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3. 1st Amendment & Task Order 01/21/2022
Kevin Madok, CPA Clerk of the Circuit Court& Comptroller— Monroe County, Florida DA'M: jaimar), 29, 2022 TO: Ju(fitll Clarke, PE, Director Eiippeening/Roads& Bridges ATTN: Nicole Tiv},riiari ExectitNe Assistant FROM: Paiiiela G. Harico*11C. SUMECT: jaimax), 21" BOCC Meetilig Attaclied is an electronic copy of the lollowiiig item for your limidlilig: C12 Task ()r(ler and Aiiieiidiiierit to the Coi-ifiriuirig Services Contract %%rifli HDR Frigiricenhig, Inc., in the amount ol'$99,21 t.00, to extend flie fenii ol'the contract for one year to provide consultant services to pefl'onii a stonimater needs analysis for county-maintained roads as required by Section ,tO3.9302(3)(a), F.S. and to evaluate road%va)' asset maiiageiiierif software systems. Slioul(l N'ou liaN,e ariN,questions please I'Cel free to contact me at (305) 292-3550. cc: C01-11ity Attorney' Finance File KEY WEST MARATHON PLANTATION KEY PK/ROTH BUILDING 500 Whitehead Street 3117 Overseas Highway 88820 Overseas Highway 50 High Point Road Key West,Florida 33040 Marathon,Florida 33050 Plantation Key,Florida 33070 Plantation Key,Florida 33070 305-294-4641 305-289-6027 305-852-7145 305-852-7145 TASK ORDER AND AMENDMENT WITH HDR ENGINEERING, INC TO EXTEND TERM OF CONTRACT FOR ONE YEAR AND TO PROVIDE CONSULTANT SERVICES TO CONDUCT A STORMWATER NEEDS ANALYSIS FOR COUNTY MAINTAINED ROADS AS REQUIRED BY SECTION 403.9302(3)(a), F.S., AND TO CONDUCT ROADWAY ASSET MANAGEMENT SOFTWARE RESEARCH AND RECOMMENDATION FOR IMPLEMENTATION BY THE ENGINEERING DEPARTMENT In accordance with the Continuing Contract for On Call Professional Engineering Services made and entered on the 17th day of January, 2018 between Monroe County hereinafter referred to as the "County" and HDR Engineering, Inc., hereinafter referred to as "Consultant" where professional services are allowed if a study does not exceed $500,000 or construction costs do not exceed $4,000,000 in accordance with F.S. 287.055 (as amended per Chapter 2020-127). All terms and conditions of the referenced Contract for On Call Professional Engineering Services apply to the Task Order, unless the Task Order modifies an Article of the Agreement of which will be specifically referenced in this Task Order and the modification shall be precisely described. This Task Order is retroactively effective to January 14, 2022 and shall expire on July 31, 2022. The term of the Agreement for On Call Professional Engineering Services shall be renewed for an additional one-year period to extend the term of the contract to January 17, 2023 to allow for completion of the Scope of Basic Services as set forth in this Task Order. Article II Scope of Basic Services, Paragraph 2.1 is amended as follows: Task 1 —Consultant will conduct national research to evaluate different available roadway asset management software based on County's specific needs. Consultant will prepare a report outlining capabilities of each, cost, pros and cons to assist county with selection of system best suited to County needs. Task 2 - the consultant will analyze the county's stormwater management program and infrastructure located within rights-of-way in unincorporated Monroe County that are owned and maintained by the County and develop a Stormwater Needs Analysis that meets the requirements of 403.9302(3) for submittal to The Department of Environmental Protection and Office of Economic and Demographic Research by July 31, 2022. The scope of work, deliverables and schedule for these tasks are more fully described in Attachment A. Article VII Compensation, Paragraph 7.1 is amended to read: The Consultant shall be paid monthly. The total Not To Exceed lump sum amount of$98,214 plus $1,000 reimbursable expenses will apply and is estimated as follows: Stormwater Needs Analysis HDR Engineering,Inc. 12/20/2021 Task I —Asset Management Study $27,916 Task 2 -Stormwater Needs Analysis Project Management $10,524 Data Evaluation $ 9,142 Stormwater Needs Analysis $40,632 Reimbursable Expenses $ 1,000 Optional Additional Services $10,000 Task Order Total $99,214 Optional services task will address unforeseen tasks that may be required. Consultant will proceed with Optional Services only upon written authorization from the County, Article V11 Compensation, Paragraph 7A.2 The individual itemized task amounts are estimates and may be adjusted as needed as long as the Total Contract Amount of$99,214 is not exceeded. WHEREOF, each party caused the Task Order to be executed by its duly authorized representative. HDR Engineering, Inc. Witness 12/2 L/2021 Signature Date Signature --Date Melanie E. Fowler Vi4lPresident V- Al BOARD OF COUNTY COMMISSIONERS gy: ADOK, Clerk OF MONROE COUNTY, FLORIDA by: As Deputy Clerk Mayor/Chairman Date: MONROE COUTTY AWORNEY q AS TO Stormwater Needs Analysis g HD R Engineering,Inc. -BAU019 12/20/2021 ASSISTANT COUN7Y ATTORNEY DATFr--=22- ATTACHM ENT A CONSULTANT SCOPE OF SERVICES Stormwater Needs Analysis HDR Engineering,Inc. 12/20/2021 Monroe County Task Authorization 003 Asset Management/Maintenance Software research and recommendation and Stormwater Needs Analysis Monroe County Engineering Services 1100 Simonton Street Key West, Florida 33040 December 25, 2021 Monroe County Asset Management/Maintenance Software research and recommendation and Stormwater Needs Analysis FN Contents Background................................................................................................................................................... 1 Descriptionof Services ................................................................................................................................. 1 Task 1.0 Asset Management/Maintenance Software research and recommendation support.......................................................................................................................................2 Task 2.0 Florida House Bill (HB) 53 Stormwater Needs Analysis ......................................................2 Task 2.1 Project Management............................................................................................................2 Task2.2 Data Evaluation....................................................................................................................2 Task 2.3 Stormwater Needs Analysis.................................................................................................3 Task2.4 Optional Services.................................................................................................................4 Scheduleof Implementation..........................................................................................................................4 Invoicing........................................................................................................................................................4 Compensation...............................................................................................................................................5 Assumptions..................................................................................................................................................5 Appendices AppendixA. Fee Estimate.............................................................................................................................6 December 25,2021 1 i Monroe County Asset Management/Maintenance Software research and recommendation and Stormwater Needs Analysis FN Background At the request of Monroe County, HDR Engineering, Inc. (HDR) is pleased to submit this proposal to perform Asset Management/Maintenance Software research and recommendation support as well as a Stormwater Needs Analysis pursuant to Florida House Bill (HB) 53. The County would like to implement a GIS based asset management/maintenance software system for roadway and drainage infrastructure. Software should be GIS centric using the existing available data and able to expand the database. The bill requires the Office of Economic& Demographic Research (EDR), beginning with the annual assessment due January 1, 2023, to include an analysis of the expenditures necessary to repair, replace, and expand water-related infrastructure in their annual assessment of Florida's water resources and conservation lands. By June 30, 2023, and every five years thereafter, the bill requires each county, municipality, or special district providing stormwater services to develop a needs analysis for its jurisdiction over the subsequent 20 years. The analysis must be compiled and submitted to EDR, which must evaluate the compiled documents for the purpose of developing a statewide analysis for inclusion in the annual assessment due January 1, 2023. The scope of services for the work shall be described herein. Description of Services The Scope of work for the Asset Management/Maintenance Software research and recommendation support entails conducting a market analysis of various softwares, preparing key requirements, an evaluation framework, and identify a solution type that would work best for the County. HDR's approach is to select the package that best meets each client's specific needs. The following softwares will be considered, but not limited to assessing any other applicable market options. Cityworks and DTS Vueworks are GIS-centric and widely used for roads, bridges, other right-of-way appurtenances, and storm drainage. DTS Vueworks started as a package for transportation agencies and are being used in all municipal infrastructure functions. Other packages (Cartegraph, Central Square, Infor Public Sector(ex-Hansen)) are not as tightly connected with GIS, but also provide rich functionality for the asset types you described. Data collection and research will be conducted through interviews with County to understand how software will be used, how can it facilitate operations, and what the output required. The County is to provide a summary of the GIS data available and description of the new data that will continue to be documented. A Technical Memorandum will summarize the vendor research information and provide a recommendation. A virtual presentation will be provided to go over the Technical Memorandum and further elaborate on the software recommendation. The scope of work for the HB 53 support includes the analysis of Monroe County's stormwater management program (i.e., stormwater infrastructure located within unincorporated Monroe County, within the county roadway rights-of-way, and that are owned and maintained by the county). The scope of work shall be divided into four tasks, as follows: December 25,2021 1 1 Monroe County Asset Management/Maintenance Software research and recommendation and Stormwater Needs Analysis 2.1 Project Management 2.2 Data Evaluation 2.3 Stormwater Needs Analysis 2.4 Additional Services AssetTask 1 .0 Management/Maintenanc and recommendation Initial assessment that considers reviewing County needs, including available data and future use of data, research, and provision of a recommendation on 3-4 vendors that satisfy these demands summarizing information and presenting them in a Technical Memorandum and a virtual presentation. Efforts for this task have been combined into two activities, Data collection and research and recommendation. Deliverables: • Technical Memorandum • Virtual Presentation FloridaTask 2.0 ill ( ) 53 Stormwater Analysis ProjectTask 2. 1 Management This task includes general functions required to maintain the project on schedule, within budget, and that the work products defined within this scope are consistent with HDR's scope of services and Monroe County requirements. HDR will prepare and submit monthly status reports with invoices. Deliverable: • Monthly status reports Task 2.2 Data Evaluation HDR will participate in a project kickoff meeting with Monroe County staff to confirm the objectives of the project and discuss the data collection request. HDR will then collect and evaluate the information necessary to complete the objectives of the project. Specific activities within this task include: • Kickoff meeting • Collection and review of data, as available: ➢ Stormwater Master Plan, capital improvement plan, and previous engineering studies ➢ NPDES Municipal Separate Storm Sewer System (MS4) Permit ➢ Historical and projected expenditures and revenues, including funding sources, related to stormwater management program December 25,2021 1 2 Monroe County Asset Management/Maintenance Software research and recommendation and Stormwater Needs Analysis FN ➢ Interviews with engineering, operations and maintenance, and budgeting staff HDR will utilize the geospatial stormwater asset data previously collected during roadway vulnerability study as part of this task. Deliverables: • Data request list • Kickoff meeting notes Task 2.3 Stormwater Needs Analysis Using the data reviewed as part of Task 2, HDR will conduct an analysis of Monroe County's stormwater program needs and prepare a document for the County's submittal to EDR following the template provided by EDR (Appendix B). The document will be divided into 8 parts, as described below: • Part 1.0 Detailed description of the stormwater management program (Section 403.9302(3)(a), F.S.) • Part 2.0 Detailed description of the stormwater management system and its facilities and projects (continued Section 403.9302(3)(a), F.S.) • Part 3.0 The number of current and projected residents served calculated in 5-year increments (Section 403.9302(3)(b), F.S.) • Part 4.0 The current and projected service area for the stormwater management program or stormwater management system (Section 403.9302(3)(c), F.S.) • Part 5.0 The current and projected cost of providing services calculated in 5-year increments (Section 403.9302(3)(d), F.S.) • Part 6.0 The estimated remaining useful life of each facility or its major components (Section 403.9302(3)(e), F.S.) • Part 7.0 The most recent 5-year history of annual contributions to, expenditures from, and balances of any capital account for maintenance or expansion of any facility or its major components. (Section 403.9302(3)(f), F.S.) • Part 8.0 The local government's plan to fund the maintenance or expansion of any facility or its major components. The plan must include historical and estimated future revenues and expenditures with an evaluation of how the local government expects to close any projected funding gap (Section 403.9302(3)(g), F.S.) HDR will present the findings to county staff in a workshop, and based on comments received during the workshop, the Stormwater Needs Analysis submittal will be updated and finalized. Deliverables: • Draft Stormwater Needs Analysis • Meeting Notes from Workshop • Final Stormwater Needs Analysis December 25,2021 1 3 Monroe County Asset Management/Maintenance Software research and recommendation and Stormwater Needs Analysis Task 2.4 Optional Services A budget for optional services has been established by the county to address unforeseen tasks that may be required to complete the Stormwater Needs Analysis. Once a new task is identified and scoped, HDR will proceed only upon written authorization from the county. Schedule of Implementation Task 1.0 Asset Management/Maintenance Software research and recommendation: Consultant estimates that the services included in this Scope of Services can be completed within 3 months from issuance of Notice To Proceed. Task 2.0 Florida House Bill (HB)53 Stormwater Needs Analysis: Task Activity Due Date 2.1 Project Management Project Management Ongoing 2.2 Data Evaluation Kickoff Meeting January 14, 2022 2.2 Data Evaluation Collect and Review February 18, 2022 Data 2.3 Stormwater Needs Analysis Analysis of Data May 19, 2022 2.3 Stormwater Needs Analysis Draft Submittal May 20, 2022 2.3 Stormwater Needs Analysis County Comments June 3, 2022 2.3 Stormwater Needs Analysis Workshop June 10, 2022 2.3 Stormwater Needs Analysis Final Submittal June 24, 2022 Invoicing Invoicing will be as per HDR Non-Exclusive Professional Services Agreement. Task deliverables will be as detailed in the proposed Scope of Work and as approved by Monroe County. December 25,2021 1 4 Monroe County Asset Management/Maintenance Software research and recommendation and Stormwater Needs Analysis FN Compensation HDR agrees to perform the work of services for a total lump sum fee summarized in the tables below. Additionally, the tables provide the budgets for reimbursable expenses. HDR shall submit monthly invoices accompanied by a progress report. Task 1.0—Asset Management/Maintenance Software research and recommendation $ 27,916.00 Task 2.1 — Project Management $ 10,524.00 Task 2.2 — Data Evaluation $ 9,142.00 Task 2.3 — Stormwater Needs Analysis $ 40,632.00 Fee Estimate Tasks 1.0-2.3 $ 60,298.00 Reimbursable Expenses Tasks 1.0-2.3 $ 1,000.00 Total Proposed Fee $ 89,214.00 Task 2.4 - Optional Services $ 9,501.00 Reimbursable Expenses Task 2.4 $ 499.00 Total Proposed Fee $ 10,000.00 TOTAL Tasks 1-2.4 $ 99,214.00 Assumptions This scope of work and deliverables are based on the following assumptions: • The Asset Management/Maintenance research task does not include procurement and/or integration. • The analysis of stormwater systems and facilities not owned and operated by Monroe County are excluded from this scope of services. • Data will be made available to HDR prior to the conclusion of the data evaluation period. • Data is accurate and suitable for inclusion in the stormwater needs analysis. • HDR will complete the following meetings in support of this project: Task No. Meeting Quantity Type 2.2 Kickoff Meeting 1 Conference Call 2.2 Data Review/Coordination 4 (max.) Conference Call 2.3 Analysis Review/Coordination 4 (max.) Conference Call 2.3 Workshop 1 In Person If required, additional meetings may be provided as an optional/additional service. • Monroe County will review the draft Stormwater Needs Analysis and forward a single set of compiled review comments to HDR prior to the workshop as indicated in the project schedule. December 25,2021 1 6 Monroe County Asset Management/Maintenance Software research and recommendation and Stormwater Needs Analysis Appendix A. Fee Estimate December 25,2021 1 6 Attachment A Asset Management/Maintenance Software research and recommendation/Stormwater Needs Analysis Fee Estimate TABLE 1-REQUIRED SERVICES Principal Senior AdministrativeTask Engineer Chief Engineer Staff Engineer Atlministmtive Associate By Task Associate Task 1 0:-Asset:Management/Maintenance:Software research and recommendation 4 48 120 8 0$ 27,916.00 Data Collection and Research i 21 241 801 4 $ 16,418.00 Recommendation 1 21 241 401 4 $ 11,498.00 Task 2.0: Florida House Bill HB 53:Stormwater.Needs Analysis Task 2.1.-Project:Management 4 16 40 8 0$ 10,524,00. Project Management 4 16 40 8 $ 10,524.00 Task 2.2:-Data Evaluation 6 12 36 0 4$ 9,142.00 Kickoff Meeting/Data Request 21 2 $ 1,006.00 Gather and Review Data 2 8 16 $ 6,850.00 Kickoff Meeting Notes 2 2 i 4$ 1,286.00 Task 2.3:-Stormwater.Needs Analysis 20 62 160 0 14$ 40,632.00 Part 1-Description of stormwater management program(Section 403.9302(3)(a),F.S.) 1 6 12 $ 3,159.00 Part 2-Description ofsystem,facilities,and projects(continued Section 403.9302(3)(a),F.S.) 1 4 12 $ 2,687.00 Part 3-Current and projected residents Section 403.9302 3 b,F.S. 1 2 8 $ 1,723.00 Part 4-Current and projected service area Section 403.9302(3)c,F.S. 1 2 8 $ 1,723.00 Parts-Current and projected service costs(Section 403.9302(3)(d),F.S.) 4 12 40 $ 8,820.00 Part 6-Estimated remaining useful life of facilities(Section 403.9302(3)(e),F.S.) 1 8 20 $ 4,615.00 Part 7-History of contributions and expenditures for maintenance and expansion(Section 403.9302(3)(f),F.S.) 2 8 20 $ 4,882.00 Part 8-Funding plan for maintenance and expansion(Section 403.9302(3)(g),F.S.) 2 8 20 $ 4,882.00 Drag Stormwater Needs Anal sis 1 2 8 8$ 2,283.00 Worksho /Meetin Notes from Worksho 2 2 4 2$ 1,638.00 Final Stormwater Needs Analysis 1 41 81 81 1 4$ 4,220.00 TOTAL HOURS 34 138 356 16 18 Contract Rate $267.00 $236.00 $123.00 $95.00 $70.00 Fee Estimate $9,078.00 $32,568.00 $43,788.00 $1,520.00 $1,260.00 $88,214.00 Reimbursable Expenses $1,000.00 Total Proposetl Fee $89,214.00 TABLE 2-OPTIONAL SERVICES Principal Senior Administrative Task Chief Engineer Staff Engineer Administrative By Task Engineer Associate Associate Task 24:-Optional:Services 8 10 35 0 10$ 9,501,00. Optional Services 81 101 351 1 10$ 9,501.00 TOTAL HOURS 8 10 35 0 10 Contract Rate $267.00 $236.00 $123.00 $95.00 $70.00 Fee Estimate $2,136.00 $2,360.00 $4,305.00 $0.00 $700.00 $9,501.00 Reimbursable Expenses $499.00 Total Proposed Fee $10,000.00 Total for Required Services and Optional Services $99,214.00 ACC-'AR" CERTIFICATE OF a DATE(MMIDD ) LIABILITYINSURANCE 611r2022 5/10/2021 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 FLOW, 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 pollcy(les)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 endorse tent(s). PRODUCER I,..00ICton Companies CON AME:TACT 444 A4 47th Street,Suite 900 PHONE IFAX — UVC No.Evil: Aac Nm Kansas City MO 64112-1906 E-MAIL (816)960-9000 mass INSURER(S)AFFORDING COVERAGE NAIL 9 — INSURER A:Le%pn ton Insurance Corn an 19437 INSURED HIIE.ENGaINEERrNG,INC. INSURER B: _ 1429676 1917 SOUTH 67TH STREET INSURER c: OMAHA,NE 68106 INSURER D: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: 16098841 REVISION NUMEIER: xxxxxxx THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF PbLIC°!EXP ..............._.. LTR TYPE OF INSURANCE POLICY NUMBER M1iMtDD A9Mtd3DtYYYY LIMITS COMMERCIAL GENERAL LIABILITY NOT APPLICABLE EACH OCCURRENCE s xxxx x CJAMAGE RENTED CLAIMS-MADE OCCUR PREMISE (Ea Occurrence} 5 xxxxxxx P.._ MED EXP(Any one person) $ xxx'xxxx _.................... PERSONAL A ADV INvURY t 5 XXXXXXX GEN`L AGGREGATE LIMIT APPLIES PER: _GENERAL AGGREGATE �I$ xxxxxxx PODGY PRO- [] JEC T LOC PRODUCTS-COMPIOP AGG $ XXXXXXX OTHER: $ AUTOMOBILE LIABILITY NOTAPPLICABLE COM131W SINGLE LIMrr $ Ea accident} xx x ANY AUTO BODILY INJURY(Per person) $ Xxxxxxx OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS xxxxxxx HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ xxxxxxx S UMBRELLA LIAR OCCUR NOT APPLICABLE EACH OCCURRENCE........ $ xxxxxxx EXCESS LIAR CLAIMS-MADE.........''..... AGGREGATE ffi xxxxxxx BED I I RETENTION$ 5 xxxxxxx WORKERS COMPENSATION ldC)T APPLICABLE PERRTUTE ORTH- AND EMPLOYERS`LIABILITY 'Y d N ANY PROPRIETCIRIPARTNERIEXECu'FIVE 0 E..L.EACH ACCIDENT 5 xxxxxxx OFFICER/MEMBER EXCLUDED? N I A (Mandatory In NH) E.L DISEASE-EA EMPLOYEE $ X' x DIf ES,describe under CRIPTION OF OPERATIONS below E..L.DISEASE-POLICY LIMIT $ X XX A ARCH&ENG N IN061853691 6'1 2021 6'12022 PER CLAIM:$1,000,000 _______....- PROFESSIONAL AGGREGATE: $2,000,000 LIABILITY DESCRIPTION OF OPERATIONS t LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) ON CALL PROFFESSIONAL ENGINEERING SERVICES. p , 9 .28 .2021 PL only__. CERTIFICATE HOLDER CANCELLATION 16098841 MON OE COUNTY BOCC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1100 SimontonStreet THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Ivey West FL 33040 AUTHORIZEDIREPRESENTATIV i 0 1966 015 ACORD CORPORATION. All rights reserved. ACORD 25(20I6103) The ACORD name and logo are registered marks of ACORD Page 1 of 2 CERTIFICATE OF LIABILITY INSURANCE D09izzizaz1Y) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Willis Towers Watson Certificate Center NAME: Willis Towers Watson Midwest, Inc. c/o 26 Century Blvd PHONE 1-877-945-7378 FAX 1-888-467-2378 A/C Na Ext: A/C No): P.O. Box 305191 ADDRIESS: certificates@willis.com Nashville, TN 372305191 USA INSURER(S)AFFORDING COVERAGE NAIC4 INSURER A: Liberty Mutual Fire Insurance Company 23035 INSURED INSURERB: Ohio Casualty Insurance Company 24074 HDR Engineering, Inc. 1917 South 67th Street INSURER C: Liberty Insurance Corporation 42404 Omaha, NE 68106 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: W22205646 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR IN SD WVD POLICYNUMBER MM/DD/YYYY MM/DD/YYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE � OCCUR D' MAGITORENT 1,000,000 PREMISES ..Ea occurrence $ A X Contractual Liability MED EXP(Any one person) $ 10,000 Y Y TB2-641-444950-031 06/01/2021 06/01/2022 PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY� PRO- � LCC PRODUCTS-COMP/OPAGG $ 4,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 2,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED Y Y AS2-641-444950-041 06/01/2021 06/01/2022 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident B UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 X EXCESS LIAB CLAIMS-MADE Y Y EUO(22)57919363 06/01/2021 06/01/2022 AGGREGATE $ 5,000,000 DED X RETENTION$ 0 $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER 1,000,000 C ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? No N/A Y WA7-64D-494950-011 06/01/2021 06/01/2022 1,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate Holder is named as Additional Insured on General Liability, Automobile Liability and Umbrella/Excess Liability on a Primary, Non-contributory basis where required by written contract. Waiver of Subrogation applies on General Liability, Automobile Liability, Umbrella/Excess Liability and Workers Compensation where required by written contract and as permitted by law. Umbrella/Excess policy is follow form over General Liabilitv. Auto Liabilitv and Employers Liability. 0 ' Iffy .� v. CERTIFICATE HOLDER CANCELLATION . 2 8 . 2021 SHOULD ANY OF THE WAPM �• THE EXPIRATION ACCORDANCE WITH THE POLICY PROVISIONS. Monroe County BOCC AUTHORIZED REPRESENTATIVE 1100 Simonton Street Key West, FL 33040 ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD SR ID: 21610880 BATCH: 2244514 AGENCY CUSTOMER ID: LOC#: AC"J?o ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED HDR Engineering, Inc. Willis Towers Watson Midwest, Inc. 1917 South 67th Street POLICY NUMBER Omaha, NE 68106 See Page 1 CARRIER NAIC CODE See Page 1 See Page 1 EFFECTIVE DATE: See Page 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Project: On Call Professaional Engineering Services Agreement. Additional Insured: FDOT and Monroe County Board of County Commissioners (MCBOCC) . ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SR ID: 21610880 BATCH: 2244514 CERT: W22205646 Policy Number: TB2-641-444950-031 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED LOCATION(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Location(s): All locations owned by or rented to the Named Insured Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. For all sums which the insured becomes legally b. Claims made or"suits" brought; or obligated to pay as damages caused by "occur- rences" under Section I—Coverage A, and for all c. Persons or organizations making claims or medical expenses caused by accidents under bringing "suits". Section I — Coverage C, which can be attributed 3. Any payments made under Coverage A for only to operations at a single designated "loca- damages or under Coverage C for medical tion" shown in the Schedule above: expenses shall reduce the Designated Loca- tion General Aggregate Limit for that desig- 1. A separate Designated Location General Hated "location". Such payments shall not re- Aggregate Limit applies each designated duce the General Aggregate Limit shown in "location", and that limit t is equal to the the the Declarations nor shall they reduce any amount the General Aggregate Limit other Designated Location General Aggre- gate Limit for any other designated "location" 2. The Designated Location General Aggregate shown in the Schedule above. Limit is the most we will pay for the sum of all 4. The limits shown in the Declarations for Each damages under Coverage A, except damag- Occurrence, Damage To Premises Rented To es because of "bodily injury" or "property You and Medical Expense continue to apply. damage" included in the "products-completed However, instead of being subject to the operations hazard", and for medical expenses General Aggregate Limit shown in the Decla- under Coverage C regardless of the number rations, such limits will be subject to the appli- of: cable Designated Location General Aggre- a. Insureds; gate Limit. CG 25 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 2 B. For all sums which the insured becomes legally C. When coverage for liability arising out of the obligated to pay as damages caused by 'occur- "products-completed operations hazard" is pro- rences" under Section I—Coverage A, and for all vided, any payments for damages because of medical expenses caused by accidents under "bodily injury" or "property damage" included in Section I — Coverage C, which cannot be at- the "products-completed operations hazard" will tributed only to operations at a single designated reduce the Products-completed Operations Ag- "location" shown in the Schedule above: gregate Limit, and not reduce the General Ag- 1. Any payments made under Coverage A for gregate Limit nor the Designated Location Gen- damages or under Coverage C for medical eral Aggregate Limit. expenses shall reduce the amount available D. For the purposes of this endorsement, the Defi- under the General Aggregate Limit or the nitions Section is amended by the addition of Products-completed Operations Aggregate the following definition: Limit, whichever is applicable; and "Location" means premises involving the same or 2. Such payments shall not reduce any Desig- connecting lots, or premises whose connection is nated Location General Aggregate Limit. interrupted only by a street, roadway, waterway or right-of-way of a railroad. E. The provisions of Section III — Limits Of Insur- ance not otherwise modified by this endorsement shall continue to apply as stipulated. Page 2 of 2 © Insurance Services Office, Inc., 2008 CG 25 04 05 09 Policy Number: TB2-641-444950-031 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Project(s): All construction projects not located at premises owned, leased or rented by a Named Insured Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. For all sums which the insured becomes legally 3. Any payments made under Coverage A for obligated to pay as damages caused by 'occur- damages or under Coverage C for medical rences" under Section I—Coverage A, and for all expenses shall reduce the Designated Con- medical expenses caused by accidents under struction Project General Aggregate Limit for Section I — Coverage C, which can be attributed that designated construction project. Such only to ongoing operations at a single designated payments shall not reduce the General Ag- construction project shown in the Schedule gregate Limit shown in the Declarations nor above: shall they reduce any other Designated Con- t. A separate Designated Construction Project struction Project General Aggregate Limit for General Aggregate Limit applies to each des- any other designated construction project ignated construction project, and that limit is shown in the Schedule above. equal to the amount of the General Aggregate 4. The limits shown in the Declarations for Each Limit shown in the Declarations. Occurrence, Damage To Premises Rented To 2. The Designated Construction Project General You and Medical Expense continue to apply. Aggregate Limit is the most we will pay for the However, instead of being subject to the sum of all damages under Coverage A, ex- General Aggregate Limit shown in the Decla- cept damages because of "bodily injury" or rations, such limits will be subject to the appli- "property damage" included in the "products- cable Designated Construction Project Gen- completed operations hazard", and for medi- eral Aggregate Limit. cal expenses under Coverage C regardless of the number of: a. Insureds; b. Claims made or"suits" brought; or c. Persons or organizations making claims or bringing "suits". CG 25 03 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 2 ❑ B. For all sums which the insured becomes legally C. When coverage for liability arising out of the obligated to pay as damages caused by "occur- "products-completed operations hazard" is pro- rences" under Section I—Coverage A, and for all vided, any payments for damages because of medical expenses caused by accidents under "bodily injury" or "property damage" included in Section I — Coverage C, which cannot be at- the "products-completed operations hazard" will tributed only to ongoing operations at a single reduce the Products-completed Operations Ag- designated construction project shown in the gregate Limit, and not reduce the General Ag- Schedule above: gregate Limit nor the Designated Construction 1. Any payments made under Coverage A for Project General Aggregate Limit. damages or under Coverage C for medical D. If the applicable designated construction project expenses shall reduce the amount available has been abandoned, delayed, or abandoned under the General Aggregate Limit or the and then restarted, or if the authorized contract- Products-completed Operations Aggregate ing parties deviate from plans, blueprints, de- Limit, whichever is applicable; and signs, specifications or timetables, the project will 2. Such payments shall not reduce any Desig- still be deemed to be the same construction pro- nated Construction Project General Aggre- ject. gate Limit. E. The provisions of Section III — Limits Of Insur- ance not otherwise modified by this endorsement shall continue to apply as stipulated. Page 2 of 2 © Insurance Services Office, Inc., 2008 CG 25 03 05 09 POLICY NUMBER: TB2-641-444950- COMMERCIAL GENERAL LIABILITY 031 CG 20 10 12 19 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 A Section II — Who Is An Insured is amended to 1. All work, including materials, parts or include as an additional insured the person(s) or equipment furnished in connection with such organization(s) shown in the Schedule, but only with work, on the project (other than service, respect to liability for "bodily injury", "property maintenance or repairs) to be performed by or damage" or "personal and advertising injury" on behalf of the additional insured(s) at the caused, in whole or in part, by: location of the covered operations has been 1. Your acts or omissions; or completed; or 2. The acts or omissions of those acting on your 2. That portion of "your work" out of which the behalf; injury or damage arises has been put to its in the performance of your ongoing operations for intended use by any person or organization the additional insured(s) at the location(s) other than another contractor or subcontractor designated above. engaged in performing operations for a principal as a part of the same project. However: C. With respect to the insurance afforded to these 1. The insurance afforded to such additional additional insureds, the following is added to insured only applies to the extent permitted by Section III —Limits Of Insurance: law; and If coverage provided to the additional insured is 2. If coverage provided to the additional insured is required by a contract or agreement, the most we required by a contract or agreement, the will pay on behalf of the additional insured is the insurance afforded to such additional insured will amount of insurance: not be broader than that which you are required 1. Required by the contract or agreement;or by the contract or agreement to provide for such additional insured. 2. Available under the applicable limits of B. With respect to the insurance afforded to these insurance; additional insureds, the following additional whichever is less. exclusions apply: This endorsement shall not increase the This insurance does not apply to "bodily injury" or applicable limits of insurance. "property damage" occurring after: SCHEDULE Name Of Additional Insured Person(s) Location(s) Of Covered Operations Or Organization(s): Any person or organization with whom you have agreed All locations as required by a written contract or through written contract, agreement or permit to provide agreement entered into prior to an'occurrence"or additional insured coverage offense Information required to complete this Schedule, if not shown above, will be shown in the Declarations. CG 20 10 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 POLICY NUMBER: TB2-641-444950- COMMERCIAL GENERAL LIABILITY 031 CG 20 37 12 19 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 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 in part, by required by a contract or agreement, the most we your work" at the location designated and will pay on behalf of the additional insured is the described in the Schedule of this endorsement amount of insurance: performed for that additional insured and included in the"products-completed operations hazard". 1. Required by the contractor agreement; or However: 2. Available under the applicable limits of 1. The insurance afforded to such additional insurance; insured only applies to the extent permitted by whichever is less. law; and This endorsement shall not increase the applicable 2. If coverage provided to the additional insured is limits of insurance. 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. SCHEDULE Name Of Additional Insured Person(s) OrOrganization(s): Location And Description Of Completed Operations Any person or organization to whom or to which you are Any location where you have agreed,through written, required to provide additional insured status in a written contract, agreement,or permit,to provide additional contract, agreement or permit except where such insured coverage for completed operations contact or agreement is prohibited. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. CG 20 37 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 Policy Number TB2-641-444950-031 Issued by Liberty Mutual Fire Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY— OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to Section IV—Conditions 4. Other Insurance and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed prior to a loss, that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. (3) This insurance is excess over any other insurance available to the additional insured for which it is also covered as an additional insured by attachment of an endorsement to another policy providing coverage for the same 'occurrence", claim or"suit'. LID 24 153 08 16 ©2016 Liberty Mutual Insurance Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. POLICY NUMBER: AS2-641-444950-041 COMMERCIAL AUTO CA20481013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE 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 this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. SCHEDULE Name Of Person(s) Or Organization(s): As required by written contract Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.1. of Section II — Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I — Covered Autos Coverages of the Auto Dealers Coverage Form. CA 20 48 10 13 ©Insurance Services Office, Inc., 2011 Page 1 of 1 Policy Number: AS2-641-444950-041 Issued by: Liberty Mutual Fire Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED- NONCONTRIBUTING This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIERS COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s)or organization(s)who are"insureds"under the Who Is An Insured Provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage form. Schedule Name of Person(s) or Organizations(s): Any person or organization where the Named Insured has agreed by written contract to include such person or organization Regarding Designated Contract or Project: Any Each person or organization shown in the Schedule of this endorsement is an"insured"for Liability Coverage,but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form. The following is added to the Other Insurance Condition: If you have agreed in a written agreement that this policy will be primary and without right of contribution from any insurance in force for an Additional Insured for liability arising out of your operations, and the agreement was executed prior to the "bodily injury" or "property damage", then this insurance will be primary and we will not seek contribution from such insurance. AC 84 23 0811 © 2010, Liberty Mutual Group of Companies. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office,Inc., with its permission. POLICY NUMBER: TB2-641-444950-031 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: As required by written contract or agreement 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 un der 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 POLICY NUMBER: AS2-641-444950-041 COMMERCIAL AUTO CA04441013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) 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. SCHEDULE Name(s) Of Person(s) Or Organization(s): Any person or organization for whom you perform work under a written contract of the contract requires you to obtain this agreement from us but only if the contract is executed prior to the injury or damage occurring. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the 'loss" under a c ontract with that person or organization. CA 04 44 10 13 ©Insurance Services Office, Inc., 2011 Page 1 of 1 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 Where required by contract or written agreement prior to loss. Issued by:Liberty Insurance Corporation For attachment to Policy No WA7-64D-444950-011 Effective Date 06/01/2021 Premium Issued to:HDR Engineering, Inc. WC 00 03 13 © 1983 National Council on Compensation Insurance, Inc. Page 1 of 1 Ed. 4/1/1984 Policy Number TB2-641-444950-031 Issued by Liberty Mutual Fire Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION OR MATERIAL REDUCTION IN COVERAGE TO THIRD PARTIES This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE PART MOTOR CARRIER COVERAGE PART GARAGE COVERAGE PART TRUCKERS COVERAGE PART EXCESS AUTOMOBILE LIABILITY INDEMNITY COVERAGE PART SELF-INSURED TRUCKER EXCESS LIABILITY COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART COMMERCIAL LIABILITY—UMBRELLA COVERAGE FORM Schedule Name of Other Person(s) / Email Address or mailing address: Number Days Notice: Organization(s): As required by written contract or As required by written contract or 30 written agreement written agreement A. If we cancel this policy for any reason other than nonpayment of premium, or make a material reduction in coverage, we will notify the persons or organizations shown in the Schedule above. We will send notice to the email or mailing address listed above at least 10 days, or the number of days listed above, if any, before the cancellation becomes effective. In no event does the notice to the third party exceed the notice to the first named insured. B. This advance notification of a pending cancellation or material reduction of coverage is intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the policy. All other terms and conditions of this policy remain unchanged. LIM 99 04 03 14 ©2014 Liberty Mutual Insurance.All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Policy Number AS2-641-444950-041 Issued by Liberty Mutual Fire Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION OR MATERIAL REDUCTION IN COVERAGE TO THIRD PARTIES This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE PART MOTOR CARRIER COVERAGE PART GARAGE COVERAGE PART TRUCKERS COVERAGE PART EXCESS AUTOMOBILE LIABILITY INDEMNITY COVERAGE PART SELF-INSURED TRUCKER EXCESS LIABILITY COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART COMMERCIAL LIABILITY—UMBRELLA COVERAGE FORM Schedule Name of Other Person(s) I Email Address or mailing address: Number Days Notice: Organization(s): As required by written contract 30 or written agreement A. If we cancel this policy for any reason other than nonpayment of premium, or make a material reduction in coverage, we will notify the persons or organizations shown in the Schedule above. We will send notice to the email or mailing address listed above at least 10 days, or the number of days listed above, if any, before the cancellation becomes effective. In no event does the notice to the third party exceed the notice to the first named insured. B. This advance notification of a pending cancellation or material reduction of coverage is intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the policy. All other terms and conditions of this policy remain unchanged. LIM 99 04 03 14 ©2014 Liberty Mutual Insurance.All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. NOTICE OF CANCELLATION TO THIRD PARTIES A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or organizations shown in the Schedule below. We will send notice to the email or mailing address listed below at least 10 days, or the number of days listed below, if any, before cancellation becomes effective. In no event does the notice to the third party exceed the notice to the first named insured. B. This advance notification of a pending cancellation of coverage is intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the policy. Schedule Name of Other Person(s)/ Email Address or mailing address: Number Days Notice: Organization(s): As required by written 30 contract or agreement All other terms and conditions of this policy remain unchanged. Issued by Liberty Insurance Corporation For attachment to Policy No.WA7-64D-444950-011 Effective Date 06/01/2021 Premium$ Issued to HDR Engineering,Inc. Endorsement No. WC 99 20 75 ©2016 Liberty Mutual Insurance Page 1 of 1 Ed.12/01/2016