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HomeMy WebLinkAboutA8564 - STANTEC CONSULTING SERVICES , IncCITY MANAGER 2022 CERTIFICATE OF LIABILITY DATE (MWDDNYYY) 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(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WANED, 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 endomemengs). PRODUCER Lockton Companies NCAOMWE ACT 444 W. 47th Street, Suite 900 PHONE Kansas City MO 64112-1906 E-MAIL (816)960-9000 ADDRESS kctsu@lockton.com INSURERIS1 AFFORDING COVERAGE NAIC0 I=O STANTEC CONSULTING 4100 SERVICES INC. 3701NTERLOCKEN BLVD, SUITE 200 BROOMFIELD CO 80021-8009 COVERAGES CERTIFICATF NIIMRFR- 1RR44RA7 REVISION MIIMRER• XXXXXXX 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 L THE TERMS, EXCLUSIONS AND CO� DITIONS OF SUCH POLICIES. LIMITS SHOA ED BY PAID CLAIMS INSR LTR TYPE OF INSURANCE DOLW INSD UB VD POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMm LIMITS COMMERCIAL GENERAL LIABILITY CIAIMSMADE❑OCCUR NOTAPPLICABL EACH OCCURRENCE f XXXXXXX MED UP (Any one Icon a xxx)(M f XXXXXXX PERSONAL&AM INJURY a XXX)V= GENL AGGREGATE LIMIT APPLIES PER: POLY❑PRO- ❑LOC JEC OTHER: GENERAL AGGREGATE s )= PRODUCTS -COMPIOPAGG a XXXXXXX s AUTOMOBILE LIABILITY ANY AUTO OWNED F ASCU SCHOSEDULED AUTOS ONLY HIRED I I NONONMED AUTOS ONLY AUTOS ONLY NOT APPLICABLE EOMBBIINEDISINGLE LIMIT a XXXXXXX BODILY INJURY(Per person) a XXXXXXX BODILY INJURY (Per ecddent) aXXXXx)OC ROPERTY AMAGE Per ace M a�()()()()()(X f UMBRELLA LIAB EXCESS LIAR WILUR ADE NOT APPLICABLE EACH OCCURRENCE f XXXXXXX AGGREGATE f XXXXXXX DIED I I RETENTION$ a WORKERS COMPENSATION AND EMPLOYERS' UASILJTY YIN ANY PeOPFiErOR/PARTNERIEXECUf1VE CTFICEWMEMBER"CLUUFD1 ❑ Daft ryMNNl nyw avealx weer DEBCRIPrgNd OPERATbN$Cebv NIA NOT APPLICABLE STERT ALME ER EL EACH ACCIDENT a XXXXXXX E.L. DISEASE - EA EMPLOYEE s xxxxxxx EL DISEASE - POLICY LIMIT s XXXXXXX A A B Professional Liab I Contractors Pollution Liab N N 47-EPP-30 B10 NO RETROACTIVE DATE I CP08DB5428 10/01/202 10/012021 10/01/202 10/01/202 $3,000,000 PER CLAIM/AGG INCLUSIVE OF COSTS S3,D00,DDO PER LOSS/AGG DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Addifiaml Remar Schedule, may he aeaehed B more spec is required) RE: ON -CALL WASTEWATER ENGINEERING SERVICES. 16844847 CITY OF PALM SPRINGS ATTN: CITY MANAGER 3200 E. TAHQUITZ CANYON WAY PALM SPRINGS CA 92262 SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTNORI ED REPRESENTATIVE -44% 07 lw— � 1988-2015 The ACORD name and logo are registered marks of ACORD All rights 1INN� o ACoItO® CERTIFICATE OF LIABILITY INSURANCE 5A 2D24 4/2t 2/ 02DATE p3 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 endorsements . PRODUCER Lockton Companies CONTACT PHONE FAX AC No: 444 W. 47th Street, Suite 900 Kansas City MO 64112-1906 (816)960-9000 E-MAIL ADDRESS: kcasu@lockton.com INSURE S AFFORDING COVERAGE NAICi INSURER A: Travelers Property Casualty Company of America 25674 INSURED STANTEC CONSULTING 1415077 SERVICES INC. INSURER a: Berkshire Hathaway Specialty Insurance Company 22276 INSURER c: INSURER o : 410 17TH STREET SUITE 1400 DENVER CO 80202-4427 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 16844940 REVISION NUMBER: XXXXXXX 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. M R TYPE OP INSURANCE AD0. POLICY NUMBER NPO� EYPY POLICY EXP.wa LIMITS B X COMMERCIALGENERALLIABWTY CWMS#IADE OCCUR Y N 47 - GLO-307584 n 51:2023 '� T 5'I:-024 EACH OCCURRENCE S 2,000,000 DAMAGE TO HEWED PREMISES aacwnance s 12000,000 X MED EXP IAryone ) s 25,000 CONTRACTUAL/CROSS X XCU COVERED PERSONAL a ADV INJURY s 2,000,000 GENL AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE s 4,000,000 POLICY ❑X JECT F—X1 LOC PRODUCTS - COMP/OP AGG S 2 00O 000 S OTHER. A A MITOMOBILELIABILIry ANY AUTO Y N TC23-CAPEO8692019(AOS) Tl-BAP-8E086820 5/1/2023 51/2023 5,'1;2024 5'12024 COMBINEDIN LELIMI Eaamdenl $ I000000 X BODILY INJURY (PerPerson) S XM)(YM OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (M ecddeni) S XXXX)XX PROPERTY DAMAGE Per acciden S XXXXXXX HIRED NON -OWNED AUTOS ONLY HAUTOS ONLY sXXXXXXX B X UMBRELLAUAB X OCCUR N N 47 - UMO-307585 5/1/2023 511.2024 EACH OCCURRENCE s 5000000 AGGREGATE S 501XI000 EXCESS LUMB CLAIMS -MADE DELI I I RETENTIONS S XXXX XX A A A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/E%ECUTiVE YIN OFFICERVEMBER EXCWDED'� (Man"wry In NH) NIA Y UB-3P635310 (ADS) LS 3P533004 (MA, WI) EXCEPT FOR H ND WA WY $/1/2023 5/1/2023 5/1/2024 5/1/2024 PER OTH- X STATUTE ER EL EACH ACCIDENT S I000000 E.L. DISEASE - EA EMPLOYE S 1000000 Ii Yes desaiee wder DESCRIPTION OF OPERATIONS twb E L DISEASE - POLICY LIMIT S 1000 000 DESCRIPTION aF OPERATIONS I LOCATIONS / VEHCLES (ACORD IM, AddiWo i Remarks SclmdOe, may W aMeN Wm span 4 raRuirad) RE: ON -CALL WASTEWATER ENGINEERING SERVICES. THE CITY OF PALM SPIRNGS, IT OFFICIALS, EMPLOYEES AND AGENTS ARE ADDITIONAL INSUREDS AS RESPECTS GENERAL LIABILITY AND AUTO LIABILITY. AND THESE COVERAGES ARE PRIMARY AND NON-CONTRIBUTORY, AS RFQCIREDBYWRITTENCONTRACT. WAIVER OF SUBROGATION APPLIES TO 6.ORKERS COMPENSATION/EMPLOYER'S LIABILITY CERTIFICATE HOLDER RpirmurRn CANCELLATION See Attachments J n O 20�� SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 16844840 VIV CITY OF PALM SPRINGS ACCORDANCE WITH THE POLICY PROVISIONS, ATTN: CITY MANAGER City Hall AUTHORIZED REPRESENTATV 3200 E. TAHQUITZ CANYON WAY Reception Desk PALM SPRINGS CA 92262 © 1988 015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 0q'862 , 05-41741) 0504 Attachment Code: D522032 Certificate ID: 16844840 POLICY NUMBER: 47 - GLO-307584 COMMERCIAL GENERAL LIABILITY CG 20 10 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Locations Of Covered Operations ALL LOCATIONS COVERED UNDER THIS POLICY, FOR ANY SUCH PERSON OR ORGANIZATION BUT ONLY TO LIABILITIES ARISING OUT OF OUR NAMED INSURED'S ;HE EXTENT REQUIRED BY A WRITTEN CONTRACT ACTIVITIES ONLY. EXECUTED PRIOR TO THE "OCCURANCE" FOR OFFENSE. 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 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. 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: 2. 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. 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 insureds) at the location of the covered operations has been completed; or 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. CG 20 10 0413 0 Insurance Services Office, Inc., 2012 Page 1 of 2 Attachment Code: D522032 Certificate ID: 16844840 C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 10 04 13 © Insurance Services Office, Inc., 2012 PAGE 2of2 Attachment Code: D522054 Certificate ID: 16844840 POLICY NUMBER: 47 - GLO-307584 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 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 LOCATION OR PROJECT WHERE YOU ARE ANY SUCH PERSON OR ORGANIZATION REQUIRED TO PROVIDE ADDITIONAL INSURED BUT ONLY TO THE EXTENT REQUIRED BY STATUS IN A WRITTEN CONTRACT OR WRITTEN A WRITTEN CONTRACT EXECUTED AGREEMENT, EXCEPT WHERE SUCH CONTRACTOR PRIOR TO THE "OCCURANCE" FOR AGREEMENT IS PROHIBITED BY LAW OFFENSE. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section 11 — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for 'bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the 'products -completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 37 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 Wolters Kluwer Financial services I Unifonn FormsTM Attachment Code: D522092 Certificate ID: 16844840 ENDORSEMENT This endorsement, effective 12:01 AM: 5/1/2023 Forms a part of Policy No.: 47 - GLO-307584 Issued to: SEE ATTACHED CERTIFICATE By: Berkshire Hathaway Insurance Company PRIMARY NONCONTRIBUTORY - OTHER INSURANCE PROVISION THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY POLICY COMMERCIAL UMBRELLA LIABILITY POLICY COMMERCIAL RETAINED LIMIT LIABILITY POLICY FOLLOW FORM EXCESS LIABILITY POLICY PRODUCTS/COMPLETED OPERATIONS LIABILITY POLICY The following Condition is added to the policy: Primary Noncontributory— Other Insurance The insurance provided by this policy is primary, and will not seek contribution from any insurance available to an additional insured under this policy, provided that: (a) The additional insured is a named insured under such other insurance; and (a) Prior to an "occurrence' you agreed, in a fully executed written contract or agreement, that this insurance would be primary and would not seek contribution from any insurance available to that additional insured. All other terms and conditions of this policy remain unchanged. Page 11 CLP-UN-065-10/2013 Includes copyrighted material of Insurance Services Office, Inc., with its permission. POLICY #: TC2J - CAP - 8EO86819 (ADS), TJ-BAP-8E086820 Attachment Code: D522094 Certificate ID: 16844840 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY WITH OTHER INSURANCE This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM PROVISIONS 1 The following is added to Paragraph A.1.c., Who Is An Insured, of SECTION II - COVERED AUTOS LIABILITY COVERAGE: This includes any person or organization who you are required under a written contract or agreement between you and that person or organization, that is signed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to name as an additional insured for Covered Autos Liability Coverage, but only for damages to which this insurance applies and only to the extent of that person's or organization's liability for the conduct of another "insured". 2. The following is added to Paragraph B.5., Other Insurance of SECTION IV - BUSINESS AUTO CONDITIONS: Regardless of the provisions of paragraph a. and paragraph d. of this part 5. Other Insurance, this insurance is primary to and non-contributory with applicable other insurance under which an additional insured person or organization is the first named insured when the written contract or agreement between you and that person or organization, that is signed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, requires this CA T4 74 02 16 ® 2016 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Attachment Code: D522252 Certificate ID: 16844840 Notification to Others of Cancellation Policy No. Ef .. Date of Pot. Exp. Date of Pol. Eff. Date of Fnd_ Producer No. Add'1. Pre. Itaum I'mm_ 47-GLO-3075M 5/1/2023 5/1/2024 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part Liquor Liability Coverage Part Products/Completed Operations Liability Coverage Part A. If we cancel this Coverage Part(s) by written notice to the first Named Insured for any reason other than nonpayment of premium, we will mail or deliver a copy of such written notice of cancellation: 1. To the name and address corresponding to each person or organization shown in the Schedule below; and 2. At least 10 days prior to the effective date of the cancellation, as advised in our notice to the first Named Insured, or the longer number of days notice if indicated in the Schedule below. B. If we cancel this Coverage Part(s) by written notice to the first Named Insured for nonpayment of premium, we will mail or deliver a copy of such written notice of cancellation to the name and address corresponding to each person or organization shown in the Schedule below at least 10 days prior to the effective date of such cancellation. C. If notice as described in Paragraphs A. or B. of this endorsement is mailed, proof of mailing will be sufficient proof of such notice. SCHEDULE Name and Address of Other Person(s) / Organization(s): Number of Days Notice: Those persons and organizati;ns as stated in a certificate of 30 Insurance, on file with the insurer, as of the date of Cancellation. All other terms and conditions of this policy remain unchanged. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Attachment Code: D522107 Certificate ID: 16844840 POLICY NUMBER: TC2J - CAP - 8EO86819 (AOS), TJ - BAP - 8EO86820 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED PERSON OR ORGANIZATION - NOTICE OF CANCELLATION OR NONRENEWAL PROVIDED BY US This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS INCLUDED IN THIS POLICY SCHEDULE CANCELLATION: Number of Days Notice: 30 WHEN WE DO NOT RENEW (Nonrenewal): PERSON OR ORGANIZATION: Number of Days Notice: 30 ANY PERSON OR ORGANIZATION TO WHOM YOU HAVE AGREED IN A WRITTEN CONTRACT THAT NOTICE OF CANCELLATION OR NONRENEWAL OF THIS POLICY WILL BE GIVEN, BUT ONLY IF: 1. YOU SEE TO IT THAT WE RECEIVE A WRITTEN REQUEST TO PROVIDE SUCH NOTICE, INCLUDING THE NAME AND ADDRESS OF SUCH PERSON OR ORGANIZATION, AFTER THE FIRST NAMED INSURED RECEIVES NOTICE FROM US OF THE CANCELLATION OF THIS POLICY; AND 2. WE RECEIVE SUCH WRITTEN REQUEST AT LEAST 14 DAYS BEFORE THE BEGINNING OF THE APPLICABLE NUMBER OF DAYS SHOWN IN THIS ENDORSEMENT. ADDRESS: THE ADDRESS FOR THAT PERSON OR ORGANIZATION INCLUDED IN SUCH WRITTEN REQUEST FROM YOU TO US. PROVISIONS A. If we cancel this policy for any legally permitted reason other than nonpayment of premium, and a number of days is shown for Cancellation in the Schedule above, we will mail notice of cancellation to the person or organization shown in such Schedule. We will mail such notice to the address shown in the Schedule above at least the number of days shown for Cancellation in such Schedule before the effective date of cancellation. B. If we do not renew this policy for any legally permitted reason other than nonpayment of premium, and a number of days is shown for When We Do Not Renew (Nonrenewal) in the Schedule above, we will mail notice of nonrenewal to the person or organization shown in such Schedule. We will mail such notice to the address shown in the Schedule above at least the number of days shown for When We Do Not Renew (Nonrenewal) in such Schedule before the effective date of nonrenewal. IL T4 00 05 19 0 2019 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 Attachment Code: D522110 Certificate ID: 16844840 WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 06 R3 (00) POLICY NUMBER: UB - 3P635310 (AOS), UB - 3P533004 (MA, WI) NOTICE OF CANCELLATION TO DESIGNATED PERSONS OR ORGANIZATIONS The following is added to PART SIX - CONDITIONS: Notice of Cancellation To Designated Persons Or Organizations If we cancel this policy for any reason other than non-payment of premium by you, we will provide notice of such cancellation to each person or organization designated in the Schedule below. We will mail or deliver such notice to each person or organization at its listed address at least the number of days shown for that person or organization before the cancellation is to take effect. You are responsible for providing us with the information necessary to accurately complete the Schedule below. If we cannot mail or deliver a notice of cancellation to a designated person or organization because the name or address of such designated person or organization provided to us is not accurate or complete, we have no responsibility to mail, delivery or otherwise notify such designated person or organization of the cancellation. SCHEDULE Name and Address of Designated Persons or Organizations Name: Any person or organization with whom you have agreed in a written contract that notice of cancellation of this policy will be given, but only if: 1. You see to it that we receive a written request to provide such notice, including the name and address of such person or organization, after the first Named Insured receives notice from us of the cancellation of this policy; and 2. We receive such written request at least 14 days before the beginning of the applicable number of days shown in this endorsement. Address: The address for that person or organization included in such written request from you to us. Number of Days Notice: 30 ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. Attachment Code: D524752 Certificate ID: t6844840 WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 00 03 13 (00) POLICY NUMBER: UB - 3P635310 (AOS); UB - 3P533004 (MA, WI) 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 for which the insured has agreed by written contract executed prior to loss to furnish this waiver. WHERE REQUIRED BY WRITTEN CONTRACT ACOR Da �, CERTIFICATE OF LIABILITY INSURANCE 5/1/2025 DATE (MM/DDNYYY) 04/25/2024 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 Lockton Companies 444 W. 47th Street, Suite 900 Kansas City MO 64112-1906 (816)960-9000 kcasu@lockton.com CNINTACTO PHOA/CNN FA E-MAIL RESS INSURERS AFFORDING COVERAGE NAIC # INSURER A : Travelers Property Casualty Company of America 25674 INSURED STANTEC CONSULTING SERVICES INC. INSURER B: Berkshire Hathaway Specialty Insurance Company 22276 INSURERC: 502423410 17TH STREET, SUITE 1400 INSURER D : DENVER CO 80202-4427 INSURER E : INSURER F : rnvcDAraoc rFDTI=irATG WI IMRFD• 13wtn22f17Q RFVISION NHMRFR: XXXXXXX 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 ADDLSUBR INSD WVD POLICY NUMBER POLICY EFF MM/DDNYYY POLICY EXP MM/DDNYYY LIMITS B X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR CONTRACTUAL/CROSS N N 47 - GLO-307584 05/01 /202 05/01/2025 EACH OCCURRENCE $ 2 000 000 DAMAGE TO RENTE PREMISES (Ea occurLrence) $ 1,000,000 X MED EXP (Any oneperson) $ 25,000 X GEN1 XCU COVERED PERSONAL & ADV INJURY $ 2 000 000 AGGREGATE LIMIT APPLIES PER: POLICY JECT PRO-- LOC OTHER: GENERAL AGGREGATE $ 4,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ A A AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY N N TC2J - CAP - 8EO86819 (AOS TJ - BAP - 8EO86820 05/01/202 05/01 /202 05/01/202 05101/2025 CMINED Ee accident SINGLE LIMIT $ 000,000 BODILY INJURY (Per person) $ XXXXXXX BODILY INJURY (Per accident) $ XXXXXXX PROPERTY DAMAGE Per accident $XXXXXXX $XXXXXXX B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE N N 47 - UMO-307585 05/01/202 05/01/2025 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DED I I RETENTION $ $XXXXXXX A A A WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN ANY PROPRIETOR/ PARTNER/EXECUTIVE inOFFICER/MENH) EXCLUDED? (Mandatory (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA N UB-3P635310 (AOS) UB - 3P533004 (MA, WI) EXCEPT FOR OH ND WA WY 05/01/202 05/01/202 05/01/202 05/01/202 X E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 � 000 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) . -- --� - -. I � - - - --.� _ _ � _ _ -- _ __