ANY PROPRIETOR/PARTNER/EXECUTIVEOFFICER/MEMBER EXCLUDED?
INSR ADDLSUBRLTR INSDWVD
PRODUCER CONTACTNAME: FAXPHONE(A/C, No):(A/C, No, Ext):E-MAILADDRESS:INSURER A :INSURED INSURER B :INSURER C :INSURER D :INSURER E :INSURER F :
POLICY NUMBERPOLICY EFFPOLICY EXPTYPE OF INSURANCELIMITS(MM/DD/YYYY)(MM/DD/YYYY)
AUTOMOBILE LIABILITY
UMBRELLA LIABEXCESS LIABWORKERS COMPENSATIONAND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
AUTHORIZED REPRESENTATIVE
EACH OCCURRENCE$DAMAGE TO RENTEDCLAIMS-MADEOCCUR $PREMISES (Ea occurrence)MED EXP (Any one person)$PERSONAL & ADV INJURY$GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE$PRO-POLICYLOC PRODUCTS - COMP/OP AGGJECT OTHER: $COMBINED SINGLE LIMIT$(Ea accident)ANY AUTO BODILY INJURY (Per person)$OWNEDSCHEDULEDBODILY INJURY (Per accident)$AUTOS ONLYAUTOSHIREDNON-OWNEDPROPERTY DAMAGE$AUTOS ONLYAUTOS ONLY(Per accident)$OCCUR EACH OCCURRENCECLAIMS-MADEAGGREGATE$DEDRETENTION$ PEROTH-STATUTEERE.L. EACH ACCIDENTE.L. DISEASE - EA EMPLOYEE$If yes, describe underE.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below INSURER(S) AFFORDING COVERAGENAIC #
COMMERCIAL GENERAL LIABILITY
Y / NN / A(Mandatory in NH)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED INACCORDANCE WITH THE POLICY PROVISIONS.
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIODINDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THISCERTIFICATE 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.
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THISCERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIESBELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZEDREPRESENTATIVE 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 onthis certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
COVERAGESCERTIFICATE NUMBER:REVISION NUMBER:
CERTIFICATE HOLDERCANCELLATION
© 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03)
CERTIFICATE OF LIABILITY INSURANCEDATE (MM/DD/YYYY)
$
$$$$
The ACORD name and logo are registered marks of ACORD
11/3/2025
License # 0E67768(858) 754-0063 50233(619) 574-628813056GMU Geotechnical, Inc.30336 EsperanzaRancho Santa Margarita, CA 9268811380 A 1,000,000XXPSB000578312/31/202412/31/20251,000,000Cont Liab/Sevr Int10,0001,000,0002,000,0002,000,000Ded 01,000,000A XXPSA000210512/31/202412/31/2025Comp. Ded.: $1,000Coll. Ded.: $1,000 5,000,000A XXPSE000254112/31/202412/31/20255,000,0000A XPSW000334112/31/202412/31/20251,000,000N 1,000,0001,000,000BProfessional Liab.USF0062542412/31/2024Per Claim2,000,000BDed.: $50K Per ClaimUSF0062542412/31/202412/31/2025Aggregate2,000,000Re: City of Huntington Beach 2025 On Call Materials TestingCity of Huntington Beach is Additional Insured with respect to General and Auto Liability per the attached endorsements as required by written contract. Insurance is Primary and Non-Contributory. Waiver of Subrogation applies to General Liability, Auto Liability and Workers' Compensation. Excess Liability follows form.30 Days Notice of Cancellation with 10 Days Notice for Non-Payment of Premium in accordance with the policy provisions.
City of Huntington Beach2000 Main StreetHuntington Beach, CA 92648 GMUGEOT-01MCCOWANA
IOA Insurance Services3636 Nobel DriveSuite 410San Diego, CA 92122Erica [email protected] Insurance CompanyFireman's Fund Indemnity Corporation X12/31/2025
X XXXXX XXXX
Policy Number: RLI Insurance CompanyNamed Insured:
PPB 304 02 12 Page 1 of 1
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.RLIPack®FOR PROFESSIONALSBLANKET ADDITIONAL INSURED ENDORSEMENTThis endorsement modifies insurance provided under the following:BUSINESSOWNERS COVERAGE FORM - SECTION II – LIABILITY1. C. WHO IS AN INSUREDis amended to include asan additional insured any person or organization thatyou agree in a contract or agreement requiringinsurance to include as an additional insured on thispolicy, but only with respect to liability for "bodilyinjury", "property damage" or "personal andadvertising injury" caused in whole or in part by youor those acting on your behalf:a.In the performance of your ongoing operations;b.In connection with premises owned by or rentedto you; orc.In connection with “your work” and includedwithin the “product-completed operationshazard”.2.The insurance provided to the additional insured bythis endorsement is limited as follows:a.This insurance does not apply on any basis toany person or organization for which coverageas an additional insured specifically is added byanother endorsement to this policy.b.This insurance does not apply to the renderingof or failure to render any "professionalservices".c.This endorsement does not increase any of thelimits of insurance stated inD. Liability AndMedical Expenses Limits of Insurance.3.The following is added toSECTION III H.2. OtherInsurance – COMMON POLICY CONDITIONS(BUT APPLICABLE ONLY TO SECTION II –LIABILITY)However, if you specifically agree in a contract oragreement that the insurance provided to an additional insured under this policy must apply on aprimary basis, or a primary and non-contributorybasis, this insurance is primary to other insurancethat is available to such additional insured whichcovers such additional insured as a named insured,and we will not share with that other insurance,provided that:a.The "bodily injury" or "property damage" forwhich coverage is sought occurs after you haveentered into that contract or agreement; orb.The "personal and advertising injury" for whichcoverage is sought arises out of an offensecommitted after you have entered into thatcontract or agreement.4.The following is added toSECTION III K. 2.Transfer of Rights of Recovery Against Others toUs – COMMON POLICY CONDITIONS (BUTAPPLICABLE TO ONLY TO SECTION II –LIABILITY)We waive any rights of recovery we may haveagainst any person or organization because ofpayments we make for "bodily injury", "propertydamage" or "personal and advertising injury" arisingout of "your work" performed by you, or on yourbehalf, under a contract or agreement with thatperson or organization. We waive these rights onlywhere you have agreed to do so as part of acontract or agreement with such person ororganization entered into by you before the "bodilyinjury" or "property damage" occurs, or the "personaland advertising injury" offense is committed.ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED.
Policy Number: RLI Insurance Company Named Insured:
PPA 300 03 13 Page 1 of 5
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. RLIPack® BUSINESS AUTO ENHANCEMENT SCHEDULE OF COVERAGES ADDRESSED BY THIS ENDORSEMENT A. Broad Form Named Insured B. Employees As Insureds C. Blanket Additional Insured D. Blanket Waiver Of Subrogation E. Employee Hired Autos F. Fellow Employee Coverage G. Auto Loan Lease Gap Coverage H. Glass Repair Waiver Of Deductible I. Personal Effects Coverage J. Hired Auto Physical Damage Coverage K. Hired Auto Physical Damage Loss Of Use L. Hired Car Worldwide Coverage M. Temporary Transportation Expenses N. Amended Bodily Injury Definition Mental Anguish O. Airbag Coverage P. Amended Insured Contract Definition Railroad Easement Q. Coverage Extensions Audio, Visual And Data Electronic Equipment Not Designed Solely For The Production Of Sound R. Notice Of And Knowledge Of Occurrence S. Unintentional Errors Or Omissions T. Towing Coverage PPA 300 03 13 Page 2 of 5
This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORMA. Broad Form Named Insured The following is added to the SECTION II COVERED AUTOS LIABILITY COVERAGE, Para-graph A.1. Who Is An Insured Provision: Any business entity newly acquired or formed by you during the policy period, provided you own fifty percent (50%) or more of the business entity and the business entity is not separately insured for Bus-iness Auto Coverage. Coverage is extended up to a maximum of one hundred eighty (180) days following the acquisition or formation of the business entity. This provision does not apply to any person or organization for which coverage is excluded by endorsement. B. Employees As Insureds The following is added to the SECTION II COVERED AUTOS LIABILITY COVERAGE, Para-graph A.1. Who Is An Insured Provision: Any employeeof yours is an insuredwhile using a covered autoyou don't own, hire or borrow in your business or your personal affairs. C. Blanket Additional Insured The following is added to the SECTION II COVERED AUTOS LIABILITY COVERAGE, Para-graph A.1. Who Is An Insured Provision: Any person or organization that you are required to include as an additional insured on this coverage form in a contract or agreement that is executed by you before the bodily injuryor property damageoccurs is an insuredfor liability coverage, but only for damages to which this insurance applies and only to the extent that person or organization qualifies as an insuredunder the Who Is An Insured provision contained in SECTION II COVERED AUTOS LIABILITY COVERAGE. The insurance provided to the additional insured will be on a primary and non-contributory basis to the verage if you are required to do so in a contract or agreement that is executed by you before the bodily injuryor property damageoccurs. D. Blanket Waiver Of Subrogation The following is added to the SECTION IV BUSI-NESS AUTO CONDITIONS, A. Loss Conditions, 5. Transfer Of Rights Of Recovery Against Others To Us: We waive any right of recovery we may have against any person or organization to the extent required of you by a contract executed prior to any accidentor loss, provided that the accidentor lossarises out of the operations contemplated by such contract. The waiver applies only to the person or organization designated in such contract. E. Employee Hired Autos 1. The following is added to the SECTION II COVERED AUTOS LIABILITY COVERAGE, Paragraph A.1. Who Is An Insured Provision: An employeeof yours is an insuredwhile operating an autohired or rented under a contract or agreement in that employee'sname, with your permission, while performing duties related to the conduct of your business. 2. Changes In General Conditions: Paragraph 5.b. of the Other Insurance Con-dition in the BUSINESS AUTO CONDITIONS is deleted and replaced with the following: b. For Hired Auto Physical Damage Coverage, the following are deemed to be covered autosyou own: (1) Any covered autoyou lease, hire, rent or borrow; and (2) Any covered autohired or rented by your employeeunder a contract in that individual employee'sname, with your permission, while performing duties related to the conduct of your business. However, any autothat is leased, hired, rented or borrowed with a driver is not a covered auto. F. Fellow Employee Coverage SECTION II COVERED AUTOS LIABILITY COVERAGE, Exclusion B.5. does not apply if you have workers compensation insurance in-force covering all of your employees. G. Auto Loan Lease Gap Coverage SECTION III PHYSICAL DAMAGE COVERAGE, C. Limit Of Insurance, is amended by the addition of the following: In the event of a total loss to a covered autoshown in the Schedule of Declarations, we will pay any unpaid amount due on the lease or loan for a covered auto, less: 1. The amount paid under the PHYSICAL DAMAGE COVERAGE section of the policy; and 2. Any: a. Overdue lease/loan payments at the time of the loss; PPA 300 03 13 Page 3 of 5
b. Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage.c. Security deposits not returned by the lessor; d. Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease; and e. Carry-over balances from previous loans or leases. H. Glass Repair Waiver Of Deductible SECTION III PHYSICAL DAMAGE COVERAGE, D. Deductible is amended by adding the following: No deductible for a covered autowill apply to glass damage if the glass is repaired rather than replaced. I. Personal Effects Coverage The following is added to SECTION III PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions: c.Personal Effects Coverage In the event of a total theft loss of your covered auto we will pay up to $400 for lossto wearing apparel and other personal effects which are: (1) Owned by an insured; and (2) In or on your covered auto; No deductible applies to Personal Effects Coverage. J. Hired Auto Physical Damage Coverage The following is added to SECTION III PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions: d. Hired Auto Physical Damage Coverage If hired autosare covered autosfor Liability Coverage and this policy also provides Physical Damage Coverage for an owned auto, then the Physical Damage Coverage is extended to autosthat you hire, rent or borrow subject to the following: (1) The most we will pay for lossin any one accidentto a hired, rented or borrowed autois the lesser of: (a) $60,000 (b) The actual cash value of the damaged or stolen property as of the time of the loss; or (c) The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality. (2) An adjustment for depreciation and physical condition will be made in the event of a total loss.(3) If a repair or replacement results in better than like kind or quality, we will not pay for the betterment. (4) A deductible equal to the highest Physical Damage deductible applicable to any owned auto will apply. (5) This Coverage Extension will not apply to: (a) Any autothat is hired, rented or borrowed with a driver; or (b) Any autothat is hired, rented or borrowed from your employee. K. Hired Auto Physical Damage Loss Of Use The following is added to SECTION III PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions: e. We will pay sums which you legally must pay to the lessor of a covered autowhich you have leased without a driver for thirty (30) days or less auto, provided: (1) This insurance provides comprehensive, specified causes of loss or collision covered on the covered auto; (2) The loss of use results from the covered autobeing damaged in an accidentwhile you are leasing it. We will pay up to a maximum limit of $1,500 for this covered extension. L. Hired Car Worldwide Coverage The following is added to SECTION II COVERED AUTOS LIABILITY COVERAGE, A.2. Coverage Extensions: f. Hired Car Worldwide Coverage (1) We will pay all sums an insuredlegally must pay as damages because of bodily injuryor property damageto which this insurance applies, caused by an accidentwhich occurs outside of the United States of America, the territories and possessions of the United States of America, Puerto Rico and Canada resulting from the maintenance, or use of any covered autoof the private passenger type you lease, hire, rent or borrow without a driver for thirty (30) days or less. (2) With respect to any claim made or suitinstituted outside the United States of America, the territories and possessions of the United States of America, Puerto Rico, and Canada:
PPA 300 03 13 Page 4 of 5
(a) You shall undertake the investigation, settlement and defense of such claims andsuitsand keep us advised of all proceedings and actions. (b) You will not make any settlement without our consent. (c) We will reimburse you: (i) For the amount of damages be-cause of liability imposed upon you by law on account of bodily injuryor property damageto which this insurance applies, and (ii) For all reasonable expenses incurred with our consent in connection with the investigation, settlement or defense of such claims or suitsReimbursement for expenses will be part of the Limit of Insurance for liability coverage shown in the Business Auto Coverage Declarations, and not in addition to such limits. (3) The limit of Insurance for Liability Coverage shown in the Business Auto Coverage Declarations is the most we will reimburse you for the sum of all damages imposed on you, as set forth in paragraph 2.c. above, and all expenses incurred by you arising out of any single accidentor loss (4) You must maintain the greater of the follow-ing primary auto liability insurance limits: (a) Compulsory admitted insurance with limits required to be in force to satisfy the legal requirements of the jurisdiction where the accident occurs; or (b) Insurance limits required by law and issued by a government entity or by an insurer licensed or permitted by law to do business in the jurisdiction where the accidentoccurs; or (c) Auto liability insurance limits of at least $300,000 combined single limit or $100,000 per person/$300,000 per acci-dent Bodily Injury, $100,000 Property Damage. If you fail to comply with the above, this insurance is not invalidated. However, in the event of a loss, we will pay only to the extent that we would have been liable had you so complied. (5) The insurance provided by this coverage extension is excess over any other collec-tible insurance available to you whether on a primary, excess contingent or any other basis.
M. Temporary Transportation Expenses SECTION III PHYSICAL DAMAGE COVERAGE, A.4. Coverage Extensions, subparagraph a. Transportation Expenses is deleted and replaced by the following: a. Transportation Expenses (1) We will pay up to a maximum of $1,500 for temporary transportation expense incurred by you because of Physical Damage to a covered auto. (2) We will pay only for those covered autosfor which you carry Comprehensive, Colli-sion or Specified Case of Loss Coverage. (3) We will pay only for those expenses incurred by you during the period of time that begins twenty-four (24) hours after the covered lossand ends at the time when the covered autocan be reasonable repaired or replaced. (4) This coverage does not apply while there are spare or reserve autosavailable to you for your operations. N. Amended Bodily Injury Definition Mental Anguish The following is added to SECTION V DEFINITIONS, Definition C.: Bodily injuryalso includes mental anguish, but only when the mental anguish arises from other bodily injury, sickness or disease. O. Airbag Coverage The following is added to SECTION III PHYSICAL DAMAGE COVERAGE B. Exclusions 3.a.: However, this exclusion will not apply to accidental discharge of an airbag due to mechanical or electrical breakdown. P. Amended Insured Contract Definition Railroad Easement SECTION V DEFINITIONS paragraph H. Insured contactis modified as follows: 1. Paragraph H.3. is replaced by the following: 3. Any easement or license agreement. 2. Paragraph H.6.a. is deleted. Q. Coverage Extensions Audio, Visual And Data Electronic Equipment Not Designed Solely For The Production Of Sound SECTION III PHYSICAL DAMAGE COVERAGE B. Exclusions, exception paragraph a. to exclusion 4.c. and 4.d. is deleted and replaced with the following:
PPA 300 03 13 Page 5 of 5
a.Equipment and accessories used with such equipment, except for tapes, records, discs or other electronic media device, provided such equipment is permanently installed in the covered autoat the time of the lossor is removable from the housing unit which is permanently installed in the covered autoat the time of the loss, and such equipment is designed to be solely operated by use of the power from the autoselectrical system, in or upon the covered autos; or R. Notice Of And Knowledge Of Occurrence SECTION IV BUSINESS AUTO CONDITIONS, A.2. Duties In The Event Of Accident, Claim Suit Or Loss, subparagraph a. is deleted and replaced with the following: a.In the event of accident, claim, suitor loss, you must give us or our authorized repre-sentative prompt notice of the accidentor lossincluding: (1) How, when and where the accidentor lossoccurred; (2) The name and address; and (3) To the extent possible, the names and addresses of any injured person and witnesses. Your duty to give us or our authorized representative prompt notice of the accidentor lossapplies only when the accidentor lossis known to: (1) You, if you are an individual; (2) A partner if you are a partnership; or (3)An executive officer or insurance manager, if you are a corporation.S. Unintentional Errors Or Omissions SECTION IV BUSINESS AUTO CONDITIONS, B. General Conditions; 2. Concealment Misrepre-sentation Or Fraud is amended by adding the following: The unintentional omission of, or unintentional error in, any information given by you shall not prejudice your rights under this insurance. However this pro-vision does not affect our right to collect additional premium or exercise our right of cancellation or nonrenewal. T. Towing Coverage SECTION III PHYSICAL DAMAGE COVERAGE, A.2. Towing, is deleted and replaced by the following: 2. We will pay up to $750 for towing and labor costs incurred each time a covered autois disabled due to a covered cause of loss. However: a. All labor must be performed at the place of disablement; and b. If the covered auto is a private passenger type no deductible applies; and c. If the covered auto is not of the private passenger type our obligation to pay will be reduced by a $250 deductible per disablement. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED.
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 4-84)
©1998 by the Workers’ Compensation Insurance Rating Bureau of California. All rights reserved.
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENTCALIFORNIA 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
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 Effective Policy No. Endorsement No.
Insured Insurance Company
Countersigned By
12/31/2024
ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED.
PPU 110 04 23 Page 1 of 1
Policy Number: PSE0002541 RLI Insurance Company
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
RLIPack® SCHEDULE OF UNDERLYING INSURANCE
This endorsement modifies insurance provided under the following:
COMMERCIAL EXCESS LIABILITY COVERAGE FORM
Item 4. of the declarations is amended to include:
Type of Coverage Carrier Eff. Date Exp. Date Limits
General Liability
Only the Type of
Coverage identified in
this Schedule of
Underlying Insurance
by Carrier, policy
number and applicable
Limits are to be
included.
RLI Insurance
Company
12/31/2024 12/31/2025
Occurrence $ 1,000,000
Aggregate $ 2,000,000
Employee Benefits
Liability
Only the Type of
Coverage identified in
this Schedule of
Underlying Insurance
by Carrier, policy
number and applicable
Limits are to be
included.
RLI Insurance
Company
12/31/2024 12/31/2025
Each Employee $1,000,000
Aggregate $1,000,000
Employers’ Liability
Only the Type of
Coverage identified in
this Schedule of
Underlying Insurance
by Carrier, policy
number and applicable
Limits are to be
included.
RLI Insurance
Company
12/31/2024 12/31/2025
Each Accident: Statutory Limits or $1,000,000
,whichever is greater
Disease Each Employee: Statutory Limits or
$1,000,000 ,whichever is greater
Disease Policy Limit: Statutory Limits or
$1,000,000 ,whichever is greater
Business Auto Liability
Only the Type of
Coverage identified in
this Schedule of
Underlying Insurance
by Carrier, policy
RLI Insurance
Company
12/31/2024 12/31/2025Each Accident $1,000,000