APPROVED CTR062472 01.01.23-01.01.24.pdf

PDF 1 MB Posted

Attached to
Master Agreement AZ|CTR062472
Contract number
CTR062472
Issued by
Arizona

About this file

This document is a comprehensive insurance certificate and associated endorsements for Parsons Transportation Group Inc., issued by multiple insurance carriers including National Union Fire Insurance Company of Pittsburgh and Lexington Insurance Company. The primary certificate holder is the State of Arizona, specifically for a Transportation Systems Management and Operations (TSMO) On-Call Consultants contract (Contract No. CTR062472) with Parsons Corporation. The insurance covers multiple policy types including commercial general liability, automobile liability, workers' compensation, and professional liability across various operational jurisdictions.

The contract appears to be an on-call consulting services agreement for transportation systems management, with a contract end date of 09/30/2023. The insurance policies provide extensive coverage with significant liability limits, including $2,000,000 for commercial general liability, $1,000,000 for automobile liability, and $5,000,000 for professional liability. The professional liability policy has a retroactive date of 06/19/1986. The policies include additional insured provisions for the State of Arizona and its departments, agencies, boards, commissions, universities, officers, and employees. The coverage is effective from 01/01/2023 to 01/01/2024, with various endorsements ensuring comprehensive protection for the contracted services.

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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)

© 1988-2015 ACORD CORPORATION. All rights reserved.

CERTIFICATE HOLDER

The ACORD name and logo are registered marks of ACORD

HIRED

AUTOS ONLY

X

19399

X

19445

X

X

X

A

A

C

1,000,000

X

LIC #CA 0C19812

X

1,000,000

10,000

XX

The State of Arizona

67426377

67426377

Washington, DC 20003-3515

CA134-1447(NJ)

11665420

1324 N. 22nd Ave.

X

USA

2,000,000

12/21/2022

X

X 2,000,000

LEXINGTON INS CO

GL17587105

AIU INS CO

NATIONAL UNION FIRE INS CO OF PITTS

Lockton-HA2

01/01/24

01/01/24

AUTO LIABILITY

PROFESSIONAL LIABILITY

ARCHITECTS & ENGINEERS

CSL (EA ACCIDENT)

POLICY AGG

PER CLAIM

01/01/24

1,000,000

X

Phoenix, AZ 85009

Lockton Companies, LLC-1 Kansas City

X

A

4,000,000

X

1,000,00001/01/23

444 W. 47th Street, Suite 900

01/01/23

01/01/23

100 M Street SE, Suite 1200

01/01/24

N B

2,000,000

CA134-1446(AOS)

B

B

Parsons Transportation Group Inc.

2,000,000

5,000,000

01/01/23

5,000,000

X

Kansas City, MO 64112-1906

WC013-75-1721(WI)

WC013-75-1719(CA)

WC013-75-1720(AOS)

01/01/23

01/01/23

01/01/23

1-816-960-9000

4,000,000

01/01/24 01/01/24

01/01/24

See attached endorsements and special clauses.

RiskManagement.Parsons@parsons.com

Contract End Date: 09/30/2023 Professional Liability Retroactive Date: 06/19/1986 officials, agents, and employees.

Additional Insureds: State of Arizona, and its departments, agencies, boards, commissions, universities, officers, RE: Contract No. CTR062472 - TSMO On-Call Consultants - ADOT CTR062472.

19437 a8812 Accepted

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POLICY NUMBER: COMMERCIAL GENERAL LIABILITY

CG 20 10 04 13

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2

ADDITIONAL INSURED OWNERS, LESSEES OR

CONTRACTORS SCHEDULED PERSON OR

ORGANIZATION

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

SCHEDULE

Name Of Additional Insured 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 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.

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 OR AGREEMENT. WHERE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT.

GL17587105

Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 04 13

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 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

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

CG 20 37 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1

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

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 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 shown in the Declarations;

whichever is less.

This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations.

WHERE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT. WHERE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT.

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.

WHERE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT.

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

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 $ Company: Countersigned By

WC 00 03 13

(Ed. 4-84)

Copyright 198:1 National Council on Compensation Insurance. AGENT COPY

AIU INS CO

The State of Arizona

WC013-75-1720(AOS)

USA

01/01/23

Phoenix, AZ 85009

1324 N. 22nd Ave.

Parsons Transportation Group Inc.

WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA

This endorsement changes the policy to which it is attached effective on inception date of the policy unless a different date is indicated below.

(The following “attaching clause” need be completed only when this endorsement is issued subsequent to preparation of the policy.)

This endorsement, effective 12:01 AM forms a part of Policy No.

Issued to:

By:

Premium: INCL

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 5% of the California workers’ compensation premium otherwise due on such remuneration.

Schedule

Person or Organization

Job Description

WC 04 03 06 Countersigned by__________________________________________ (Ed. 4-84) Authorized Representative

01/01/23

Parsons Transportation Group Inc.

Phoenix, AZ 85009

Where required by written contract or agreement.

1324 N. 22nd Ave.

WC013-75-1719(CA)

AIU INS CO

The State of Arizona

SUPP (10/00)

SUPPLEMENT TO CERTIFICATE OF INSURANCE

DATE

NAME OF INSURED:

Parsons Transportation Group Inc.

12/21/2022 notification to that effect.

cancellation, or reduction in coverage or limits, of any insurance within thirty (30) days of receipt of insurers'

The named insured, Parsons Corporation or its Insurance Broker shall notify the certificate holder of any

Cancellation Notice:

by the policy).

General Liability includes Contractual Liability (insurance is available only to the extent provided

Contractual Liability:

SPECIAL CLAUSES

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