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,

FORM NUMBER: FORM TITLE:

ADDITIONAL REMARKS

ADDITIONAL REMARKS SCHEDULE Page of

AGENCY CUSTOMER ID:

LOC #:

AGENCY

CARRIER NAIC CODE

POLICY NUMBER

NAMED INSURED

EFFECTIVE DATE:

HDR Engineering, Inc.

1917 South 67th Street Omaha, NE 68106

Re: CTR074224 (CTR074224 - Capacity Development/Technical Assistance to Small Public Drinking Water Systems - Steven Townsend; Solicitation No. BPM006379

2 2

Willis Towers Watson Midwest, Inc.

See Page 1

See Page 1 See Page 1 See Page 1

25 Certificate of Liability Insurance

W35846588CERT:3674472BATCH:26640182SR ID:

CG 25 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 2

Policy Number: TB2-641-444950-034

THIS ENDORSEMENT 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(s):

All 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 obligated to pay as damages caused by "occur-rences" 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 "loca-tion" 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 damag-es 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 Loca-tion General Aggregate Limit for that desig-nated "location". Such payments shall not re-duce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Designated Location General Aggre-gate 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 Decla-rations, such limits will be subject to the appli-cable Designated Location General Aggre-gate Limit.

Page 2 of 2 © Insurance Services Office, Inc., 2008 CG 25 04 05 09

B. For all sums which the insured becomes legally obligated to pay as damages caused by "occur-rences" under Section I – Coverage A, and for all medical expenses caused by accidents under Section I – Coverage C, which cannot be at-tributed 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 Desig-nated Location General Aggregate Limit.

C. When coverage for liability arising out of the "products-completed operations hazard" is pro-vided, any payments for damages because of "bodily injury" or "property damage" included in the "products-completed operations hazard" will reduce the Products-completed Operations Ag-gregate Limit, and not reduce the General Ag-gregate Limit nor the Designated Location Gen-eral Aggregate Limit.

D. For the purposes of this endorsement, the Defi-nitions 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 Insur-ance not otherwise modified by this endorsement shall continue to apply as stipulated.

CG 25 03 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 2

Policy Number: TB2-641-444950-034

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 premises 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 obligated to pay as damages caused by "occur-rences" 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 des-ignated 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, ex-cept damages because of "bodily injury" or "property damage" included in the "products-completed operations hazard", and for medi-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".

3. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the Designated Con-struction Project General Aggregate Limit for that designated construction project. Such payments shall not reduce the General Ag-gregate Limit shown in the Declarations nor shall they reduce any other Designated Con-struction 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 Decla-rations, such limits will be subject to the appli-cable Designated Construction Project Gen-eral Aggregate Limit.

Page 2 of 2 © Insurance Services Office, Inc., 2008 CG 25 03 05 09

B. For all sums which the insured becomes legally obligated to pay as damages caused by "occur-rences" under Section I – Coverage A, and for all medical expenses caused by accidents under Section I – Coverage C, which cannot be at-tributed 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 Desig-nated Construction Project General Aggre-gate Limit.

C. When coverage for liability arising out of the "products-completed operations hazard" is pro-vided, any payments for damages because of "bodily injury" or "property damage" included in the "products-completed operations hazard" will reduce the Products-completed Operations Ag-gregate Limit, and not reduce the General Ag-gregate 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 contract-ing parties deviate from plans, blueprints, de-signs, specifications or timetables, the project will still be deemed to be the same construction pro-ject.

E. The provisions of Section III – Limits Of Insur-ance not otherwise modified by this endorsement shall continue to apply as stipulated.

POLICY NUMBER: TB2-641-444950-

COMMERCIAL GENERAL LIABILITY

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 under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

A. Section II – 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.

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.

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:

C. With respect to the insurance afforded to these additional insureds, the following is added to Section III – 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;

whichever is less.

This endorsement shall not increase the applicable limits of insurance.

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

SCHEDULE

Location(s) Of Covered Operations

Any person or organization with whom you have agreed through written contract, agreement or permit to provide additional insured coverage

All locations as required by a written contract or agreement entered into prior to an "occurrence" or offense

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

CG 20 10 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1

POLICY NUMBER: TB2-641-444950-

COMMERCIAL GENERAL LIABILITY

CG 20 37 12 19

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

ADDITIONAL INSURED – OWNERS, LESSEES OR

CONTRACTORS – COMPLETED OPERATIONS

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART

A. Section II – 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 III – 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;

whichever is less.

This endorsement shall not increase the applicable limits of insurance.

SCHEDULE

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

Any person or organization to whom or to which you are required to provide additional insured status in a written contract, agreement or permit except where such contact or agreement is prohibited.

Any location where you have agreed, through written, contract, agreement, or permit, to provide additional insured coverage for completed operations

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

CG 20 37 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1

Policy Number TB2-641-444950-034 Issued by Liberty Mutual Fire Insurance Company

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

PRIMARY AND NONCONTRIBUTORY –

OTHER INSURANCE CONDITION

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

PRODUCTS/COMPLETED 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 is a 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 to the additional insured.

(3) This insurance is excess over any other insurance available to the additional insured for which it is also covered as an additional insured by attachment of an endorsement to another policy providing coverage for the same "occurrence", claim or "suit".

LD 24 153 08 16 © 2016 Liberty Mutual Insurance Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission.

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

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

As required by written contract or agreement.

COMMERCIAL GENERAL LIABILITY

CG 24 04 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 PART

ELECTRONIC DATA LIABILITY COVERAGE PART

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

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 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.

CG 24 04 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1

POLICY NUMBER: TB2-641-444950-034

POLICY NUMBER: AS2-641-444950-044 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 II – 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 1 of 1

Policy Number: AS2-641-444950-044 Issued by: Liberty Mutual Fire Insurance Company

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 Person(s) or Organizations(s):

Any person or organization where the Named Insured has agreed by written contract to include such person or organization

Regarding Designated Contract or Project:

Any

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 08 11 © 2010, Liberty Mutual Group of Companies. All rights reserved.

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

POLICY NUMBER: AS2-641-444950-044 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

Name(s) Of Person(s) Or Organization(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 © Insurance Services Office, Inc., 2011 Page 1 of 1

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 by:Liberty Insurance Corporation

For attachment to Policy No WA7-64D-444950-014

Issued to:HDR Engineering, Inc.

Effective Date 06/01/2024 Premium

WC 00 03 13

Ed. 4/1/1984

© 1983 National Council on Compensation Insurance, Inc. Page 1 of 1

Policy Number TB2-641-444950-034

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 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) / Organization(s):

Email Address or mailing address: Number Days Notice:

As required by written contract or written agreement

As required by written contract 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 © 2014 Liberty Mutual Insurance. All rights reserved.

Policy Number AS2-641-444950-044

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 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) / Organization(s):

Email Address or mailing address: Number Days Notice:

As required by written contract 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 © 2014 Liberty Mutual Insurance. All rights reserved.

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) / Email Address or mailing address: Number Days Notice:

Organization(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-444950-014 Effective Date 06/01/2024 Premium $

Issued to HDR Engineering, Inc. Endorsement No.

WC 99 20 75

Ed. 12/01/2016

© 2016 Liberty Mutual Insurance Page 1 of 1

10.0.2.20120224.1.869952

DATE (MM/DD/YYYY): 10/24/2024
PRODUCER: Willis Towers Watson Midwest, Inc.

c/o 26 Century Blvd P.O. Box 305191 Nashville, TN 372305191 USA

FAX (A/C, No):: 1-877-945-7378
FAX (A/C, No):: 1-888-467-2378
FAX (A/C, No):: certificates@wtwco.com
NAIC #_INSURER A :: Liberty Mutual Fire Insurance Company
NAIC #_INSURER A :: 23035
INSURED: HDR Engineering, Inc.

1917 South 67th Street Omaha, NE 68106

NAIC #_INSURER B :: Ohio Casualty Insurance Company
NAIC #_INSURER C :: Liberty Insurance Corporation
NAIC #_INSURER B :: 24074
NAIC #_INSURER C :: 42404
NAIC #_INSURER D ::
NAIC #_INSURER D ::
NAIC #_INSURER E ::
NAIC #_INSURER E ::
NAIC #_INSURER F ::
NAIC #_INSURER F ::
CERT_NUMBER: W35846588
GL INSR LETTER: A
CGL_checkbox: Yes
Clams_Made_checkbox: 0
Occur_checkbox: Yes
OTHER 1 checkbox: Yes
OTHER 1 checkbox: Off
undefined: 2,000,000
undefined: 1,000,000
undefined: 10,000
GL_OTHER_1_TYPE_OF_INS: Contractual Liability
GL_OTHER_2_TYPE_OF_INS:
undefined: 2,000,000
undefined: 4,000,000
undefined: 4,000,000
Gen_Agg_Policy_checkbox: 0
Gen_Agg_Project_checkbox: Yes
Gen_Agg_Location_checkbox: Yes
INSR ADDL_Row_1: Y
WVD SUBR_Row_1: Y
POLICY NUMBER_Row_1: TB2-641-444950-034
POLICY EFF (MM/DD/YYYY)_Row_1: 06/01/2024
POLICY EXP (MM/DD/YYYY)_Row_1: 06/01/2025
OTHER_LIMIT_DESC:
undefined:
ANY_AUTO_checkbox: Yes
AL INSR LETTER: A
undefined: 2,000,000
NON-OWNED_AUTOS_checkbox: 0
SCHEDULED_AUTOS_checkbox: 0
ALL_OWNED_AUTOS_checkbox: 0
HIRED_AUTO_checkbox: 0
POLICY EXP (MM/DD/YYYY)_Row_1: 06/01/2025
undefined:
POLICY EFF (MM/DD/YYYY)_Row_1: 06/01/2024
undefined:
undefined:
AL_OTHER_1_checkbox: 0
AL_OTHER_1_DESC:
PROPERTY DAMAGE (Per accident)_Row_1:
AL_OTHER_2_checkbox: 0
AL_OTHER_2_DESC:
INSR ADDL_Row_2: Y
WVD SUBR_Row_2: Y
POLICY NUMBER_Row_2: AS2-641-444950-044
undefined:
UMB_LIAB: 0
UMB_EX_OCC: Yes
UMB INSR LETTER: B
undefined: 5,000,000
EX_LIAB_checkbox: Yes
CLAIMS_MADE_checkbox: 0
RET_checkbox: Yes
DED_checkbox: Off
DED_RET_AMOUNT: 0
INSR ADDL_Row_3: Y
WVD SUBR_Row_3: Y
POLICY NUMBER_Row_3: EUO(25)57919363
POLICY EFF (MM/DD/YYYY)_Row_3: 06/01/2024
POLICY EXP (MM/DD/YYYY)_Row_3: 06/01/2025
undefined: 5,000,000
AGGREGATE_Row_1:
undefined:
POLICY NUMBER_N / A: WA7-64D-444950-014
STATUTORY: Yes
OTHER: Off
WC_OTHER_DESC:
WC INSR LETTER: C
WVD SUBR_N / A: Y
undefined: 1,000,000
Y / N: No
POLICY EFF (MM/DD/YYYY)_Row_3: 06/01/2024
POLICY EXP (MM/DD/YYYY)_Row_3: 06/01/2025
undefined: 1,000,000
undefined: 1,000,000
OTHER 1 INSR LETTER:
OTHER_1_TYPE_OF_INS:
OTHER_2_TYPE_OF_INS:
N / A_Row_1:
WVD SUBR_Row_5:
N / A_Row_1:
OTHER_1_LIMIT_OF_INS:
OTHER 2 INSR LETTER:
POLICY NUMBER_Row_5:
POLICY NUMBER_Row_5:
POLICY EFF (MM/DD/YYYY)_Row_5:
POLICY EFF (MM/DD/YYYY)_Row_5:
POLICY EXP (MM/DD/YYYY)_Row_5:
POLICY EXP (MM/DD/YYYY)_Row_5:
OTHER_2_LIMIT_OF_INS:
WVD SUBR_Row_5:
OTHER 3 INSR LETTER:
WVD SUBR_Row_5:
POLICY NUMBER_Row_5:
POLICY EFF (MM/DD/YYYY)_Row_5:
OTHER_3_TYPE_OF_INS:
N / A_Row_1:
POLICY EXP (MM/DD/YYYY)_Row_5:
OTHER_3_LIMIT_OF_INS:
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if 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.

INSURED:

Arizona Department of Environmental Quality Attn: Ana Machiche 1110 W. Washington St.

Phoenix, AZ 85007

AUTHORIZED REPRESENTATIVE:
BATCH_NUMBER: 3674472
SR_NUMBER: 26640182
SRID_label: SR ID:
Batch_label: BATCH:
GL_Agg_applies_per_Other_checkbox: 0
GL_Agg_applies_per_Other:
OTHER_3_LIMIT_OF_INS_AMT3:
OTHER_2_LIMIT_OF_INS_AMT_2:
OTHER_1_LIMIT_OF_INS_AMT_1:
Contact_Name: WTW Certificate Center
DATE (MM/DD/YYYY): Page 1 of 2

File details come from the government source that posted it. Updated .