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HomeMy WebLinkAboutCAG2019-337 - Amendment - #1 - Wood Environment & Infrastructure Solutions, Inc. - Milwaukee II Levee Environmental Site Assessment - 12/30/2019 ,oe** Agreement Routing Form s KEN T For Approvals, Signatures and Records Management W A S H I N G T O N This form combines&replaces the Request for Mayor's Signature and Contract Cover Sheet forms. (Print on pink or cherry colored paper) Originator. Nancy for Steve Lincoln Department: Public Works Date Sent: 12/30/19 Date Required: 1/3/20 o Authorized Director or Designee Date of / A. to Sign: Council N A eaC Mayor Approval: Budget D20090 Grant? Yes No Account Number: Type: N/A Vendor or Name: Wood Environment & Infrastructure Soluti Cate 9 Y Contract = Vendor Sub-Category 0 Number. 37655 g v Amendment E Project Name: Milwaukee II Levee � 0 = Project , Details: Extend the time of completion. c EAgreement 0 Basis for y Amount: Selection of Contractor: Q Start Date: 12/30/19 Termination Date: 12/31/20 Notice required prior to Yes No Contract Number: C,q-(rp10/rj 33 7 disclosure? 1:1 Date Received by City Attorney: Comments: o~ c 0 N L 3 M 0 Date Routed to the Mayor's Office: in TDate Routed to the City Clerk's Office: 'a a, Date Sent to Originator: Visit Documents.KentWA.gov to obtain copies of all agreements adccW22373_6_19 • KEN T W A 5 H I N G T O N AMENDMENT NO. 1 NAME OF CONSULTANT OR VENDOR: Wood Environment & Infrastructure Solutions, Inc. CONTRACT NAME & PROJECT NUMBER: Milwaukee II Levee ORIGINAL AGREEMENT DATE: June 10, 2019 This Amendment is made between the City and the above-referenced Consultant or Vendor and amends the original Agreement and all prior Amendments. All other provisions of the original Agreement or prior Amendments not inconsistent with this Amendment shall remain in full force and effect. For valuable consideration and by mutual consent of the parties, Consultant or Vendor's work is modified as follows: 1. Section I of the Agreement, entitled "Description of Work," is hereby modified to add additional work or revise existing work as follows: In addition to work required under the original Agreement and any prior Amendments, the Consultant or Vendor shall: No change to the scope of work, however an amendment is needed to extend the time of completion to December 31, 2020 due to a delay to the start of the project. 2. The contract amount and time for performance provisions of Section II "Time of Completion," and Section III, 'Compensation," are modified as follows: Original Contract Sum, $29,775 including applicable WSST Net Change by Previous Amendments $0 including applicable WSST Current Contract Amount $29,775 including all previous amendments Current Amendment Sum $0 Applicable WSST Tax on this $0 Amendment Revised Contract Sum $29,775 AMENDMENT - 1 OF 2 Original Time for Completion 1.2/31/19 (insert date) Revised Time for Completion under n/a prior Amendments (insert date) Add'I Days Required (f) for this 366 calendar days Amendment Revised Time for Completion 12/31/20 (insert date) The Consultant or Vendor accepts all requirements of this Amendment by signing below, by its signature waives any protest or claim it may have regarding this Amendment, and acknowledges and accepts that this Amendment constitutes full payment and final settlement of all claims of any kind or nature arising from or connected with any work either covered or affected by this Amendment, including, without limitation, claims related to contract time, contract acceleration, onsite or home office overhead, or lost profits. This Amendment, unless otherwise provided, does not relieve the Consultant or Vendor from strict compliance with the guarantee and warranty provisions of the original Agreement. All acts consistent with the authority of the Agreement, previous Amendments (if any), and this Amendment, prior to the effective date of this Amendment, are hereby ratified and affirmed, and the terms of the Agreement, previous Amendments (if any), and this Amendment shall be deemed to have applied. The parties whose names appear below swear under penalty of perjury that they are authorized to enter into this Amendment, which is binding on the parties of this contract. IN WITNESS, the parties below have executed this Amendment, which will become effective on the last date written below. -- ------------ — -- -- - - ----- ... CONSULTANT`VENDOR: CITY O ENT: By: eaola�AL��,/Llgy ture) (si ature) Print me: 4 q Print Name: Timothy J. LaPorte, P.E. Its Its Public Works Director (title) itle) DATE: t 2 DATE: / ATTEST: i APPROVED AS TO FORM: (applicable if Mayor's signature required) Kent City Jerk Kent Law Department Wood-Kiwaukee 2 Amd 3/Uln.^oln AMENDMENT - 2 OF 2 R CERTIFICATE OF LIABILITY INSURANCE DATE6/27/20119 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 w certificate does not confer rights to the certificate holder in lieu of such endorsement(s). E PRODUCER CONTACT AOn Risk Services Southwest, Inc. PHONE Houston TX Office (AIC.No.Ext): (866) 283-7122 a 0 010 `y 5555 San Felipe E.MAJL Suite 1500 ADDRESS: 0_ Houston TX 77056 USA INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURERA: AIG Specialty Insurance Company 26883 JWGUSA Holdings, Inc. INSURER B: ACE American Insurance Company 22667 sO USA, Inc.and INSURER C: AIG Europe Limited AA1120841 and itt Su P s Subsidiaries and Affiliates 17325 Park ROW INSURER D: Houston TX 77084 USA INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570077149935 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. Limits shown are as requested LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYYI (MWDDNYYYI LIMITS X COMMERCIAL GENERAL LIABILITY HDOG EACH OCCURRENCE $2,000,000 CLAIMS-MADE X❑OCCUR DAMAGE TO 9179TI77- PREMISES Ea occurrence $2,000,000 MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY S2,000,000 M GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 6i POLICY �P JECT ❑LOC PRODUCTS-COMP/OPAGG $4,000,000 OTHER: p 0 tBAUIOMOBILE LL4BILITY ISA H2$300312 07/Ol/201907/O1/2020 COMBINED SINGLE LIMB r- Ea accident $1,000,000 ANYAUTO BODILY INJURY(Per person) O OWNED SCHEDULED BODILY INJURY Per accident) Z d AUTOS ONLY AUTOS ( ) LU HIREDAUTOS NON-OWNED PROPERTY DAMAGE 10 v ONLY AUTOS ONLY Per awdent B X UMBRELLA LIAB X OCCUR XOOG24876238010 07/01/2019 07/01/2020 EACH OCCURRENCE $1,000,000 U EXCESS LIAB CLAIMS-MADE AGGREGATE $1,000,000 DED I X IRETENTION$10,000 B WORKERS COMPENSATION AND WLRC66039262 07 01 2019 07 01 2 220 PER DTH- EMPLOYERS'LUIBILITY X STATUTE ANY PROPRIETOR/PARTNER/EXECUI I— YIN Work Comp- ADS B OFF ICER/MEMBEREXCLUDED? N NIA RWCC66039304 07/01/2019 07/01/2020 E.L.EACH ACCIDENT $1,000,000 (Mandatory in NH) Work Comp- WI E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000- C Archit&Eng Prof PSDEF1900726 07/01/2019 07/01/2020 Aggreagate Limit 35,0 00,000 Claims Made- Prof. Liab. Any one Claim $5,000,000 SIR applies per policy terns & conditions DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) SEE ATTACHED ADDENDUM FOR ADDITIONAL NAMED INSURED WOOD COMPANIES. RE: Project Description: Phase I and II ESA and Limited Good Faith Asbestos and other RMS at property 7641 S. 259th St. in Kent, wA. Certificate Holder is included as Additional -_■-.A Insured in accordance with the policy provisions of the General Liability and Automobile Liability policies. _ CERTIFICATE HOLDER CANCELLATION1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Ci ty AUTHOR of Kent 2 AUTHORIZED REPRESENTATIVE 2 Fourth Avenue south - Kent wA 98032 USA c�SRPfb i=��I Vq(�� eJ 77LL ACORD 25 2016/03 ©1988-2015 ACORD CORPORATION.All rights reserved. ( ) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 570000021966 ACORO® LOC#: `-- ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY NAMED INSURED Aon Risk Services Southwest, Inc. 3WGUSA Holdings, Inc. POLICY NUMBER See Certificate Number: 570077149935 CARRIER NAIC CODE See Certificate Number: 570077149935 EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURER(S)AFFORDING COVERAGE NAIC# INSURER INSURER INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information,refer to the corresponding policy on the ACORD certificate form for policy limits. POLICY POLICY INSR ADDL SUBR EFFECTIVE EXPIRATION LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER LIMITS DATE DATE MM/DD MM/DD OTHER A Env contr Poll CPL12456119 07 01 2019 07 01 2020 Aggregate E5,000,000 claims made- Poll. Liab. Limit Per Loss $5,000,000 Limit ACORD 101(2008/01) ©2008 ACORD CORPORATION.All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 570000021966 �.1 LOC#: ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY NAMED INSURED Aon Risk services Southwest, Inc. JWGUSA Holdings, Inc. POLICY NUMBER see Certificate Number: 570077149935 CARRIER NAIC CODE See Certificate Number: 570077149935 EFFECTIVE DATE ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Additional Named Insured Named Insureds: JWGUSA Holdings, Inc. AGRA Pipeline Professionals, Inc. AMEC Construction Management, Inc. AMEC E&E, P.C. AMEC Engineering and Consulting of Michigan, Inc. AmeC Foster wheeler Inc. AmeC Foster wheeler USA Corporation Amec Foster wheeler Programs Inc. AmeC Foster wheeler Power Systems, Inc. AmeC Foster wheeler Constructors, Inc. AmeC Foster Wheeler Energia, S.L.U. AmeC Foster wheeler E&C Services, Inc. AmeC Foster wheeler Industrial Power Company, Inc. AMEC Massachusetts, Inc. AmeC Foster wheeler Martinez Inc. AmeC Foster wheeler North America Corp AmeC Foster wheeler ventures, Inc. AmeC Foster Wheeler Oil and Gas, Inc. AMEC USA Holdings, Inc. Foster Wheeler Development Corporation Foster wheeler Intercontinental Corporation Amec Foster Wheeler Kamtech, Inc. MACTEC Engineering and Consulting, P.C. QED International LLC Rider Hunt International USA, Inc. wood Group USA, Inc. wood Group Alaska, LLC wood Group PSN, Inc. Altablue, Inc. Cape Software, Inc. BMA Solutions, Inc. Global Performance, LLC John wood Group PLC RWG (Repair & Overhauls) USA, Inc. Ingenious, Inc. Mustang Process and Industrial Mustang International, LP C E C Controls Company, Inc. wood Environment & Infrastructure Solutions Inc. ACORD 101(2008/01) CO 2008 ACORD CORPORATION.All rights reserved. The ACORD name and logo are registered marks of ACORD 11 POLICY NUMBER: HDO G71570009 Endorsement Number: 10 COMMERCIAL GENERAL LIABILITY CG 2010 04 13 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) Location(s)Of Covered Operations Any Owner, Lessee or Contractor whom you have All locations where you are performing operations for agreed to include as an additional insured under a such additional insured pursuant to any such written written contract, provided such contract was executed contract. prior to the date of loss. I i r Information required to complete this Schedule if not shown above will be s i_ 3 P _ _._..._ _.l _ _.�__. shown In Declarations. A. Section 11 — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional organization(s) shown in the Schedule, but only exclusions apply: with respect to liability for"bodily injury", "property This insurance does not apply to "bodily injury"or damage" or "personal and advertising injury" "property damage"occurring after. caused, in whole or in part,by: 1. Your acts or omissions;or 1• All work, including materials, parts or equipment furnished in connection with such 2. The acts or omissions of those acting on your work, on the project (other than service, behalf. maintenance or repairs) to be performed by or in the performance of your ongoing operations for on behalf of the additional insured(s) at the the additional insured(s) at the location(s) location of the covered operations has been designated above. completed;or However: 2. That portion of "your work" out of which the 1. The insurance afforded to such additional injury or damage arises has been put to its insured only applies to the extent permitted by intended use by any person or organization law;and other than another contractor or subcontractor engaged In performing operations for a 2. If coverage provided to the additional insured is principal as a part of the same project. required by a contract or agreement, the C. With respect to the insurance afforded to these insurance afforded to such additional insured additional insureds, the following is added to will not be broader than that which you are Section III—Limits Of Insurance: required by the contract or agreement to provide for such additional insured. If coverage provided to the additional insured is required by a contract or agreement, the most we CG 20 10 0413 0 Insurance Services Office,Inc.,2012 Page 1 of 2 will pay on behalf of the additional insured is the whichever is less. amount of insurance: This endorsement shall not increase the 1. Required by the contract or agreement;or applicable Limits of Insurance shown in the 2. Available under the applicable Limits of Declarations. Insurance shown in the Declarations; Page 2 of 2 ©Insurance Services Office, Inc.,2012 CG 2010 0413 5 POLICY NUMBER: HDO G71570009 Endorsement Number: 12 COMMERCIAL GENERAL LIABILITY CG 20 37 0413 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 Organizatfon(s) Location And Description Of Completed Operations Any person or organization whom you have agreed to All locations where you perform work for such additional I include as an additional insured under a written insured pursuant to any such written contract. j contract,provided such contract was executed prior to the date of loss i i C Information required to complete this Schedule, if not shown above,will be shown in the Declarations. A. Section II —Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III—Limits Of Insurance: with respect to liability for 'bodily injury" or If coverage provided to the additional insured is "property damage"caused,in whole or a part,by required by a contract or agreement, the most we 'your work" at the location designated and described in the Schedule of this endorsement will pay on behalf of the additional insured is the performed for that additional insured and amount of insurance: included in the "products-completed operations 1. Required by the contract or agreement;or hazard". 2. Available under the applicable Limits of However: Insurance shown in the Declarations; 1. The insurance afforded to such additional whichever is less, insured only applies to the extent permitted This endorsement shall not increase the applicable by law; and Limits of Insurance shown in the Declarations. 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. CG 20 37 0413 0 Insurance Services Office, Inc..2012 Page 1 of 1 3 POLICY NUMBER: HDO G71570009 Endorsement Number: 13 COMMERCIAL GENERAL LIABILITY CG 2015 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - VENDORS 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 Organizations Vendor _ _ Your Products Any Vendor whom you have agreed to include as an All of your products. additional insured under a written contract, provided such contract was executed prior to the date of loss. i information re�c wired to complete this Schedule, if not shown above,will be shown in the Declarations, A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured any person(s) or vendors,the following additional exclusions apply: organization(s) (referred to throughout this 1. The insurance afforded the vendor does not endorsement as vendor) shown in the Schedule. apply to. but only with respect to"bodily injury"or"property damage" arising out of "your products" shown in a. 'Bodily injury" or "property damage" for the Schedule which are distributed or sold in the which the vendor is obligated to pay regular course of the vendor's business. damages by reason of the assumption of liability in a contract or agreement. This However� exclusion does not apply to liability for 1. The insurance afforded to such vendor only damages that the vendor would have in the applies to the extent permitted by law;and absence of the contract or agreement; 2. If coverage provided to the vendor is required b. Any express warranty unauthorized by you; by a contract or agreement, the insurance c. Any physical or chemical change in the afforded to such vendor will not be broader product made intentionally by the vendor; than that which you are required by the contract or agreement to provide for such d. Repackaging, except when unpacked solely vendor for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; CG 20 15 0413 �D Insurance Services Office, Inc,.2012 Page 1 of 2 e. Any failure to make such inspections. (2) Such inspections, adjustments, tests or adjustments, tests or servicing as the servicing as the vendor has agreed to vendor has agreed to make or normally make or normally undertakes to make in undertakes to make in the usual course of the usual course of business, in business, in connection with the distribution connection with the distribution or sale or sale of the products; of the products. f. Demonstration, installation, servicing or 2. This insurance does not apply to any insured repair operations, except such operations person or organization, from whom you have performed at the vendor's premises in acquired such products, or any ingredient, part connection with the sale of the product; or container, entering into, accompanying or g. Products which, after distribution or sale by containing such products. you, have been labeled or relabeled or C. With respect to the insurance afforded to these used as a container, part or ingredient of vendors, the following is added to Section III — any other thing or substance by or for the Limits Of Insurance: vendor; or If coverage provided to the vendor is required by a h. "Bodily injury"or"property damage" arising contract or agreement, the most we will pay on out of the sole negligence of the vendor for behalf of the vendor is the amount of insurance: its own acts or omissions or those of its 1. Required by the contract or agreement;or employees or anyone else acting on its behalf. However, this exclusion does not 2. Available under the applicable Limits of apply to: Insurance shown in the Declarations; (1) The exceptions contained in Sub- whichever is less. paragraphs d.or f.;or This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations i E i i Page 2 of 2 ®Insurance Services Office, Inc.,2012 CG 20 15 04 13 i BLANKET ADDITIONAL INSURED ENDORSEMENT Named Insured Wood Group USA, Inc. }Endorsement Number }1 Policy Sym; Policy Number Pokey Period Effective Date of Endorsement HDO G71570009 107/01/2019 TO 07/01/2020 Issued By(Name of insurance Company) ACE American Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: COMMERCIAL GENERAL LIABILITY COVERAGE FORM Section II —Who Is An Insured is amended to include as an additional insured any person or organization to whom you are obligated, in connection with your business, by written contract or written agreement, executed prior to the date of loss, to provide insurance such as is afforded by this policy, but not for broader coverage or greater limits of insurance than is required by said contract or agreement and in no event, for broader coverage or greater limits of insurance than is otherwise provided by the policy. MS•11177(01/18) xhut:b 2016 All nghtsreserved Page 1 of 1 ADDITIONAL INSURED-EMPLOYEES FELLOW EMPLOYEES-BODILY INJURY ONLY Named Insured Wood Group USA, Inc. Endorsement Number 24 Policy Symbol Policy Number Policy Period T' Effective Date of Endorsement HDO IG71570009 07/01/2019 To 07l01/2020 issued 8y(Name of Insurance Company) ACE American Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: COMMERCIAL GENERAL LIABILITY COVERAGE FORM Paragraph 2.a of Section 11—'WHO IS AN INSURED"is replaced by the following: a. Your "employees", other than your "executive officers", but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business. However, no 'employee" is an insured for (1) "Personal and Advertising Injury': (a) To you, to your partners or members (if you are a partnership or joint venture), or to a co- "employee"while in the course of his or her employment or while performing duties related to the conduct of your business; (b) To the spouse, child, parent, brother or sister of the co'employee" as a consequence of paragraph(1)(a)above; (c) For much there is an obligation to share damages with or repay someone else who must pay damages because of the injury described in paragraphs(1)(a)or(b)above. (2) "Property damage"to property: (a) Owned, occupied or used by, you or your "employees" or, if you are a partnership or joint venture, by any partner or member; (b) Rented to, in the care, custody or control of, or over which physical control is being exercised for any purpose by you, any of your"employees" or, if you are a partnership or joint venture, any partner or member. MS-11178 (01/17) CChubb 2016 Alt nghts reserved Page 1 of 1 3 POLICY NUMBER: HDO G71570009 Endorsement Number: 2 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Any person or organization against whom you have agreed to waive your right of recovery in a written contract,provided such contract was executed prior to the date of loss. Information required to complete this Schedule, if not shown above,will be shown in the Declarations. The following is added to Paragraph 8.Transfer Of Rights Of Recovery Against Others To Us of Section IV—Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products- completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 ®Insurance Services Office, Inc., 2008 Page 1 of 1 17 NON-CONTRIBUTORY ENDORSEMENT FOR ADDITIONAL INSUREDS Named Insured Endorsement Number Wood Group USA, Inc. 3 Policy Symbol Policy Number �— Policy Period Effective Date of Endorsement HDO G71570009 07/01/2019 to 07/01/2020 Issued By(Name of Insurance Company) ACE American Insurance Company Insert the policy number The remainder of the intormauon is to be completed only when this endorsement s issued subsepuent to me properavon of the"icy THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY COVERAGE Schedule Organization Additional Insured Endorsement Any additional insured with whom you have agreed to provide such non-contributory insurance,pursuant to and as required under a written contract executed prior to the date of loss. (If no information is filled in,the schedule shall read.'Ail persons or entities added as additional insureds through an endorsement with the term'Additional Insured"in the title) For organizations that are listed in the Schedule above that are also an Additional Insured under an endorsement attached to this policy, the following is added to Section IVA.a: If other insurance is available to an insured we cover under any of the endorsements listed or described above (the "Additional Insured")for a loss we cover under this policy, this insurance will apply to such loss on a primary basis and we will not seek contribution from the other insurance available to the Additional Insured. Authori2ed Agent� y �� LD-20287(D6/06) Page 1 of 1 POLICY NUMBER: HDO G71570009 C H U B ES* NOTICE TO POLICYHOLDERS NOTICE TO OTHERS —SCHEDULE NOTICE BY INSURED'S REPRESENTATIVE A. If we cancel this Policy prior to its expiration date by notice to you or the first Named insured for any reason other than nonpayment of premium,we will endeavor to send written notice of cancellation, to the persons or organizations listed in the schedule that you or your representative create or maintain (the"Schedule") by allowing your representative to send such notice to such persons or organizations. This notice will be in addition to our notice to you or the first Named Insured,and any other party whom we are required to notify by statute and in accordance with the cancellation provisions of the Policy. B. The notice of cancellation, as provided by your representative, is intended only to be a courtesy notification to the person(s) or organization(s) named in the Schedule in the event of a pending cancellation of coverage, We have no legal obligation of any kind to any such person(s) or organization(s). The failure to provide advance notification of cancellation to the person(s)or organization(s) shown in the Schedule will impose no obligation or liability of any kind upon us, our agents or representatives, will not extend any Policy cancellation date and will not negate any cancellation of the Policy. C. We are not responsible for verifying any information in any Schedule, nor are we responsible for any incorrect information that you or your representative may use. D. We will only be responsible for sending such notice to your representative, and your representative will in turn send the notice to the persons or organizations listed in the Schedule at least 30 days prior to the cancellation date applicable to the Policy. You will cooperate with us in providing the Schedule, or in causing your representative to provide the Schedule. E. The provisions of this notice do not apply in the event that you cancel the Policy. ALL-34275(10/11) Page 1 of 1 GULF OF MEXICO EXTENSION Named Insured Wood Group USA, Inc. Endorsement Number 23 Policy Symbol Policy Number Policy Period Effective Dale of Endorsement HDQ G71570009 '07/01/2019 To 07/01/2020 Issued By(Name of Insurance Company) ACE American Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: COMMERCIAL GENEARL LIABILITY COVERAGE FORM SECTION V-DEFINITIONS,4, is deleted in its entirety and replaced by the following: 4. 'Coverage territory"means a. The United States of America(including its territories and possessions)and Puerto Rico. b International waters or airspace, but only if the injury occurs in the course of travel or transportation between any places included in a. above;or c. All other parts of the world if the injury or damage arises out of: (1) Goods or products made or sold by you in the territory described in a. above;or (2) The activities of a persons whose home is in the territory described in a. above, but is away for a short time on your business;or (3) "Personal and advertising injury'offenses that take place through the Internet or similar electronic means of communication d. That portion of the Gulf of Mexico that is northwest of a line between a point near Yucatan,Mexico at 21'25'N 1 87° 11'W to a point near Key West, Florida at 25"05' N 180*26'W, excluding the territorial waters claimed by any political subdivision other than the United States or one of its States, but only for the operations of the Named Insured; provided the Insured's responsibility to pay damages is determined in a"suit"on the merits,in the territory described in a, above or in a settlement we agree to. All other terms and conditions of the policy remain the same. MS-11187(01117) OChubb.2016 All rights reserved Page 1 of 1 2 POLICY NUMBERS HDO G71570009 Endorsement Number: 25 COMMERCIAL GENERAL LIABILITY CG 2417 10 01 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTUAL LIABILITY - RAILROADS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Scheduled Railroad: Designated Job Site: Any railroad which you have agreed to indemnify all job sites where you are operating under an pursuant to a written contract entered into with easement granted by a scheduled railroad,and such railroad that was signed prior to loss, in where you have agreed to indemnify such railroad connection with an easement granted by such for your operations pursuant to such easement railroad to you. under a written contract entered into with such railroad prior to the loss. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) With respect to operations performed for, or Paragraph f.does not include that part of any affecting, a Scheduled Railroad at a Designated Job contract or agreement Site, the definition of "insured contract" in the (1) That indemnifies an architect, engineer or Definitions section is replaced by the following: surveyor for injury or damage arising out 9. "Insured Contract"means: of; a. A contract for a lease of premises. However, (a) Preparing, approving or failing to pre- that portion of the contract for a lease of pare or approve maps, shop drawings, premises that indemnifies any person or opinions, reports, surveys, field orders, organization for damage by fire to premises change orders or drawings and specifi- while rented to you or temporarily occupied by cations;or you with permission of the owner is not an (b) Giving directions or instructions, or fail- "insured contract"; ing to give them, if that is the primary b. A sidetrack agreement; cause of the injury or damage; c. Any easement or license agreement; (2) Under which the insured, if an architect, d. An obligation, as required by ordinance, to engineer or surveyor, assumes liability for indemnify a municipality,except in connection an injury or damage arising out of the in- with work for a municipality; sured's rendering or failure to render pro- fessional services,including those listed in e. An elevator maintenance agreement; Paragraph (1) above and supervisory, in- f. That part of any other contract or agreement spection. architectural or engineering pertaining to your business (including an in- activities. demnirication of a municipality in connection with work performed for a municipality) under which you assume the tort liability of another party to pay for "bodily injury" or "property damage" to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. CG 2417 10 01 Q ISO Properties, Inc., 2000 Page 1 of 1 POLICY NUMBER: HDO G715700D9 Endorsement Number. 38 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COVERAGE FOR INJURY TO LEASED WORKERS This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTSICOMPLETED OPERATIONS LIABILITY COVERAGE PART With respect to the Employer's Liability exclusion (Section 1) only, the definition of "employee" in the DEFINITIONS Section is replaced by the following: "Employee"does not include a"leased worker"or a"temporary worker" CGO424(10/93) Q Insurance Services Office, Inc., Page 1 of 1 3 ADDITIONAL INSURED — DESIGNATED PERSONS OR ORGANIZATIONS Named insured Mood Group USA, Inc. T Endorsement Number j1 Policy Symbol Policy Number Pollry Period Effective Date of Erxfarsement ISA H25300312 07/012019 To 07/01/2020 Issued By(Name of Insurance Company) ACE American Insurance Company nsert tha potty number The remainder or the.nformu on ra to be=mNeted only when this endonemnt is rasued subsequent to the prcparatbn of the pcNicy THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following; BUSINESS AUTO COVERAGE FORM AUTO DEALERS COVERAGE FORM MOTOR CARRIER COVERAGE FORM EXCESS BUSINESS AUTO COVERAGE FORM Additlonal Insured(s). Any person or organization whom you have agreed to include as an additional insured under a written contract-provide- such contract was executed prior to the dategf loss ,- A For a covered'auto,'Who Is Insured is amended to include as an "insured,"the persons or organizations named in this endorsement. However,these persons or organizations are an"insured"only for"bodily injury"or"property damage" resulting from acts or omissions of; 1. You. 2. Any of your"employees"or agents. 3. Any person operating a covered"auto"with permission from you,any of your"employees"or agents- B. The persons or organizations named in this endorsement are not liable for payment of your premium. Authorized RepresentativeT�^ DA-9U74c(03/16) Page 1 of 1 3 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS Named Insured Wood Group USA, Inc. Endorsement Number 2 Policy Symbol I Policy Number Policy Period Effective Date of Endorsement ISA IH25300312 07/01/2019 To 07/01/2020 Issued By(Name of Insurance Company) ACE American Insurance Company Insert the pOfky number The remainder of We inform abon is to be completed Dray when this endorsement,is issued subsequent to fhe praparatron Of the policy THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, This Endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIERS COVERAGE FORM AUTO DEALERS COVERAGE FORM We waive any right of recovery we may have against the person or organization shown in the Schedule below because of payments we make for injury or damage arising out of the use of a covered auto. The waiver applies only to the person or organization shown in the SCHEDULE. SCHEDULE Any person or organization against whom you have agreed to waive your right of recovery in a written contract, provided such contract was executed prior to the date of loss. Authorized Representative DA-13115a(06/14) Page 1 of 1 4 NON-CONTRIBUTORY ENDORSEMENT FOR ADDITIONAL INSUREDS Named Insured Wood Group USA, Inc. Endorsement Number 3 Policy Symbol Policy Number Policy Period Effective Date of Endorsement ISA IH25300312 07/01/2019 TO 07/0112020 Issued By(Name of Insurance Company) ACE American Insurance Company Insert the poiicy number The remainder of the information is to be completed cnky when this endorsement is Issued subsequent to the preparation of tra palcy THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM AUTO DEALERS COVERAGE FORM Schedule organization Additional Insured Endorsement Any additional insured with whom you have agreed to provide such non- contributory insurance, pursuant to and as required under a written contract executed prior to the date of loss. (lf no information is filled in,the schedule shall read 'All persons or entities added as additional insureds through an endorsement with the term'Additional Insured"in the title) For organizations that are listed in the Schedule above that are also an Additional Insured under an endorsement attached to this policy, the following is added to the Other Insurance Condition under General Conditions: If other insurance is available to an insured we cover under any of the endorsements listed or described above (the "Additional Insured") for a loss we cover under this policy, this insurance will apply to such loss on a primary basis and we will not seek contribution from the other insurance available to the Additional Insured, Authorized Representative DA-21886b(06114) Page 1 of 1 3 POLICY NUMBER: ISA H25300312 Endorsement Number: 7 COMMERCIAL AUTO CA 20 01 1013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LESSOR - ADDITIONAL INSURED AND LOSS PAYEE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement, This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Wood Group USA, Inc. Endorsement Effective Date: SCHEDULE Insurance Company: ACE American Insurance Company Policy Number: ISA H25300312 j Effective Date: 07/01/2019 Expiration Date: 07101/2020 i Named Insured: Wood Group USA,Inc. i Address: 17420 Katy Frwy I Suite 500 Houston TX 77094 Additional Insured(Lessor): Any Lessor whom you have agreed to include as an additional insured under a written contract, provided such contract was executed prior to the date of loss. Address: Designation Or Description Of"Leased Autos": All autos leased by you l Coverages Limit Of Insurance Covered Autos Liability k2,000,000 Each"Accident' Actual Cash Value Or Cost Of Repair,Whichever Is Less,Minus Comprehensive $500 Deductible For Each Covered"Leased Auto" I Actual Cash Value Or Cost Of Repair,Whichever Is Less,Minus Collislon $500 Deductible For Each Covered"Leased Auto" CA 20 01 10 13 0 Insurance Services Office, Inc„2011 Page 1 of 2 Specified Actual Cash Value Or Cost Of Repair,Whichever Is Less,Minus Causes Of Loss ; Deductible For Each Covered"Leased Auto" ;_Information required to complete this Schedule if not shown above,will be shown in the Declarations. A. Coverage B. Loss Payable Clause 1. Any "leased auto' designated or described in the 1. We will pay, as interest may appear, you and the Schedule will be considered a covered "auto" you lessor named in this endorsement for "loss" to a own and not a covered"auto'you hire or borrow, "leased auto". 2. For a "leased auto" designated or described In the 2. The insurance covers the interest of the lessor Schedule, the Who Is An Insured provision under unless the 'loss" results from fraudulent acts or Covered Autos Liability Coverage is changed to omissions on your part. include as an "insured" the lessor named in the 3. If we make any payment to the lessor, we will Schedule. However, the lessor is an "insured" only obtain his or her rights against any other party. for 'bodily injury" or "property damage" resulting C. Cancellation from the acts or omissions by: a. You; 1. If we cancel the policy, we will mail notice to the lessor in accordance with the Cancellation b. Any of your"employees"or agents;or Common Policy Condition. c. Any person, except the lessor or any"employee" 2. If you cancel the policy, we will mail notice to the or agent of the lessor, operating a 'leased auto" lessor. with the permission of any of the above. 3. The coverages provided under this endorsement 3. Cancellation ends this agreement. apply to any "leased auto' described in the D. The lessor is not liable for payment of your premiums. Schedule until the expiration date shown in the E. Additional Definition Schedule, or when the lessor or his or her agent As used in this endorsement: takes possession of the "leased auto", whichever occurs first. "Leased auto" means an "auto' leased or rented to you, including any substitute, replacement or extra "auto"needed to meet seasonal or other needs, under a leasing or rental agreement that requires you to provide direct primary insurance for the lessor. Page 2 of 2 0 Insurance Services Office, Inc.,2011 CA 20 01 1013 POLICY NUMBER: ISA H25300312 I_ I'-'I U E3 E3 NOTICE TO POLICYHOLDERS NOTICE TO OTHERS -SCHEDULE NOTICE BY INSURED'S REPRESENTATIVE A. If we cancel this Policy prior to its expiration date by notice to you or the first Named insured for any reason other than nonpayment of premium,we will endeavor to send written notice of cancellation, to the persons or organizations listed in the schedule that you or your representative create or maintain (the"Schedule") by allowing your representative to send such notice to such persons or organizations. This notice will be In addition to our notice to you or the first Named Insured, and any other party whom we are required to notify by statute and in accordance with the cancellation provisions of the Policy. B. The notice of cancellation, as provided by your representative, is intended only to be a courtesy notification to the person(s) or organization(s) named in the Schedule in the event of a pending cancellation of coverage, We have no legal obligation of any kind to any such person(s) or organization(s). The failure to provide advance notification of cancellation to the person(s)or organization(s) shown in the Schedule will impose no obligation or liability of any kind upon us, our agents or representatives, will not extend any Policy cancellation date and will not negate any cancellation of the Policy. C. We are not responsible for verifying any information in any Schedule, nor are we responsible for any incorrect information that you or your representative may use. D. We will only be responsible for sending such notice to your representative, and your representative will in turn send the notice to the persons or organizations listed in the Schedule at least 30 days prior to the cancellation date applicable to the Policy. You will cooperate with us in providing the Schedule, or in causing your representative to provide the Schedule. E. The provisions of this notice do not apply in the event that you cancel the Policy. ALL-34275(10/11) Page 1 of 1 3 POLICY NUMBER: ISA H25300312 Endorsement Number: 8 COMMERCIAL AUTO CA 9910 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DRIVE OTHER CAR COVERAGE - BROADENED COVERAGE FOR NAMED INDIVIDUALS This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Wood Group USA, Inc, Endorsement Effective Date: SCHEDULE Name Of Individual: Any employee assigned a company vehicle who is not covered under a personal auto liability policy. Covered Autos Uability Coverage Limit: $2,000,000 Premium: $Included Auto Medical Payments Limit: $NIA Premium: $Included Comprehensive Deductible: $ Premium: $ _ rCollision Deductible: $ Premium: $ Uninsured Motorists Limit: $Excluded Premium: $Excluded Underinsured Motorists Limit: $Excluded Premium: $Excluded Information required to complete this Schedule, if not shown above,will be shown in the Declarations. Note: When Uninsured Motorists Coverage is provided at limits higher than the basic limits required by a financial responsibility law, Underinsured Motorists Coverage is included, unless otherwise noted. If Underinsured Motorists Coverage is provided as a separate coverage, make appropriate entry in the Schedule above. A. This endorsement changes only those coverages b. Any"auto" used by that individual or his or her where a premium is shown in the Schedule. spouse while working in a business of selling, B. Changes In Covered Autos Liability Coverage servicing, repairing or parking"autos". 1. Any "auto" you don't own, hire or borrow is a 2. The following is added to Who Is An Insured: covered"auto"while being used by any individual Any individual named in the Schedule and his or named in the Schedule or by his or her spouse her spouse, while a resident of the same while a resident of the same household except, household, are "insureds" while using any a. Any "auto" owned by that individual or by any covered"auto"described in Paragraph B.I.of this member of his or her household. endorsement. CA 99 10 1013 m Insurance Services Office, Inc., 2011 Page 1 of 2 C. Changes In Auto Medical Payments And 1. Any "auto" owned by that individual or by any Uninsured And Underfnsured Motorists member of his or her household. Coverages 2. Any "auto" used by that individual or his or her The following Is added to Who Is An Insured: spouse while working in a business of selling, Any individual named in the Schedule and his or her servicing, repairing or parking"autos". "family members"are"insureds"while"occupying"or E. Additional Definition while a pedestrian when being struck by any "auto" you don't own except As used in this endorsement: Any"auto"owned by that individual or by any"family "Family member" means a person related to the member". individual named in the Schedule by blood, marriage or adoption who is a resident of the individual's D. Changes In Physical Damage Coverage household, including a ward or foster child. Any private passenger type "auto" you don't own, hire or borrow is a covered "auto" while in the care, custody or control of any individual named in the Schedule or his or her spouse while a resident of the same household except: Page 2 of 2 ©Insurance Services Office, Inc,, 2011 CA 99 10 1013 Workers'Compensation and Employers'Liability Policy Named Insured Endorsement Number WOOD GROUP USA, INC. 17420 KATY FRWY SUITE 500 Policy Number HOUSTON TX 77094 S mbol:WLR Number: C66039262 P0"cy Period Effective Date of Endorsement 07-01-2019 TO 07-01-2020 07-01-2019 issued fay(Name of Insurance Company) -- - ACE AMERICAN INSURANCE COMPANY Insert the polig number.The remainder of the information is to be completed on! when this endorsement is issued subsequent to the preparation of the policy, 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 AGAINST WHOM YOU HAVE AGREED TO WAIVE YOUR RIGHT OF RECOVERY IN A WRITTEN CONTRACT, PROVIDED SUCH CONTRACT WAS EXECUTED PRIOR TO THE DATE OF LOSS. For the states of CA, UT,TX, refer to state specific endorsements. This endorsement is not applicable in KY, NH, and NJ. The endorsement does not apply to policies in Missouri where the employer is in the construction group of code classifications.According to Section 287.150(6) of the Missouri statutes, a contractual provision purporting to waive subrogation rights against public policy and void where one party to the contract is an employer in the construction group of code classifications. For Kansas, use of this endorsement is limited by the Kansas Fairness in Private Construction Contract Act(K.S.A.. 16-1801 through 16-1807 and any amendments thereto) and the Kansas Fairness in Public Construction Contract Act(K.S.A 16-1901 through 16-1908 and any amendments thereto). According to the Acts a provision in a contract for private or public construction purporting to waive subrogation rights for losses or claims covered or paid by liability or workers compensation insurance shall be against public policy and shall be void and unenforceable except that, subject to the Acts, a contract may require waiver of subrogation for losses or claims paid by a consolidated or wrap-up insurance program. Authorized Representative WC 00 03 13 (11/05) Copyright 1982-83,National Council on Compensation Workers' Compensation and Employers' Liability Policy Named insured Endorsement Number WOOD GROUP USA, INC. 17420 KATY FRWY SUITE 500 Pbiicy Number HOUSTON TX 77094 Symbol:WLR Number:C66039262 Policy Period Effective Date of Endorsement 07-01-2019 TO 07-01-2020 07-01-2019 Issued By!Name of Insurance Comoanv) ACE AMERICAN INSURANCE COMPANY Insert the policy number.The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. ALTERNATE EMPLOYER ENDORSEMENT This endorsement applies only with respect to bodily injury to your employees while in the course of special or temporary employment by the alternate employer in the state named in Item 2 of the Schedule. Part One (Workers Compensation Insurance) and Part Two (Employers Liability Insurance) will apply as though the alternate employer is insured. If an entry is shown in Item 3 of the Schedule the insurance afforded by this endorsement applies only to work you perform under the contract or at the project named in the Schedule. Under Part One (Workers Compensation Insurance) we will reimburse the alternate employer for the benefits required by the workers compensation law if we are not permitted to pay the benefits directly to the persons entitled to them. The insurance afforded by this endorsement is not intended to satisfy the alternate employer' s duty to secure its obligations under the workers compensation law. We will not file evidence of this insurance on behalf of the alternate employer with any government agency. We will not ask any other insurer of the alternate employer to share with us a loss covered by this endorsement. Premium will be charged for your employees while in the course of special or temporary employment by the alternate employer- The policy may be canceled according to its terms without sending notice to the alternate employer. Part Four (Your Duties If Injury Occurs) applies to you and the alternate employer. The alternate employer will recognize our right to defend under Parts One and Two and our right to inspect under Part Six. Schedule 1. Alternate Employer Address IF ANY DOES NOT APPLY TO ANY EMPLOYEE LEASE CONTRACT/ARRANGEMENT 2. State of Special or Temporary Employment ANY STATE SHOWN IN ITEM 3A OF THE INFORMATION PAGE 3. Contract or Project WHERE REQUIRED BY WRITTEN CONTRACT For the state of HI, MI, OK refer to state specific endorsements. This endorsement is not applicable in AK. �! Authorized Agent WC 00 03 01A (E7 2-89) 1 �a ace usa NOTICE TO OTHERS—SCHEDULE NOTICE BY INSURED'S REPRESENTATIVE A. If we cancel this Policy prior to its expiration date by notice to you or the first Named insured for any reason other than nonpayment of premium, we will endeavor to send written notice of cancellation, to the persons or organizations listed in the schedule that you or your representative create or maintain (the "Schedule") by allowing your representative to send such notice to such persons or organizations. This notice will be in addition to our notice to you or the first Named Insured, and any other party whom we are required to notify by statute and in accordance with the cancellation provisions of the Policy. B. The notice of cancellation, as provided by your representative, is intended only to be a courtesy notification to the person(s) or organization(s) named in the Schedule in the event of a pending cancellation of coverage. We have no legal obligation of any kind to any such person(s) or organization(s). The failure to provide advance notification of cancellation to the person(s)or organization(s) shown in the Schedule will impose no obligation or liability of any kind upon us, our agents or representatives, will not extend any Policy cancellation date and will not negate any cancellation of the Policy. C. We are not responsible for verifying any information in any Schedule, nor are we responsible for any incorrect information that you or your representative may use. D. We will only be responsible for sending such notice to your representative, and your representative will in turn send the notice to the persons or organizations listed in the Schedule at least 30 days prior to the cancellation date applicable to the Policy. You will cooperate with us in providing the Schedule, or in causing your representative to provide the Schedule. E. The provisions of this notice do not apply in the event that you cancel the Policy. WC 99 03 88(10/11) Workers'Compensation and Employers'Liability Policy Named Insured Endorsement Number WOOD GROUP USA, INC. 17420 KATY FRWY SUITE 500 Policy Number HOUSTON TX 77094 Symbol:WLR Number:C66039262 Policy Period Effective Date of Endorsement 07-01-2019 TO 07-01-2020 07-01-2019 Issued By(Name of Insurance Company) ACE AMERICAN INSURANCE COMPANY Insert the policy number.The remainder of the information is to be completed only when this endorsement is issued subsequent to tlhepreparation of the policy. TEXAS WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement applies only to the insurance provided by the policy because Texas is shown in item 3.A. of the Information Page. 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, but this waiver applies only with respect to bodily injury arising out of the operations described in the Schedule, where you are required by a written contract to obtain this waiver from us. This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule. The premium for this endorsement is shown in the schedule. Schedule 1. ( ) Specific Waiver Name of person or organization: ( X ) Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. 2. Operations: ALL TEXAS OPERATIONS 3. Premium: The premium charge for this endorsement shall be 2.0 percent of the premium developed on payroll in connection with work performed for the above person(s)or organization(s)arising out of the operations described. 4. Advance Premium: $0 i Authorized Representative WC 42 03 04B(06/14) ®Copyright 2014 National Council on compensation Insurance,Inc.All Rights Reserved. Workers'Compensation and Employers'Liability Policy __ _.._ __.___.__...._-------...._-- ---- f Named iry;ured Endorsement Number WOOD GROUP USA, INC. j 17420 KATY FRWY SUITE 500 Policy Number T HOUSTON TX 77094 Symbol: R Number: C66039262 Policy Period Effective Date of Endorsement 07-01-2019 TO 07-01-2020 07-01-2019 Issued By(Name of Insurance Company) _ ACE AMERICAN INSURANCE COMPANY Insert the policy number.The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy, CALIFORNIA WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement applies only to the insurance provided by the policy because California is shown in Item 3.A. of the Information Page. 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, but this waiver applies only with respect to bodily injury arising out of the operations described in the Schedule, where you are required by a written contract to obtain this waiver from us. You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. Schedule 1. ( ) Specific Waiver Name of person or organization: ( X ) Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. 2. Operations: ALL OPERATIONS CONDUCTED BY AN INSURED PURSUANT TO SUCH WRITTEN CONTRACT 3. Premium: The premium charge for this endorsement shall be 2.0 percent of the California premium developed on payroll in connection with work performed for the above person(s) or organization(s) arising out of the operations described. 4. Minimum Premium: $0 Authorized Representative WC 90 03 75(05/18) Named Insured Workers'Compensation and Employers'Liability Policy WOOD GROUP USA, INC. Endorsement Number 17420 KATY FRWY SUITE 500 Policy Number HOUSTON TX 77094 S mbol:WLR Number:C66039262 Policy Period Effective Date of Endorsement 07-01-2019 TO 07-01-2020 07-01-2019 Issued By(Name of Insurance Company) ACE AMERICAN INSURANCE COMPANY lnscri the policy number.The remainder of the information is to be corn toted only when this endorsement is iawued subsStAucot to the pmoaration oribc policy. UTAH WAIVER OF SUBROGATION ENDORSEMENT This endorsement applies only to the insurance provided by the policy because Utah is shown in Item 3.A. of the Information Page. 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 a s.) This agreement shall not operate directly or indirectly to benefit anyone not named in the schedule. Our waiver of rights does not release your employees' rights against third parties and does not release our authority as trustee of claims against third parties. Schedule ANY PERSON OR ORGANIZATION AGAINST WHOM YOU HAVE AGREED TO WAIVE YOUR RIGHT OF RECOVERY IN A WRITTEN CONTRACT, PROVIDED SUCH CONTRACT WAS EXECUTED PRIOR TO THE DATE OF LOSS. .f Authorized Agent WC 43 03 05 (10/00)Ptd.in U.S.A. Workers'Compensation and Employers'Liability Policy Named Insured ��� _ Endorsement Number WOOD GROUP USA, INC. 17420 KATY FREEWAY SUITE 300 Policy Number HOUSTON TX 77094 S mbol:WLR Number:C66039262 Policy Period Effective Date of Endorsement 07-01-2019 TO 07-01-2020 07-01-2019 Issued By(Name of Insurance ComoanO ACE AMERICAN INSURANCE COMPANY Insert the polio number.The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of!fie ii FEDERAL EMPLOYERS' LIABILITY ACT COVERAGE ENDORSEMENT This endorsement applies only to the work subject to the Federal Employers' Liability Act(45 USC Sections 51-60)and any amendment to that Act that is in effect during the policy period. G. Limits of Liability of Part Two (Employers Liability Insurance)is replaced by the following: G. Limits of Liability Our liability to pay for damages is limited. Our limits of liability are shown in the Schedule.They apply as explained below. 1. Bodily Injury by Accident. The limit shown for "bodily injury by accident-each accident" is the most we will pay for all damages covered by this insurance because of bodily injury to one or more employees in any one accident. A disease is not bodily injury by accident unless it results directly from bodily injury by accident. 2. Bodily Injury by Disease. The limit shown for "bodily injury by disease-aggregate" is the most we will pay for all damages covered by this insurance because of bodily injury by disease to one or more employees. The limit applies separately to bodily injury by disease arising out of work in each state shown in Item 3.A. of the Information Page or in the Schedule. Bodily injury by disease does not include disease that results directly from bodily injury by accident. 3. We will not pay any claims for damages after we have paid the applicable limit of our liability under this insurance. If any state is named in item 2 of the Schedule, Part Two (Employers Liability Insurance) applies in that state to work subject to the Federal Employers' Liability Act as though that state were listed in item 3.A. of the Information Page. Part One (Workers Compensation Insurance)does not apply in a state shown in the Schedule. Schedule 1. Limits of Liability Bodily Injury by Accident $ 1,000,00 each accident Bodily Injury by Disease $1,000,000 aggregate 2. State TX This form is only applicable in TX, Mi. Authorized Agent WC 00 01 04(04-84) _� Workers'Compensation and Employers'Liability Policy Named Insured Endorsement Number WOOD GROUP USA, INC. 17420 KATY FRWY SUITE 500 Policy Number HOUSTON TX 77094 Symbol:WLR Number:C66039262 Policy Period Effective Date of Endorsement 07-01-2019 TO 07-01-2020 07-01-2019 Issued By(Name of Insurance Company) ACE AMERICAN INSURANCE COMPANY Insert the Dolicy number.The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. VOLUNTARY COMPENSATION AND EMPLOYERS LIABILITY COVERAGE ENDORSEMENT This endorsement adds Voluntary Compensation Insurance to the policy. A. How This Insurance Applies This insurance applies to bodily injury by accident or bodily injury by disease. Bodily injury includes resulting death. 1. The bodily injury must be sustained by an employee included in the group of employees described in the Schedule. 2. The bodily injury must arise out of and in the course of employment necessary or incidental to work in a state listed in the Schedule. 3. The bodily injury must occur in the United States of America, its territories or possessions or Canada and may occur elsewhere if the employee is a United States or Canadian citizen temporarily away from those places. 4. Bodily injury by accident must occur during the policy period. 5. Bodily injury by disease must be caused or aggravated by the conditions of your employment. The employee's last day of last exposure to the conditions causing or aggravating such bodily injury by disease must occur during the policy period. B. We Will Pay We will pay an amount equal to the benefits that would be required of you if you and your employees described in the Schedule were subject to the workers compensation law shown in the Schedule. We will pay those amounts to the persons who would be entitled to them under the law. C. Exclusions This insurance does not cover: 1. any obligation imposed by a workers compensation or occupational disease law, or any similar law. 2. bodily injury intentionally caused or aggravated by you. D. Before We Pay Before we pay benefits to the persons entitled to them,they must: 1. Release you and us, in writing,of all responsibility for the injury or death. 2. Transfer to us their right to recover from others who may be responsible for the injury or death. 3. Cooperate with us and do everything necessary to enable us to enforce the right to recover from others. If the persons entitled to the benefits of this insurance fail to do those things, our duty to pay ends at once. If they claim damages from you or from us for the injury or death,our duty to pay ends at once. WC 00 03 11 A(08/91) Page 1 of 2 E. Recovery From Others If we make a recovery from others, we will keep an amount equal to our expenses of recovery and the benefits we paid. We will pay the balance to the persons entitled to it. If the persons entitled to the benefits of this insurance make a recovery from others, they must reimburse us for the benefits we paid them. F. Employers Liability Insurance Part Two (Employers Liabiity Insurance) applies to bodily injury covered by this endorsement as though the State of Employment shown in the Schedule were shown in Item 3.A. of the Information Page. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. Schedule Employee ANY EMPLOYEE EXEMPT FROM THE WORKERS COMPENSATION LAW. NJ& WI ARE EXCLUDED State of Employment ALL STATES LISTED UNDER ITEM 3.A. OF THE INFORMATION PAGE EXCEPT NJ &WI Designated Workers Compensation Law STATE OF HIRE This form is not applicable in CA, HI, NJ, &TX. This form is applicable in WI only for industrial sponsored athletic teams, volunteer fire departments, masters and members of vessels and USL&H. Authorized Representative WC 00 03 11 A(08/91) Page 2 of 2 Workers'Compensation and Employers'Liability_Policy Named Insured __v�^ ���"�� Endorsement Number WOOD GROUP USA, INC. 1 17420 KATY FRWY SUITE 500 PolcyfVumber�'—N� HOUSTON TX 77094 Symbol:WLR Number: C66039262 Policy Period Effective Date of Endorsement 07-01-2019 TO 07-01-2020 07-01-2019 -- _ _._.........__ _- lecnAtl Rv lNamo of Inouro rro Cmm�n rnil ACE AMERICAN INSURANCE COMPANY Insert the policy number.The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the polic . VOLUNTARY COMPENSATION AND EMPLOYERS LIABILITY COVERAGE ENDORSEMENT-CALIFORNIA If the employer named in item 1 of the Information Page has in his employment persons not entitled to compensation under Division 4 of the Labor Code of the State of California, this policy shall operate as an election on the part of the employer to come under the compensation provisions of Division 4 with respect to those persons described in the Schedule below. This policy applies to those persons described in the Schedule below as employees. Schedule ANY EMPLOYEE EXEMPT FROM THE WORKERS COMPENSATION LAW Authorized Agent WC 04 03 05(7/85) — ------ Workers'Compensation and Employers'Liability Policy Named Insured Endorsement Number WOOD GROUP USA, INC. 17420 KATY FRWY SUITE 500 Policy Number HOUSTON TX 77094 Symbol:WLR Number:C66039262 Policy Period Effective Date of Endorsement 07-01-2019 TO 07-01-2020 t 07-01-2019 Issued By(Name of Insurance Company) ACE AMERICAN INSURANCE COMPANY Insert the policy number.The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. OHIO EMPLOYERS LIABILITY COVERAGE ENDORSEMENT This endorsement applies only to work in Ohio. A. Part One (Workers Compensation Insurance)does not apply to work in Ohio. B. Part Two (Employers Liability Insurance) applies to work in Ohio as though it were shown in Item 3.A. of the Information Page. C. Part Two (Employers Liability Insurance), C. Exclusions is changed by adding these exclusions. C. Exclusions This insurance does not cover: 5. bodily injury intentionally caused or aggravated by you, or bodily injury resulting from an act which is determined to have been committed by you with the belief that an injury is substantially certain to occur; 13. bodily injury to an employee when you are deprived of common law defenses or are subject to penalty because of your failure to secure your obligations under the workers compensation law of Ohio or otherwise fail to comply with that law. Authorized Representative WC 34 03 01C(03/10) 0 Copyright 1985, 1988, 1991,2010 National Council on Compensation Insurance,Inc.All Rights Reserved. 2 POLICY NUMBER: HDO G27874265 Endorsement Number: 4 COMMERCIAL GENERAL LIABILITY CG24040609 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Any person or organization against whom you have agreed to waive your right of recovery in a written contract, provided such contract was executed prior to the date of loss. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV--Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products- completed operations hazard". This waiver applies only tc the person or organization shown in the Schedule above. i i I i CG 24 04 05 09 ©Insurance Services Office, Inc., 2008 Page 1 of 1