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Governor and Executive Council Agenda item PDF - 2026-05-20 - agenda 5

John O. Morton Building · 7 Hazen Drive · P.O. Box 483 · Concord, New Hampshire 03302-0483

Telephone: (603) 271-3734 · Fax: (603) 271-3914 · TDD: Relay NH 1-800-735-2964 · dot.nh.gov

The State of New Hampshire

Department of Transportation

David Rodrigue, P.E.

Commissioner

Michelle L. Winters

Deputy Commissioner

Her Excellency, Governor Kelly A. Ayotte Bureau of Highway Design

and the Honorable Council April 13, 2026

State House

Concord, New Hampshire 03301

Requested Action

Authorize the Department of Transportation to amend Contract # 4014739 with HDR Engineering, Inc., Bedford, NH,

Vendor #169983, for Preliminary engineering, environmental services, public involvement services, and final design

are needed for improvements to US 3 (South River Road) in the Town of Bedford, by extending the completion date

from June 30, 2026, to December 31, 2026, effective upon Governor and Council approval. The original Agreement

was approved by Governor and Council on May 15, 2024 (Item #44). Time extension only, no additional funding.

Explanation

On May 15, 2024, the Governor and Council authorized the subject agreement (Item # 44) in the amount of

$1,491,959.78 for Preliminary engineering, environmental services, public involvement services, and final design. The

objective of the project is to make improvements to the Daniel Webster Highway US 3 (South River Road) in the Town

of Bedford.

The purpose of this time extension amendment is to allow the consultant time for continued advancement of the

project within the current budget limits. The work is approximately 70% complete and of the original $1,491,959.78

amount for this contract there is a balance of approximately $455,250 remaining (100% Federal Funds).

This Agreement (Bedford 40664) has been approved by the Attorney General as to form and execution. The

Department has verified that the necessary funds are available. Copies of the fully-executed Agreement are on file at

the Secretary of State's Office and the Department of Administrative Services, and subsequent to Governor and

Council approval will be on file at the Department of Transportation.

The Department of Transportation has determined that the Consultant is in good standing with the Secretary of

State’s Office, has secured the required levels of insurance, and has provided evidence of authority to execute and be

bound by the contract. Documents supporting these assertions are available at the agency, for review upon request.

It is respectfully requested that authority be given to amend this Agreement for consulting services as outlined above.

Sincerely,

David Rodrigue, P.E.

Commissioner

Attachments

JOHN O. MORTON BUILDING • 7 HAZEN DRIVE • P.O. BOX 483 • CONCORD, NEW HAMPSHIRE 03302-0483

TELEPHONE: (603) 271-3734 • FAX: (603) 271-3914 • TDD: RELAY NH 1-800-735-2964 • DOT.NH.GOV

THE STATE OF NEW HAMPSHIRE

DEPARTMENT OF TRANSPORTATION

William Cass, P.E.

Commissioner

David Rodrigue, P.E.

Assistant Commissioner

Michelle L. Winters

Deputy Commissioner

BEDFORD Bureau of Highway Design

X-A004(462) Room 200

40664 Tel. (603) 271-2165

Time Extension Amendment January 13, 2026

(Agreement Dated MARCH 27, 2024, Contract No. 4014739)

Thomas Roach, PE

Area Manager, Vice President

HDR Engineering, Inc.

5 Bedford Farms Drive, Suite 202

Bedford, NH 03110-6531

Dear Mr. Roach:

This letter amends Article I, Section J (Date of Completion) in the above-referenced Agreement.

The original and amended dates are as follows:

Original Completion Date JUNE 30, 2026

By this letter, amended to DECEMBER 31, 2026

This no-additional-cost change order for the extension is as requested by your letter dated January

7, 2026.

This amendment becomes effective upon approval by the Governor and Council.

Sincerely,

David S. Smith,

Project Manager

Approved: Tobey L. Reynolds, P.E.

Director of Project Development

JOHN O. MORTON BUILDING • 7 HAZEN DRIVE • P.O. BOX 483 • CONCORD, NEW HAMPSHIRE 03302-0483

TELEPHONE: 603-271-3734 • FAX: 603-271-3914 • TDD: RELAY NH 1-800-735-2964 • INTERNET: WWW.NHDOT.COM

We concur with the subject Amendment.

HDR ENGINEERING, INC.

By:

Name:

Title:

DSS/kgm

Vice President

Thomas F. Roach

AGREEMENT AMENDMENT

BEDFORD, X-A004(462), 40664

HDR ENGINEERING, INC.

Consultant

WITNESS TO THE CONSULTANT

By:By:

Thomas F. Roach (Name)

Vice PresidentSenior Project Accountant.(Title)

1/22/2026 1/22/2026Dated:Dated:

Department of Transportation

THE STATE OF NEW HAMPSHIRE

By: By;

Dated: Dated:

Attorney General,\ n By: Dated: A

Secretary of State

approved this

Attest:Dated:

By:

Secretary of State

JOHN O. MORTON BUILDING • 7 HAZEN DRIVE • P.O. BOX 483 • CONCORD, NEW HAMPSHIRE 03302-0483

TELEPHONE: 603-271-3734 • FAX: 603-271-3914. TDD: RELAY NH 1-800-735-2964 • INTERNET: WWW.NHDOT.COM

This is to certify that the GOVERNOR AND COUNCIL on

amended AGREEMENT.

DAVID RODRIGUE, P.E.

Kylie Kozlowski

TAssrsjam Attorney General-

This is to certify that the above-amended AGREEMENT has been reviewed by this office and is approved as

to form and execution.

IN WITNESS WHEREOF the parties hereto have executed this amended AGREEMENT on the day and

year first above written.

WITNESS TO THE STATE OF NEW HAMPSHIRE

____________________

coood~Pro-am splci ahst T

CONSULTANT

£

CERTIFICATE

I, David M. Scanlan, Secretary of State of the State of New Hampshire, do hereby certify that HDR ENGINEERING, INC. is

a Nebraska Profit Corporation registered to transact business in New Hampshire on June 17, 1985. I further certify that all fees

and documents required by the Secretary of State’s office have been received and is in good standing as far as this office is

concerned.

Business ID: 84977

Certificate Number: 0007901978

IN TESTIMONY WHEREOF,

I hereto set my hand and cause to be affixed

the Seal of the State of New Hampshire,

this 7th day of April A.D. 2026.

David M. Scanlan

Secretary of State

State of New Hampshire

Department of State

NHDOT Bedford 40664

Certificate of Authority # 1 (Corporation, Non-Profit Corporation)

Corporate Resolution. I hereby certify the following is a true copy of a vote taken at

with the State of New Hampshire and any of

its agencies or departments and further is authorized to execute any documents

which may in his/her judgment be desirable or necessary to effect the purpose of

this vote.

I hereby certify that said vote has not been amended or repealed and remains in full force

and effect as of the date of the contract to which this certificate is attached. This authority

remains valid for thirty (30) days from the date of this Corporate Resolution. I further certify

that it is understood that the State of New Hampshire will rely on this certificate as evidence that

the person(s) listed above currently occupy the position(s) indicated and that they have full

authority to bind the corporation. To the extent that there are any limits on the authority of any

listed individual to bind the corporation in contracts with the State of New Hampshire, all such

04.17.2026

duly authorized to enter into contracts or agreements on behalf of

HDR Engineering, Inc.

(Name of Corporation)

Assistant

^Elizabeth C. Hoffman, hereby certify that I am duly elected Clerk/Secretary/Officer of

(Name)

HDR Engineering, Inc.

(Name of Corporation)

a meeting of the Board of Directors/shareholders, duly called and held onSeptember 72025

by Consent and Agreement

at which a quorum ofthc Directors/shareholders were present and voting.

Thomas F. Roach, Vice President.VOTED: That.(may list more than one person) is

(Name and Title)

limitations are expressly stated herein............

V SEM-'jJI

ATTEST: -------------------------

/Name & Title)

Elizabeth C. Hoffman, Assistant Secretary

NOTICE OF CANCELLATION TO CERTIFICATE HOLDERS ENDORSEMENTExcept with respect to cancellation for non-payment of premium (10 day notice cancellation), theInsurers1. The First Named Insured is required by contract to give notice of cancellation to the Certificate Holder,and2. Prior to theInsurerssending its notice of cancellation to theFirst Named Insured, the First NamedInsuredshall provide theInsurers, in writing, either directly or through theFirst Named Insured brokerof record, the name of each person or organization requiring notice of cancellation and thecorresponding address for such person or for the employee responsible for receipt of notice ofcancellation on behalf of such organization.Notice of cancellation will be sent in accordance with the terms and conditions of the policy, except thattheInsurersmay provide written notice individually or collectively to the Certificate Holders by email atthe current email address given by the First Named Insured. Proof of sending of the notice ofcancellation by email shall be sufficient proof of notice.Any failure to provide notice of cancellation to the Certificate Holder due to inaccurate or incompleteinformation provided by theFirst Named Insured shall remain the sole responsibility of theFirst Named Insured.The following definitions apply to this endorsement:1.First Named Insured means the Named Insured shown in the Declarations.ALL OTHER TERMS AND CONDITIONS OF THE POLICY SHALL REMAIN UNCHANGED.

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN

ACCORDANCE WITH THE POLICY PROVISIONS.

INSURER(S) AFFORDING COVERAGE

INSURER F:

INSURER E:

INSURER D:

INSURER C:

INSURER B:

INSURER A:

NAIC #

NAME:

CONTACT

(A/C, No):

FAX

E-MAIL

ADDRESS:

PRODUCER

(A/C, No, Ext):

PHONE

INSURED

REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES

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).

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.

OTHER:

(Per accident)

(Ea accident)

$

$

N / A

SUBR

WVD

ADDL

INSD

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. $

$

$

$PROPERTY DAMAGE

BODILY INJURY (Per accident)

BODILY INJURY (Per person)

COMBINED SINGLE LIMIT

AUTOS ONLY

AUTOSAUTOS ONLY

NON-OWNED

SCHEDULEDOWNED

ANY AUTO

AUTOMOBILE LIABILITY

Y / N

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY

OFFICER/MEMBER EXCLUDED?

(Mandatory in NH)

DESCRIPTION OF OPERATIONS below

If yes, describe under

ANY PROPRIETOR/PARTNER/EXECUTIVE

$

$

$

E.L. DISEASE - POLICY LIMIT

E.L. DISEASE - EA EMPLOYEE

E.L. EACH ACCIDENT

ER

OTH-

STATUTE

PER

LIMITS(MM/DD/YYYY)

POLICY EXP

(MM/DD/YYYY)

POLICY EFF

POLICY NUMBERTYPE OF INSURANCELTR

INSR

DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)

EXCESS LIAB

UMBRELLA LIAB $EACH OCCURRENCE

$AGGREGATE

$

OCCUR

CLAIMS-MADE

DED RETENTION $

$PRODUCTS - COMP/OP AGG

$GENERAL AGGREGATE

$PERSONAL & ADV INJURY

$MED EXP (Any one person)

$EACH OCCURRENCE

DAMAGE TO RENTED

$PREMISES (Ea occurrence)

COMMERCIAL GENERAL LIABILITY

CLAIMS-MADE OCCUR

GEN'L AGGREGATE LIMIT APPLIES PER:

POLICY PRO-

JECT LOC

CERTIFICATE OF LIABILITY INSURANCE

DATE (MM/DD/YYYY)

CANCELLATION

AUTHORIZED REPRESENTATIVE

ACORD 25 (2016/03)

© 1988-2016 ACORD CORPORATION. All rights reserved.

CERTIFICATE HOLDER

The ACORD name and logo are registered marks of ACORD

HIRED

AUTOS ONLY

Willis Towers Watson Midwest, Inc.

c/o 26 Century Blvd

P.O. Box 305191

Nashville, TN 372305191 USA

HDR Engineering, Inc.

1917 South 67th Street

Omaha, NE 68106

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 Liability, Auto Liability and

Employers Liability.

State of New Hampshire Department of Transportation

7 Hazen Drive

Concord, NH 03302-0483

05/14/2025

1-877-945-7378

1-888-467-2378

certificates@wtwco.com

Liberty Mutual Fire Insurance Company

23035

Ohio Casualty Insurance Company

Liberty Insurance Corporation

24074

42404

W39026006

A

2,000,000

1,000,000

10,000

Contractual Liability

2,000,000

4,000,000

4,000,000

Y

Y

TB2-641-444950-035

06/01/2025

06/01/2026

A

2,000,000

06/01/2026

06/01/2025

Y

Y

AS2-641-444950-045

B

5,000,000

0

Y

Y

EUO(26)57919363

06/01/2025

06/01/2026

5,000,000

WA7-64D-444950-015

C

Y

1,000,000

No

06/01/2025

06/01/2026

1,000,000

1,000,000

3963267

27756742

SR ID:

BATCH:

WTW Certificate Center

ACORD 101 (2008/01)

The ACORD name and logo are registered marks of ACORD

© 2008 ACORD CORPORATION. All rights reserved.

THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,

FORM NUMBER:

FORM TITLE:

ADDITIONAL REMARKS

ADDITIONAL REMARKS SCHEDULE

Page of

AGENCY CUSTOMER ID: LOC #:

AGENCY

CARRIER

NAIC CODE

POLICY NUMBER

NAMED INSURED

EFFECTIVE DATE:

HDR Engineering, Inc.

1917 South 67th Street

Omaha, NE 68106

PROJECT: Bedford X-A004(462) 40664 Part B

Additional Insured: STATE

2

2

Willis Towers Watson Midwest, Inc.

See Page 1

See Page 1

See Page 1

See Page 1

25

Certificate of Liability Insurance

W39026006

CERT:

3963267

BATCH:

27756742

SR ID:

CG 25 04 05 09 © Insurance Services Office, Inc., 2008

Policy Number: TB2-641-444950-035

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

obligated to pay as damages caused by "occur-

rences" under Section I – Coverage A, and for all

medical expenses caused by accidents under

Section I – Coverage C, which can be attributed

only to operations at a single designated "loca-

tion" shown in the Schedule above:

1. A separate Designated Location General

Aggregate Limit applies to each designated

"location", and that limit is equal to the

amount of the General Aggregate Limit

shown in the Declarations.

2. The Designated Location General Aggregate

Limit is the most we will pay for the sum of all

damages under Coverage A, except damag-

es because of "bodily injury" or "property

damage" included in the "products-completed

operations hazard", and for medical 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".

3. Any payments made under Coverage A for

damages or under Coverage C for medical

expenses shall reduce the Designated Loca-

tion General Aggregate Limit for that desig-

nated "location". Such payments shall not re-

duce the General Aggregate Limit shown in

the Declarations nor shall they reduce any

other Designated Location General Aggre-

gate Limit for any other designated "location"

shown in the Schedule above.

4. The limits shown in the Declarations for Each

Occurrence, Damage To Premises Rented To

You and Medical Expense continue to apply.

However, instead of being subject to the

General Aggregate Limit shown in the Decla-

rations, such limits will be subject to the appli-

cable Designated Location General Aggre-

gate Limit.

© Insurance Services Office, Inc., 2008 CG 25 04 05 09

B. For all sums which the insured becomes legally

obligated to pay as damages caused by "occur-

rences" under Section I – Coverage A, and for all

medical expenses caused by accidents under

Section I – Coverage C, which cannot be at-

tributed only to operations at a single designated

"location" shown in the Schedule above:

1. Any payments made under Coverage A for

damages or under Coverage C for medical

expenses shall reduce the amount available

under the General Aggregate Limit or the

Products-completed Operations Aggregate

Limit, whichever is applicable; and

2. Such payments shall not reduce any Desig-

nated Location General Aggregate Limit.

C. When coverage for liability arising out of the

"products-completed operations hazard" is pro-

vided, any payments for damages because of

"bodily injury" or "property damage" included in

the "products-completed operations hazard" will

reduce the Products-completed Operations Ag-

gregate Limit, and not reduce the General Ag-

gregate Limit nor the Designated Location Gen-

eral Aggregate Limit.

D. For the purposes of this endorsement, the Defi-

nitions Section is amended by the addition of

the following definition:

"Location" means premises involving the same or

connecting lots, or premises whose connection is

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.

CG 25 03 05 09 © Insurance Services Office, Inc., 2008 

Policy Number: TB2-641-444950-035

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

obligated to pay as damages caused by "occur-

rences" under Section I – Coverage A, and for all

medical expenses caused by accidents under

Section I – Coverage C, which can be attributed

only to ongoing operations at a single designated

construction project shown in the Schedule

above:

1. A separate Designated Construction Project

General Aggregate Limit applies to each des-

ignated construction project, and that limit is

equal to the amount of the General Aggregate

Limit shown in the Declarations.

2. The Designated Construction Project General

Aggregate Limit is the most we will pay for the

sum of all damages under Coverage A, ex-

cept damages because of "bodily injury" or

"property damage" included in the "products-

completed operations hazard", and for medi-

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".

3. Any payments made under Coverage A for

damages or under Coverage C for medical

expenses shall reduce the Designated Con-

struction Project General Aggregate Limit for

that designated construction project. Such

payments shall not reduce the General Ag-

gregate Limit shown in the Declarations nor

shall they reduce any other Designated Con-

struction Project General Aggregate Limit for

any other designated construction project

shown in the Schedule above.

4. The limits shown in the Declarations for Each

Occurrence, Damage To Premises Rented To

You and Medical Expense continue to apply.

However, instead of being subject to the

General Aggregate Limit shown in the Decla-

rations, such limits will be subject to the appli-

cable Designated Construction Project Gen-

eral Aggregate Limit.

© Insurance Services Office, Inc., 2008 CG 25 03 05 09

B. For all sums which the insured becomes legally

obligated to pay as damages caused by "occur-

rences" under Section I – Coverage A, and for all

medical expenses caused by accidents under

Section I – Coverage C, which cannot be at-

tributed only to ongoing operations at a single

designated construction project shown in the

Schedule above:

1. Any payments made under Coverage A for

damages or under Coverage C for medical

expenses shall reduce the amount available

under the General Aggregate Limit or the

Products-completed Operations Aggregate

Limit, whichever is applicable; and

2. Such payments shall not reduce any Desig-

nated Construction Project General Aggre-

gate Limit.

C. When coverage for liability arising out of the

"products-completed operations hazard" is pro-

vided, any payments for damages because of

"bodily injury" or "property damage" included in

the "products-completed operations hazard" will

reduce the Products-completed Operations Ag-

gregate Limit, and not reduce the General Ag-

gregate Limit nor the Designated Construction

Project General Aggregate Limit.

D. If the applicable designated construction project

has been abandoned, delayed, or abandoned

and then restarted, or if the authorized contract-

ing parties deviate from plans, blueprints, de-

signs, specifications or timetables, the project will

still be deemed to be the same construction pro-

ject.

E. The provisions of Section III – Limits Of Insur-

ance not otherwise modified by this endorsement

shall continue to apply as stipulated.

POLICY NUMBER: TB2-641-444950-

035

COMMERCIAL GENERAL LIABILITY

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

include as an additional insured the person(s) or

organization(s) shown in the Schedule, but only with

respect to liability for "bodily injury", "property

damage" or "personal and advertising injury"

caused, in whole or in part, by:

1. Your acts or omissions; or

2. The acts or omissions of those acting on your

behalf;

in the performance of your ongoing operations for

the additional insured(s) at the location(s)

designated above.

1. All work, including materials, parts or

equipment furnished in connection with such

work, on the project (other than service,

maintenance or repairs) to be performed by or

on behalf of the additional insured(s) at the

location of the covered operations has been

completed; or

2. That portion of "your work" out of which the

injury or damage arises has been put to its

intended use by any person or organization

other than another contractor or subcontractor

engaged in performing operations for a

principal as a part of the same project.

However:

1. The insurance afforded to such additional

insured only applies to the extent permitted by

law; and

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.

B. With respect to the insurance afforded to these

additional insureds, the following additional

exclusions apply:

This insurance does not apply to "bodily injury" or

"property damage" occurring after:

C. With respect to the insurance afforded to these

additional insureds, the following is added to

Section III – Limits Of Insurance:

If coverage provided to the additional insured is

required by a contract or agreement, the most we

will pay on behalf of the additional insured is the

amount of insurance:

1. Required by the contract or agreement; or

2. Available under the applicable limits of

insurance;

whichever is less.

This endorsement shall not increase the

applicable limits of insurance.

Name Of Additional Insured Person(s)

Or Organization(s):

SCHEDULE

Location(s) Of Covered Operations

Any person or organization with whom you have agreed

through written contract, agreement or permit to provide

additional insured coverage

All locations as required by a written contract or

agreement entered into prior to an "occurrence" or

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

POLICY NUMBER: TB2-641-444950-

035

COMMERCIAL GENERAL LIABILITY

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

include as an additional insured the person(s) or

organization(s) shown in the Schedule, but only

with respect to liability for "bodily injury" or

"property damage" caused, in whole or in part, by

"your work" at the location designated and

described in the Schedule of this endorsement

performed for that additional insured and included

in the "products-completed operations hazard".

However:

1. The insurance afforded to such additional

insured only applies to the extent permitted by

law; and

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.

B. With respect to the insurance afforded to these

additional insureds, the following is added to

Section III – Limits Of Insurance:

If coverage provided to the additional insured is

required by a contract or agreement, the most we

will pay on behalf of the additional insured is the

amount of insurance:

1. Required by the contract or agreement; or

2. Available under the applicable limits of

insurance;

whichever is less.

This endorsement shall not increase the applicable

limits of insurance.

SCHEDULE

Name Of Additional Insured Person(s)

Or Organization(s): Location And Description Of Completed Operations

Any person or organization to whom or to which you are

required to provide additional insured status in a written

contract, agreement or permit except where such

contact or agreement is prohibited.

Any location where you have agreed, through written,

contract, agreement, or permit, to provide additional

insured coverage for completed operations

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

Policy Number TB2-641-444950-035

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".

LD 24 153 08 16 © 2016 Liberty Mutual Insurance

Includes copyrighted material of Insurance Services Office, Inc., with its permission.

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

Name Of Person(s) Or Organization(s):

As required by written contract or agreement.

COMMERCIAL GENERAL LIABILITY

CG 24 04 12 19

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:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

ELECTRONIC DATA LIABILITY COVERAGE PART

LIQUOR LIABILITY COVERAGE PART

POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES

POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES

PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART

RAILROAD PROTECTIVE LIABILITY COVERAGE PART

UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS

SCHEDULE

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 against the person(s)

or organization(s) shown in the Schedule above

because of payments we make under thi s Coverage

Part. Such waiver by us applies only to the extent that

the insured has waived its right of recovery against

such person(s) or organization(s) prior to loss. This

endorsement applies only to the person(s) or

organization(s) shown in the Schedule above.

CG 24 04 12 19 © Insurance Services Office, Inc., 2018

POLICY NUMBER: TB2-641-444950-035

POLICY NUMBER: AS2-641-444950-045 COMMERCIAL AUTO

CA 20 48 10 13

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

Policy Numbe r: AS2-641-444950-045

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 08 11 © 2010, Liberty Mutual Group of Companies. All rights reserved.

Includes copyrighted material of Insurance Services Office, Inc.,

with its permission.

POLICY NUMBER: AS2-641-444950-045 COMMERCIAL AUTO

CA 04 44 10 13

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

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-444950-015

$

Issued to:HDR Engineering, Inc.

Effective Date 06/01/2025 Premium

WC 00 03 13

Ed. 4/1/1984

© 1983 National Council on Compensation Insurance, Inc.

Policy Number TB2-641-444950-035

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) /

Organization(s):

Email Address or mailing address: Number Days Notice:

As required by written contract or

written agreement

As required by written contract or

written agreement

30

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.

Includes copyrighted material of Insurance Services Office, Inc., with its permission.

Policy Number AS2-641-444950-045

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) /

Organization(s):

Email Address or mailing address: Number Days Notice:

As required by written contract

or written agreement

30

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.

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-444950-015 Effective Date 06/01/2025 Premium $

Issued to HDR Engineering, Inc. Endorsement No.

WC 99 20 75

Ed. 12/01/2016

© 2016 Liberty Mutual Insurance

Case records

Open case page

Docket: 2026-0005

Date Record Text Type Party PDF
May 20, 2026 Governor and Executive Council Agenda item PDF - 2026-05-20 - agenda 5 Current page Other PDF