Insurance Certificates 2020/21 CASC Engineering & Consultingpage 2 of 9
Client#: 1250938 305CASCENG
ACORD.CERTIFICATE OF LIABILITY INSURANCE D12130lDOfY2/30/2020
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING 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 any rights to the certificate holder in lieu of such endorsement(s).
PRODUCER Mary Faber
McGriff Insurance Services PHONE EXt 714 941-2800 No:
[PJC. o,
2400 E Katella Ave Suite 1100 E-MAIL ADD ESS: MFaber@McGriff.com
Anaheim, CA 92806
lN5UFiER[SIAFFORDING COVERAGE NAIC #J
714 941-2800 Transportation Insurance Company :20494
INSURER A : P P Y
INSURED INSURER B
CASC Engineering and Consulting Inc
INSURER C :
1470 E Cooley Drive
INSURER D
Colton, CA 92324 - -- —
INSURER E
INSURER F:
..�� I+G�TICIl�ATC auuacoc. RFVI-QIAN NIIMRFR-
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 CONTRACTOR 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 Ai]DL u.11R POLICY E POLICY EXP LIMITS
LTR TYPE OF INSURANCE INS �WV POLICY NUMBER {¢IM/Il0/YYY MWDDNYYY
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$
CLAIMS -MADE OCCUR
❑AMAGE TO RENTED
PREMISES EaoecurDe 11 _
$
MED EXP (Any one person)
$
PERSONAL $ ADV INJURY
$
L AGGREGATE LIMIT APPLIES PER;
GENERAL AGGREGATE
$
PRO-
POLICY� JECT LOC
r'OTHER:
PRODUCTS - COMP/OP AGG
$
$
AUTOMOBILE LIABILITY
COMFSiNE� SINGLE LIMIT
Ea aoc n4
$
BODILY INJURY (Per person)
$
ANY AUTO
BODILY INJURY (Per accident)
$
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
PROPERTY DAMAGE
Par acpdent
$
UMBRELLA LIAR H
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAB
CLAIMS -MADE
DED t RETENTION $
$
A
WORKERS COMPENSATION
ANO EMPLOTERS' LIABILITY
OAN Y FPICERP%IET DPJ R PA[CMLUDM7 ECUTIVE -
jMandalory In NH)
N / A
7011705080
12/31/2020
12/31/2021
PER OTH-
X
1
E.L. EACH ACCIDENT
$1 000 000
E.L. DISEASE - EA EMPLOYEE
$1 000 Q00
E.L. DISEASE- POLICY LIMIT
$1,000,Q00
If yes, describe under
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is reclulred)
This certificate is for the Workers Compensation renewal only effective 12/31/2020 to 12131/2021.
Please retain previously issued certificate for general liability, automobile liability and excess
liability for the term of 2/01/2020 to 2/01/2021.
RE: Covered California operations performed on behalf of the named insured
City of La Quinta is named additional insured as respects General Liability and this insurance is primary
(See Attached Descriptions)
1+=MTIMIIATC unl rtir-❑ rAMCF-I.I ATION
City of La Quinta
78-495 Calle Tampico
La Quinta, CA 92253
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
O 1988-2015 ACORD CORPORATION. All rights reservea.
ACORD 25 (2016/03) 1 of 2 The ACORD name and logo are registered marks of ACORD
5701 #S27101891/M27101860 MJFAB
page 3 of 9
DESCRIPTIONS (Continued from Page 1)
and noncontributory with any other insurance of the additional insureds; Waiver of subrogation applies
as respects General Liability and Workers Compensation as required by written contract per the attached
endorsements.
SAGITTA 25.3 (201 &03) 2 of 2
#S27101891/M27101860
5702
page 4 of 9
::
_ r
BLANKET ;WA4i R OF: .OUR RIGHT -TO RECOVER FROM OTHERS
This endorsement changes the policy to which it is attached.
It is agreed that Part One - Workers' Compensation Insurance G. Recovery From Others and Part Two -
Employers' Liability Insurance H. Recovery From Others are amended by adding the following::
We will not enforce our right to recover againsl. peisuns ur uigaiii/al.iuns. (This agreement applies only to the
extent that you perform work under a written contract that requires you to obtain this `agreement fr,;om us.)
PREMIUM CHARGE - Refer to the Schedule of Operations
The charge will be an amount to which you and we agraP that is a percentage of the totalstandard..premium for
California exposure. The amount is Blanket Waiver of Subrogation Percentage Chargp%.
All other terms and conditions of the policy remain unchanged.
This endorsement, which forms a part of and is for attachment to the policy I:Ss ed by the designated Insurers,
takes effect on the Policy Effective date of said policy at:th..e hour stated in said.;p.O...,C:y; unless another
effective date (the Endorsement Effective Date) is shown; :below; an.d expires cone rtently with said policy
unless another expiration date is shown below.
Form No: G-19160-B (11-1997) Policy No: P Policy 701170.1,080
Endorsement Effective Date: 12-31-20 Endorsement Expiration Date:12-31-21 Effective Date: 1 2-31--10 Polley
Endorsement No:: Pigs: I of 1 Page: x of y
Underwriting Company: 1 ranvpnrtation Insurance• Carnpassy
0 Copyright CNA All Rights Reserved.
5703
MR..
page 2 of 19 � I
p `�1
Client#: 1250938 305CASCENG
ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE (MMMD/YYYY)
01131 /2020
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING 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 any rights to the certificate holder in lieu of such endorsement(s).
PRODUCER NAME"cT Mary Faber
McGriff Insurance Services PHONE 714 941-2800AX
A/C. No, Ei�d A1C, Np
2400 E Katella Ave Suite 1100 E-MAIL ' MFaber@McGrifflnsurance.com
Anaheim, CA 92806 ADn Ess:
714 941-2800 INSURER(G)AFFORDING COVERAGE NAIC #
_ INSURER A: Continental Casualty Company 20443
INSURED Continental Insurance Com an 35289
CASC Engineering and Consulting Inc
1470 E Cooley Drive
Colton, CA 92324
INSURER B: p Y
INSURER C : Sentinel Insurance Company Ltd 11000
INSURER D : Landmark American Insurance Co 33138
INSURER E,
COVERAGES CFRTIFICATF Nt1MRFR- RFVI1RInN NIIMRFR-
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 CONTRACTOR 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.
1NSTi
LTR
TYPE OF INSURANCE
AODL
INSR
UBR
WVD
POLICY NUMBER _
POLICY EFF
(MMlDD/YYYY�
POLICY EXP
&MLDD/YYYY
LIMITS
A
X
COMMERCIAL GENE RALLIABILITY
6076584085
02/01/2020
02/01/2021
EACH OCCURRENCE
$1 OOOOOO
CLAIMS -MADE .X] OCCUR
PREMISES Eaeccurrence
S500000
X
$15 000
BI/PD Ded:5,000
MED EXP (Any one person)
PERSONAL & ADV INJURY
$1 000 000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY JECT EILOC
DR
GENERAL AGGREGATE
s2,000,000
PRODUCTS - COMP/OP AGG
S 2 000 000
$
OTHER.
B AUTOMOBILE
I xi
LIABILITY
ANY AUTO
6076584099
)2I01/2020
02/01/2021
EOMBINE't') SINGLELIMIT
S1,000000
BODILY INJURY (Per person)
$
X
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED i NON -OWNED
AUTOS ONLY I X AUTOS ONLY
BODILY INJURY (Per accident)
S
PROPERTY DAMAGE
Per accident
$
S
6076584104
B X
UMBRELLA LIAB
X
OCCUR
02/01/2020
02/Ol/2021
EACH OCCURRENCE
$2 000 ppp f
AGGREGATE
$2 000 000
EXCESS LIAB
CLAIMS -MADE_
N/A
1
DED X RETENTION %10000
$
`+
WORKERS COMPENSATION
AND EMPLOYERS' LtABIL}TY Y / N
ANY PROPRiETORIPARTNEWEXECUTIVE y
;OFFICEFVMEMBER EXCLUDED?
72WEDU9077
12/31/2019
12/31/202
X PER OTH-
TATU7 E3—
E.L. EACH ACCIDENT
$11,000,000
E.L. DISEASE - EA EMPLOYEE
$1 000 000
(Mandatory Ih NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
S11,000 OOO
D
Professional Liab
_ _
_ _
LHR839457 )2/01/2020
02/01/2021
2,000,000 EaClaim/Aggr
Errors & Omission
Claims -Made
Retro Dte2-1-93
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
RE: Covered California operations performed on behalf of the named insured
City of La Quinta is named additional insured as respects General Liability and this insurance is primary
and noncontributory with any other insurance of the additional insureds; Waiver of subrogation applies
as respects General Liability and Workers Compensation as required by written contract per the attached
endorsements.
i.cn I i r i L, IA I C 11 LJ LUCn
City of La Quinta
78-495 Calle Tampico
La Quinta, CA 92253
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CAN�ELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
O 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD
438 #S25136327/M25136295 MJFAB
Pa..
page 4 of 19
CNA
1. ADDITIONAL INSUREDS
Insured: CASC Engineering and Consulting Inc
Architects, Engineers and Surveyors General Liability
Extension Endorsement
a. WHO IS AN INSURED is amended to include as an Insured any person or organization described in paragraphs
A. through I. below whom a Named Insured is required to add as an additional insured on this Coverage Part
under a written contract or written agreement, provided such contract or agreement:
(1) is currently in effect or becomes effective during the term of this Coverage Part; and
(2) was executed prior to:
(a) the bodily injury or property damage; or
(b) the offense that caused the personal and advertising injury,
for which such additional insured seeks coverage.
b. However, subject always to the terms and conditions of this policy, including the limits of insurance, the Insurer
will not provide such additional insured with:
(1) a higher limit of insurance than required by such contract or agreement; or
(2) coverage broader than required by such contract or agreement, and in no event broader than that described
by the applicable paragraph A. through I. below.
Any coverage granted by this endorsement shall apply only to the extent permissible by law.
A. Controlling Interest
Any person or organization with a controlling interest in a Named Insured, but only with respect to such person or
organization's liability for bodily injury, property damage or personal and advertising injury arising out of:
1. such person or organization's financial control of a Named Insured; or
2. premises such person or organization owns, maintains or controls while a Named Insured leases or occupies
such premises;
provided that the coverage granted by this paragraph does not apply to structural alterations, new construction or
demolition operations performed by, on behalf of, or for such additional insured.
B. Co-owner of Insured Premises
A co-owner of a premises co -owned by a Named Insured and covered under this insurance but only with respect
to such co -owner's liability for bodily injury, property damage or personal and advertising injury as co-owner
of such premises.
C. Engineers, Architects or Surveyors Engaged By You
An architect, engineer or surveyor engaged by the Named Insured, but only with respect to liability for bodily
injury, property damage or personal and advertising injury caused in whole or in part by the Named
Insured's acts or omissions, or the acts or omissions of those acting on the Named Insured's behalf:
a. in connection with the Named Insured's premises; or
b. in the performance of the Named Insured's ongoing operations.
But the coverage hereby granted to such additional insureds does not apply to bodily injury, property damage
or personal and advertising injury arising out of the rendering of or failure to render any professional services
by, on behalf of, or for the Named Insured, including but not limited to:
1. the preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys,
field orders, change orders or drawings and specifications; or
2. supervisory, inspection, architectural or engineering activities.
D. Lessor of Equipment
CNA74858XX (1-15) Policy No: 6076584085
Page 2 of 16 Endorsement No:
Continental Casualty Effective Date: 02/01/20
Insured Name: CASC ENGINEERING AND CONSULTING INC
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission.
440
N
page 5 of 19
Insured: CASC Engineering and Consulting Inc
Architects, Engineers and Surveyors General Liability
Extension Endorsement
Any person or organization from whom a Named Insured leases equipment, but only with respect to liability for
bodily injury, property damage or personal and advertising injury caused, in whole or in part, by the Named
Insured's maintenance, operation or use of such equipment, provided that the occurrence giving rise to such
bodily injury, property damage or the offense giving rise to such personal and advertising injury takes place
prior to the termination of such lease.
E. Lessor of Land
Any person or organization from whom a Named Insured leases land but only with respect to liability for bodily
injury, property damage or personal and advertising injury arising out of the ownership, maintenance or use
of such land, provided that the occurrence giving rise to such bodily injury, property damage or the offense
giving rise to such personal and advertising injury takes place prior to the termination of such lease. The
coverage granted by this paragraph does not apply to structural alterations, new construction or demolition
operations performed by, on behalf of, or for such additional insured.
F. Lessor of Premises
An owner or lessor of premises leased to the Named Insured, or such owner or lessor's real estate manager, but
only with respect to liability for bodily injury, property damage or personal and advertising injury arising out
of the ownership, maintenance or use of such part of the premises leased to the Named Insured, and provided
that the occurrence giving rise to such bodily injury or property damage, or the offense giving rise to such
personal and advertising injury, takes place prior to the termination of such lease. The coverage granted by
this paragraph does not apply to structural alterations, new construction or demolition operations performed by,
on behalf of, or for such additional insured.
G. Mortgagee, Assignee or Receiver
A mortgagee, assignee or receiver of premises but only with respect to such mortgagee, assignee or receiver's
liability for bodily injury, property damage or personal and advertising injury arising out of the Named
Insured's ownership, maintenance, or use of a premises by a Named Insured.
The coverage granted by this paragraph does not apply to structural alterations, new construction or demolition
operations performed by, on behalf of, or for such additional insured.
H. State or Governmental Agency or Subdivision or Political Subdivisions —Permits
A state or governmental agency or subdivision or political subdivision that has issued a permit or authorization but
only with respect to such state or governmental agency or subdivision or political subdivision's liability for bodily
injury, property damage or personal and advertising injury arising out of:
1. the following hazards in connection with premises a Named Insured owns, rents, or controls and to which
this insurance applies:
a. the existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings,
canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoistaway openings, sidewalk
vaults, street banners, or decorations and similar exposures; or
b. the construction, erection, or removal of elevators; or
c. the ownership, maintenance or use of any elevators covered by this insurance; or
2. the permitted or authorized operations performed by a Named Insured or on a Named Insured's behalf.
The coverage granted by this paragraph does not apply to:
a. Bodily injury, property damage or personal and advertising Injury arising out of operations performed
for the state or governmental agency or subdivision or political subdivision; or
b. Bodily injury or property damage included within the products -completed operations hazard.
CNA74858XX (1-15)
Page 3 of 16
Continental Casualty
Insured Name: CASC ENGINEERING AND CONSULTING INC
Policy No:
Endorsement No:
Effective Date:
6076584085
02/01 /20
441 Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission.
page 6 of 19
a-
CNA Insured: CASC Engineering and Consulting Inc
Architects, Engineers and Surveyors General Liability
Extension Endorsement
With respect to this provision's requirement that additional insured status must be requested under a written
contract or agreement, the Insurer will treat as a written contract any governmental permit that requires the
Named Insured to add the governmental entity as an additional insured.
I. Trade Show Event Lessor
1. With respect to a Named Insured's participation in a trade show event as an exhibitor, presenter or displayer,
any person or organization whom the Named Insured is required to include as an additional insured, but only
with respect to such person or organization's liability for bodily injury, property damage or personal and
advertising Injury caused by:
a. the Named Insured's acts or omissions; or
b. the acts or omissions of those acting on the Named Insured's behalf,
in the performance of the Named Insured's ongoing operations at the trade show event premises during the
trade show event.
2. The coverage granted by this paragraph does not apply to bodily injury or property damage included within
the products -completed operations hazard.
2. ADDITIONAL INSURED -PRIMARY AND NON-CONTRIBUTORY TO ADDITIONAL INSURED'S INSURANCE
The Other Insurance Condition in the COMMERCIAL GENERAL LIABILITY CONDITIONS Section is amended to
add the following paragraph:
If the Named Insured has agreed in writing in a contract or agreement that this insurance is primary and non-
contributory relative to an additional insured's own insurance, then this insurance is primary, and the Insurer will not
seek contribution from that other insurance. For the purpose of this Provision 2., the additional insured's own
insurance means insurance on which the additional insured is a named insured. Otherwise, and notwithstanding
anything to the contrary elsewhere in this Condition, the insurance provided to such person or organization is excess
of any other insurance available to such person or organization.
3. ADDITIONAL INSURED —EXTENDED COVERAGE
When an additional insured is added by this or any other endorsement attached to this Coverage Part, WHO IS AN
INSURED is amended to make the following natural persons Insureds.
If the additional insured is:
a. An individual, then his or her spouse is an Insured;
b. A partnership or joint venture, then its partners, members and their spouses are Insureds;
c. A limited liability company, then its members and managers are Insureds; or
d. An organization other than a partnership, joint venture or limited liability company, then its executive officers,
directors and shareholders are Insureds;
but only with respect to locations and operations covered by the additional insured endorsement's provisions, and
only with respect to their respective roles within their organizations.
Please see the ESTATES, LEGAL REPRESENTATIVES, AND SPOUSES provision of this endorsement for
additional coverage and restrictions applicable to spouses of natural person Insureds.
4. BOATS
Under COVERAGES, Coverage A — Bodily Injury And Property Damage Liability, the paragraph entitled
Exclusions is amended to add the following additional exception to the exclusion entitled Aircraft, Auto or
Watercraft:
This exclusion does not apply to:
CNA74858XX (1-15) Policy No: 6076584085
Page 4 of 15 Endorsement No:
Continental Casualty Effective Date: 02/01/20
Insured Name: CASC ENGINEERING AND CONSULTING INC
442 Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its
permission.
M.
page 8 of 19
Casc Engineering and Consulting Inc.
CNAArchitects, Engineers and Surveyors General Liability
Extension Endorsement
services performed for the Named Insured under the Named Insured's direct supervision. All limitations that apply
to employees and volunteer workers also apply to anyone qualifying as an Insured under this Provision.
24. SUPPLEMENTARY PAYMENTS
The section entitled SUPPLEMENTARY PAYMENTS — COVERAGES A AND B is amended as follows:
A. Paragraph 1.b. is amended to delete the $250 limit shown for the cost of bail bonds and replace it with a $5,000.
limit; and
B. Paragraph 1.d. is amended to delete the limit of $250 shown for daily loss of earnings and replace it with a
$1,000. limit.
25. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS
If the Named Insured unintentionally fails to disclose all existing hazards at the inception date of the Named
Insured's Coverage Part, the Insurer will not deny coverage under this Coverage Part because of such failure.
26. WAIVER OF SUBROGATION - BLANKET
Under CONDITIONS, the condition entitled Transfer Of Rights Of Recovery Against Others To Us is amended to add
the following:
The Insurer waives any right of recovery the Insurer may have against any person or organization because of
payments the Insurer makes for injury or damage arising out of:
1. the Named Insured's ongoing operations; or
2. your work included in the products -completed operations hazard.
However, this waiver applies only when the Named Insured has agreed in writing to waive such rights of recovery in
a written contract or written agreement, and only if such contract or agreement:
1. is in effect or becomes effective during the term of this Coverage Part; and
2. was executed prior to the bodily injury, property damage or personal and advertising injury giving rise to the
claim.
27. WRAP-UP EXTENSION: OCIP, CCIP, OR CONSOLIDATED (WRAP-UP) INSURANCE PROGRAMS
Note: The following provision does not apply to any public construction project in the state of Oklahoma, nor to any
construction project in the state of Alaska, that is not permitted to be insured under a consolidated (wrap-up)
insurance program by applicable state statute or regulation.
If the endorsement EXCLUSION — CONSTRUCTION WRAP-UP is attached to this policy, or another exclusionary
endorsement pertaining to Owner Controlled Insurance Programs (O.C.I.P.) or Contractor Controlled Insurance
Programs (C.C.I.P.) is attached, then the following changes apply:
A. The following wording is added to the above -referenced endorsement:
With respect to a consolidated (wrap-up) insurance program project in which the Named Insured is or was
involved, this exclusion does not apply to those sums the Named Insured become legally obligated to pay as
damages because of.,
1. Bodily injury, property damage, or personal or advertising injury that occurs during the Named
Insured's ongoing operations at the project, or during such operations of anyone acting on the Named
Insured's behalf; nor
2. Bodily Injury or property damage included within the products -completed operations hazard that arises
out of those portions of the project that are not residential structures.
B. Condition 4. Other Insurance is amended to add the following subparagraph 4.b.(1)(c):
This insurance is excess over:
CNA74858XX (1-15) Policy No: 6076584085
Page 15 of 16 Endorsement No:
Continental Casualty Effective Date: 02/01/20
Insured Name: CASC ENGINEERING AND CONSULTING INC
444 Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission.
page 10 of 19
12.1
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WAIVER OF OUR RIGHT TO RECOVER FROM
OTHERS ENDORSEMENT - CALIFORNIA
Policy Number: 72 WE DU9077 Endorsement Number:
Effective Date: 12 /31/ 19 Effective hour is the same as stated on the Information Page of the policy.
Named Insured and Address: CASC ENGINEERING AND CONSULTING
INC
1470 E COOLEY DR
COLTON, CA 92324
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.)
You must maintain payroll records accurately segregating the remuneration of your employees while engaged in
the work described in the Schedule.
The additional premium for this endorsement shall be
premium otherwise due on such remuneration.
Person or Organization
ANY PERSON OR ORGANIZATION
FROM WHOM YOU ARE REQUIRED
BY WRITTEN CONTRACT OR
AGREEMENT TO OBTAIN THIS
WAIVER OF RIGHTS FROM US
SCHEDULE
Countersigned by
2 % of the California workers' compensation
Job Description
BLANKET AS REQUIRED BY
CONTRACT.
Authorized Representative
Form WC 04 03 06 (1) Printed in U.S.A.
Process Date:
446
Policy Expiration Date: 12/31/20