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HomeMy WebLinkAboutPM 2004-36 - Certificate of Insurance - 10/30/2008 ACORDM CERTIFICATE OF LIABILITY INSURANCE DATE 8' PRODUCER (559)485-7100 FAX: (559)485-6476 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION EATON & EATON INSURANCE BROKERS ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 2115 Kern Street, Suite 100 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Fresno CA 93721 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A:Scottsdale Insurance Fancher Creek Properties, L.L.C. INSURER B: c/o The Penstar Group INSURER C: PO BOX 7967 INSURER Fresno CA 93747 INSURER E: OVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS 1NSR ADD'L POLICY TYPE OF INSURANCE POLICY NUMBER DATEMMFDD/YYE POLICY MMDIYY EXPIRATION LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 10,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED 0 PREMISE Ea occurrence $ A CLAIMSMADE 7 OCCUR BCS014711 3/15/2007 12/1/2008 MED EXP An oneperson) $ 10,000 PERSONAL&ADV INJURY $ 10,000,000 GENERAL AGGREGATE $ 10,000,000 GENT AGGREGATE LIMIT APPLIES PER, PRODUCTS-COMP/ PAGG $ 0 X POLICY PE� L LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY $ NON-OWNEDAUTOS r MA AGE (Per accident) I "IC ENT DIMION PROPERTY DAMAGE All (Per accident) S AP GARAGE LIABILITY ve ang S; AUTO ONLY-EA ACCIDENT $ ANY AUTO d-j-�1—z)K OTHER THAN EA ACC $ I' n d AUTO ONLY: AGG $ EXCESSIUMBRELIA LIABILITY -EACHRR $ OCCUR CLAIMS MADE AGGREGATE $ S DEDUCTIBLE $ RETENTION WORKERS COMPENSATION AND ORISTAM T O IR EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT S OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE$ If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT S OTHER DESCRIPTION OF OPERATIONS/LOCATIONSIV£HICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS The City of Fresno, its officers, officials, agents, employees and volunteers are additional insureds as respects to general liability as per form #CG20100397 attached. This insurance is primary, and our obligations are not affected by any other insurance carried by such additional insured whether primary, exess, contingent, or on any other basis. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE City of Fresno EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL C/O Construction Management Division 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT Attn: Maryann Lewis FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE 1721 Van Ness Avenue Fresno, CA 93721 INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE R Gregory Eaton/KATHI ACORD 25(2001108) ©ACORD CORPORATION 1988 INS025(oim).oaa Page 1 of 2 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION 1S 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25(2001/08) INS025(oloa).oaa Page 2 of 2 POLICY NUMBER: BCS014711 COMMERCIAL GENERAL LIABILITY CG 20 10 03 97 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 Person or Organization: The City of Fresno, its officers, officials, employees, agents and volunteers Such insurance as is afforded by the policy is primary and any other insurance shall be excess and not contribute to the insurance afforded by this endorsement. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that insured. CG 20 10 03 97 Copyright, Insurance Services Office, Inc., 1996 Page 1 of 1❑ i FANCHER CREEK PROPERTIES, LLC 855 M Street, Suite 1110 Fresno, CA 93721 559.268.6090 or 559.268.6030 Fax l September 19, 2008 Mr.Jon Bartel City of Fresno 2600 Fresno Street Fresno, CA 93721 Re: Insurance—PM 2004-36 Subdivision Agreement I Dear Mr. Bartel, This letter is being sent as a follow-up to our conversation regarding the worker's compensation, employer's liability, and automobile liability insurance requirements referenced in Fancher Creek Properties, LLC subdivision agreement for Parcel Map 2004-36. As discussed, Fancher Creek Properties, LLC does not carry this coverage because we do not have any employees or owned automobiles. All of our construction work is contracted out. Our contractor does however carry all of the above referenced coverage and has a blanket policy on file with the City of Fresno. j f Should you have any questions regarding this information, please feel free to contact me any i time. VerEnderson Fanerties, LLC S Cc: Chron File