COI_exp_07.01.2022.pdf
PDF 291 KB Posted
- Attached to
- Master Agreement AZ|CTR057927
- Contract number
- CTR057927
- Issued by
- Arizona
About this file
This is a Certificate of Liability Insurance issued by Lockton Companies on behalf of Corrpro Companies, Inc., a contractor based in Tempe, Arizona. The certificate holder is the Arizona Department of Corrections located in Phoenix, Arizona. The insurance policies are underwritten by four carriers: XL Insurance America, Inc., ACE American Insurance Company, Indemnity Insurance Co of North America, and Indian Harbor Insurance Company. The certificate references contract BPM003920 for Cathodic Protection Service for Water Tanks under contract number CTR057927. The insurance is effective from July 1, 2021, through July 1, 2022.
The policy provides comprehensive liability coverage including Commercial General Liability with limits of $2,000,000 per occurrence and $4,000,000 general aggregate; Automobile Liability with a combined single limit of $5,000,000 per accident; Workers' Compensation coverage of $1,000,000 per accident; Contractor Professional Liability with $10,000,000 per claim and aggregate limits and a $500,000 self-insured retention; and Contractor Pollution Liability coverage. The certificate includes multiple endorsements establishing the Arizona Department of Corrections and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees as additional insureds on a primary and non-contributory basis where required by written contract. Waiver of subrogation provisions apply to General Liability, Automobile Liability, Workers' Compensation, and Contractor Professional Liability where required by written contract and permitted by law.
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ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
INSR ADDL SUBR
LTR INSD WVD
DATE (MM/DD/YYYY)
PRODUCER CONTACT
NAME:
FAXPHONE
(A/C, No):(A/C, No, Ext):
ADDRESS:
INSURER A :
INSURED INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F :
POLICY NUMBER
POLICY EFF POLICY EXP
TYPE OF INSURANCE LIMITS(MM/DD/YYYY) (MM/DD/YYYY)
AUTOMOBILE LIABILITY
UMBRELLA LIAB
EXCESS LIAB
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
AUTHORIZED REPRESENTATIVE
EACH OCCURRENCE $
DAMAGE TO RENTED
CLAIMS-MADE OCCUR $PREMISES (Ea occurrence)
MED EXP (Any one person) $
PERSONAL & ADV INJURY $
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $
PRO-
POLICY LOC PRODUCTS - COMP/OP AGG $JECT
OTHER: $
COMBINED SINGLE LIMIT $(Ea accident) ANY AUTO BODILY INJURY (Per person) $
OWNED SCHEDULED BODILY INJURY (Per accident) $
AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTY DAMAGE $
AUTOS ONLY AUTOS ONLY (Per accident)
OCCUR EACH OCCURRENCE $
CLAIMS-MADE AGGREGATE $
DED RETENTION $ $
PER OTH-
STATUTE ER
E.L. EACH ACCIDENT $
E.L. DISEASE - EA EMPLOYEE $
If yes, describe under
E.L. DISEASE - POLICY LIMIT $DESCRIPTION OF OPERATIONS below
INSURER(S) AFFORDING COVERAGE NAIC #
COMMERCIAL GENERAL LIABILITY
Y / N
N / A (Mandatory in NH)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
CERTIFICATE HOLDER CANCELLATION
© 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORDACORD 25 (2016/03)
CERTIFICATE OF LIABILITY INSURANCE
Lockton Companies Three City Place Drive, Suite 900 St. Louis MO 63141-7081
(314) 432-0500
Corrpro Companies, Inc.
645 W. 24th Street Suite 102 Tempe AZ 85282
CORCO02
ACE American Insurance Company 22667 Indemnity Insurance Co of North America 43575 Indian Harbor Insurance Company 36940
XL Insurance America, Inc. 24554
X X
2,000,000 1,000,000 10,000 2,000,000 4,000,000 4,000,000
X 5,000,000
XXXXXXX
XXXXXXX
XXXXXXX
XXXXXXX
XXXXXXX
XXXXXXX
XXXXXXX
N
X
1,000,000 1,000,000 1,000,000
Contr Prof. Liab Contr Poll. Liab
Per Policy:
$10,000,000 per claim/Agg.
$500,000 SIR each loss
B ISA H2554867A 7/1/2021 7/1/2022
A CGD300084906 7/1/2021 7/1/2022
A XCU / BROAD FORM PD
D CEO742002409 7/1/2021 7/1/2022
D CPL742035808 7/1/2021 7/1/2022
D (PROF-CLAIMS MADE)
B WLRC67822389 (CA/MA) 7/1/2021 7/1/2022
C WLRC67822341 (AOS) 7/1/2021 7/1/2022
C (EXCLUDING MONOPOLISTIC)
NOT APPLICABLE
7/1/2022
1319367
Y Y
Y Y
Y
11/11/2021
N Y
18009034
18009034 XXXXXXX
AZ Dept of Corrections 1600 W Jefferson Avenue Phoenix AZ 85007
THIS CERTIFICATE SUPERSEDES ALL PREVIOUSLY ISSUED CERTIFICATES FOR THIS HOLDER, APPLICABLE TO THE CARRIERS LISTED AND THE POLICY TERM(S) REFERENCED.
Re: BPM003920 Cathodic Protection Service for Water Tanks - # CTR057927. See page 2.
X X
See Attachments
CONTINUATION DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS (Use only if more space is required)
ACORD 25 (2016/03)
The State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and empoyees are additional insureds under General Liability and Automobile Liability on a primary and non-contributory basis where required by written contract executed prior to loss, but only with respect to liability arising out of the Named Insured’s operations. Waiver of Subrogation applies under General Liability, Automobile Liability, Workers’ Compensation, Contractor Professional Liability if required by written contract, executed prior to loss, and where permissible by law.
Certificate Holder ID:
AZ Dept of Corrections 1600 W Jefferson Avenue
Lockton Companies Three CityPlace Dr, Suite 900 / St. Louis, MO 63141-7088
314-432-0500 / lockton.com
Phoenix AZ 85007
IMPORTANT NOTICE
To whom it may concern:
In our continued effort to provide timely certificate delivery, Lockton Companies is transitioning to paperless delivery of Certificates of Insurance going forward.
To ensure future renewals of this certificate, we need your email address. Please contact us via one of the methods below, referencing Certificate ID 18009034
• Email: stl-edelivery@lockton.com
• Phone: (866) 728-5657 (toll-free)
If we do not receive your email address via one of the above methods prior to the client’s next renewal, we will assume you no longer need the certificate.
If you received this certificate through an internet link where the current certificate is viewable, we have your email and no further action is needed.
The above inbox is for collecting email addresses for renewal electronic certificate delivery ONLY. You will not receive a response from this inbox.
Thank you for your cooperation.
Lockton Companies
Attachment Code: D592023 Master ID: 1319367, Certificate ID: 18009034
Name of Person(s) or Entity(ies) Mailing Address:
Number of Days Advanced Notice of
Cancellation:
AS PER SCHEDULE ON FILE WITH 30
THE COMPANY.
All other terms and conditions of the Policy remain unchanged.
IXI 405 0910
© 2010 X.L. America, Inc. All Rights Reserved.
May not be copied without permission.
ENDORSEMENT #
This endorsement, effective 12:01 a.m., 7/1/2021, forms a part of
Policy No. CGD300084906 issued to AEGION CORPORATION
By XL Insurance America, Inc.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CANCELLATION NOTIFICATION TO OTHERS ENDORSEMENT
In the event coverage is cancelled for any statutorily permitted reason, other than nonpayment of premium, advanced written notice will be mailed or delivered to person(s) or entity(ies) according to the notification schedule shown below:
Attachment Code: D544456 Certificate ID: 18009034
NOTICE TO OTHERS ENDORSEMENT SCHEDULE
NOTICE BY INSURED'S REPRESENTATIVE
Named Insured Aegion Corporation
Policy Symbol
ISA
Policy Number
ISA
H2554867A
Policy Period
7/1/2021TO 7/1/2022
Effective Date of Endorsement
Issued By (Name of Insurance Company)
ACE American Insurance Company
Insert the policy number. The remainder of the information is to be completed only when this endorsement Is issued subsequent to the preparation of the policy.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
A. If we cancel this Policy prior to its expiration dale by notice to you or the first Named Insured for any reason other than nonpayment of premium, we will endeavor, as set out in this endorsement, to send written notice of cancellation, to the persons or organizations listed in the schedule that you or your representative create or maintain (the "Schedule") by allowing your representative to send such notice to such persons or organizations. This notice will be in addition to our notice to you or the first Named Insured, and any other party whom we are required to notify by statute and in accordance with the cancellation provisions of the Policy.
B. The notice referenced in this endorsement as provided by your representative is intended only to be a courtesy notification to the person(s) or organization(s) named in the Schedule in the event of a pending cancellation of coverage.
We have no legal obligation of any kind to any such person(s) or organization(s). The failure to provide advance notification of cancellation to the person(s) or organization(s) shown in the Schedule will impose no obligation or liability of any kind upon us, our agents or representatives, will not extend any Policy cancellation date and will not negate any cancellation of the Policy.
C. We are not responsible for verifying any information in any Schedule, nor are we responsible for any incorrect information that you or your representative may use.
D. We will only be responsible for sending such notice to your representative, and your representative will In turn send the notice to the persons or organizations listed in the Schedule at least 30 days prior to the cancellation date applicable to the Policy. You will cooperate with us in providing the Schedule, or in causing your representative to provide the Schedule.
E. This endorsement does not apply In the event that you cancel the Policy.
All other terms and conditions of this Policy remain unchanged.
Authorized Representative
ALL-32686 (01/11) Page 1 of 1
Attachment Code: D543763 Certificate ID: 18009034
Workers' Compensation and Employers' Liability Policy
Named Insured
AEGION CORPORATION
17988 EDISON AVENUE
CHESTERFIELD MO 63005
EndorsementNumber
Policy Number
Symbol: WLR Number: WLRC67822341 (AOS)
PolicyPeriod
7/1/2021 TO 7/1/2022
Effective Date of Endorsement 7/1/2021
IssuedBy (Name of InsuranceCompany) Indemnity Insurance Co of North America Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy.
NOTICE TO OTHERS ENDORSEMENT – SCHEDULE
NOTICE BY INSURED’S REPRESENTATIVE
A. If we cancel this Policy prior to its expiration date by notice to you or the first Named insured for any reason other than nonpayment of premium, we will endeavor, as set out in this endorsement, to send written notice of cancellation, to the persons or organizations listed in the schedule that you or your representative create or maintain (the “Schedule”) by allowing your representative to send such notice to such persons or organizations. This notice will be in addition to our notice to you or the first Named Insured, and any other party whom we are required to notify by statute and in accordance with the cancellation provisions of the Policy.
B. The notice referenced in this endorsement as provided by your representative is intended only to be a courtesy notification to the person(s) or organization(s) named in the Schedule in the event of a pending cancellation of coverage. We have no legal obligation of any kind to any such person(s) or organization(s). The failure to provide advance notification of cancellation to the person(s) or organization(s) shown in the Schedule will impose no obligation or liability of any kind upon us, our agents or representatives, will not extend any Policy cancellation date and will not negate any cancellation of the Policy.
C. We are not responsible for verifying any information in any Schedule, nor are we responsible for any incorrect information that you or your representative may use.
D. We will only be responsible for sending such notice to your representative, and your representative will in turn send the notice to the persons or organizations listed in the Schedule at least 30 days prior to the cancellation date applicable to the Policy. You will cooperate with us in providing the Schedule, or in causing your representative to provide the Schedule.
E. This endorsement does not apply in the event that you cancel the Policy.
All other terms and conditions of this Policy remain unchanged.
This endorsement is not applicable in the states of AZ, FL, ID, ME, NC, NJ, NM, TX and WI.
Authorized Representative
WC 99 03 69 (01/11) Page 1 of 1
Attachment Code: D544740 Certificate ID: 18009034
Name of Person(s) or Entity(ies) Mailing Address:
Number of Days Advanced Notice of
Cancellation:
Per Schedule on File with the Company 60
All other terms, conditions and exclusions of this Policy remain unchanged.
KPD 404 1214 © 2014 X.L. America, Inc. Page 1 of 1 All Rights Reserved. May not be copied without permission.
ENDORSEMENT #020
This endorsement, effective 12:01 a.m.,7/1/2021, forms a part of Policy No. CEO742002409 issued to AEGION CORPORATION by Indian Harbor Insurance Company.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
MANUSCRIPT ENDORSEMENT - CANCELLATION NOTIFICATION TO OTHERS ENDORSEMENT
This endorsement modifies insurance provided under the following:
PA/CE: Professional Activities/Complete Execution
PROFESSIONAL LIABILITY FOR CONSTRUCTION CONTRACTORS AND CONSTRUCTION SUPPORT
SERVICES PROVIDERS
In consideration of the premium charged, the Named Insured and the Company agree to the following Policy change(s):
In the event coverage is cancelled for any statutorily permitted reason, other than nonpayment of premium, advanced written notice will be mailed or delivered to person(s) or entity(ies) according to the notification schedule shown below:
Attachment Code: D553311 Certificate ID: 18009034
Policy #: CEO742002409 Carrier: Indian Harbor Ins. Co. Policy Term:7/1/2021
Severability M. Except with respect to the Limits of Liability and the Self-Insured Retention Amount, and any rights or duties specifically assigned in this policy to you, this insurance applies: (a) as if each Named Insured were the only Named Insured; and (b) separately to each Insured against or by whom a Claim is made.
Misrepresentation, concealment, breach of condition or violation of any duty under this policy by one Insured shall not prejudice the interest or coverage of another Insured under this policy.
Sole Agent N. You will act on behalf of all Insured(s) for the payment or return of premium, receipt and acceptance of any endorsement issued to form a part of this policy, giving and receiving notice of cancellation or non-renewal and the exercise of the rights provided in Section 6:
Extended Reporting Period, B. Optional Extended Reporting Period.
Subrogation O. In the event of any payment under this policy, we will be subrogated to all of the Insured's rights of recovery against any person or organization and the Insured will execute and deliver instruments and papers and do whatever else is necessary to secure such rights. The Insured will do nothing at any time to prejudice our subrogation rights.
However, we waive our right(s) of recovery against any person or organization included in the definition of an Insured or against the Insured's clients, if prior to a Professional Liability Claim, a waiver of subrogation was so required and accepted under a specific contractual undertaking by the Insured.
Territory P. Coverage granted under this policy will apply anywhere in the world, to the extent permitted by law.
KPD 050 1012 © 2012 X.L. America, Inc. Page 15 of 15 All Rights Reserved. May not be copied without permission.
Attachment Code: D563965 Certificate ID: 18009034
Attachment Code: D563965 Certificate ID: 18009034
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
ANY PERSON OR ORGANIZATION THAT YOU ARE REQUIRED IN
A WRITTEN CONTRACT OR WRITTEN AGREEMENT TO INCLUDE VARIOUS AS REQUIRED PER WRITTEN CONTRACT
AS AN ADDITIONAL INSURED PROVIDED THE “BODILY INJURY”
OR “PROPERTY DAMAGE” OCCURS SUBSEQUENT TO THE
EXECUTION OF THE WRITTEN CONTRACT OR WRITTEN
AGREEMENT, INCLUDING INDEMNIFICATION AGREEMENTS.
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
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.
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.
CG 20 10 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 2
POLICY NUMBER: CGD300084906 COMMERCIAL GENERAL LIABILITY
CG 20 10 12 19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Attachment Code: D544786 Certificate ID: 18009034
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 limits of 2.
insurance;
whichever is less.
Available
This endorsement shall not increase the under applicable limits of insurance.
the applicable amount of insurance:
1. Required by the contract or agreement; or
Page 2 of 2 © Insurance Services Office, Inc., 2018 CG 20 10 12 19
POLICY NUMBER: CGD300084906 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
SCHEDULE
Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations
ANY PERSON OR ORGANIZATION THAT YOU ARE REQUIRED IN A
WRITTEN CONTRACT OR WRITTEN AGREEMENT TO INCLUDE AS VARIOUS AS REQUIRED PER THE WRITTEN CONTRACT.
AN ADDITIONAL INSURED PROVIDED THE “BODILY INJURY” OR
“PROPERTY DAMAGE” OCCURS SUBSEQUENT TO THE
EXECUTION OF THE WRITTEN CONTRACT OR WRITTEN
AGREEMENT, INCLUDING INDEMNIFICATION AGREEMENTS.
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 limits of
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 insurance;
whichever is less.
2. Available
This endorsement shall not increase the under applicable limits of insurance.
the applicable 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.
CG 20 37 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1
AUTOMATIC ADDITIONAL INSURED ENDORSEMENT
Named insured Aegion Corporation
Policy Symbol Policy Number
ISA ISA H2554867A
Policy Period
7/1/2021 TO 7/1/2022
Effective Date of Endorsement 7/1/2021
Issued By (Name of Insurance Company)
ACE American Insurance Company Insert the policy number. The remainder of the information Is to be completed only when this endorsement Is Issued subsequent to the preparation of the policy.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
SECTION II - LIABILITY COVERAGE, WHO IS AN INSURED is amended to include as an "insured' any person or organization you are required in a written contract or agreement to name as an Additional Insured on your policy but only for "bodily injury" or "property damage" to which this insurance applies if the "accident" is caused by:
1. You, while using a covered "auto" or
2. Any other person, while using a covered "auto" with your permission.
The insurance provided by this endorsement shall be subject to the following additional condition:
1. The Limit of Insurance provided for the Additional insured shall not be greater than those required by contract and, In no event, shall the policy Limits of Insurance be increased by the contract.
2, All insuring agreements, exclusions, terms and conditions of the policy shall apply to the coverage (s) provided to the Additional Insured, and such coverage shall not be enlarged or expanded by reason of the contract.
3. Coverage provided by this endorsement shall be excess over any other valid and collectible insurance available to the Additional Insured (s) whether primary, excess, contingent or on any other basis unless the contract specifically requires that this insurance be primary or you request that it apply on a primary basis prior to loss.
Attachment Code: D544797 Certificate ID: 18009034
NON-CONTRIBUTORY ENDORSEMENT FOR ADDITIONAL INSUREDS
Named Insured Aegion Corporation Endorsement Number
Policy Symbol
ISA
Policy Number
ISA
H2554867A
Policy Period
7/1/2021 TO 7/1/2022
Effective Date of Endorsement 7/1/2021 issued By (Name of Insurance Company)
ACE American Insurance Company
Insert the policy number. The remainder of the Information is to be completed only when this endorsement is issued subsequent to the preparation of the policy.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
AUTO DEALERS COVERAGE FORM
Schedule
Organization
Any additional insured with whom you have agreed to provide such non-contributory insurance, pursuant to and as required under a written contract executed prior to the date of loss.
Additional Insured Endorsement
(if no information is filled in, the schedule shall read: "All persons or entities added as additional insureds through an endorsement with the term "Additional Insured" in the title)
For organizations that are listed in the Schedule above that are also an Additional Insured under an endorsement attached to this policy, the following is added to the Other Insurance Condition under General Conditions:
If other insurance is available to an insured we cover under any of the endorsements listed or described above (the "Additional Insured") for a loss we cover under this policy, this insurance will apply to such loss on a primary basis and we will not seek contribution from the other insurance available to the Additional Insured.
DA-21886b (06/14) Page 1 of 1
Attachment Code: D544797 Certificate ID: 18009034
POLICY NUMBER:CGD300084906 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
Name Of Person(s) Or Organization(s):
Where required by written contract or agreement executed prior to loss (except where not permitted by law).
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 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
Attachment Code: D544819 Certificate ID: 18009034
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS
Named Insured Aegion Corporation
Policy Symbol
ISA
Policy Number
ISA
H2554867A
Policy Period
7/1/2021TO 7/1/2022
Effective Date of Endorsement 7/1/2021
Issued By (Name of Insurance Company)
ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This Endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIERS COVERAGE FORM
AUTO DEALERS COVERAGE FORM
We waive any right of recovery we may have against the person or organization shown in the Schedule below because of payments we make for injury or damage arising out of the use of a covered auto. The waiver applies only to the person or organization shown in the SCHEDULE.
SCHEDULE
Any person or organization against whom you have agreed to waive your right of recovery in a written contract, provided such contract was executed prior to the date of loss.
Authorized Representative
DA-13115a (06/14) Page 1 of 1
Attachment Code: D544792 Certificate ID: 18009034
Workers' Compensation and Employers' Liability Policy Named Insured
AEGION CORPORATION
17988 EDISON AVENUE
CHESTERFIELD MO 63005
Endorsement Number
Policy Number Symbol: WLR Number. WLRC67822341 (AOS)Policy Period
7/1/2021TO 7/1/2022
Effective Date of Endorsement 7/1/2021
Issued By (Name of Insurance Company)
INDEMNITY INS. CO. OF NORTH AMERICA
Insert the policy number. The remainder of the information is to be completed only when thi endorsement is issued subsequent to the preparation of the policy.
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 any one not named in the Schedule.
Schedule
ANY PERSON OR ORGANIZATION AGAINST WHOM YOU HAVE AGREED TO WAIVE
YOUR RIGHT OF RECOVERY IN A WRITTEN CONTRACT, PROVIDED SUCH CONTRACT
WAS EXECUTED PRIOR TO THE DATE OF LOSS.
For the states of CA, UT, TX, refer to state specific endorsements.
This endorsement is not applicable in KY, NH, and NJ.
The endorsement does not apply to policies in Missouri where the employer is in the construction group of code classifications. According to Section 287.150(6) of the Missouri statutes, a contractual provision purporting to waive subrogation rights against public policy and void where one party to the contract is an employer in the construction group of code classifications.
For Kansas, use of this endorsement is limited by the Kansas Fairness in Private Construction Contract Act(K.S.A..
16-1801 through 16-1807 and any amendments thereto) and the Kansas Fairness in Public Construction Contract
Act(KS.A 16-1901 through 16-1908 and any amendments thereto). According to the Acts a provision in a contract for private or public construction purporting to waive subrogation rights for losses or claims covered or paid by liability or workers compensation insurance shall be against public policy and shall be void and unenforceable except that, subject to the Acts, a contract may require waiver of subrogation for losses or claims paid by a consolidated or wrap-up insurance program.
WC 00 03 13 (11105) CD Copyright 1983-2017 National Council on Compensator' Insurance, Inc. Al Rights Reserved.
Attachment Code: D544826 Certificate ID: 18009034
File details come from the government source that posted it. Updated .