CTR074819-COI-_Exp_2025-11-13_-Atlast_Technical.pdf
PDF 431 KB Posted
- Attached to
- Master Agreement AZ|CTR074819
- Contract number
- CTR074819
- Issued by
- Arizona
About this file
This document is a Certificate of Liability Insurance for Atlas Technical Consultants, LLC, issued by Lockton Insurance Brokers, LLC, with primary insurers Steadfast Insurance Company and Zurich American Insurance Company. The certificate is specifically for a Brownfields Contract (No. CTR074819) with the Arizona Department of Environmental Quality, located in Phoenix, Arizona. The insurance coverage spans multiple liability categories including commercial general liability, automobile liability, umbrella liability, excess liability, and workers' compensation, effective from 11/13/2024 to 11/13/2025.
The insurance policy provides comprehensive coverage with significant aggregate limits, including $2,000,000 per occurrence for commercial general liability, $5,000,000 for automobile liability, and $5,000,000 for excess liability. Additional specialized coverages include environmental contractor's pollution liability and professional errors and omissions coverage, each with per occurrence and aggregate limits of $2,000,000/$6,000,000. The policy includes provisions for additional insured status, primary and non-contributory coverage, and waiver of subrogation for the Arizona Department of Environmental Quality and its associated entities. The named insured encompasses a wide range of Atlas Technical Consultants' subsidiary and affiliated companies, ensuring broad protection across the organization's operational entities.
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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 Insurance Brokers, LLC 777 S. Figueroa Street, 52nd Fl.
CA License #0B99399 Los Angeles CA 90017
(213) 689-0065
Atlas Technical Consultants, LLC 13215 Bee Cave Parkway Building B, Suite 230 Austin, TX 78738
Steadfast Insurance Company 26387 Zurich American Insurance Company 16535
X X
X X,C,U Included X Contractual Liab
2,000,000 1,000,000 10,000 2,000,000 6,000,000 4,000,000
X
X X
5,000,000
XXXXXXX
XXXXXXX
XXXXXXX
XXXXXXX
X X
5,000,000 5,000,000
XXXXXXX
N
X
1,000,000 1,000,000 1,000,000
Env Contr Poll Env Prof (E&O)
Per Occur/Agg:$2,000,000/$6,000,000 Per Claim/Agg:$2,000,000/$6,000,000
B BAP-0217109-09 11/13/2024 11/13/2025
A GPL-0217085-09 11/13/2024 11/13/2025
A GPL-0217085-09 11/13/2024 11/13/2025
A GPL-0217085-09 11/13/2024 11/13/2025
A SXS-0217077-09 11/13/2024 11/13/2025
B WC-0217111-09 (AOS) 11/13/2024 11/13/2025
B WC-7306651-03 (WIS) 11/13/2024 11/13/2025
11/13/2025
1528938
Y Y
Y Y
Y N
Y
12/9/2024
Y Y
21212729
21212729 XXXXXXX
Arizona Department of Environmental Quality 1110 West Washington Street 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: BPM006394, Brownfields Contract No. CTR074819. Arizona Department of Environmental Quality, its agents, representatives, or Subcontractors, departments, boards, commissions, universities, officers, officials, agents and employees are Additional Insured(s) as per the attached endorsement or policy language. Insurance provided to Additional Insured(s) is primary and non-contributory as per the attached endorsements or policy language. Waiver of subrogation applies as per the attached endorsements or policy language, where allowed by law. Notice of Cancellation applies as per attached endorsement or policy language.
X X X Policy Aggregate $6M
See Attachments
The Excess Liability policy is excess of the underlying General Liability, Automobile Liability, Employers' Liability, Professional Liability, and Contractor's Pollution Liability.
Excess Liability policy is following form of the underlying policies.
The General Liability, Contractor's Pollution Liability and Professional Liability are part of a package policy. The Aggregate reflected for these coverages is a combined aggregate and not separate aggregates for each coverage.
The General Liability policy includes blanket additional insured and Waiver of Subrogation endorsements that provide additional insured status to the certificate holder and Waiver of Subrogation only when there is a written contract between the named insured and the Certificate Holder that requires it, as permitted by law. The General Liability policy contains a special endorsement with “Primary and Noncontributory” wording.
The Business Auto policy includes blanket additional insured and Waiver of Subrogation endorsements that provide additional insured status to the certificate holder and Waiver of Subrogation only when there is a written contract between the named insured and the Certificate Holder that requires it, as permitted by law. The Business Auto policy contains a special endorsement with “Primary and Noncontributory” wording.
Contractor's Pollution Liability policy includes blanket additional insured and Waiver of Subrogation endorsements that provide additional insured status to the certificate holder and Waiver of Subrogation only when there is a written contract between the named insured and the Certificate Holder that requires it, as permitted by law. The Contractor's Pollution Liability policy contains a special endorsement with “Primary and Noncontributory” wording.
The Workers Compensation policy includes a blanket automatic waiver of subrogation endorsement that provides this feature only when there is a written contract between the named insured and the certificate holder that requires it, as permitted by law.
Stop Gap coverage included. ND, OH, WA, WY.
Attachment Code: D631186 Master ID: 1528938, Certificate ID: 21212729
1 Alliance Geomatics, LLC Alta Vista Engineering Services AG Alta Vista Solutions Inc.
Arrow ATC Holdings, LLC Arrow Environmental Holdings LP Arrow Environmental Holdings, GP LLC ATC Associates of North Carolina, PC ATC Associates of Ohio, LP ATC Associates, Inc.
ATC Construction Services, Inc.
ATC Engineering of Michigan, LP ATC Engineering, LLP ATC Environmental, Inc.
ATC Group Holdings LLC ATC Group Partners LLC ATC Group Services LLC ATC Group Services, LLC dba Atlas Technical Consultants, LLC ATC Holding, Inc.
ATC Leasing Company, LLC ATC New England Corporation ATC Sole Member LLC Atlantic Engineering Laboratories of New York, Inc.
Atlantic Engineering Laboratories, Inc.
Atlantic Engineering Laboratories, LLC Atlas ATC Engineering, Inc.
Atlas Consulting Services
Long Engineering, LLC Materials Testing & Inspection, LLC O’Neill Service Group, LLC Oris Solutions, LLC Pavetex Engineering, LLC fka PaveTex Engineering & Testing Piedmont Geotechnical Consultants, LLC Pipeline Environmental Services Plant Services Quality Assurance Engineering, Inc.
Quality Assurance Engineering, Inc. dba Consolidated
Engineering Laboratories Rocky Mountain PSI, LLC Sage ATC Environmental Consulting LLC Sage ATC Environmental Holdings LLC Sge Engineering, Inc.
Sage Environmental Consulting, LP Sage Environmental Holdings, LLC
SCST, LLC
Southwest Geophysics, LLC The Environmental Institute Transmart Technologies, LLC TanSmart, Inc.
TranSmart, LLC United Testing, LLC fka United Testing Corporation WesTest, LLC Wilkins Environmental Consulting, Inc.
WSP- Atlas Midtown Engineers LLC
Atlas Engineering West, Inc.
Atlas Intermediate Holdings LLC Atlas TC Holdings LLC Atlas Technical Consultants Holdings, LP Atlas Technical Consultants LLC Atlas Technical Consultants Sole Member LLC Atlas Technical Consultants, Inc.
Bananza Industries, Inc.
BCM Engineering, Inc.
Beest Express, LLC Caitcon, LLC Cardno ATC (MA), Inc.
CEL Consulting, LLC Consolidated Engineering Laboratories Dexter ATC Field Services LLC Dexter Field Services, LP Engineering & Testing Services LLC Engineering Services, LLC Environmental Compliance Services, Inc.
ETS-ESC Holdings LLC Geosphere Consultants, Inc.
HES Testing, LLC Long Engineering, Inc.
Atlas Technical Consultants, Inc.
Schedule of Named Insureds
Attachment Code: D631175 Master ID: 1528938, Certificate ID: 21212729
Additional Insured-Automatic-Owners, Lessees Or e
~ ZURICH
Contractors Coverage Part One-Commercial General Liability Coverage Part Two-Contractor's Pollution Liability
Policy No. Eff. Date of Pol. Exp Date of Pol. E ff Date of End. Producer Add? Prem. Return Ptem.
GPL-0217085-09 11/13/2024 11/13/2025 11/13/2024 14317000 - -
Named Insured and Mailing Address:Producer:
ATLAS TECHNICAL CONSULTANTS, INC.
13215 BEE CAVE PKWY, BUILDING A, SUITE 250
AUSTIN, TX 78738.
Lockton Insurance Brokers, LLC 777 S. Figueroa Street, 52nd fl.
Los Angeles CA 90017
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provded under the following:
Environmental Services Package Policy
[X] COVERAGE PART ONE-COMMERCIAL GENERAL LIABILITY
[X] COVERAGE PART TWO-CONTRACTOR'S POLLUTION LIABILITY
tWho is an Insured (Section I.) in the COMMON COVERAGE PROVISIONS is amended to include as an additional insured any person(s) or organization(s) whom you are required to add as an additional insured on this pol icy under a written contract or written agreement.
2. The insurance provided to the additional insured person(s) or organ zation(s) applies only to:
a. "Bodily injury", "property damage" or "personal and advertising injury" under COVERAGE PART ONE- COMMERCIAL GENERAL LIABILITY, COVERAGE A- BODILY INJURY AND PROPERTY DAMAGE LIABILITY and COVERAGE B -PERSONAL AND ADVERTISING INJURY LIABILITY 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:
(a) Your ongoing operations performed for the additional insured, which is the subject of the written contract or written agreement; or
(b) "Your work' completed as included in the "products-competed operations hazard", performed for the additional insured, which is the subject of the written contract or written agreement; and/or b "Claims" arising out of a "pollution event" under COVERAGE PART TWO - CONTRACTOR'S POLLUTION LIABILITY, 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:
(a) "Covered operations" performed for the additional insured, which is the subject of the written contract or written agreement; or
STF-E SP-101-F CW (04/13)
Page 1 0f3
Attachment Code: D630735 Certificate ID: 21212729
GPL-0217085-09
(b) "Completed operations" of the "covered operations" performed for the additional insured, which is the subject of the written contract or written agreement.
3. However, regardless of the provisions of paragraphs 1. and 2. above, the insurance afforded to such additional insured:
a. Only applies to the extent permitted by law: and
b. Will not be broader than that which you are required by the written contract or written agreement to provide to such additional insured.
4. With respect to the insurance afforded to the additional insured under this endorsement, the following is added to Section III —Limits Of Insurance and Deductible:
The most we will pay on behalf of the additional insured is the amount of insurance:
a. Required by the written contract or written agreement you have entered into with the additional insured; or
b. 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
5. The insurance provided to the additional insured person or organization does not apply to:
"Bodily injury', "property damage or "personal and advertising injury" arising out of the rendering or failure to render any professional architectural, engineering or surveying services including:
(1) The preparing. approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys.
field orders, change orders or drawings and specifications: and
(2) Supervisory, inspection, architectural or engineering activities.
This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any architectural. engineering or surveying services.
6. The additional insured must see to it that:
a. We are notified as soon as practicable of an "occurrence", offense or "pollution event", as applicable, that may result in a claim:
b. We receive written notice of a claim or "suit" as soon as practicable; and
c. A request for defense and indemnity of the claim or "suit" will promptly be brought against any policy issued by another insurer under which the additional insured may be an insured in any capacity. This provision does not apply to insurance on which the additional insured is a Named Insured, if the written contract or written agreement requires that this coverage be primary and non-contributory.
7. For the coverage provided by this endorsement:
a. The following paragraph is added to Paragraph 8.a. Other Insurance, Conditions (Section V.) in the
COMMON COVERAGE PROVISIONS:
Primary and Noncontributory Insurance
This Insurance is primary to and will not seek contribution from any other insurance available to an additional insured under this endorsement provided that
(1) The additional insured is a Named Insured under such other insurance: and
(2) You have agreed in a written contract or written agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured.
b. The following paragraph is added to Paragraph 8.b. Other Insurance, Conditions (Section V.) in the COMMON
COVERAGE PROVISIONS:
This insurance is excess over:
STF-E SP-101F CW (04/13)
GPL-0217085-09
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 noncontributory basis.
8. This endorsement does not apply to an additional insured which has been added to this policy by an endorsement shaving the additional insured in a Schedule of additional insureds. and which endorsement applies specifically to that identified additional insured.
ALL OTHER TERMS AND CONDITIONS OF THE POLICY SHALL APPLY AND REMAIN UNCHANGED.
STF-E SP-101-F CW (04113)
Waiver of Transfer of Rights of Recovery Against Others – Blanket as Required by Contract
Policy No. Eff. Date of Pol. Exp. Date of Pol. Eff. Date of End. Producer Add'l Prem. Return Prem.
GPL-0217085-09 11/13/2024 11/13/2025 11/13/2024 14317000
Named Insured and Mailing Address: Producer:
ATLAS TECHNICAL CONSULTANTS, INC.
13215 BEE CAVE PKWY, BUILDING A, SUITE 250
AUSTIN, TX 78738
Lockton Insurance Brokers, LLC 777 S. Figueroa Street, 52nd fl.
Los Angeles CA 90017
[ ] COVERAGE PART ONE – COMMERCIAL GENERAL
LIABILITY[ ] COVERAGE PART TWO – CONTRACTOR’S POLLUTION
LIABILITY[ ] COVERAGE PART THREE – PROFESSIONAL
LIABILITY
ITHIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT
CAREFULLY.
This endorsement modifies insurance provided under the following:
X
X
X
In consideration of the payment of premium and the Deductible by you and in reliance upon the statements in the Application made a part hereof, we agree with you, subject to all the terms, exclusions and conditions that with respect to the coverage parts indicated above Conditions (Section V.) of the COMMON COVERAGE PROVISIONS, Condition 14.
Subrogation is amended by the addition of the following:
We waive any right of recovery we may have against any person or organization whom you are required to waive your right of subrogation by a written contract or written agreement executed and effective prior to the performance of your services which is the subject of such written contract or permit or written agreement.
ALL OTHER TERMS AND CONDITIONS OF THE POLICY SHALL APPLY AND REMAIN UNCHANGED.
STF-ESP-248-A CW (04/10)
Attachment Code: D630736 Certificate ID: 21212729
Policy No. Eff. Date of Pol. Exp. Date of Pol. Eff. Date of End. Producer Add'l Prem. Return Prem.
GPL-0217085-09 11/13/2024 11/13/2025 11/13/2024 14317000
Named Insured and Mailing Address: Producer:
ATLAS TECHNICAL CONSULTANTS, INC.
13215 BEE CAVE PKWY, BUILDING A, SUITE 250
AUSTIN, TX 78738
Lockton Insurance Brokers, LLC 777 S. Figueroa, 52nd Floor Los Angeles, CA 90017
Blanket Notification to Others of Cancellation
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the:
Agribusiness Pollution Liability Insurance Policy - Claims Made and Reported Coverage
Commercial Umbrella Liability Policy
Commercial Umbrella Liability Policy – Claims Made and Reported Coverage
Contractor’s Pollution Liability Insurance Policy
Contractor’s Pollution Liability Insurance Policy - Claims Made and Reported Coverage
Environmental Cleanup and Liability Insurance Policy - Claims Made and Reported Coverage
Environmental Impairment Liability Insurance Policy - Claims Made and Reported Coverage
Environmental Services Package Policy
Excess Environmental Insurance Policy - Claims Made and Reported Coverage
Follow Form Excess Liability Policy
Follow Form Excess Liability Policy – Claims Made and Reported Coverage
Healthcare Pollution Liability Insurance Policy - Claims Made and Reported Coverage
Lender Environmental Collateral Protection and Liability Insurance Outstanding Loan Balance - Claims Made and Reported Coverage
Lender Environmental Collateral Protection and Liability Insurance Policy – Claims Made and Reported Coverage
Professional Consultant’s Liability Insurance Policy - Claims Made and Reported Coverage
Professional Environmental Consultant’s Liability Insurance Policy
Professional Environmental Consultant’s Liability Insurance Policy - Claims Made and Reported Coverage
Public Entity Pollution Liability - Claims Made and Reported Coverage
Real Estate Environmental Liability Insurance Policy - Claims Made and Reported Coverage
Remediation Stop Loss
Z Choice Pollution Liability
Z Choice® Real Estate Environmental Liability - Claims Made and Reported Coverage
Z Choice™ Pollution Liability - Claims Made and Reported Coverage
Z Link® Commercial General and Pollution Liability
A. If we cancel this policy by written notice to the first Named Insured for any reason other than nonpayment of premium, we will deliver electronic notification that such policy has been cancelled to each person or organization shown in a Schedule provided to us by the First Named Insured. Such Schedule:
Attachment Code: D630738 Certificate ID: 21212729
1. Must be initially provided to us within 15 days:
a. After the beginning of the policy period shown in the Declarations; or
b. After this endorsement has been added to policy;
2. Must contain the names and e-mail addresses of only the persons or organizations requiring notification that such Coverage Part has been cancelled;
3. Must be in an electronic format that is acceptable to us; and
4. Must be accurate.
Such Schedule may be updated and provided to us by the First Named Insured during the policy period. Such updated Schedule must comply with Paragraphs 2. 3. and 4. above.
B. Our delivery of the electronic notification as described in Paragraph A. of this endorsement will be based on the most recent Schedule in our records as of the date the notice of cancellation is mailed or delivered to the first Named Insured. Delivery of the notification as described in Paragraph A. of this endorsement will be completed as soon as practicable after the effective date of cancellation to the first Named Insured.
C. Proof of emailing the electronic notification will be sufficient proof that we have complied with Paragraphs A. and B. of this endorsement.
D. Our delivery of electronic notification described in Paragraphs A. and B. of this endorsement is intended as a courtesy only. Our failure to provide such delivery of electronic notification will not:
1. Extend the Coverage Part cancellation date;
2. Negate the cancellation; or
3. Provide any additional insurance that would not have been provided in the absence of this endorsement.
E. We are not responsible for the accuracy, integrity, timeliness and validity of information contained in the Schedule provided to us as described in Paragraphs A. and B. of this endorsement.
ALL OTHER TERMS AND CONDITIONS OF THE POLICY SHALL APPLY AND REMAIN UNCHANGED.
STF-ENVL-1632-A CW (11/10)
Attachment Code: D630738 Certificate ID: 21212729
BAP-0217109-09 11/13/2024 11/13/2025 11/13/2024 14317000
Coverage Extension Endorsement – Liability Only
Policy f No. Eff. Date of Pol. Exp. Date of Pol. Eff. Date of End. Producer No. Add’l. Prem Return Prem.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the:
Business Auto Coverage Form Motor Carrier Coverage Form
A. Amended Who Is An Insured
1. The following is added to the Who Is An Insured Provision in Section II – Covered Autos Liability Coverage:
The following are also "insureds":
a.
b. Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow for acts performed within the scope of employment by you. Any “employee” of yours is also an “insured” while operating an “auto” hired or rented under a contract or permit or agreement in an “employee’s” name, with your permission, while performing duties related to the conduct of your business.
c. Anyone volunteering services to you is an "insured" while using a covered "auto" you don’t own, hire or borrow to transport your clients or other persons in activities necessary to your business.
d. Anyone else who furnishes an "auto" referenced in Paragraphs A.1.a. and A.1.b. in this endorsement.
e. Where and to the extent permitted by law, any person(s) or organization(s) where required by written contract or permit or written agreement with you executed prior to any "accident", including those person(s) or organization(s) directing your work pursuant to such written contract or written agreement with you, provided the "accident" arises out of operations governed by such contract or agreement and only up to the limits required in the written contract or permit or written agreement, or the Limits of Insurance shown in the Declarations, whichever is less.
Coverage for any person(s) or organization(s), where required by written contract or written agreement with you executed prior to any "accident", will apply on a primary and non-contributory basis and any insurance maintained the terms and conditions of the Coverage Form.
B. Amendment – Supplementary Payments
Paragraphs a.(2) and a.(4) of the Coverage Extensions Provision in Section II – Covered Autos Liability
Coverage are replaced by the following:
(2) Up to $5,000 for the cost of bail bonds (including bonds for related traffic law violations) required because of an "a3c cident" we cover. We do not have to furnish these bonds.
(4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a da" y because of time off from work.
U-CA-428-A CW (02-14)
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
Attachment Code: D630742 Certificate ID: 21212729
BAP-0217109-09
C. Fellow Employee Coverage
The Fellow Employee Exclusion contained in Section II – Covered Autos Liability Coverage does not apply.
D. Driver Safety Program Liability Coverage
The following is added to the Racing Exclusion in Section II – Covered Autos Liability Coverage:
This exclusion does not apply to covered "autos" participating in a driver safety program event, such as, but not limited to, auto or truck rodeos and other auto or truck agility demonstrations.
E. Amended Duties In The Event Of Accident, Claim, Suit Or Loss
Paragraph a. of the Duties In The Event Of Accident, Claim, Suit Or Loss Condition is replaced by the following:
a. In the event of "accident", claim, "suit" or "loss", you must give us or our authorized representative prompt notice of the "accident", claim, "suit" or "loss". However, these duties only apply when the "accident", claim, "suit" or "loss" is known to you (if you are an individual), a partner (if you are a partnership), a member (if you are a limited liability company) or an executive officer or insurance manager (if you are a corporation). The failure of any agent, servant or employee of the "insured" to notify us of any "accident", claim, "suit" or "loss" shall not invalidate the insurance afforded by this policy.
Include, as soon as practicable:
(1) How, when and where the "accident" or "loss" occurred and if a claim is made or "suit" is brought, written notice of the claim or "suit" including, but not limited to, the date and details of such claim or "suit";
(2) The "insured’s" name and address; and
(3) To the extent possible, the names and addresses of any injured persons and witnesses.
If you report an "accident", claim, "suit" or "loss" to another insurer when you should have reported to us, your failure to report to us will not be seen as a violation of these amended duties provided you give us notice as soon as practicable after the fact of the delay becomes known to you.
F. Waiver of Transfer Of Rights Of Recovery Against Others To Us
The following is added to the Transfer Of Rights Of Recovery Against Others To Us Condition:
This Condition does not apply to the extent required of you by a written contract, executed prior to any "accident" or "loss", provided that the "accident" or "loss" arises out of operations contemplated by such contract. This waiver only applies to the person or organization designated in the contract or permit.
G. Unintentional Failure to Disclose Hazards
The following is added to the Concealment, Misrepresentation Or Fraud Condition:
However, we will not deny coverage under this Coverage Form if you unintentionally:
(1) Fail to disclose any hazards existing at the inception date of this Coverage Form; or
(2) Make an error, omission, improper description of "autos" or other misstatement of information.
You must notify us as soon as possible after the discovery of any hazards or any other information that was not provided to us prior to the acceptance of this policy.
H. Hired Auto – World Wide Coverage
Paragraph 7a.(5) of the Policy Period, Coverage Territory Condition is replaced by the following:
(5) Anywhere in the world if a covered "auto" is leased, hired, rented or borrowed for a period of 60 days or less, I. Bodily Injury Redefined
The definition of "bodily injury" in the Definitions Section is replaced by the following:
"Bodily injury" means bodily injury, sickness or disease, sustained by a person including death or mental anguish, resulting from any of these at any time. Mental anguish means any type of mental or emotional illness or disease.
U-CA-428-A CW (02-14)
BAP-0217109-09
J. Expected Or Intended Injury
The Expected Or Intended Injury Exclusion in Paragraph B. Exclusions under Section II – Covered Auto Liability Coverage is replaced by the following:
Expected Or Intended Injury
"Bodily injury" or "property damage" expected or intended from the standpoint of the "insured". This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property.
All other terms, conditions, provisions and exclusions of this policy remain the same.
U-CA-428-A CW (02-14)
Blanket Notification to Others of Cancellation or Non-Renewal
Policy No. Eff. Date of Pol. Exp. Date of Pol. Eff. Date of End. Producer No. Add’l. Prem Return Prem.
BAP-0217109-09 11/13/2024 11/13/2025 11/13/2024
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 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 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.
All other terms and conditions of this policy remain unchanged.
U-CA-832-A CW (01/13)
Attachment Code: D631814 Certificate ID: 21212729
SXS-0217077-09 14317000 --------- ----------
Named Insured and Mailing Address:
ATLAS TECHNICAL CONSULTANTS,INC.
13215 Bee Cave Pkwy, Building A Suite 250 Austin, TX 78738
Producer:
Lockton Insurance Brokers, LLC
777 S. Figueroa Street, 52nd fl.
Los Angeles CA 90017
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
The following is added to Definition G. of SECTION VI. DEFINITIONS, underlying insurance, as paragraph two
(2):
Underlying insurance also includes any person or organization qualifying as an additional insured in the underlying insurance but only to the same extent that such person or organization is an additional insured under such underlying insurance.
BY:_____________________________________________
Authorized Representative
Date
11/13/2024 11/13/2025 11/13/2024
Endorsement # 09
ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED.
U-EXS-MAN-3 (04/99)
Includes copyrighted material of Insurance Services Office, Inc. with its permission.
Form Number – Form Name
Underlying Insurance Amendment – Additional Insured
Addl/Return Premium
Policy No. Eff. Date of Pol. Exp. Date of Pol. Eff. Date of End. Producer Add’l Prem. Return Prem.
Attachment Code: D631815 Certificate ID: 21212729
Endorsement # 12
Other Insurance Condition Amendment
Policy No. Eff. Date of Pol. Exp. Date of Pol. Eff. Date of End. Producer Add'l Prem. Return Prem.
SXS-0217077-09 11/13/2024 11/13/2025 11/13/2024
11/13/2024
14317000 --------- ----------
Named Insured and Mailing Address:
ATLAS TECHNICAL CONSULTANTS, INC.
13215 Bee Cave Pkwy, Building A Suite 250 Austin, TX 78738
Producer:
Lockton Insurance Brokers, LLC
777 S. Figueroa Street, 52nd fl.
Los Angeles CA 90017
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
SECTION V. CONDITIONS, CONDITION G. Other Insurance is deleted in its entirety and replaced with the following:
G. Other Insurance
If other insurance applies to damages that are also covered by this policy, this policy will apply excess of the other insurance. However, this provision will not apply:
1. If the other insurance is written to be excess of this policy; or
2. If the Named Insured has agreed in a written contract to carry insurance to apply prior to and be non-contributory with that of another person or organization's insurance, the other insurance of that person or organization will apply as excess and not contribute prior to the insurance afforded by this policy.
Nothing herein will be construed to make this policy subject to the terms, conditions and limitations of such other insurance.
ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED.
Signed by: ______________________________________ Authorized Representative Date
U-EXS-MAN-2 (04/99)
Includes copyrighted material of Insurance Services Office, Inc. with its permission.
Attachment Code: D638041 Certificate ID: 21212729
Policy No. Eff. Date of Pol. Exp. Date of Pol. Eff. Date of End. Producer Add'l Prem. Return Prem.
SXS 0217077-08 11/13/2024 11/13/2025 11/13/2024 75428000
Named Insured and Mailing Address: Producer:
ATLAS TECHNICAL CONSULTANTS, INC.
13215 BEE CVE PARKWAY BUILDING B SUITE 230
AUSTIN, TX 78738
LOCKTON INSURANCE BROKERS, LLC
777 S FIGUEROA ST STE 5200
LOS ANGELES, CA 90017-5850
Blanket Notification to Others of Cancellation or Nonrenewal
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
The following is added to SECTION V. CONDITIONS:
Blanket Notification to Others of Cancellation or Nonrenewal
1. If we cancel or non-renew this policy by written notice to the first Named Insured, 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 the first Named Insured 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 the first Named Insured. 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 the first Named Insured. 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 THE POLICY SHALL APPLY AND REMAIN UNCHANGED.
U-EXS-441-A-CW (01/13)
Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1
Endorsement # 05
Attachment Code: D648070 Certificate ID: 21212729
WC-0217111-09 (AOS)
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
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.
(This information below is required only when this endorsement is issued subsequent to preparation of the policy.)
ENDORSEMENT EFFECTIVE: 11/13/2024 ENDORSEMENT NO.
POLICY NO. WC-0217111-09 (AOS) PREMIUM
Insured: Atlas Technical Consultants, LLC
Insurance Company:
Zurich American Insurance Company
WC 00 03 13 1983 National Council on Compensation Insurance.
(Ed. 4-84)
Attachment Code: D630768 Certificate ID: 21212729
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 11/13/2024 Policy No. WC-0217111-09 (AOS) Endorsement No.
Insured: Atlas Technical Consultants, LLC Premium $
Insurance Company: Zurich American Insurance Company
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 perm ission.
2012 Copyright National Council on Compensation Insurance, Inc. All Rights Reser ved.
Attachment Code: D630771 Certificate ID: 21212729
File details come from the government source that posted it. Updated .