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HomeMy WebLinkAboutCOI_ American Asphalt South, Inc_12.29.25SHOULD 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-MAILADDRESS: 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 EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR 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) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 12/29/2025 InterWest Insurance Services,LLC 8950 Cal Center Drive Building 3,Suite 200 Sacramento CA 95826 Cheryl Trusler 916-609-8494 916-609-8494 ctrusler@iwins.com License#:0B01094 Pennsylvania Mfr's Assn Ins Co 12262 AMERASP-02 Travelers Property &Casualty Co of America 25674AmericanAsphaltSouth,Inc. P.O.Box 7427 Riverside CA 92513 Arch Insurance Company 11150 Westchester Surplus Lines Ins 10172 287169150 A X 1,000,000 X 300,000 10,000 1,000,000 2,000,000 X Y Y 3025011581305 12/31/2025 12/31/2026 2,000,000 Deductible 0 A 1,000,000 X X X Y Y 1525011581305 12/31/2025 12/31/2026 B X X 6,000,000 X CUPA762679325 12/31/2025 12/31/2026 6,000,000 X 0 C XYZAWCI10458004/1/2025 4/1/2026 1,000,000 1,000,000 1,000,000 D Pollution Liability Y Y G70915613005 8/27/2024 8/27/2026 Each Pollution Condit Aggregate Limit Deductible 5,000,000 10,000,000 10,000 Additional Insured status applies to requested entities,if required by written contract,per the attached policy forms/endorsements.Primary non-contributory applies to requested entities,if required by written contract,per the attached policy forms/endorsements.Waiver of subrogation applies to requested entities,if required by written contract,per the attached policy forms/endorsements. Umbrella is following form over the General Liability,Auto Liability &Employers Liability. Re:Purchase Order #4100422467. The County of San Bernardino Purchasing Department 777 E.Rialto Avenue San Bernardino CA 92415 INSURED COPY COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 20 10 07 04 ISO Properties, Inc., 2004 Page 1 of 1 ADDITIONAL INSURED --- OWNERS, LESSEES OR CONTRACTORS --- SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Location(s) Of Covered OperationsOr Organization(s): Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II ---- Who Is An Insured is amended to 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) desig- nated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equip- ment 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 in- tended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a princi- pal as a part of the same project. POLICY NUMBER:302501-15-81-30-5 WHERE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT COMMERCIAL GENERAL LIABILITY CG 20 01 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 20 01 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 PRIMARY AND NONCONTRIBUTORY – OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition 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 in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. INSURED COPY POLICY NUMBER: 302501-15-81-30-5 P o licy Numb er : 30250ii58i305 COMMERCIAL GENERAL LIABILITY AP27 THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY TOTAL AGGREGATE LIMIT,DESIGNATED PROJECT AGGREGATE LIMIT AND GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE -LIMITS OF INSURANCE AND DESIGNATED PROJECT LIMITS OF INSURANCE $5,000,000 $2,000,000 $2,000,000 Total Aggregate Limit (Other Than Projects and Products-Completed Operations) Designated Project Aggregate Limit (Other Than Products-Completed Operations) General Aggregate Limit (Other Than Products-Completed Operations) Designated Projects: PROVISIONS 1.The General Aggregate Limit (Other Than Products-Completed Operations)shown in the Declarations is replaced by the Limits of Insurance shown in the SCHEDULE-LIMITS OF INSURANCE AND DESIGNATED PROJECT. 2.Thefollowing replaces Paragraph 1.of SECTION III -LIMITS OF INSURANCE: (1)The Limits of Insurance shown in the Declarations or the SCHEDULE -LIMITS OF INSURANCE AND DESIGNATED PROJECT,whichever apply,subject to the following provisions fix the most we will pay regardless of the numberof: a.Insureds; b.Claims made or "suits"brought; c.Persons or organizations making claims or bringing "suits";or d."Projects". 3.The following replaces Paragraph 2.of SECTION III -LIMITS OFINSURANCE: (1)The Total Aggregate Limit shown in the SCHEDULE -LIMITS OF INSURANCE AND DESIGNATED PROJECT is the most we will pay for the sum of all amounts under the Designated Project Aggregate Limit and all amounts under the General Aggregate Limit.This includes: a.Damages under Coverage A,except damages because of "bodily injury"or "property damage"included in the "products-completed operationshazard"; b.Damages under Coverage B;and c.Medical expenses under Coverage C. AP 27 Includes copyrighted material of Insurance Services Office,Inc.,with its permission Page 1 of 3 PMA Companies,201 9 POLICY NUMBER 3025011581305 COMMERCIAL GENERAL LIABILITY AP 27 4.The Designated Project Aggregate Limit shown in the SCHEDULE -LIMITS OF INSURANCE AND DESIGNATED PROJECT is subject to all of the following provisions: (1 )The Designated Project Aggregate Limit is the most we will pay for the sum of: a.Damages under Coverage A because of "bodily injury"and "property damage;and b.Medicalexpenses under Coverage C for"bodily injury"caused by accidents;that can be attributed solely to operations at a single “project” (2)The Designated Project Aggregate Limit applies separately to each "project". (3)The Designated Project Aggregate Limit does not apply to damages because of "bodily injury"or "property damage"included in the "products-completed operations hazard".Instead,the Products- Completed Operations Aggregate Limit described in Paragraph 6.below applies to such damages. (4)The Designated Project Aggregate Limit does not apply to damages under Coverage B.Instead,the General Aggregate Limit described in Paragraph 5.below applies to such damages. (5)Any payments made for damages under Coverage A or medical expenses under Coverage C to which the Designated Project Aggregate Limit applies will reduce: a.The Total Aggregate Limit;and b.The Designated Project Aggregate Limit for the "project". Such payments will not reduce the General Aggregate Limit described in Paragraph 5.below,nor will they reduce the Designated Project Aggregate Limit for any other "project". 5.Subject to the Total Aggregate Limit described in Paragraph 3.above,the General Aggregate Limit shown in the SCHEDULE -LIMITS OF INSURANCE AND DESIGNATED PROJECT is further subject to all of the following provisions: (1)TheGeneral Aggregate Limit is the mostwe will pay forthe sum of: a.Damages under Coverage A because of "bodily injury"and "property damage"and medical expenses under Coverage C that cannot be attributed solely to operations at a single "project"and b.Damages under Coverage B. (2)The General Aggregate Limit does not apply to damages for "bodily injury"or "property damage" included in the "products-completed operations hazard".Instead,the Products-Completed Operations Aggregate Limit described in Paragraph 6.below applies to such damages. (3)Any payments made for damages under Coverage A or medical expenses under Coverage C to which the General Aggregate Limit applies will reduce: a.The Total Aggregate Limit;and b.TheGeneral Aggregate Limit. Such payments will not reduce the Designated Project Aggregate Limit for any "project". 6.The following replaces Paragraph 3.of SECTION III -LIMITS OF INSURANCE: (1)The Products-Completed Operations Aggregate Limit shown in the Declarations is the most we AP27 Includes copyrighted material of Insurance Services Office,Inc.,with its permission Page 2 of 3 PMA Companies,201 9 POLICY NUMBER 3025011581305 COMMERCIAL GENERAL LIABILITY AP 27 will pay under Coverage A for damages because of "bodily injury”and "property damage"included in the "products-completed operations hazard".Any payments made for such damages will not reduce the Total Aggregate Limit,the General Aggregate Limit or the Designated Project Aggregate Limit for any "project" 7.The following is added to the DEFINITIONSSection but only for purposes of the Designated Project shown in the SCHEDULE -LIMITS OF INSURANCE "Project"means any designated project shown in the SCHEDULE -LIMITS OF INSURANCE AND DESIGNATED PROJECT that is away from premises owned by or rented to you and at which you are performing operations pursuant to a written contract or agreement.For the purposes of determining the applicable aggregate limit of insurance,each "project"that includes a premise involving the same or connecting lots,or premises whose connection is interrupted only by a street,roadway,waterway,or by a right-of-way of a railroad,will be considered a single "project". AP27 Includes copyrighted material of Insurance Services Office,Inc.,with its permission Page 3 of 3 PMA Companies,201 9 CG 24 04 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 POLICY NUMBER: 302501-15-81-30-5 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) 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 Name Of Person(s) Or Organization(s): WHERE 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 against the person(s) or organization(s) shown in the Schedule above because of payments we make under this 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. This endorsement modifies insurance provided under the following: INSURED COPY 12/31/2025 152501-15-81-30-5 American Asphalt South, Inc. POLICY NUMBER: 152501-15-81-30-5 INSURED COPY COMMERCIAL AUTO CA 04 44 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CA 04 44 10 13 Insurance Services Office, Inc., 2011 Page 1 of 1 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. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Endorsement Effective Date: SCHEDULE Name(s) Of Person(s) Or Organization(s): 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 contract with that person or organization. POLICY NUMBER: 152501-15-81-30-5 WHERE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT American Asphalt South, Inc. 12/31/2025 This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement No. Premium $ Countersigned By INCL.Insured American Asphalt South, Inc. Insurance Company ARCH INSURANCE COMPANY 1998 by the Workers’ Compensation Insurance Rating Bureau of California. All rights reserved. 1999.From the WCIRB’s California Workers’ Compensation Insurance Forms Manual WC 04 03 06WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY (Ed. 04-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA 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 % of the California workers’ compensation premium otherwise due on such remuneration. SCHEDULE PERSON OR ORGANIZATION JOB DESCRIPTION ANY PERSON OR ORGANIZATION WHERE INCL ALL JOBS UNDER CONTRACT WAIVER OF OUR RIGHT TO RECOVER IS PERMITTED BY LAW AND IS REQUIRED BY WRITTEN CONTRACT PROVIDED SUCH CONTRACT WAS EXECUTED PRIOR TO DATE OF LOSS Policy No. ZAWCI1045800 Endorsement Effective 4/1/2025 ENV-3250 (12/18) (221012.1) Includes copyrighted material of Insurance Services Office, Inc. with its permission Page 1 of 2 However: ADDITIONAL INSURED ENDORSEMENT – ONGOING WORK OR OPERATIONS Named Insured American Asphalt South, Inc. Endorsement Number Policy Symbol CPW Policy Number G70915613 005 Policy Period 8/27/2024 To 8/27/2026 Effective Date of Endorsement 8/27/2024 Issued By (Name of Insurance Company) Westchester Surplus Lines Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: CONTRACTORS POLLUTION LIABILITY COVERAGE PART SCHEDULE: Name of Person(s) or Organization(s): As required by written contract, prior to a loss to which this insurance applies (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. SECTION II - WHO IS AN INSURED is amended to include as an additional insured the persons or organizations shown in the Schedule, but only with respect to liability for injury or damage, to which this insurance applies, 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 insureds. 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 exclusion is added: Exclusions This insurance does not apply to injury or damage occurring after: a.All work or operations, including materials, parts or equipment furnished in connection with such work or operations, on the project (other than service, maintenance or repairs) to be performed by you or on your behalf at the site of the covered operations has been completed; or ENV-3250 (12/18) (221012.1) Includes copyrighted material of Insurance Services Office, Inc. with its permission Page 2 of 2 1. Required by the contract or agreement; or b.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 the additional insured as a part of the same project. 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: 2.Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. All other terms and conditions of this policy remain unchanged. ADDITIONAL INSURED ENDORSEMENT – PRODUCTS-COMPLETED OPERATIONS HAZARD Named Insured American Asphalt South, Inc. Endorsement Number Policy Symbol CPW Policy Number G70915613 005 Policy Period 8/27/2024 To 8/27/2026 Effective Date of Endorsement 8/27/2024 Issued By (Name of Insurance Company) Westchester Surplus Lines Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: CONTRACTORS POLLUTION LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: As required by written contract, prior to a loss to which this insurance applies (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) 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 injury or damage, to which this insurance applies, caused by or resulting from your work performed for that additional insured and included in the products-completed operations hazard, and only to the extent that such injury or damage is caused, in whole or in part, by your negligence or the negligence of those acting on your behalf. 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 shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. All other terms and conditions of this policy remain unchanged. ENV-3251 (12/18) (221012.2) Includes copyrighted material of Insurance Services Office, Inc. with its permission Page 1 of 1 PRIMARY AND NONCONTRIBUTORY – OTHER INSURANCE CONDITION Named Insured American Asphalt South, Inc. Endorsement Number Policy Symbol CPW Policy Number G70915613 005 Policy Period 8/27/2024 To 8/27/2026 Effective Date of Endorsement 8/27/2024 Issued By (Name of Insurance Company) Westchester Surplus Lines Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: CONTRACTOR’S POLLUTION LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary and Noncontributory Insurance This policy is primary to, and will not seek contribution from, any other insurance available to an additional insured under this policy, provided that: a.The additional insured is a named insured under such other insurance; and b.The named insured has agreed in a written contract or agreement that this insurance would: (1)act as primary insurance; and (2)would not seek contribution from any other insurance available to the additional insured. All other terms and conditions of this policy remain unchanged. ENV-3253 (12-18) (266562.2)Includes copyrighted material of Insurance Services Office, Inc. with its permission Page 1 of 1 ENV-3143 (03-05)Includes copyrighted material of Insurance Services Office, Inc. with its permission Page 1 of 1 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Named Insured American Asphalt South, Inc. Endorsement Number Policy Symbol CPW Policy Number G70915613 005 Policy Period 8/27/2024 To 8/27/2026 Effective Date of Endorsement 8/27/2024 Issued By (Name of Insurance Company) Westchester Surplus Lines Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS POLLUTION LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: As required by written contract, prior to a loss to which this insurance applies (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition is amended by the addition of the following: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or your work done under a contract with that person or organization and included in the products-completed operations hazard. This waiver applies only to the person or organization shown in the Schedule above. All other terms and conditions remain the same.