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HomeMy WebLinkAboutAdvanced American Construction Inc - HDR Engineering, Inc - WWTP Improvements Phase 2 - Cert of Liability 2023-24D►® ACCORCERTIFICATE OF MARINE / ENERGY INSURANCE E (MMIDDIYYYY) DAr9/28/2023 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). PRODUCER Durham and Bates Insurance 1211 SW 5th Ave. 2800 CONTACT NAME: Katrina Green PHONE FAX ac No Ext : 503-224-5170 A/c No): 503-221-0540 E-MAIL katrinag@dbates.com ADDRESS: g@dbates.com Portland OR 97204 PRODUCER CUSTOMER ID #: INSURERS AFFORDING COVERAGE NAIC # INSURED Advanced American Construction, Inc. PO Box 83599 INSURER A: Subscription INSURER B : Starr Indemnity &Liability Co 38318 INSURERC: Portland OR 97283 INSURER D : INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER:172001098 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR I OF INSURANCE L ADDTYPE I WV POLICYNUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A HULL AND MACHINERY X COLLISION LIABILITY X TOWERS LIABILITY DB53577 10/1/2023 10/1/2024 X PER SCHEDULE ON FILE INSURED VALUE $ COLLISION (Ea occurrence) $ As Scheduled TOWERS (Ea occurrence) $As Scheduled A PROTECTION AND INDEMNITY CREW LIABILITY ❑ JONES ACT COLLISION LIABILITY TOWERS LIABILITY REMOVAL OF WRECK IN REM DB53577 10/1/2023 10/1/2024 PER CLUB RULES X EAOCCURRENCE PER VESSEL, CSL $ 1,000,000 X COLLISION (Ea occ), CSL $ 1,000,000 X TOWERS (Ea occ), CSL $ 1,000,000 X REMOVAL OF WRECK Ea occurrence $ 1,000,000 $ B POLLUTION LIABILITY X OPA 90 X CERCLA NON-OPA / NON-CERCLA V1322523 10/1/2023 10/1/2024 EAOCCURRENCE $1,000,000 $ $ $ MARITIME EMPLOYERS LIABILITY ALTERNATE EMPLOYER INCLUDES ❑ CREW ❑ EMPS JONES ACT DEATH ON THE HIGH SEAS IN REM ENDORSEMENT N / A ANY ONE PERSON $ ANY ONE ACCIDENT $ $ $ $ $ $ l,tKI IrIL.AI It rIULUtK LAIVI.tLLA I IUIV City of Pasco Public Works Department -Engineering PO Box 293 Pasco WA 99301 SHOULD ANY OF THE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE VAk,x:*a K('1r 0_N Page 1 of 2 © 2012-2015 ACORD CORPORATION. All rights reserved. ACORD 31 (2016/03) The ACORD name and logo are registered marks of ACORD COVERAGES CERTIFICATE NUMBER: 172001098 INSR LTR TYPE OF INSURANCE D IN D UBR WVD POLICYNUMBER POLICY EFF MWDD POLICY EXP MWDD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY MARINE GENERAL LIABILITY CLAIMS -MADE OCCUR AGGREGATE LIMIT APPLIES PER: JECT POLICY ❑ PRO- ❑ LOC OTHER: EACH OCCURRENCE $ DAMAGE T ENTED PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L PRODUCTS -COMP / OP AGG $ $ $ AUTOMOBILE LIABILITY ANY AUTO SCHEDULED AUTOS OWNED NON -OWNED AUTOS ONLY AUTOS ONLY HIRED AUTOS ONLY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ WORKERS COMPENSATION AND EMPLOYERS LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y� OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below ALTERNATE EMPLOYER USL&HENDORSEMENT MARITIME EMPLOYERS LIABILITY OCSL ACT NIA A PER OTH- TAT TE ER E.L. (Each accident) $ E.L. DISEASE (Ea employee) $ E.L. DISEASE -POLICY LIMIT $ $ $ $ $ COMPENSATION LONGSHORE & HARBOR WORKERS ACT ALTERNATE EMPLOYER MARITIME EMPLOYERS LIABILITY OCSL ACT N / A ElSEER AT ER E.L. (Each accident) $ E.L. DISEASE (Ea employee) $ E.L. DISEASE -ANN AGG $ AIRCRAFT LIABILITY OWNED AIRCRAFT NON -OWNED AIRCRAFT PASSENGER LIABILITY EACH OCCURRENCE $ AGGREGATE $ $ $ A UMBRELLA / EXCESS LIAB / BUMBERSHOOT X UMBRELLA A I BUMBERSHOOT EXCESS CLAIMS MADE X❑ OCCUR DED RETENTION $ PDB53579 10/1/2023 10/1/2024 EACH OCCURRENCE $ 9,000,000 AGGREGATE $ 9,000,000 $ $ $ ENERGY CONTROL OF WELL/OPERATORS EXTRA EXPENSE CARE, CUSTODY AND CONTROL (CCC) OFFSHORE OIL AND GAS PROPERTY PLATFORMS PIPELINES ONSHORE OIL AND GAS PROPERTY OIL & GAS PROPERTY CONTRACTORS EQUIPMENT J NAMED WINDSTORM ccC SHORE SHORE CSL, ANY ONE OCCURRENCE (100% interest) $ ANY ONE OCCURRENCE 100°k interest $ VALUES AS SCHEDULED $ VALUES AS SCHEDULED $ VALUES AS SCHEDULED $ VALUES AS SCHEDULED $ $ AGGREGATE $ VESSEL(S): I I AS PER ATTACHED SCHEDULE AS DETAILED IN THE DESCRIPTION OF OPERATIONS DESCRIPTION OF OPERATIONS / LOCATIONS (ACORD 101, Additional Remarks Schedule, may be attached, If more space Is required) Subscription Insurers: Hull/P&I: Endurance American Insurance Co. (NAIC #10641); US Specialty Insurance Co. (NAIC #29599); Continental Insurance Co. (NAIC #35289); Aspen American Insurance Co. (NAIC #43460); StarStone National Insurance Co. (NACI #25496). Bumbershoot (Excess Limits) Liability: US Specialty Insurance Co. (NAIC #29599); StarStone National Insurance Co. (NACI #25496); Continental Insurance Co. (NAIC #35289); Aspen American Insurance Co. (NAIC #43460); StarNet Insurance Company (NAIC #40045). Excess extends over Protection & Indemnity, Vessel Pollution. City of Pasco Project #21-237B; WWTP Outfall Replacement. Protection & Indemnity - includes Collision Liability, and property damage and bodily injury arising from vessel operations. ACORD 31 (2016/03) Page 2 of 2 ACt7RD0 C40 CERTIFICATE OF LIABILITY INSURANCE DATE (MWDD/YY" 9i28/2023 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). PRODUCER CONTANAME: CT Katrina Green Durham and Bates Insurance PHONE FAX 1211 SW 5th Ave. A/c No Ext : 503-224-5170 AC'No): 503-221-0540 E-MSuite ADDRESS: katrinag@dbates.com 2800 Portland OR 97204 INSURER(S) AFFORDING COVERAGE NAIC# INSURER A: Subscription INSURED ADVAAME-01 INSURER B: Saif Corporation 36196 Advanced American Construction, Inc. PO Box 83599 INSURER c : Tokio Marine Specialty Insurance Company 23850 INSURER D : Ascot Insurance Company 23752 Portland OR 97283 INSURER E: United States Fire Insurance Company 21113 INSURER F : COVERAGES CERTIFICATE NUMBER: 1351718474 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE DDL INSD UBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY PDB53578 10/1/2023 10/1/2024 EACH OCCURRENCE $1,000,000 CLAIMS -MADE OCCUR PREMISES Ea occurrence $100,000 X MED EXP (Any one person) $10,000 Maring Gen Liab X Stop Gap PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JR O- LOC PRODUCTS - COMP/OP AGG $ 2,000,000 Stop Gap $ 1,000,000 OTHER: E AUTOMOBILE LIABILITY 133-755605-1 10/1/2023 10/1/2024 COMBINED SINGLE LIMIT Ea accident $ 2,000,000 BODILY INJURY (Per person) $ X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY A X UMBRELLA LIAB X OCCUR PDB53579 10/1/2023 10/1/2024 EACH OCCURRENCE $ 9,000,000 X AGGREGATE $9,000,000 EXCESS LAB CLAIMS -MADE DED 1 1 RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOR/PARTNER/EXECUTIVE 985962 10/1/2023 10/1/2024 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 OFFICE R/MEMBEREXCLUDED? ❑ N/A E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 B USL&H 985962 10/1/2023 10/1/2024 Limit -Statutory C D Pollution Liability Excess Liab (Bumbershoot) PPK2608118-000 PDB53580 10/1/2023 10/1/2023 10/1/2024 10/1/2024 Per Occurrence Excess $9M Ea Occ/Agg 5,000,000 15,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Subscription Insurers: MGL: Continental Insurance Co. (NAIC #35289); US Specialty Insurance Co. (NAIC #29599); Aspen American Insurance Co. (NAIC #43460); StarStone National Insurance Co. (NACI #25496). Bumbershoot (Excess Limits) Liability: US Specialty Insurance Co. (NAIC #29599); StarStone National Insurance Co. (NACI #25496); Continental Insurance Co. (NAIC #35289); Aspen American Insurance Co. (NAIC #43460); StarNet Insurance Company (NAIC #40045). (NAIC #43460). Excess Bumbershoot Liability: Endurance American Insurance Co. (NAIC #10641); US Specialty Insurance Co. (NAIC #29599); StarStone National Insurance Co. (NAIC #25496); StarNet Insurance Company (NAIC #40045). See Attached... CERTIFICATE HOLDER CANCELLATION City of Pasco Public Works Department -Engineering PO Box 293 Pasco WA 99301 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTlIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: ADVAAME-01 _ LOC #: ACOOR L> ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY Durham and Bates Insurance NAMED INSURED Advanced American Construction, Inc. PO Box 83599 Portland OR 97283 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Leased/Rented Equip Limit $2,500,000; Policy MKLM51M0052923 10/01/2023-10/01/2024; Markel American Insurance Company (NAIC 28932) Excess extends over Marine General Liability, Auto Liability, Employers Liability City of Pasco Project#21-237B; WWTP Outfall Replacement Owner - City of Pasco; Engineer - Consor North American, Inc.; State of Washington, Department of Natural Resources: Additional Insured, Primary/Non-Contributory performs attached. Marine General Liability - includes Washington Stop Gap; applies to both both ongoing and completed operations; no exclusion for explosion, collapse and underground. Excess Bumbershoot (Excess Liability) - following form. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ENDORSEMENT NO.: 2 EFFECTIVE: OCTOBER 1. 2023 (12:01 a.m.) PDT ATTACHED TO AND FORMING PART OF POLICY NO.: PDB-53578 — Marine General Liability ISSUED TO: ADVANCED AMERICAN CONSTRUCTION, INC., et al ADDITIONAL ASSURED AND WAIVER OF SUBROGATION ENDORSEMENT It is agreed that to the extent that the Named Assured is obligated by contract to name any person or organization as additional assureds hereunder, the Company agrees that such persons or organizations shall be considered as Additional Assureds but only with respect to operations performed by or on behalf of the Named Assured or to the facilities of or used by the Named Assured. It is further agreed that the Company waives its right of subrogation against any person or organizations to whom the Named Assured is obligated by contract to provide such waiver, but only to the extent of such obligation and only with respect to operations by or on behalf of the Named Assured or to the facilities of or used by the Named Assured. ALL OTHER TERMS, CONDITIONS, LIMITATIONS AND EXCLUSIONS REMAIN UNCHANGED. 23 AAC MGL Policy PDB-53578 Durham ?,"j" Bates ENDORSEMENT NO EFFECTIVE: OCTOBER 1, 2023 (12:01 a.m.) PDT ATTACHED TO AND FORMING PART OF POLICY NO.: PDB-53578 — Marine General Liability ISSUED TO: ADVANCED AMERICAN CONSTRUCTION, INC., et al PRIMARY AND NON-CONTRIBUTORY INSURANCE It is understood and agreed that, when required by a written contract, this policy shall be the principal coverage as respects the liabilities of the Named Assured and any other insurance carried by an Additional Assured shall not be contributory as respects the liabilities of the Named Assured, nor shall the Additional Assured be responsible for any premium hereunder. ALL OTHER TERMS, CONDITIONS, LIMITATIONS AND EXCLUSIONS REMAIN UNCHANGED. 23 AAC MGL Policy PDB-53578 Durham. ,,Bates ENDORSEMENT NO.: 13 EFFECTIVE: OCTOBER 1, 2023 (12:01 a.m.) PDT ATTACHED TO AND FORMING PART OF POLICY NO.: PDB-53578 — Marine General Liability ISSUED TO: ADVANCED AMERICAN CONSTRUCTION, INC., et al RAILROAD PROPERTY ENDORSEMENT When required by written contract, this endorsement amends the policy to delete Endorsement 10, Exclusion Clause B.5.: "To bodily injury or property damage arising out of construction or demolition operations within 50 feet of any railroad property, and affecting any railroad bridge or trestle, tracks, road beds, tunnel, underpass or crossing; but this exclusion does not apply to side-track agreements." 23 AAC MGL Policy PDB-53578 Durham �Ba.tes ENDORSEMENT NO.: 8 EFFECTIVE: OCTOBER 1, 2023 (12:01 a.m.) PDT ATTACHED TO AND FORMING PART OF POLICY NO.: PDB-53578 — Marine General Liability ISSUED TO: ADVANCED AMERICAN CONSTRUCTION, INC., et al CROSS LIABILITY ENDORSEMENT Premium: $ (included) inconsideration of the additional premium shown in the schedule to this endorsement and subject to the terms and conditions of the policy, it is agreed that the inclusion of more than one corporation, person, organization, firm or entity as insured under this policy shall not in any way effect the rights of any such corporation, person, organization, firm or entity as respects any claim, demand, suit or judgment made, brought or recovered, by or in favor of any other insured, or by or in favor of any employee of such other insured. This policy shall protect each corporation, person, organization, firm or entity in the same manner as though a separate policy had been issued to each, but nothing herein shall operate to increase our liability as set forth elsewhere in this policy beyond the amount for which we would have been liable if only one person or interest had been named as the insured. ALL OTHER TERMS, CONDITIONS, LIMITATIONS AND EXCLUSIONS REMAIN UNCHANGED. 23 AAC MGL Policy PDB-53578 Durham Bates ENDORSEMENT NO.: 18 EFFECTIVE: OCTOBER 1, 2023 (12:01 a.m.) PDT ATTACHED TO AND FORMING PART OF POLICY NO.: PDB-53578 — Marine General Liability ISSUED TO: ADVANCED AMERICAN CONSTRUCTION, INC., et at UNMANNED FLYING CRAFT (DRONE) ENDORSEMENT It is hereby understood and agreed that wherever the term "aircraft" is used in this policy, it specifically excludes by definition any "drones" or unmanned flying craft used in connection with the Assured's business operations insured herein. The Assured will adhere to the necessary licensing, registration, operating guidelines and regulations as established by the Federal Aviation Administration, other federal agencies and local governments. 23 AAC MGL Policy PDB-53578 Du rham t,--.�Ba.tes THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL AUTOMOBILE BROAD FORM ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM 1. Broadened Insured Status 2. Blanket Additional Insured When Required Under Written Contract SCHEDULE 14. Audio, Visual, And Data Electronic Equipment 15. Loan/Lease Payoff Coverage 3. Employee Hired Autos Liability Coverage 16. Airbag Coverage 4. Employees As Insureds 17. Multiple Deductible Protection — Covered "Auto" And Trailer 5. Coverage Extensions — Supplementary Payments 6. Limited Fellow Employee Coverage 7. Limited Hired Auto - Physical Damage Coverage — Private Passenger (Includes Employee Hired Autos Physical Damage Coverage) 8. Custom Signs And Decoration 9. Extended Towing Coverage 10. Glass Breakage 11. Reimbursement For Increased Temporary Transportation Expense For Private Passenger And Commercial Vehicles 12. Extra Expense — Stolen Vehicles 13. Personal Effects Coverage 18. Duties In The Event Of An Accident, Claim, Suit, Or Loss 19. Non -Owned Auto Waiver Of Subrogation 20. Blanket Waiver Of Subrogation When Required Under Written Contract ...,�` 21. Coverage Territory — Short Term Hired Commercial "Autos" 22. Limited Mexico Coverage 23. Unintentional Failure To Disclose Hazards 24. Mental Anguish Resulting From "Bodily Injury" 25. Waiver Of Sovereign Immunity 26. Application Of This Endorsement FM 114.0.1378 10 13 Page 1 of 10 Includes copyrighted material of Insurance Service Office, Inc. with its permission. 1. Broadened Insured Status SECTION II — COVERED AUTOS LIABILITY COVERAGE, Paragraph A. Coverage, Subparagraph 1. Who Is An Insured is amended to include as an insured: A. Any subsidiary which is a legally incorporated entity of which you own a financial interest of more than 50% of the voting stock on the effective date of this Coverage Form, while using with your permission a covered "auto." However, the insurance afforded by this provision I.A. does not apply to any subsidiary that is an insured under any other automobile liability policy, or would be an insured under such policy but for the termination of such policy or the exhaustion of such policy's limits of insurance. B. Any organization you newly acquire or form, and over which you maintain majority interest, while using with your permission a covered "auto". The insurance afforded by this provision 1.B.: 1. Is effective on the acquisition or formation date, and is afforded only until the end of the policy period of this Coverage Form, or the next anniversary of its inception date, whichever is earlier. 2. Does not apply to "bodily injury" or "property damage" resulting from an "accident" that occurred before you acquired or formed the organization. 3. Does not include any newly acquired or formed organization that is: a. A joint venture or partnership; or b. An insured under any other automobile liability policy, or would be an insured under such policy but for the termination of such policy or the exhaustion of such policy's limits of insurance. �.�2. Blanket Additional Insured When Required Under Written Contract Paragraph A.1. Who Is An Insured under SECTION II — COVERED AUTOS LIABILITY COVERAGE is amended to add: d. Any person, organization or governmental entity with respect to the operation, maintenance, or use of a covered "auto" if you are required to add such person, organization or governmental entity to this policy as an additional "insured" in order to comply with the terms of a written contract or written agreement. This Additional Insured status is not conferred when such written contract or written agreement: (1) Involves the owner or anyone else from whom you hire or borrow a covered "auto" unless it is a "trailer" connected to a covered "auto" you own; or (2) Is executed after the date of "accident" or "loss"; Paragraph d.(2) above does not apply if: (a) the terms and conditions of the written contract or written agreement had been agreed upon prior to the "accident" or "loss"; and (b) you can definitively establish that the terms and conditions of the written contract or written agreement ultimately executed are the same as those which had been agreed upon prior to the "accident" or "loss". Paragraph a. of Condition 5. Other Insurance of Part B. General Conditions under Section IV — Business Auto Conditions is amended by the addition of the following: Regardless of whether other insurance is maintained by an additional insured on a primary basis, the coverage provided by Provision 2. of the Commercial Auto Broad Form Endorsement will be primary to and noncontributing with other insurance maintained by the additional insured if the written contract or written agreement between FM 114.0.1378 10 13 Page 2 of 10 Includes copyrighted material of Insurance Service Office, Inc. with its permission. you and the additional insured specifically requires that this insurance be primary. 3. Employee Hired Autos Liability Coverage The following is added to the Who Is An Insured Provision of SECTION II — COVERED AUTOS LIABILITY COVERAGE: An "employee" of yours is an "insured" while operating an "auto" hired or rented under a written contract or written agreement in that "employee's" name, with your permission, while performing duties related to the conduct of your business. 4. Employees As Insureds The following is added to the Section II — COVERED AUTOS LIABILITY COVERAGE, Paragraph A.I. Who Is An Insured Provision: Any "employee" of yours while using with your permission a covered "auto" you don't own, hire or borrow if such "auto" is being used in your business or your personal affairs. 5. Coverage Extensions - Supplementary Payments Paragraphs a.(2) and a.(4) under SECTION II — COVERED AUTOS LIABILITY COVERAGE, Paragraph 2.a. Supplementary Payments are revised as follows: 1. In a.(2), the limit for the cost of bail bonds is increased to $5,000; and 2. In a.(4), the limit for the actual loss of earnings is increased to $1,000 per day. 6. Limited Fellow Employee Coverage The following is added to Subparagraph 5. Fellow Employee under Paragraph B. Exclusions in SECTION II — COVERED AUTOS LIABILITY COVERAGE: But this exclusion does not apply if: a. the "bodily injury" results from the use of a covered "auto" you own or hire, and b. you have Workers Compensation insurance in force covering all of your "employees." Such coverage as is afforded by this provision is excess over any other collectible insurance. 7. Limited Hired Auto - Physical Damage Coverage - Private Passenger (Includes Employee Hired Autos Physical Damage Coverage) The following is added to Subparagraph 1. under Paragraph A. Coverage under SECTION III — PHYSICAL DAMAGE COVERAGE: d. Limited Hired Auto — Physical Damage — Private Passenger If hired "autos" are covered "autos" for Covered Autos Liability Coverage, and if Physical Damage Coverage of Comprehensive or Collision is provided under this Coverage Form for any "auto" you own, then Comprehensive and Collision Physical Damage Coverages as provided under SECTION III — PHYSICAL DAMAGE COVERAGE of this Coverage Part are extended to "autos" of the private passenger type you or your employee hires under a written contract or written agreement without a driver, at your direction, for the purpose of conducting your business, subject to the following: (1) The most we will pay for "loss" to any hired "auto" is $35,000 or the actual cash value or cost to repair or replace, whichever is the least, minus a deductible. FM 114.0.1378 10 13 Page 3 of 10 Includes copyrighted material of Insurance Service Office, Inc. with its permission. 5. A member, if you are a limited liability company. 19. Non -Owned Auto Waiver Of Subrogation The following is added to Subparagraph 5. Transfer Of Rights Of Recovery Against Others To Us, under Paragraph A. Loss Conditions in SECTION IV — BUSINESS AUTO CONDITIONS: We hereby waive any right of subrogation against any of your officers, directors, or "employees" which might arise by reason of any payment under the insurance afforded by this policy for the operation, maintenance, use, loading, or unloading of non -owned "autos". This waiver extends only to payments in excess of other valid and collectible insurance available to the officer, director, or "employee". 20. Blanket Waiver Of Subrogation When Required Under Written Contract The following is added to Subparagraph 5. Transfer Of Rights Of Recovery Against Others To Us, under Paragraph A. Loss Conditions in SECTION IV - BUSINESS AUTO CONDITIONS: However, we waive any right of recovery we may have against a person, organization or governmental entity when you have waived such right of recovery under a written contract or written agreement provided such written contract or agreement is: 1. currently in effect or becoming effective during the term of this policy; and 2. executed prior to the "accident" or "loss"; or 3. executed after the "accident" or "loss" if: a. the terms and conditions of the written contract or written agreement had been agreed upon prior to the "accident" or "loss"; and b. you can definitively establish that the terms and conditions of the written contract or written agreement ultimately executed are the same as those which had been agreed upon prior to the "accident" or "loss". 21. Coverage Territory - Short Term Hired Commercial "Autos" Paragraph 7. Policy Period, Coverage Territory under Paragraph B. General Conditions in SECTION IV — BUSINESS AUTO CONDITIONS is amended by the addition of the following: The coverage territory is extended to anywhere in the world if: 1. A covered "auto" of the commercial van, pick-up, or truck type is leased, hired, rented or borrowed for a period of 30 days or less; and 2. The "insured's" responsibility to pay damages is determined in a "suit" on the merits, in the United States of America, the territories and possessions of the United States of America, Puerto Rico, or Canada or in a settlement we agree to. We will also cover "loss" to, or "accidents" involving, a covered "auto" while being transported between any of these places. FM 114.0.1378 10 13 Page 8 of 10 Includes copyrighted material of Insurance Service Office, Inc. with its permission. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL AUTOMOBILE BROAD FORM ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM SCHEDULE 1. Broadened Insured Status 14. Audio, Visual, And Data Electronic Equipment 2. Blanket Additional Insured When Required Under Written Contract 15. Loan/Lease Payoff Coverage 3. Employee Hired Autos Liability Coverage 16. Airbag Coverage 4. Employees As Insureds 5. Coverage Extensions — Supplementary Payments 6. Limited Fellow Employee Coverage 7. Limited Hired Auto - Physical Damage Coverage — Private Passenger (Includes Employee Hired Autos Physical Damage Coverage) 8. Custom Signs And Decoration 9. Extended Towing Coverage 10. Glass Breakage 11. Reimbursement For Increased Temporary Transportation Expense For Private Passenger And Commercial Vehicles 12. Extra Expense — Stolen Vehicles 13. Personal Effects Coverage 17. Multiple Deductible Protection — Covered "Auto" And Trailer 18. Duties In The Event Of An Accident, Claim, Suit, Or Loss 19. Non -Owned Auto Waiver Of Subrogation 20. Blanket Waiver Of Subrogation When Required Under Written Contract 21. Coverage Territory — Short Term Hired Commercial "Autos" 22. Limited Mexico Coverage 23. Unintentional Failure To Disclose Hazards 24. Mental Anguish Resulting From "Bodily Injury" 25. Waiver Of Sovereign Immunity 26. Application Of This Endorsement FM 114.0.1378 10 13 Page 1 of 10 Includes copyrighted material of Insurance Service Office, Inc. with its permission. 1. Broadened Insured Status SECTION II — COVERED AUTOS LIABILITY COVERAGE, Paragraph A. Coverage, Subparagraph 1. Who Is An Insured is amended to include as an insured: A. Any subsidiary which is a legally incorporated entity of which you own a financial interest of more than 50% of the voting stock on the effective date of this Coverage Form, while using with your permission a covered "auto." However, the insurance afforded by this provision 1.A. does not apply to any subsidiary that is an insured under any other automobile liability policy, or would be an insured under such policy but for the termination of such policy or the exhaustion of such policy's limits of insurance. B. Any organization you newly acquire or form, and over which you maintain majority interest, while using with your permission a covered "auto". The insurance afforded by this provision 1.B.: 1. Is effective on the acquisition or formation date, and is afforded only until the end of the policy period of this Coverage Form, or the next anniversary of its inception date, whichever is earlier. 2. Does not apply to "bodily injury" or "property damage" resulting from an "accident" that occurred before you acquired or formed the organization. 3. Does not include any newly acquired or formed organization that is: a. A joint venture or partnership; or b. An insured under any other automobile liability policy, or would be an insured under such policy but for the termination of such policy or the exhaustion of such policy's limits of insurance. ��2. Blanket Additional Insured When Required Under Written Contract Paragraph A.I. Who Is An Insured under SECTION II — COVERED AUTOS LIABILITY COVERAGE is amended to add: d. Any person, organization or governmental entity with respect to the operation, maintenance, or use of a covered "auto" if you are required to add such person, organization or governmental entity to this policy as an additional "insured" in order to comply with the terms of a written contract or written agreement. This Additional Insured status is not conferred when such written contract or written agreement: (1) Involves the owner or anyone else from whom you hire or borrow a covered "auto" unless it is a "trailer" connected to a covered "auto" you own; or (2) Is executed after the date of "accident" or "loss"; Paragraph d.(2) above does not apply if: (a) the terms and conditions of the written contract or written agreement had been agreed upon prior to the "accident" or "loss"; and (b) you can definitively establish that the terms and conditions of the written contract or written agreement ultimately executed are the same as those which had been agreed upon prior to the "accident" or "loss". Paragraph a. of Condition 5. Other Insurance of Part B. General Conditions under Section IV — Business Auto Conditions is amended by the addition of the following: Regardless of whether other insurance is maintained by an additional insured on a primary basis, the coverage provided by Provision 2. of the Commercial Auto Broad Form Endorsement will be primary to and noncontributing with other insurance maintained by the additional insured if the written contract or written agreement between FM 114.0.1378 10 13 Page 2 of 10 Includes copyrighted material of Insurance Service Office, Inc. with its permission. you and the additional insured specifically requires that this insurance be primary. 3. Employee Hired Autos Liability Coverage The following is added to the Who Is An Insured Provision of SECTION II — COVERED AUTOS LIABILITY COVERAGE: An "employee" of yours is an "insured" while operating an "auto" hired or rented under a written contract or written agreement in that "employee's" name, with your permission, while performing duties related to the conduct of your business. 4. Employees As Insureds The following is added to the Section II — COVERED AUTOS LIABILITY COVERAGE, Paragraph A.1. Who Is An Insured Provision: Any "employee" of yours while using with your permission a covered "auto" you don't own, hire or borrow if such "auto" is being used in your business or your personal affairs. S. Coverage Extensions - Supplementary Payments Paragraphs a.(2) and a.(4) under SECTION II — COVERED AUTOS LIABILITY COVERAGE, Paragraph 2.a. Supplementary Payments are revised as follows: 1. In a.(2), the limit for the cost of bail bonds is increased to $5,000; and 2. In a.(4), the limit for the actual loss of earnings is increased to $1,000 per day. 6. Limited Fellow Employee Coverage The following is added to Subparagraph 5. Fellow Employee under Paragraph B. Exclusions in SECTION II — COVERED AUTOS LIABILITY COVERAGE: But this exclusion does not apply if: a. the "bodily injury" results from the use of a covered "auto" you own or hire, and b. you have Workers Compensation insurance in force covering all of your "employees." Such coverage as is afforded by this provision is excess over any other collectible insurance. 7. Limited Hired Auto - Physical Damage Coverage - Private Passenger (Includes Employee Hired Autos Physical Damage Coverage) The following is added to Subparagraph 1. under Paragraph A. Coverage under SECTION III — PHYSICAL DAMAGE COVERAGE: d. Limited Hired Auto — Physical Damage — Private Passenger If hired "autos" are covered "autos" for Covered Autos Liability Coverage, and if Physical Damage Coverage of Comprehensive or Collision is provided under this Coverage Form for any "auto" you own, then Comprehensive and Collision Physical Damage Coverages as provided under SECTION III — PHYSICAL DAMAGE COVERAGE of this Coverage Part are extended to "autos" of the private passenger type you or your employee hires under a written contract or written agreement without a driver, at your direction, for the purpose of conducting your business, subject to the following: (1) The most we will pay for "loss" to any hired "auto" is $35,000 or the actual cash value or cost to repair or replace, whichever is the least, minus a deductible. FM 114.0.1378 10 13 Page 3 of 10 Includes copyrighted material of Insurance Service Office, Inc. with its permission. 5. A member, if you are a limited liability company. 19. Non -Owned Auto Waiver Of Subrogation The following is added to Subparagraph 5. Transfer Of Rights Of Recovery Against Others To Us, under Paragraph A. Loss Conditions in SECTION IV — BUSINESS AUTO CONDITIONS: We hereby waive any right of subrogation against any of your officers, directors, or "employees" which might arise by reason of any payment under the insurance afforded by this policy for the operation, maintenance, use, loading, or unloading of non -owned "autos". This waiver extends only to payments in excess of other valid and collectible insurance available to the officer, director, or "employee". . 20. Blanket Waiver Of Subrogation When Required Under Written Contract The following is added to Subparagraph 5. Transfer Of Rights Of Recovery Against Others To Us, under Paragraph A. Loss Conditions in SECTION IV - BUSINESS AUTO CONDITIONS: However, we waive any right of recovery we may have against a person, organization or governmental entity when you have waived such right of recovery under a written contract or written agreement provided such written contract or agreement is: 1. currently in effect or becoming effective during the term of this policy; and 2. executed prior to the "accident" or "loss"; or 3. executed after the "accident" or "loss" if: a. the terms and conditions of the written contract or written agreement had been agreed upon prior to the "accident" or "loss"; and b. you can definitively establish that the terms and conditions of the written contract or written agreement ultimately executed are the same as those which had been agreed upon prior to the "accident" or "loss". 21. Coverage Territory - Short Term Hired Commercial "Autos" Paragraph 7. Policy Period, Coverage Territory under Paragraph B. General Conditions in SECTION IV — BUSINESS AUTO CONDITIONS is amended by the addition of the following: The coverage territory is extended to anywhere in the world if: 1. A covered "auto" of the commercial van, pick-up, or truck type is leased, hired, rented or borrowed for a period of 30 days or less; and 2. The "insured's" responsibility to pay damages is determined in a "suit" on the merits, in the United States of America, the territories and possessions of the United States of America, Puerto Rico, or Canada or in a settlement we agree to. We will also cover "loss" to, or "accidents" involving, a covered "auto" while being transported between any of these places. FM 114.0.1378 10 13 Page 8 of 10 Includes copyrighted material of Insurance Service Office, Inc. with its permission. ADVANCED AMERICAN CONSTRUCTION, INC., et al Bumbershoot (Excess) Liability Policy No. PDB-53579 Effective: October 1, 2023, 12:01 am, PST Additional Assured/Waivers of Subrogation It is agreed that the Company waives its right of subrogation against any person or organizations to whom the Named Assured is obligated by written contract to provide such waiver, but only to the extent of such obligation and only with respect to operations by or on behalf of the Named Assured or to the facilities of or used by the Named Assured. It is further agreed that to the extent that the Named Assured is obligated by written contract to name any person or organization as additional assureds hereunder, the Company agrees that such persons or organizations shall be considered as Additional Assureds but only with respect to operations performed by or on behalf of the Named Assured or to the facilities of or used by the Named Assured. ADVANCED AMERICAN CONSTRUCTION, INC., et al Bumbershoot (Excess) Liability Policy No. PDB-53579 Effective: October 1, 2023, 12:01 am, PST Primary and Non -Contributory Insurance Endorsement It is understood and agreed that, when required by the underlying agreement, this policy shall be the principal coverage as respects the liabilities of the Named Assured and any other insurance carried by an Additional Assured shall not be contributory as respects the liabilities of the Named Assured, nor shall the Additional Assured be responsible for any premium hereunder. " 11 0 0 RR .11, 1 111 PIC-EVCP-001 (07/22) We will pay on befialf of the Insured4or: loss or remediation expense in excess of the self. Insuredratention-that the Insured becomes. . legally obligated to pay as a result of contamination on, at, under or migrating. beyond the legal boundaries of your insured location, provided that: I., Such contamination first.commencesdudrig1he policy period; 2., Such, contamination ceases fully wWh. ten (10 days of its commencement; and 3. The T I he . loss or remediationexpense is the result of: (1) a claim for bodily injury, property damage or environmental damage that is first made against the insured and reported to us during the policy period,.or as expressly provided for in the extended reporting period, if applicable; or (ii) contamination that caused the insured to. incur emergency expense during the policy period. E. image Restoration Coverage We will reimburse you for image restoration expenses incurred because of contamination or an actual or alleged negligent act, error or omission in the performance of your professional services reported to us during the policy period or as expressly provided for I In the extended reporting pe&*'If applicable, and that results in bodily injury, property damage,: or environmental damage covered under Insuring Agreements I.A.,B.,C..orD,,,asapplicable. Reimbursement is limited. to the. costs of restoring your reputation and consumer confidence through image consulting,. is :Subject to the self - Insured retention for the applicable coverage part, and will in no event exceed the amount shown in ITEM 5.—E. in the Declarations. DEFINITIONS A. :Additional insured means any individual, organization or entity to the extent that they are contractually liable for loss or remediation expense to which this insurance applies as. a result of your, contracting operations, completedoperations, or transportation performed by or on behalf of the named insured or arising out of the named insured's ownership, use maintenance or operation of.your insured location, provided: I. Such individual, .organizationorenfityis,sch.edu.led to - this policy as an additional insured by an endorsement; or, 2. Solelywi I th regard to Coverage. B. — Contracting Operations Environmental . Liab.i 11111y,such individual, organization, or entity is required. to be an additional insured under this policy. ina written contract, or agreement for your contracting operations or ...completed operations, provided that such contract or agreement was fully executed .prior to the date that your contracting operations first commenced. Any coverage afforded such additional 'Insured under this policy is available up to and not exceeding any specified hilts of lnsuranceas.: required by the written contract with .you or subject to the applicable Coverage B.Contracting Operations Environmental Uability Coverage Limit of: Insurance., whichever Is less. The additional insured Is not provid, ed any coverage under this policy for any portion of �it6 own neI gligence or I eg0l. llaNljty, 4 B. Boday-1101 mea S 1. Physical injury; sickness..O disease including associated medical or environmental monitoring; and Page 3 of 28