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HomeMy WebLinkAboutTERRACON CONSULTANTS, INC. (2)-AGE ON FILE I IZY PROCEED MAYOR .tali- INSURANCE E) Vicente Sarmiento MAYOR PRO TEM David Penaloza L cA OF COUNCIL COUNCILMEMBERS •rl c' Phil Bacena Johnathan Ryan Hernandez Jessie Lopez Nelida Mendoza Thai Viet Phan A-2018-192-01 CITY MANAGER `:y Kristine Ridge CITY ATTORNEY ' Sonia R. Carvalho .' ICE'► CLERK OF THE COUNCIL Daisy Gomez CITY OF CANTA ANA D:?WR (S)(OlinlyNquVnjuvytji SEP 0 2 2021 August 18, 2021 Terracon Consultants, Inc. 1421 Edinger Ave., Ste. C Tustin, CA 92780 PUBLIC WORKS AGENCY 20 Civic Center Plaza, M-36 • P.O. Box 1988 Santa Ana, California 92702 www.santa-ana.org Re: Extension of Consultant Agreement No. A-2018-192 To Terracon Consultants, Inc., Pursuant to Section 4.a. ("Performance Period") of Agreement No. A-2018-192, entered into by Terracon Consultants, Inc. ("Consultant") and the City of Santa Ana, dated August 21, 2018, the time period of said Agreement is hereby extended for an additional one (1) year period from August 21, 2021 to August 20, 2022. The insurance certificates are required to be extended and/or renewed to cover this time extension. All other terns and conditions of said Agreement remain unchanged and in full force and effect. Sincerely, j �I a h h Nabil Saba, PE Executive Director, Public Works Agency CITY OF SANTA ANA Kristine Ridge' City Manager TCON CONSULTANTS, INC. By: Islam (Sami) R. Noaman Title: Environmental Department Manager II Daisy Gomez Clerk of the Council APPRO—W-q AS TO FORM Bianndon Salvatierra Deputy City Attorney SANTA ANA CITY COUNCIL Vicente Sarmienlo David Penaloza Thai Viet Phan Jessie Lopez Phil Bacerra Johnalhan Ryan Hernandez Yr Nelida Mendoza Mayor Mayor Pm Test, Ward 2 Ward I Ward 3 Ward 4 Ward 5 Ward 6 vsanmenlo(dsanla-ana or o doenaloza(alsanta-ana om IQanpRisanta-ana ors es el (d I - obaceno(asanla-ana om irvanhemendezai8Une-an nmendoza0sa ila- Francine R. Villareal Villareal i l ® AC0/120 CERTIFICATE OF LIABILITY INSURANCE I/l/2022 uar:zon.os.ta te:n. -molt DATE(MMIDDNYYY) 12/21/2020 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 INSURERS), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the poiicy(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 CONTACT PHONE FAX No: E-MAIL ADDRESS, INSURI AFFORDING COVERAGE NAIC # INSURER A: Lexington Insurance Conipmy 19437 INSURED TERRACON CONSULTANTS, INC. 1312893 INSURER B : Travelers Property Casualty Co of America 25674 INSURER C: The Travelers Indemnity Company 25658 1421 EDINGERAVE., STE C TUSTIN CA 92780 INSURER D : NSURERE: NSURERF: COVERAGES TERCO01 CERTIFICATE NUMBER: 15603400 REVISION NUMBER: XXX){XX,y 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 ADDL SUBR POLICY NUMBER POLICY EFF MM/DDIYYYY POLICY EXP MM/DD/YYYY LIMBS H X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR Y N TC2J-GLSA-1118L293 1/1/2021 1/1/2022 EACH OCCURRENCE $ 2,000,000 DAMAGE TO Ea oRENTED— PREMISES unence $ 1,000,000 X MED EXP (Any one person) $ 25,000 CONTRACTUAL LIAR X XCU COVERAGE PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY [X] jE T [� LOG GENERALAGGREGATE $ 4000000 PRODUCTS-COMP/OPAGG $ 4,000,000 $ OTHER: E AUTOMOBILE LIABILITY Y N TC2J-CAP-131J3858. 1/1/2021 1/1/2022 COeBc dEDISINGLE LIMIT $ 2 000 000 X BODILY INJURY (Per person) $ )CyXXXX)c ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS N BODILY INJURY (Peraccidenl) $ XXXXXXX HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ XX 'i�Xxxx $ )0Ck)= UMBRELLA LIAB OCCUR NOTAPPLICABLE EACHOCCURRENCE $ )000XXxx AGGREGATE $ XX)x_�' EXCESS LIAB CLAIMS -MADE DED RETENTION$ $ xa)_XX E C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN OFFICEWMEMBER EXCLUDED? NIA N TC2J-UE-6N32541-0(ADS)) TRK-UB-6N32384-6(AZ,MA,WI 1/l/2021 I/l/2021 1/l/2022 1/1/2022 PER OTH- X STATUTE ER E.L. EACH ACCIDENT $ 1000000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory In NH) If yes, describe under E.L. DISEASE -POLICY LIMIT $ 1000000 DESCRIPTION OF OPERATIONS below A PROFESSIONAL LIABILITY N N 26010216 1/1/2021 I/1/2022 $1,000,000 EACH CLAIM & $1,000,000 ANNUAL AGGREGATE DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) RE: PROJECT # P60187197; PROJECT NAME: CITY OF SANTA ANA: HAZARDOUS MATERIALS SURVEYS AND REPORTS. CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS, AND REPRESENTATIVE ARE ADDITIONAL INSUREDS AS RESPECTS GENERAL LIABILITY, AUTO LIABILITY AND UMBRELLA/EXCESS LIABILITY, THESE COVERAGES ARE PRIMARY AND NON-CONTRIBUTORY AS REQUIRED BY WRITTEN CONTRACT. 15603400 CITY OF SANTA ANA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE RISK MANAGEMENT DIVISION THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 CIVIC CENTER PLAZA, 4TLI FLOOR ACCORDANCE WITH THE POLICY PROVISIONS. SANTA ANA CA 92701 AUTHORIZED REPRESENTA / / /y7 RiskMtllYgenuotfDisbem 1�1-! a. REVIEWED&APPROVEDBY: ©1988 615 ACORD C ) F'A . R. v:P&,Zd ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD RSk Management Analyst POLICY NUMBER: TC2J-GLSA-1118L293 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - AUTOMATIC STATUS IF REQUIRED BY WRITTEN CONTRACT (CONTRACTORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The following is added to SECTION 11- WHO IS AN INSURED: Any person or organization that: a. You agree in a "written contract requiring insurance" to include as an additional insured on this Coverage Part; and b. Has not been added as an additional insured for the same project by attachment of an endorsement under this Coverage Part which includes such person or organization in the endorsement's schedule; is an insured, but: a. Only with respect to liability for "bodily injury", "property damage" or "personal injury"; and b. Only as described in Paragraph (1), (2) or (3) below, whichever applies: (1) If the "Written contract requiring insurance" specifically requires you to provide additional insured coverage to that person or organization by the use of: (a) The Additional Insured - Owners, Lessees or Contractors - (Form B) endorsement CG 20 10 11 85; or (b) Either or both of the following: the Additional Insured - Owners, Lessees or Contractors - Scheduled Person Or Organization endorsement CG 20 10 10 01, or the Additional Insured - Owners, Lessees or Contractors - Completed Operations endorsement CG 20 37 10 01; the person or organization is an additional insured only if the injury or damage arises out of "your work" to which the "written contract requiring insurance" applies; (2) If the "written contract requiring insurance" specifically requires you to provide additional insured coverage to that person or organization by the use of: (a) The Additional Insured - Owners, Lessees or Contractors - Scheduled Person or Organization endorsement CG 20 10 07 04 or CG 20 10 04 13, the Additional Insured - Owners, Lessees or Contractors - Completed Operations endorsement CG 20 37 07 04 or CG 20 37 04 13, or both of such endorsements with either of those edition dates; or (b) Either or both of the following: the Additional Insured - Owners, Lessees or Contractors - Scheduled Person Or Organization endorsement CG 20 10, or the Additional Insured Owners, Lessees or Contractors - Completed Operations endorsement CG 20 37, without an edition date of such endorsement specified; the person or organization is an additional insured only if the injury or damage is caused, in whole or in part, by acts or omissions of you or your subcontractor in the performance Miscellaneous Attachment: M482524 s, WekMa wganortDbiefnn Certificate ID: 15603400 RenEuveo & Araeov®Br. F4"Ie� t:, W&44't V�� RBk Management Analyst of "your work" to which the "written contract requiring insurance" applies; or (3) If neither Paragraph (1) nor (2) above applies: (a) The person or organization is an additional insured only if, and to the extent that, the injury or damage is caused by acts or omissions of you or your subcontractor in the performance of "your work" to which the "written contract requiring insurance" applies; and (b) The person or organization does not qualify as an additional insured with respect to the independent acts or omissions of such person or organization. 2. The insurance provided to the additional insured by this endorsement is limited as follows: a. If the Limits of Insurance of this Coverage Part shown in the Declarations exceed the minimum limits of liability required by the "written contract requiring insurance", the insurance provided to the additional insured will be limited to such minimum required limits of liability. For the purposes of determining whether this limitation applies, the minimum limits of liability required by the "written contract requiring insurance" will be considered to include the minimum limits of liability of any Umbrella or Excess liability coverage required for the additional insured by that "written contract requiring insurance". This endorsement will not increase the limits of insurance described in Section III - Limits Of Insurance. b. The insurance provided to the additional insured does not apply to "bodily injury", "property damage" or "personal injury" arising out of the rendering of, 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 or change orders, or the preparing, approving, or failing to prepare or approve, drawings and specifications; and (2) Supervisory, inspection, architectural or engineering activities. c. The insurance provided to the additional insured does not apply to "bodily injury" or "property damage" caused by "your work" and included in the "products -completed operations hazard" unless the "written contract requiring insurance" specifically requires you to provide such coverage for that additional insured during the policy period. 3. The insurance provided to the additional insured by this endorsement is excess over any valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the additional insured. However, if the "written contract requiring insurance" specifically requires that this insurance apply on a primary basis or a primary and non-contributory basis, this insurance is primary to other insurance available to the additional insured under which that person or organization qualifies as a named insured, and we will not share with that other insurance. But the insurance provided to the additional insured by this endorsement still is excess over any valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the additional insured when that person or organization is an additional insured, or is any other insured that does not qualify as a named insured, under such other insurance. 4. As a condition of coverage provided to the additional insured by this endorsement: a. The additional insured must give us written notice as soon as practicable of an "occurrence" or an offense which may result in a claim. To the extent possible, such notice should include: (1) How, when and where the "occurrence" or offense took place; (2) The names and addresses of any injured persons and witnesses; and (3) The nature and location of any injury or damage arising out of the "occurrence" or Miscellaneous Attachment: M482524 Certificate fD: 15603400 w"ItttutoMsion RE%AEwLm 6 APPRav®8Y: 1 RBk Managenrent Analyst i offense. b. If a claim is made or "suit' is brought against the additional insured, the additional insured must: (1) Immediately record the specifics of the claim or "suit' and the date received; and (2) Notify us as soon as practicable. The additional insured must see to it that we receive written notice of the claim or "suit' as soon as practicable. c. The additional insured must immediately send us copies of all legal papers received in connection with the claim or "suit', cooperate with us in the investigation or settlement of the claim or defense against the "suit', and otherwise comply with all policy conditions. d. The additional insured must tender the defense and indemnity of any claim or "suit' to any provider of other insurance which would cover the additional insured for a loss we cover under this endorsement. However, this condition does not affect whether the insurance provided to the additional insured by this endorsement is primary to other insurance available to the additional insured which covers that person or organization as a named insured as described in Paragraph 3. above. 5. The following is added to the DEFINITIONS Section: "Written contract requiring insurance" means that part of any written contract or agreement under which you are required to include a person or organization as an additional insured on this Coverage Part, provided that the "bodily injury" and "property damage" occurs, and the "personal in -jury" is caused by an offense committed, during the policy period and: a. After the signing and execution of the contract or agreement by you; and b. While that part of the contract or agreement is in effect. CG D6 04 08 13 EwED tugemostD[D un BY.- Rtntwm 6 APPROVm SY: Rtsk Managernent Analyst Miscellaneous Attachment: M482524 Certificate fD: 15603400 Iviiscellaneous Attachment: M467648 Certificate ID: 15603400 POLICY NUMBER: TC2J-CAP-131J3858 COMMERCIAL AUTO ISSUE DATE: 01/01/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE - PRIMARY AND NON-CONTRIBUTORY WITH OTHER INSURANCE - CONTRACTORS This endorsement modifies insurance provided by the following: BUSINESS AUTO COVERAGE FORM SCHEDULE OF ADDITIONAL INSURED PERSONS OR ORGANIZATIONS WHERE REQUIRED BY WRITTEN CONTRACT. PROVISIONS 1. The following is added to Paragraph c. in A. 1., Who Is An Insured, of SECTION II- COVERED AUTOS LIABILITY COVERAGE: This includes any person or organization designated in the Schedule Of Additional Insured Persons Or Organizations who you are required under a written contract or agreement, 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 designated person's or organization's liability for the conduct of another "insured". 2. The following is added to Paragraph 5., Other Insurance, in B., General Conditions , 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 the person or organization designated in the Schedule of Additional Insured Persons Or Organizations is a named insured when a written contract or agreement with you, that is signed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, requires this insurance to be primary and non-contributory. CA T6 00 02 16 r....... RiskManagannit Division o® (rROE AEwm S APPROVED BYE: r�/.dYM•t �. V Risk Management Analyst Miscellaneous Attachment: M463695 Certificate ID: 15603400 POLICY NUMBER: TC2J-GLSA-1118L293 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED ENTITY - EARLIER NOTICE OF CANCELLATIONMONRENEWAL 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 NAME: ANY PERSON OR ORGANIZATION FOR WHOM YOU HAVE AGREED IN A WRITTEN CONTRACT THAT NOTICE OF CANCELLATION, NONRENEWAL OR MATERIAL REDUCTION IN COVERAGE 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, NONRENEWAL, OR MATERIAL LIMITATION 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 A. For any statutorily permitted reason other than nonpayment of premium, the number of days required for notice of cancellation, as provided in the CONDITIONS Section of this insurance, or as amended by any applicable state cancellation endorsement applicable to this insurance, is increased to the number of days shown in the SCHEDULE above. B. For any statutorily permitted reason other than nonpayment of premium, the number of days required for notice of When We Do Not Renew (Nonrenewal), as provided in the CONDITIONS Section of this insurance, or as amended by any applicable state When We Do Not Renew (Nonrenewal) endorsement applicable to this insurance, is increased to the number of days shown in the SCHEDULE above. C. We will mail notice of cancellation or nonrenewal or material limitation of those coverage forms to the person or organization shown in the schedule above. We will mail the notice with at least the Number of Days indication above before the effective date to our action. IL T3 54 03 98 Risk D'niaian je .,.� Mmagernenf x� [RREMEWED& pAPIPIR��M�/ED� B�YE/. F4.111.(A.h2 Imo. Va�UM41t AWI R6k Management Analyst Miscellaneous Attachment: M463694 Certificate ID: 15603400 POLICY NUMBER: TC2J-CAP-131J3858 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED ENTITY - NOTICE OF CANCELLATION PROVIDED BY US This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS INCLUDED IN THIS POLICY SCHEDULE CANCELLATION: Number of Days Notice of Cancellation: 30 NAME: ANY PERSON OR ORGANIZATION FOR 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 OR 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: If we cancel this policy for any statutorilly 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 the schedule above. We will mail such notice to the address shown in the schedule above at least the number of days shown for cancellation in the schedule above before the effective date of cancellation. IL T4 05 03 11 Risk Mougenmt Division REVIEWED& AP,PIRovim BY: of\L�1.111Y'-L' f AILi�lM1 M1. Vk(NWFC ®' Rlsk Management Analyst Miscellaneous Attachment: M463692 Certificate 11): 15603400 WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 06 R3 POLICY NUMBER: TC2J-UB-6N32541-0-20 (AOS) & TRK-UB-6N32384-6 (AZ, 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 in 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, deliver or otherwise notify such designated person or organization of the cancellation. SCHEDULE Name and Address of Designated Persons or Organizations: ANY PERSON OR ORGANIZATION FOR 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 OR MATERIAL LIMITATION 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. 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. RIAMuaganentDhisbn �J //d RR��EVIEwm&pDAPPROV®BY. r44*4, . VjLtud Risk Managemmnt Analyst Miscellaneous Attachment: M450465 Certificate ID: 15603400 This endorsement, effective 12:01 AM 01/01/2021 Forms a part of policy no.: 026030216 Issued to: TERRACON CONSULTANTS, INC. By: LEXINGTON INSURANCE COMPANY ADVICE OF CANCELLATION TO ENTITIES OTHER THAN THE NAMED INSURED ENDORSEMENT This endorsement modifies insurance provided by the policy: SCHEDULE Name of Certificate Holder(s) and Address: WHERE PURSUANT TO A CONTRACT OR WRITTEN AGREEMENT THE INSURED HAS AGREED TO PROVIDE SUCH ADVICE OF CANCELLATION A. If the Insurer cancels this policy, prior written notice of cancellation shall be given to the Certificate Holder(s) shown in the above Schedule (hereinafter, "Certificate Holder(s)") as follows: a ten (10) day prior written notice of cancellation shall be given for nonpayment of premium; 2, a thirty (30) day prior written notice of cancellation shall be given for any reason other than cancellation for non-payment of premium, 3. a thirty (30) day prior written notice of shall be given for non -renewal of this policy. B. The Insurer shall provide thirty (30) days prior written notice of a material change during the policy period to the Certificate Holder(s). Other than the right to receive notice of cancellation or a notice of a material change as set forth herein, this endorsement confers no rights under this policy to the Certificate Holcier(s) including, but not limited to, additional insured status or additional Named Insured status. The following definitions apply to this endorsement: Insurer means the insurance company shown in the header on the Declarations Page of this policy. 2. Material change means the addition of an endorsement(s) to the policy after the policy inception date which: a. Reduces the Limits of insurance/Liability All other terms and conditions of the policy remain the same. LX0404 Au(in ItIAMot,gme,t0w� Countersignature (In .s'*� REVIEJVID &APPROVD)BY: al .. Rak M anagenrent Analyst