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HomeMy WebLinkAboutAtlas Technical Consultants, Inc. (2)ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? INSR ADDL SUBR LTR INSD WVD DATE (MM/DD/YYYY) PRODUCER CONTACT NAME: FAXPHONE (A/C, No):(A/C, No, Ext): E-MAIL ADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY)(MM/DD/YYYY) AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATION AND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE OCCUR $PREMISES (Ea occurrence) MED EXP (Any one person)$ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $ PRO-POLICY LOC PRODUCTS - COMP/OP AGG $JECT OTHER:$ COMBINED SINGLE LIMIT $(Ea accident) ANY AUTO BODILY INJURY (Per person)$ OWNED SCHEDULED BODILY INJURY (Per accident)$AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $AUTOS ONLY AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE $ CLAIMS-MADE AGGREGATE $ DED RETENTION $$ PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMIT $DESCRIPTION OF OPERATIONS below INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A (Mandatory in NH) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORDACORD 25 (2016/03) CERTIFICATE OF LIABILITY INSURANCE Lockton Insurance Brokers,LLC CA License #0F15767 777 S. Figueroa Street, 52nd fl. Los Angeles CA 90017 213-689-0065 Atlas Technical Consultants, Inc. 13215 Bee Cave Parkway Building B, Suite 230 Austin, TX 78738 ATSI23 Steadfast Insurance Company 26387 Zurich American Insurance Company 16535 X X X X,C,U Included X Contractual Liab 2,000,000 100,000 5,000 2,000,000 6,000,000 4,000,000 X X X 5,000,000 XXXXXXX XXXXXXX XXXXXXX XXXXXXX X X 10,000,000 10,000,000 XXXXXXX N X 1,000,000 1,000,000 1,000,000 Env Contr Poll Env Prof (E&O) Per Occur/Agg:$2,000,000/$6,000,000 Per Claim/Agg:$2,000,000/$6,000,000 B BAP 0217109 08 11/13/2023 11/13/2024 A GPL 0217085-08 11/13/2023 11/13/2024 A GPL 0217085 08 11/13/2023 11/13/2024 A GPL 0217085-08 11/13/2023 11/13/2024 A SXS 0217077-08 11/13/2023 11/13/2024 B WC0217111-08 11/13/2023 11/13/2024 11/13/2024 1530409 Y Y Y Y Y Y Y 10/27/2023 N N 19958473 19958473 XXXXXXX For Information Purposes Only Certificate Holder(s) are Additional Insured(s) as per the attached endorsement or policy language. Insurance provided to Additional Insured(s) is primary and non-contributory as per the attached endorsements or policy language. Waiver of subrogation applies as per the attached endorsements or policy language, where allowed by law. Notice of Cancellation applies as per attached endorsement or policy language. X X X Policy Aggregate $6M See Attachments The Excess Liability policy is excess of the underlying General Liability, Automobile Liability, Employers' Liability, Professional Liability, and Contractor's Pollution Liability. Excess Liability policy is following form of the underlying policies. The General Liability, Contractor's Pollution Liability and Professional Liability are part of a package policy. The Aggregate reflected for these coverages is a combined aggregate and not separate aggregates for each coverage. The General Liability policy includes blanket additional insured and Waiver of Subrogation endorsements that provide additional insured status to the certificate holder and Waiver of Subrogation only when there is a written contract between the named insured and the Certificate Holder that requires it, as permitted by law. The General Liability policy contains a special endorsement with “Primary and Noncontributory” wording. The Business Auto policy includes blanket additional insured and Waiver of Subrogation endorsements that provide additional insured status to the certificate holder and Waiver of Subrogation only when there is a written contract between the named insured and the Certificate Holder that requires it, as permitted by law. The Business Auto policy contains a special endorsement with “Primary and Noncontributory” wording. Contractor's Pollution Liability policy includes blanket additional insured and Waiver of Subrogation endorsements that provide additional insured status to the certificate holder and Waiver of Subrogation only when there is a written contract between the named insured and the Certificate Holder that requires it, as permitted by law. The Contractor's Pollution Liability policy contains a special endorsement with “Primary and Noncontributory” wording. The Workers Compensation policy includes a blanket automatic waiver of subrogation endorsement that provides this feature only when there is a written contract between the named insured and the certificate holder that requires it, as permitted by law. Stop Gap coverage included. ND, OH, WA, WY. Attachment Code: D631186 Master ID: 1530409, Certificate ID: 19958473 a Additional Insured-Automatic-Owners, Lessees Or e ~ ZURICH Contractors Coverage Part One•Commercial General Liability Coverage Part Two-Contractor's Pollution Liability Policy No. GPL 0217085-08 11/13/2023 11/13/2024 11/13/2023 14317000 -- Eff. Date of Pol. Named Insured and Mailing Address:Producer: Exp Date of Pol.E ff Date of End.Producer Add? Prem.Return Ptem. ATLAS TECHNICAL CONSULTANTS, INC. 13215 BEE CAVE PKWY, BUILDING A, SUITE 250 AUSTIN, TX 78738. Lockton Insurance Brokers, LLC 777 S. Figueroa Street, 52nd fl. Los Angeles CA 90017 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provded under the following: Environmental Services Package Policy [X]COVERAGE PART ONE-COMMERCIAL GENERAL LIABILITY [X]COVERAGE PART TWO-CONTRACTOR'S POLLUTION LIABILITY tWho is an Insured (Section I.) in the COMMON COVERAGE PROVISIONS is amended to include as an additional insured any person(s) or organization(s) whom you are required to add as an additional insured on this pol icy under a written contract or written agreement. 2.The insurance provided to the additional insured person(s) or organ zation(s) applies only to: a. "Bodily injury", "property damage" or "personal and advertising injury" under COVERAGE PART ONE - COMMERCIAL GENERAL LIABILITY, COVERAGE A- BODILY INJURY AND PROPERTY DAMAGE LIABILITY and COVERAGE B -PERSONAL AND ADVERTISING INJURY LIABILITY caused, in whole or in part, by: (1) Your acts or omissions; or (2) The acts or omissions of those acting on your behalf; In the performance of: (a) Your ongoing operations performed for the additional insured, which is the subject of the written contract or written agreement; or (b) "Your work' completed as included in the "products-competed operations hazard", performed for the additional insured, which is the subject of the written contract or written agreement; and/or b "Claims" arising out of a "pollution event" under COVERAGE PART TWO - CONTRACTOR'S POLLUTION LIABILITY, caused, in whole or in part, by: (1) Your acts or omissions; or (2) The acts or omissions of those acting on your behalf, In the performance of: (a) "Covered operations" performed for the additional insured, which is the subject of the written contract or written agreement; or STF-E SP-101-F CW (04/13) Page 1 0f3 Attachment Code: D630735 Master ID: 1530409, Certificate ID: 19958473 (b) "Completed operations" of the "covered operations" performed for the additional insured, which is the subject of the written contract or written agreement. 3.However, regardless of the provisions of paragraphs 1. and 2. above, the insurance afforded to such additional insured: a.Only applies to the extent permitted by law: and b.Will not be broader than that which you are required by the written contract or written agreement to provide to such additional insured. 4. With respect to the insurance afforded to the additional insured under this endorsement, the following is added to Section III —Limits Of Insurance and Deductible: The most we will pay on behalf of the additional insured is the amount of insurance: a.Required by the written contract or written agreement you have entered into with the additional insured; or b.Available under the applicable Limits of Insurance shown in the Declarations, whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations 5.The insurance provided to the additional insured person or organization does not apply to: "Bodily injury', "property damage or "personal and advertising injury" arising out of the rendering or failure to render any professional architectural, engineering or surveying services including: (1) The preparing. approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys. field orders, change orders or drawings and specifications: and (2) Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any architectural. engineering or surveying services. 6. The additional insured must see to it that: a.We are notified as soon as practicable of an "occurrence", offense or "pollution event", as applicable, that may result in a claim: b.We receive written notice of a claim or "suit" as soon as practicable; and c.A request for defense and indemnity of the claim or "suit" will promptly be brought against any policy issued by another insurer under which the additional insured may be an insured in any capacity. This provision does not apply to insurance on which the additional insured is a Named Insured, if the written contract or written agreement requires that this coverage be primary and non-contributory. 7. For the coverage provided by this endorsement: a. The following paragraph is added to Paragraph 8.a. Other Insurance, Conditions (Section V.) in the COMMON COVERAGE PROVISIONS: Primary and Noncontributory Insurance This Insurance is primary to and will not seek contribution from any other insurance available to an additional insured under this endorsement provided that (1) The additional insured is a Named Insured under such other insurance: and (2) You have agreed in a written contract or written agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. b. The following paragraph is added to Paragraph 8.b. Other Insurance, Conditions (Section V.) in the COMMON COVERAGE PROVISIONS: This insurance is excess over: STF-E SP-101F CW (04/13) Page 2 of 3 Attachment Code: D630735 Master ID: 1530409, Certificate ID: 19958473 Any of the other insurance, whether primary, excess, contingent or on any other basis, available to an additional insured, in which the additional insured on our policy is also covered as an additional insured on another policy providing coverage for the same "occurrence", offense. claim or "suit". This provision does not apply to any policy in which the additional insured is a Named Insured on such other policy and where our policy is required by written contract or written agreement to provide coverage to the additional insured on a primary and noncontributory basis. 8. This endorsement does not apply to an additional insured which has been added to this policy by an endorsement shaving the additional insured in a Schedule of additional insureds. and which endorsement applies specifically to that identified additional insured. ALL OTHER TERMS AND CONDITIONS OF THE POLICY SHALL APPLY AND REMAIN UNCHANGED. STF-E SP-101-F CW (04113) Page 3 of 3 Attachment Code: D630735 Master ID: 1530409, Certificate ID: 19958473 Waiver of Transfer of Rights of Recovery Against Others – Blanket as Required by Contract Policy No.Eff. Date of Pol.Exp. Date of Pol.Eff. Date of End.Producer Add'l Prem.Return Prem. GPL 0217085-08 11/13/2023 11/13/2024 11/13/2023 14317000 Named Insured and Mailing Address:Producer: ATLAS TECHNICAL CONSULTANTS, INC. 13215 BEE CAVE PKWY, BUILDING A, SUITE 250 AUSTIN, TX 78738 Lockton Insurance Brokers, LLC 777 S. Figueroa Street, 52nd fl. Los Angeles CA 90017 ---------- ---------- [ ] COVERAGE PART ONE – COMMERCIAL GENERAL LIABILITY[ ] COVERAGE PART TWO – CONTRACTOR’S POLLUTION LIABILITY[ ] COVERAGE PART THREE – PROFESSIONAL LIABILITY ITHIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: X X X In consideration of the payment of premium and the Deductible by you and in reliance upon the statements in the Application made a part hereof, we agree with you, subject to all the terms, exclusions and conditions that with respect to the coverage parts indicated above Conditions (Section V.) of the COMMON COVERAGE PROVISIONS, Condition 14. Subrogation is amended by the addition of the following: We waive any right of recovery we may have against any person or organization whom you are required to waive your right of subrogation by a written contract or written agreement executed and effective prior to the performance of your services which is the subject of such written contract or written agreement. ALL OTHER TERMS AND CONDITIONS OF THE POLICY SHALL APPLY AND REMAIN UNCHANGED. STF-ESP-248-A CW (04/10) Page 1 of 1 Attachment Code: D630736 Master ID: 1530409, Certificate ID: 19958473 BAP 0217109 08 11/13/2023 11/13/2024 11/13/2023 14317000 Coverage Extension Endorsement – Liability Only Policy f No.Eff. Date of Pol.Exp. Date of Pol.Eff. Date of End.Producer No.Add’l. Prem Return Prem. ------------------ _ THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: Business Auto Coverage Form Motor Carrier Coverage Form A. Amended Who Is An Insured 1. The following is added to the Who Is An Insured Provision in Section II – Covered Autos Liability Coverage: The following are also "insureds": a. b.Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow for acts performed within the scope of employment by you. Any “employee” of yours is also an “insured” while operating an “auto” hired or rented under a contract or agreement in an “employee’s” name, with your permission, while performing duties related to the conduct of your business. c.Anyone volunteering services to you is an "insured" while using a covered "auto" you don’t own, hire or borrow to transport your clients or other persons in activities necessary to your business. d.Anyone else who furnishes an "auto" referenced in Paragraphs A.1.a. and A.1.b. in this endorsement. e.Where and to the extent permitted by law, any person(s) or organization(s) where required by written contract or written agreement with you executed prior to any "accident", including those person(s) or organization(s) directing your work pursuant to such written contract or written agreement with you, provided the "accident" arises out of operations governed by such contract or agreement and only up to the limits required in the written contract or written agreement, or the Limits of Insurance shown in the Declarations, whichever is less. 2. The following is added to the Other Insurance Condition in the Business Auto Coverage Form and the Other Insurance – Primary and Excess Insurance Provisions Condition in the Motor Carrier Coverage Form: Coverage for any person(s) or organization(s), where required by written contract or written agreement with you executed prior to any "accident", will apply on a primary and non-contributory basis and any insurance maintained the terms and conditions of the Coverage Form. B. Amendment – Supplementary Payments Paragraphs a.(2) and a.(4) of the Coverage Extensions Provision in Section II – Covered Autos Liability Coverage are replaced by the following: (2) Up to $5,000 for the cost of bail bonds (including bonds for related traffic law violations) required because of an "a3c cident" we cover. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a da" y because of time off from work. U-CA-428-A CW (02-14) Page 1 of 3 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Attachment Code: D630742 Master ID: 1530409, Certificate ID: 19958473 C. Fellow Employee Coverage The Fellow Employee Exclusion contained in Section II – Covered Autos Liability Coverage does not apply. D. Driver Safety Program Liability Coverage The following is added to the Racing Exclusion in Section II – Covered Autos Liability Coverage: This exclusion does not apply to covered "autos" participating in a driver safety program event, such as, but not limited to, auto or truck rodeos and other auto or truck agility demonstrations. E. Amended Duties In The Event Of Accident, Claim, Suit Or Loss Paragraph a. of the Duties In The Event Of Accident, Claim, Suit Or Loss Condition is replaced by the following: a.In the event of "accident", claim, "suit" or "loss", you must give us or our authorized representative prompt notice of the "accident", claim, "suit" or "loss". However, these duties only apply when the "accident", claim, "suit" or "loss" is known to you (if you are an individual), a partner (if you are a partnership), a member (if you are a limited liability company) or an executive officer or insurance manager (if you are a corporation). The failure of any agent, servant or employee of the "insured" to notify us of any "accident", claim, "suit" or "loss" shall not invalidate the insurance afforded by this policy. Include, as soon as practicable: (1) How, when and where the "accident" or "loss" occurred and if a claim is made or "suit" is brought, written notice of the claim or "suit" including, but not limited to, the date and details of such claim or "suit"; (2) The "insured’s" name and address; and (3) To the extent possible, the names and addresses of any injured persons and witnesses. If you report an "accident", claim, "suit" or "loss" to another insurer when you should have reported to us, your failure to report to us will not be seen as a violation of these amended duties provided you give us notice as soon as practicable after the fact of the delay becomes known to you. F. Waiver of Transfer Of Rights Of Recovery Against Others To Us The following is added to the Transfer Of Rights Of Recovery Against Others To Us Condition: This Condition does not apply to the extent required of you by a written contract, executed prior to any "accident" or "loss", provided that the "accident" or "loss" arises out of operations contemplated by such contract. This waiver only applies to the person or organization designated in the contract. G. Unintentional Failure to Disclose Hazards The following is added to the Concealment, Misrepresentation Or Fraud Condition: However, we will not deny coverage under this Coverage Form if you unintentionally: (1) Fail to disclose any hazards existing at the inception date of this Coverage Form; or (2) Make an error, omission, improper description of "autos" or other misstatement of information. You must notify us as soon as possible after the discovery of any hazards or any other information that was not provided to us prior to the acceptance of this policy. H. Hired Auto – World Wide Coverage Paragraph 7a.(5) of the Policy Period, Coverage Territory Condition is replaced by the following: (5) Anywhere in the world if a covered "auto" is leased, hired, rented or borrowed for a period of 60 days or less, I.Bodily Injury Redefined The definition of "bodily injury" in the Definitions Section is replaced by the following: "Bodily injury" means bodily injury, sickness or disease, sustained by a person including death or mental anguish, resulting from any of these at any time. Mental anguish means any type of mental or emotional illness or disease. U-CA-428-A CW (02-14) Page 2 of 3 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Attachment Code: D630742 Master ID: 1530409, Certificate ID: 19958473 J. Expected Or Intended Injury The Expected Or Intended Injury Exclusion in Paragraph B. Exclusions under Section II – Covered Auto Liability Coverage is replaced by the following: Expected Or Intended Injury "Bodily injury" or "property damage" expected or intended from the standpoint of the "insured". This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. All other terms, conditions, provisions and exclusions of this policy remain the same. U-CA-428-A CW (02-14) Page 3 of 3 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Attachment Code: D630742 Master ID: 1530409, Certificate ID: 19958473 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. SCHEDULE ALL PERSONS AND/OR ORGANIZATIONS THAT ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT WITH THE INSURED, EXECUTED PRIOR TO THE ACCIDENT OR LOSS, THAT WAIVER OF SUBROGATION BE PROVIDED UNDER THIS POLICY FOR WORK PERFORMED BY YOU FOR THAT PERSON AND/OR ORGANIZATION This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (This information below is required only when this endorsement is issued subsequent to preparation of the policy.) ENDORSEMENT EFFECTIVE:11/13/2023 ENDORSEMENT NO. POLICY NO. WC0217111-08 PREMIUM Insured: Insurance Company: WC 00 03 13 1983 National Council on Compensation Insurance. (Ed. 4-84) Attachment Code: D630768 Master ID: 1530409, Certificate ID: 19958473 SXS 0217077-08 14317000 ------------------- Named Insured and Mailing Address: ATLAS TECHNICAL CONSULTANTS,INC. 13215 Bee Cave Pkwy, Building A Suite 250 Austin, TX 78738 Producer: Lockton Insurance Brokers, LLC 777 S. Figueroa Street, 52nd fl. Los Angeles CA 90017 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. The following is added to Definition G. of SECTION VI. DEFINITIONS, underlying insurance, as paragraph two (2): BY:_____________________________________________ Authorized Representative ______________________________________ Date 11/13/2023 11/13/2024 11/13/2023 Endorsement #09 ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. U-EXS-MAN-3 (04/99) Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Form Number – Form Name Underlying Insurance Amendment – Additional Insured Addl/Return Premium Policy No.Eff. Date of Pol.Exp. Date of Pol.Eff. Date of End.Producer Add’l Prem.Return Prem. Attachment Code: D631815 Master ID: 1530409, Certificate ID: 19958473 14317000 ------------------- Named Insured and Mailing Address: ATLAS TECHNICAL CONSULTANTS, INC. 13215 Bee Cave Pkwy, Building A Suite 250 Austin, TX 78738 Producer: Lockton Insurance Brokers, LLC 777 S. Figueroa Street, 52nd fl. Los Angeles CA 90017 SXS 0217077-08 11/13/2023 11/13/2024 11/13/2023 Endorsement # 10 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. The following is added to Condition I. Transfer of Rights of Recovery Against Others to Us of SECTION V. CONDITIONS as paragraph three (3) of Subsection 1.: Also, if any insured is required by a written contract or agreement which is executed before a loss to waive their rights of recovery from any person or organization, we agree to waive our rights of recovery. This waiver of rights shall not be construed to be a waiver with respect to any other operations for which the insured has not waived their rights of recovery by contract. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. Signed by:___________________________________________________________________________________________ Authorized Representative Date U-EXS-MAN-4 (4/99) Page 1 of 1 Waiver of Subrogation – Blanket Policy No.Eff. Date of Pol.Exp. Date of Pol.Eff. Date of End.Producer Add’l Prem.Return Prem. Attachment Code: D631816 Master ID: 1530409, Certificate ID: 19958473 Policy No.Eff. Date of Pol.Exp. Date of Pol.Eff. Date of End.Producer Add'l Prem.Return Prem. GPL 0217085-08 11/13/2023 11/13/2024 11/13/2023 14317000 Named Insured and Mailing Address:Producer: ATLAS TECHNICAL CONSULTANTS, INC. 13215 BEE CAVE PKWY, BUILDING A, SUITE 250 AUSTIN, TX 78738 Lockton Insurance Brokers, LLC 777 S. Figueroa, 52nd Floor Los Angeles, CA 90017 ---------- ---------- Blanket Notification to Others of Cancellation THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: Agribusiness Pollution Liability Insurance Policy - Claims Made and Reported Coverage Commercial Umbrella Liability Policy Commercial Umbrella Liability Policy – Claims Made and Reported Coverage Contractor’s Pollution Liability Insurance Policy Contractor’s Pollution Liability Insurance Policy - Claims Made and Reported Coverage Environmental Cleanup and Liability Insurance Policy - Claims Made and Reported Coverage Environmental Impairment Liability Insurance Policy - Claims Made and Reported Coverage Environmental Services Package Policy Excess Environmental Insurance Policy - Claims Made and Reported Coverage Follow Form Excess Liability Policy Follow Form Excess Liability Policy – Claims Made and Reported Coverage Healthcare Pollution Liability Insurance Policy - Claims Made and Reported Coverage Lender Environmental Collateral Protection and Liability Insurance Outstanding Loan Balance - Claims Made and Reported Coverage Lender Environmental Collateral Protection and Liability Insurance Policy – Claims Made and Reported Coverage Professional Consultant’s Liability Insurance Policy - Claims Made and Reported Coverage Professional Environmental Consultant’s Liability Insurance Policy Professional Environmental Consultant’s Liability Insurance Policy - Claims Made and Reported Coverage Public Entity Pollution Liability - Claims Made and Reported Coverage Real Estate Environmental Liability Insurance Policy - Claims Made and Reported Coverage Remediation Stop Loss Z Choice Pollution Liability Z Choice® Real Estate Environmental Liability - Claims Made and Reported Coverage Z Choice™ Pollution Liability - Claims Made and Reported Coverage Z Link® Commercial General and Pollution Liability A. If we cancel this policy by written notice to the first Named Insured for any reason other than nonpayment of premium, we will deliver electronic notification that such policy has been cancelled to each person or organization shown in a Schedule provided to us by the First Named Insured. Such Schedule: Attachment Code: D630738 Master ID: 1530409, Certificate ID: 19958473 1.Must be initially provided to us within 15 days: a.After the beginning of the policy period shown in the Declarations; or b.After this endorsement has been added to policy; 2.Must contain the names and e-mail addresses of only the persons or organizations requiring notification that such Coverage Part has been cancelled; 3.Must be in an electronic format that is acceptable to us; and 4.Must be accurate. Such Schedule may be updated and provided to us by the First Named Insured during the policy period. Such updated Schedule must comply with Paragraphs 2. 3. and 4. above. B. Our delivery of the electronic notification as described in Paragraph A. of this endorsement will be based on the most recent Schedule in our records as of the date the notice of cancellation is mailed or delivered to the first Named Insured. Delivery of the notification as described in Paragraph A. of this endorsement will be completed as soon as practicable after the effective date of cancellation to the first Named Insured. C. Proof of emailing the electronic notification will be sufficient proof that we have complied with Paragraphs A. and B. of this endorsement. D. Our delivery of electronic notification described in Paragraphs A. and B. of this endorsement is intended as a courtesy only. Our failure to provide such delivery of electronic notification will not: 1.Extend the Coverage Part cancellation date; 2.Negate the cancellation; or 3.Provide any additional insurance that would not have been provided in the absence of this endorsement. E. We are not responsible for the accuracy, integrity, timeliness and validity of information contained in the Schedule provided to us as described in Paragraphs A. and B. of this endorsement. ALL OTHER TERMS AND CONDITIONS OF THE POLICY SHALL APPLY AND REMAIN UNCHANGED. STF-ENVL-1632-A CW (11/10) Page 2 of 2 Attachment Code: D630738 Master ID: 1530409, Certificate ID: 19958473 Blanket Notification to Others of Cancellation or Non-Renewal Policy No.Eff. Date of Pol.Exp. Date of Pol.Eff. Date of End.Producer No.Add’l. Prem Return Prem. BAP 0217109 08 11/13/2023 11/13/2024 11/13/2023 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: Commercial Automobile Coverage Part A.If we cancel or non-renew this Coverage Part by written notice to the first Named Insured, we will mail or deliver notification that such Coverage Part has been cancelled or non-renewed to each person or organization shown in a list provided to us by the first Named Insured if you are required by written contract or written agreement to provide such notification. However, such notification will not be mailed or delivered if a conditional notice of renewal has been sent to the first Named Insured. Such list: 1.Must be provided to us prior to cancellation or non-renewal; 2.Must contain the names and addresses of only the persons or organizations requiring notification that such Coverage Part has been cancelled or non-renewed; and 3.Must be in an electronic format that is acceptable to us. B.Our notification as described in Paragraph A. of this endorsement will be based on the most recent list in our records as of the date the notice of cancellation or non-renewal is mailed or delivered to the first Named Insured. We will mail or deliver such notification to each person or organization shown in the list: 1.Within seven days of the effective date of the notice of cancellation, if we cancel for non-payment of premium; or 2.At least 30 days prior to the effective date of: a.Cancellation, if cancelled for any reason other than nonpayment of premium; or b.Non-renewal, but not including conditional notice of renewal. C.Our mailing or delivery of notification described in Paragraphs A. and B. of this endorsement is intended as a courtesy only. Our failure to provide such mailing or delivery will not: 1.Extend the Coverage Part cancellation or non-renewal date; 2.Negate the cancellation or non-renewal; or 3.Provide any additional insurance that would not have been provided in the absence of this endorsement. D.We are not responsible for the accuracy, integrity, timeliness and validity of information contained in the list provided to us as described in Paragraphs A. and B. of this endorsement. All other terms and conditions of this policy remain unchanged. U-CA-832-A CW (01/13) Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Attachment Code: D631814 Master ID: 1530409, Certificate ID: 19958473 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 43 BLANKET NOTIFICATION TO OTHERS OF CANCELLATION OR NONRENEWAL ENDORSEMENT This endorsement adds the following to Part Six of the policy. PART SIX CONDITIONS Blanket Notification to Others of Cancellation or Nonrenewal 1.If we cancel or non-renew this policy by written notice to you, we will mail or deliver notification that such policy has been cancelled or non-renewed to each person or organization shown in a list provided to us by you if you are required by written contract or written agreement to provide such notification. However, such notification will not be mailed or delivered if a conditional notice of renewal has been sent to you. Such list: a.Must be provided to us prior to cancellation or non-renewal; b.Must contain the names and addresses of only the persons or organizations requiring notification that such policy has been cancelled or non-renewed; and c.Must be in an electronic format that is acceptable to us. 2.Our notification as described in Paragraph 1. above will be based on the most recent list in our records as of the date the notice of cancellation or non-renewal is mailed or delivered to you. We will mail or deliver such notification to each person or organization shown in the list: a.Within seven days of the effective date of the notice of cancellation, if we cancel for non-payment of premium; or b.At least 30 days prior to the effective date of: (1) Cancellation, if cancelled for any reason other than nonpayment of premium; or (2) Non-renewal, but not including conditional notice of renewal. 3.Our mailing or delivery of notification described in Paragraphs 1. and 2. above is intended as a courtesy only. Our failure to provide such mailing or delivery will not: a.Extend the policy cancellation or non-renewal date; b.Negate the cancellation or non-renewal; or c.Provide any additional insurance that would not have been provided in the absence of this endorsement. 4.We are not responsible for the accuracy, integrity, timeliness and validity of information contained in the list provided to us as described in Paragraphs 1. and 2. above. All other terms and conditions of this policy remain unchanged. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 11/13/2023 Policy No. WC0217111-08 Endorsement No. Insured Premium $ Insurance Company WC 99 06 43 Page 1 of 1 (Ed. 01-13)Includes copyright material of the National Council on Compensation Insurance, Inc. used with its perm ission. 2012 Copyright National Council on Compensation Insurance, Inc. All Rights Reser ved. Attachment Code: D630771 Master ID: 1530409, Certificate ID: 19958473