HomeMy WebLinkAboutPM 2014-06 - Certificate of Insurance - 11/14/2017 G(NDDEV-01
�►C��Q CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
09/07/2017
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED -
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL ENSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorse_ment s.
PRODUCER License#OE02096 c aCT
DIBuduo 8,DeFendis Insurance Brokers,LLC PA/HCNNo,Ext: 559)432-0222 AC Nu: 559 431-7941
P.O.Box 5479
Fresno,CA 93755-5478
_ —INSUEk SLA FORDING COVERAGE NAIC#
INSURER A.James River Insurance Company 12203
INSURED INsU B•Evanston insurance Company 35 7
Sky Park,LLC INSURER C:
759 W.All uvlal Ave.,#102 INSURER D.,
Fresno,CA 93711
ENSURER E:
_ INSURER F:
COVERAGE CERTIFICATE NUMBER: REVISION NUMBER:
THIS 18 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR TYPE OF INSURANCE ADD SU8 POLICY NUMBER POLICY EFF POLICY EXP LIMITS
A X COMMERCIAL GENERAL LIABILITY EACH OCCURRE E 1' 0'000
CLAIMS-MADE FX OCCUR 000679312 08/01/2017 08101/2018 0AMAGE70 RENTED 50,000
PBEMM (EdU
MED EXP Any oneperson) 1,000
i� PERSONAL&ADV INJURY 1'000'006
nDIVISIN GENERAL AGGREGATE $ 2,000,000GEN'L AGGREGATE LIMIT APPLIES PER: I\ MAV - GV
POLICY n' El LOC p roved. PRODUCTS-COMPJOPAGG $ 2,000,000
OTHER: -- 777
AUTOMOBILE LIABILITY 1 .. f �1� COMBINED SINGLE LIMIT
ANY AUTO Date BODILY INJURY e son
ONMED SCHEDULED ig ped
AUTOS ONLY AUTOS
INJURY Peraccden
AUT OS ONLY AUTOS ONLY PROPER7Y,DAMAGE
Per asci
B UMBRELLA LIAR X OCCUR EACH OCCURRENCE S 5'000'000
X EXCESS LIAa CLAIMS-MADE XOBW7243217 08/01/2017 08/01/2018 AGGREGATE a 5,000,000
DED RETENTION$ I S
wORKERSCDMPENSATION PER OTH-
AND EMPLOYERS'LIABILITY YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE F--] N/A E L EACH ACCIDENT S
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH) E.L.DISEASE-EA EMPLOYE
l yyes,describe under
0 SCRIPTI N OF OPERATIONS below E L DISEASE-POLICY LIMIT
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES ACORD 101,Additional Remarks Schedule,may be attached if mores ace Is required)
Policy limitation-Amended Aggregate Limits of Insurance Per Project:$10,000,000 per policy form AA5012US 12-03 attached.
RE:Project ID:Parcel Map No.2014-06
The Cityof Fresno,its officers,officials,employees,agents and volunteers are named additional insured as respects General Liability perwritten contract per
policy form CG2037 0704.This insurance Is primary,and our obligations are not affected by any other insurance carried by such additional insured whether
primary,excess,contingent or on any other basis. Primary wording for General Liability applies per written contract per policy form AP5031 US 04-10.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Ci Of Fresno THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City ACCORDANCE WITH THE POLICY PROVISIONS.
Public Works Department
2600 Fresno Street -- -
Fresno,CA 93721 AUTHORIZED REPRESENTATIVE
ACORD 25(2016103) r C 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
COMMERCIAL GENERAL LIABILITY
CG 20 10 07 04
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
SCHEDULE
Name Of Additional Insured Person(s)
Or❑r anization s : Locations of covered Operations
Where required by written contract or written agreement All operations of the Named Insureds
Information required to complete this Schedule, if not sill above.will be shown in the Declarations
A. Suction Il — Who Is An Insured is amended to B. With aspect to the insurance afforded to these
include as an additional insured the person(s) or additlono[ insureds, the following additional exclu-
organization(s) shown in the Schedule, put Only sions apply:
with resp .l to liability for"bodily injury", "property This insurance does nota I to "bodily injury" or
damage" or " orsonal and advertisin Injury" F�pY Y
P 9 � property damage"occurring after:
caused, in whole or in part; by:
1. Your acts or omissions; or 1• All work; including materials, parts or equip-
ment furnished in connection with such work,
2. The acts or omissions of those acting on your on the project(other than service, maintenance
behalf; or repairs)to be performed by or on behalf of
in the performance of your ongoing operations for the additional Insured(is) at the location of the
the additional insured($) at the location(s) de-sig- covered operations has been completed;or
nated above. 2. That portion of 'your worIC out of which the
injury of damage:arises has been put to its In-
tended use by any person or organization oth-
er than another contractor or suboontrector
engaged in perParming operations for a princi-
pal as a part of the same project.
CG 2010 07 04 Q 130 Properties, Inc., 2004 Page 1 of 1 M
POLICY NUMBER:00067931-2 COMMERCIAL GENERAL LIABILITY
CG 20 37 07 04
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
SCH EDIT LE
Name Of Additional Insured Person(s) Location And Description Of Completed Opera.
Or Organization(s): tions
Where required by written contractor written All operations of the Named Insureds.
agreement.
Information required to complete this Schedule, if not shown above. will be shown in the Declarations.
Section it—Who Is An Insured is amended to include
as an additional insured the person(s) or organiza-
tion(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 desig-
nated and described in the schedule of this endorse-
ment performed for that additional insured and inoluded
in the"products-completed operations hazard"
CO 20 37 07 04 0 130 Properties, Inc,, 2004 Page 1 of 1 ❑
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
PRIMARY AND NON CONTRIBUTORY
ENDORSEMENT
This endorsement modifies insurance provided under the following:
ALL COVERAGE PARTS
Name Of Additional Insured Person(s)
Or Or anization s :
City of Fresno, its officers, officials, employees, agents and volunteers
If no entry appears above, this endorsement applies to all Additional Insureds covered under
this policy.
Any coverage provided to an Additional Insured under this policy shall be excess over any other
valid and collectible insurance available to such Additional Insured whether primary, excess,
contingent or on any other basis unless a written contract or written agreement specifically
requires khat this insurance apply on a primary and noncontributory basis.
ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED.
AP5031US O4-10 Page 1 of 1
i
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
POLICY LIMITATION - AMENDED AGGREGATE
LIMITS OF INSURANCE PER PROJECT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
CONTRACTORS COMBINED LIABILITY POLICY
SECTION III—LIMITS OF INSURANCE-The General Aggregate Limit applies separately to
each"Project"of the Named Insured.
Notwithstanding the application of the General Aggregate Limit to each"Project" of the
Named Insured, under no circumstances will we pay more than$10,000,000 for all claims
under this policy that are subject to the General Aggregate limit.
For the purpose of this endorsement, the following definition is added:
"Project" means all work done by you or on your behalf, away from premises owned or
rented to you, to complete an individual bid or negotiated contract to provide services for
a specified period of time. Multiple jobs,work orders, purchase orders, or work done at
multiple"locations" under one contract are not separate"projects"within the meaning of
this coverage.
ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED.
AP5012US 12-03 Page 1 of 1
SKYPARK, LLC
City of Fresno
Attn: Jon Bartel
Heather Haupt
2600 Fresno Street, RM 10030
Fresno, CA 93721
November 13, 2017
To whom it may concern,
Sky Park, LLC has no employees and does not own any autos.
Thank you,
i �
Ric d C. finder r.
Manager
759 W.Alluvial Ave. PHONE 559-225-4500 ext. 104
Suite 102 FAX 559-476-1655
Sky R3r1, LLC Fresno,CA 93711 EMAIL rweils@ginderdevelopment.com
EXCESSIU MB RELLA
POLICY NUMBER: XOBVV7137817
MARKEV EVANSTON INSURANCE COMPANY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DESIGNATED COVERAGE FOLLOWING FORM
This endorsement modifies insurance provided under the following:
COMMERCIAL EXCESS LIABILITY POLICY
COMMERCIAL UMBRELLA LIABILITY POLICY
SCHEDULE
Designated Coverage(s):
(James River Insurance Company) Form AP5031US 04-10 - Primary and Non Contributory Endorsement.
This policy applies to the Designated Coverage(s) shown in the Schedule of this endorsement only to the extent that
coverage is provided by a policy shown in the Schedule Of Underlying Insurance. When coverage applies, it follows all
terms, conditions, limits and exclusions of the"underlying insurance" and any conflicting exclusions are superseded.
All other terms and conditions remain unchanged.
MAUR 1510 05 16 Page 1 of 1
Subdivision Agreement
Parcel Map No. 2014-06
Page 6
guarantee and warranty of the work for a period of one (1) year following acceptance against any
defective work or labor done or defective materials furnished. In accordance with Section 15-3807
of the Fresno Municipal Code, said warranty security shall be in the form of cash or a certificate of
deposit. The warranty security shall be returned to the Subdivider, less any amount required to be
used for fulfillment of the warranty one (1) year after final acceptance of the subdivision
improvement.
8. The Subdivider and his contractor and subcontractors shall pay for any materials,
provisions, provender, and other supplies or terms used in, upon,for, or about the performance of
the work contracted to be done and for any work or labor thereon of any kind and for amounts due
under the Unemployment Insurance Act of the State of California with respect to such work or labor
and shall file with City pursuant to Section 3800 of the Labor Code a Certificate of Workers
Compensation and shall maintain a valid policy of Workers Compensation Insurance forthe duration
of the period of construction.
9. Indemnification.
a. To the furthest extent allowed by law, Subdivider shall indemnify, hold
harmless and defend City and each of its officers, officials, employees, agents and
volunteers from any and all loss, liability, fines, penalties, forfeitures, costs and damages
(whether in contract,tort or strict liability, including but not limited to personal injury, death at
any time and property damage) incurred by City, Subdivider or any other person, and from
any and all claims,demands and actions in law or equity(including attorney's fees, litigation
and legal expenses incurred by City or held to be the liability of City, including plaintiffs or
petitioner's attorney's fees if awarded, in connection with City's defense of its actions in any
proceeding), arising or alleged to have arisen directly or indirectly out of performance or in
any way connected with: (i) the making of this Agreement; (ii) the performance of this
Agreement; (iii)the performance or installation of the work or improvements by Subdivider
and Subdivider's employees, officers, agents, contractors or subcontractors;(iv)the design,
installation, operation, removal or maintenance of the work and improvements; or(v) City's
granting, issuing or approving use of this Agreement.
b. Subdivider's obligations under the preceding sentence shall apply regardless
of whether City or any of its officers, officials, employees or agents are negligent, but shall
not apply to any loss, liability,fines, penalties,forfeitures,costs or damages caused solely by
Subdivision Agreement
Parcel Map No. 2014-06
Page 7
the gross negligence, or caused by the willful misconduct, of City or any of its officers,
officials, employees, agents or authorized volunteers.
C. If Subdivider should subcontract all or any portion of the work to be performed
under this Agreement, Subdivider shall require each subcontractor to indemnify, hold
harmless and defend City and each of its officers, officials, employees, agents and
volunteers in accordance with the terms of paragraphs "a" and "b" of this Section.
Notwithstanding the preceding sentence, any subcontractor who is a "design professional"
as defined in Section 2782.8 of the California Civil Code shall, in lieu of indemnity
requirements set forth in paragraphs "a" and "b" of this Section, be required to indemnify,
hold harmless and defend City and each of its officers, officials, employees, agents and
volunteers to the furthest extent allowed by law, from any and all loss, liability, fines,
penalties,forfeitures,costs and damages(whether in contract,tort or strict liability, including
but not limited to personal injury,death at any time and property damage),and from any and
all claims, demands and actions in law or equity(including reasonable attorney's fees and
litigation expenses)that arise out of, pertain to, or relate to the negligence, recklessness or
willful misconduct of the design professional, its principals, officers, employees, agents or
volunteers in the performance of this Agreement.
d. Subdivider further agrees that the use for any purpose and by any person of
any and all of the streets and improvements hereinbefore specified, shall be at the sole and
exclusive risk of Subdivider at all times prior to final acceptance by City of the completed
street and other improvements thereon and therein.
e. This Section shall survive termination or expiration of this Agreement.
10. Insurance. Throughout the life of this Agreement, Subdivider shall pay for and
maintain in full force and effect all policies of insurance described in this Section with an insurance
company(ies) either (i) admitted by the California Insurance Commissioner to do business in the
State of California and rated not less than"A-VII"in Best's Insurance Rating Guide,or(ii)authorized
by City's Risk Manager. The following policies of insurance are required:
a. COMMERCIAL GENERAL LIABILITY insurance, which shall be at least as
broad as the most current version of Insurance Services Office(ISO) Commercial General
Liability Coverage Form CG 00 01 and shall include insurance for bodily injury, property
damage, and personal and advertising injury with coverage for premises and operations
(including the use of owned and non-owned equipment), products and completed
operations, contractual liability(including indemnity obligations under this Agreement),with
Subdivision Agreement
Parcel Map No. 2014-06
Page 8
limits of liability of not less than $5,000,000 per occurrence for bodily injury and property
damage, $1,000,000 per occurrence for personal and advertising injury and $5,000,000
aggregate for products and completed operations, and $10,000,000 general aggregate.
b. COMMERCIAL AUTOMOBILE LIABILITY insurance,which shall be at least
as broad as the most current version of Insurance Services Office (ISO) Business Auto
Coverage Form CA 00 01 and shall include coverage for all owned, hired, and non-owned
automobiles or other licensed vehicles (Code 1-Any Auto), with combined single limits of
liability of not less than $1,000,000 per accident for bodily injury and property damage.
C. WORKERS' COMPENSATION insurance as required under the California
Labor Code.
d. EMPLOYERS' LIABILITY with minimum limits of liability of not less than
$1,000,000 each accident, $1,000,000 disease policy limit and $1,000,000 disease each
employee.
Subdivider shall be responsible for payment of any deductibles contained in any insurance
policies required hereunder and Subdivider shall also be responsible for payment of any self-insured
retentions.
The above described policies of insurance shall be endorsed to provide an unrestricted 30
calendar day written notice in favor of City of policy cancellation of coverage,except for the Workers'
Compensation policy which shall provide a 10 calendar day written notice of such cancellation of
coverage. In the event any policies are due to expire during the term of this Agreement,
Subdivider shall provide a new certificate evidencing renewal of such policy(ies) not less
than 15 calendar days prior to the expiration date of the expiring policy(ies). Upon issuance
by the insurer, broker, or agent of a notice of cancellation in coverage, Subdivider shall file with City
a new certificate and all applicable endorsements for such policy(ies).
The General Liability and Automobile Liability insurance policies shall be written on an
occurrence form and shall name City, its officers, officials, agents, employees and volunteers as an
additional insured. Such policy(ies)of insurance shall be endorsed so Subdivider's insurance shall
Subdivision Agreement
Parcel Map No. 2014-06
Page 9
be primary and no contribution shall be required of City. In the event claims-made forms are used
for any Professional Liability coverage,either(i)the policy(ies)shall be endorsed to provide not less
than a five (5) year discovery period, or(ii)the coverage shall be maintained for a minimum of five
(5)years following the termination of this Agreement and the requirements of this Section relating to
such coverage shall survive termination or expiration of this Agreement. Any Workers'
Compensation insurance policy shall contain a waiver of subrogation as to City, its officers,officials,
agents, employees and volunteers.
Subdivider shall have furnished City with the certificate(s) and applicable
endorsements for ALL required insurance prior to City's execution of the Agreement.
Subdivider shall furnish City with copies of the actual policies upon the request of City's Risk
Manager at any time during the life of the Agreement or any extension, and this requirement shall
survive termination or expiration of this Agreement.
The fact that insurance is obtained by Subdivider or his/her/its subcontractors shall not be
deemed to release or diminish the liability of Subdivider or his/her/its subcontractors including
without limitation, liability under the indemnity provisions of this Agreement. The duty to indemnify
City, its officers, officials, agents, employees and volunteers, shall apply to all claims and liability
regardless of whether any insurance policies are applicable. The policy limits do not act as a
limitation upon the amount of indemnification to be provided by Subdivider or his/her/its
subcontractors. Approval or purchase of any insurance contracts or policies shall in no way relieve
from liability nor limit the liability of Subdivider, its principals, officers, agents, employees, persons
under the supervision of Subdivider, vendors, suppliers, invitees, subcontractors, consultants or
anyone employed directly or indirectly by any of them.
If at any time during the life of the Agreement or any extension, Subdivider fails to maintain
the required insurance in full force and effect, the Director of Public Works for the City, or his/her
designee, may order that the Subdivider, or its contractors or subcontractors, immediately
Subdivision Agreement
Parcel Map No. 2014-06
Page 10
discontinue any further work under this Agreement and take all necessary actions to secure the
work site to insure that public health and safety is protected. All payments due or that become due
to Subdivider shall be withheld until notice is received by City that the required insurance has been
restored to full force and effect and that the premiums therefore have been paid for a period
satisfactory to City. Any failure to maintain the required insurance shall be sufficient cause for City
to terminate this Agreement.
If Subdivider should subcontract all or any portion of the services to be performed under this
Agreement, Subdivider shall require each subcontractor to provide insurance protection in favor of
City, its officers,officials,employees,volunteers and agents in accordance with the terms of each of
the preceding paragraphs,except that the subcontractors'certificates and endorsements shall be on
file with Subdivider and City prior to the commencement of any work by the subcontractor.
11. Compaction and other materials testing performed for the determination of
compliance with Public Works Standards shall conform to Section 2-11 of the City Standard
Specifications, entitled "Materials Acceptance Testing." Materials testing shall at all times remain
under the review of the City Engineer who may determine additional test procedures,and additional
locations to be tested. All materials testing for improvement work within the public easements and
rights-of-way shall be ordered and paid for by the Subdivider.
12. Subdivider shall comply with the provisions of the prevailing Building, Plumbing,
Mechanical, Electrical and Zoning Codes and any other Codes of the City.
13. It shall be the responsibility of the Subdivider to coordinate all work done by his
contractors and subcontractors, such as scheduling the sequence of operations and the
determination of liability if one operation delays another. In no case shall representatives of the City
be placed in the position of making decisions that are the responsibility of the Subdivider. It shall
further be the responsibility of the Subdivider to give the City Engineer written notice not less than
two (2) working days in advance of the actual date on which work is to be started. Failure on the