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HomeMy WebLinkAboutT-5597 - Certificate of Insurance - 12/14/2012 "y°' MEMORANDUM PUBLIC WORKS DEPARTMENT LAND DIVISION 2600 FRESNO STREET FRESNO,CA 93721 DATE: November 14, 2012 -z TO: HEIDI BRIGGS �n Personnel Services Department _y T 3 Mrnm FROM: JONATHAN BARTEL r 27 c Public Works Department SUBJECT: REQUEST FOR CERTIFICATE OF LIABILITY AND ENDORSEMENT OF INSURANCE APPROVAL FOR THE FINAL MAP OF TRACT NO. 5597 Attached are certificates of liability insurance required for the subdivision agreement for the Final Map. Please review for conformity to City acceptance policies. If you have any questions, please contact me at 621-8684. Thank you, Jonathan Bartel DATE(MWDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 12111/2012 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 INSURE ,the policy(ies)must 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 w certificate holder in lieu of such endorsement(s). PRODUCER CONTACT .(D Aon Risk Insurance services West, Inc. NAME: Newport Beach CA Office (AIC,No.E■t): (949) 608-6300 ac No (949) 608-6459 `y 100 Bayview Circle E-MAIL c Newport Beach CA 92660 USA ADDRESS: _ INSURER(S)AFFORDING COVERAGE NAIC N INSURED INSURER A: steadfast Insurance Company 26387 Granville Homes, Inc. INSURER e: 1396 W. Herndon Ave., Suite 101 Fresno CA 93711-7126 USA INSURER C: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:570048363696 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED VANIED 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. Limits shown are as requested INSR LTR TYPE OF INSURANCE INSR WVD ADD SUBR� POLICY NUMBER POLICYEFF POLICY EXP MMIDD/YYYY MMIDD LIMITS A GENERAL LIABILITY HBP EACH OCCURRENCE $5,000,000 X COMMERCIAL GENERAL LIABILITY SIR applies per policy terns & conditions DAMAGE TO RENTED $100,000 PREMISES Ea occurrence CLAIMS-MADE F]OCCUR MED EXP(Any one person) $25,000 Silica:SIM ea.occ. PERSONAL&ADV INJURY $5,000,000 m GENERAL AGGREGATE $10,000,000 rl GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $10,000,000 X POLICY PRO LOC o JFQT n AUTOM0131LE LIABILITY COMBINED SINGLE LIMIT `n Ea accident ANY AUTO BODILY INJURY(Per person) Z ALL OWNED SCHEDULED AUTOS IS MAN MEW D V1SlO IC INJURY(Per accident) y AUTOS HIRED AUTOS NON-OWNED lived. ROPERTY DAMAGE V AUTOS (Per accident) d UMBRELLA LIAR OCCUR r/ CH OCCURRENCE t..) 1 uREGATE EXCESS LIAR CLAIMS-MADE S r.ed Date DED RETENTION WORKERS COMPENSATION ANDWC STATU- OTH- EMPLOYERS'LIABILITY YIN TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E,L.EACH ACCIDENT OFFICER/MEMBER FXCLUDED7 ❑ N I A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE If yes,descnbe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,d more space Is required) The City of Fresno, its officers, officials, employees, agents and volunteers are additional insured as respects to General �. Liability insurance. The above policy contains Resultant Bodily Injury and Property Damage from Professional Liability. 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. Re: subdivision Final Map Tract 5597. *GL endorsement attached. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City Of Fresno AUTHORIZED REPRESENTATIVE - C/o Ken Turner 2600 Fresno Street Room 3076 Fresno CA 93721-3612 USA ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Issued in lieu of certificate dated: 8/2/2012 Endorsement#004 General Change Endorsement ZURICH Policy No. Eff. Date of Pol. Exp. Date of Pol. Eff. Date of End. Producer Add'I Prem. Return Prem. HBP 9140836-02 12/31/2010 12131/2012 07/31/2012 75428-000 N/C N/C Named Insured and Mailing Address: Producer: GRANVILLE HOMES, INC. Aon Risk Insurance Services West, Inc. (SEE ENDORSEMENT STF-GL-10102-A CW) Newport Beach CA Office 1396 W. HERNDON AVE., STE 101 100 Bayview Circle FRESNO, CA 93711 Newport Beach CA 92660 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: Home Builders Protective Policy In consideration of no change in premium,subject to final audit,effective 07131/2012 the policy is amended as follows: The following entity is hereby added as an Additional Insured per the attached Additional Insured- Scheduled -Owners, Lessees or Contractors, STF-G L-101 17-D CW: The City of Fresno, it's officers, officials, employees, agents and volunteers. All other terms and conditions remain unchanged. STF-GL-12003-A CW (03/10) Page 1 of 1 Includes copyrighted material of Insurance Services Office,Inc.with its permission. Endorsement#004 Additional Insured - Scheduled - Owners, Lessees Or ZURICH Contractors - Scheduled Person Or Organization Policy No. Eff. Date of Pd. Exp. Date of Pol. Eff. Date of End. Producer Add'I Prem. Retum Prem. HBP 9140836-02 1 12/312010 12/312012 07(31/2012 75428-000 N/C N/C Named Insured and Mailing Address: Producer: GRANVILLE HOMES, INC. Aon Risk Insurance Services West, Inc. (SEE ENDORSEMENT STF-GL-10102-A CW) Newport Beach CA Office 1396 W. HERNDON AVE., STE 101 100 Bayview Circle FRESNO, CA 93711 Newport Beach CA 92660 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: Home Builders Protective Policy SCHEDULE NAME OF PERSON(S) OR ORGANIZATION(S): The City of Fresno, it's officers, officials, employees, agents and volunteers. Department of Public Works Attn: Anthony Sanchez 2600 Fresno Street Room 3623 Fresno, CA 93721 LOCATION AND DESCRIPTION OF COVERED OPERATIONS: Tract No. 5597(N. Garfield/W. Barstow) Fresno, CA Infrastructure work for single-family residential subdivision (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) STF-GL-10117-D CW (04/08) Page 1 of 3 Includes copyrighted material of Insurance Services Office, Inc.with its permission. A. Section II - WHO IS AN INSURED is amended to include as an insured the person or organization shown in the Schedule above, whom you are required to add as an additional insured on this policy under a written contract or written agreement. B. The insurance provided to the additional insured person or organization applies only to "bodily injury", "property damage" or "personal and advertising injury" covered under Section I - Coverage A, BODILY INJURY AND PROPERTY DAMAGE LIABILITY, and Section I - Coverage B - PERSONAL AND ADVERTISING INJURY LIABILITY, and Section I — Coverage D — Construction Damage Liability, 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; and resulting directly from: a. Your ongoing operations performed for the additional insured at the location designated and described in the Schedule;or b. "Your work" completed as included in the "products-completed operations hazard", performed for the additional insured at the location designated and described in the Schedule. C. However, regardless of the provisions of paragraphs A. and B. above: 1. We will not extend any insurance coverage to the additional insured person or organization: a. That is not provided to you in this policy, or b. That is any broader coverage than you are required to provide to the additional insured person or organization in the written contract or written agreement, and 2. We will not provide Limits of Insurance to the additional insured person or organization that exceed the lower of. a. The Limits of Insurance provided to you in this policy;or b. The Limits of Insurance you are required to provide in the written contract or written agreement. D. The insurance provided to the additional insured person or organization does not apply to: "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering or failure to render any professional architectural, engineering or surveying services including: 1. The preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and 2. Supervisory, inspection, architectural or engineering activities. E. The additional insured must see to it that: 1. We are notified as soon as practicable of an "occurrence", "construction occurrence"or offense that may result in a claim, 2. We receive written notice of a claim or"suit' as soon as practicable; and 3. A request for defense and indemnity of the claim or "suit' will promptly be brought against any policy issued by another insurer under which the additional insured may be an insured in any capacity. This provision does not apply to insurance on which the additional insured is a Named Insured, if the written contract or written agreement requires that this coverage be primary and non-contributory. F. With respect to the insurance provided by this endorsement: 1. The following paragraph is added to Paragraph 1.n.(1) of the Other Insurance Condition of Section V — Home Builders Protective Conditions: This insurance is primary insurance as respects our coverage to the additional insured person or organization, where the written contract or agreement requires that this insurance be primary and non-contributory. In that event, we will not seek contribution from any other insurance policy available to the additional insured on which the additional insured person or organization is a Named Insured, 2. The following paragraph is added to Paragraph 1.n.(2) of the Other Insurance Condition of Section V — Home Builders Protective Conditions. STF-GL-10117-D CW (04/08) Page 2 of 3 Includes copyrighted material of Insurance Services Office, Inc.with its permission. This insurance is excess over: Any of the other insurance, whether primary, excess., contingent or on any other basis, available to an additional insured, in which the additional insured on our policy is also covered as an additional insured by attachment of an endorsement to another policy providing coverage for the same"occurrence", claim or ''suit This provision does not apply to any policy in which the additional insured is a Named Insured on such other policy and where our policy is required by written contract or written agreement to provide coverage to the additional insured on a primary and non-contributory basis. Any provisions in this Coverage Part not changed by the terms and conditions of this endorsement continue to apply as written. STF-GL-10117-D CW (04/08) Page 3 of 3 Includes copyrighted material of Insurance Services Office, Inc.with its permission. ,aco CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYYI � 11/2'8/2012 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, CXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETW)=EN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THS CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must 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 Fieu of such endorsement(s). PRODUCER CONTACT Genn Hutsell, CISR NAME: y James G Parker Insurance Associates PHONE (cJ CJ9)2227]22 FAX. (559)222-1724 A/CNo License #0554959 E-MAIL g 3�hutsell@ arker.com ADD ESS: 1753 E Fir Ave INSURER(S)AFFORDING COVERAGE NAIC# Fresno CA 9372G INSURER A'American States Insurance Co .19704 INSURED INSURER B Granville Homes Inc INSURERC: 1396 W Herndon Ave, #101 INSURER D: INSURER E: Fresno CA 93711 INSURER F: COVERAGES CERTIFICATE NUMBER:11-12 BA and Umb REVISION NUMBER: 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. INSR TYPE OF INSURANCE B POLICY EFF POLICY EXP LIMITS LTR I POLICY NUMBER MM/DD/YYYY MMIDD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE T R cc r I\/I I PREMISES Ea occurrence § CLAIMS-MADE OCCUR ny one person) $ RISK Mq�(GEIVENT 11 i�i RSONAe5D EXP(L&ADV NJURY S A, roved. GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER A. roV' d w/ nan es: PRODUCTS-COMP/OP AGG S POLICY PRO- LOC $ AUTOMOBILE LIABILITY {r7a D'ate' E ?iC�identSl G LIMIT S 1,000,000 A X ANY AUTO i BODILY INJURY(Per person) S ALL OWNED SCHEDULED 1CI3217483 /1/2012 /1/2013 BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPER DAMAGE $ AUTOS Per accident U ninsured motorist combined $ 11000,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE S 4,000,000 A EXCESS LIAB CLAIMS-MADE AGGREGATE S 4,000,000 DED RETENTIONS 1XS15637340 /1/2012 /1/2013 1 S WORKERS COMPENSATION WC STATU- TH- AND EMPLOYERS'LIABILITY Y/N LIMITSTORY ANY PROPRIETOR/PARTNER/EXECUTIVEE.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space Is required) RE: Tract #5597. The City of Fresno, it's officers, officials, employees, agents and volunteers are named as Additional Insured with respect to Auto Liability per the attached CA7110 03/07. *This Certificate replaces one issued on 07/24/12. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fresno ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Ken Turner 2600 Fresno St. , #3076 AUTHORIZED REPRESENTATIVE Fresno, CA 93721 James Parker III/GDE1 ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 oninnslni Tha Af'f1Rr1 nnma nnrl Innn nra ranictararl m—kc of Af:f1RI1 •'•'REPRINTEDFROM THE FORMS LIBRARY'•" COMMERCIAL AUTO CA 71 10 03 07 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AUTO PLUS ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. EXTENDED CANCELLATION CONDITION BLANKET ADDITIONAL INSURED Paragraph 2.b. of the CANCELLATION Common SECTION II — LIABILITY COVERAGE — A.1. WHO Policy Condition is replaced by the following: IS AN INSURED provision is amended by the addition b. 60 days before the effective date of cancellation of the following: if we cancel for any other reason. e. Any person or organization for whom you are re- quired by an "insured contract" to provide insur- TEMPORARY SUBSTITUTE AUTO — PHYSICAL ance is an "insured", subject to the following DAMAGE COVERAGE additional provisions: Under paragraph C. — CERTAIN TRAILERS, MO- (1) The "insured contract" must be in effect BILE EQUIPMENT AND TEMPORARY SUBSTITUTE during the policy period shown in the Decla- AUTOS of SECTION 1 — COVERED AUTOS, the rations and must have been executed prior following is added: to the bodily injury" or `property damage". (2) This person or organization is an "insured" If Physical Damage coverage is provided by this Cov- only to the extent you are liable due to your erage Form, then you have coverage for: ongoing operations for that insured, whether the work is performed by you or for you, and Any "auto" you do not own while used with the per- only to the extent you are held liable for an mission of its owner as a temporary substitute for a "accident" occurring while a covered "auto" covered "auto" you own that is out of service be- is being driven by you or one of your em- cause of its breakdown, repair, servicing, "loss" or ployees. destruction. (3) There is no coverage provided to this person BROAD FORM NAMED INSURED or organization for "bodily injury" to its em- ployees, nor for "property damage" to its SECTION II — LIABILITY COVERAGE — A.1. WHO property. IS AN INSURED provision is amended by the addition (4) Coverage for this person or organization of the following: shall be limited to the extent of your negli- gence or fault according to the applicable d. Any business entity newly acquired or formed by principles of comparative negligence or fault. you during the policy period provided you own " (5) The defense of any claim or suit" must be 50% or more of the business entity and the business entity is not separately insured for tendered by this person or organization as Business Auto Coverage. Coverage is extended soon as practicable to all other insurers which potentially provide insurance for such up to a maximum of 180 days following acquisi- tion or formation of the business entity. Coverage claim or "suit". under this provision is afforded only until the end of the policy period. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Copyright, Insurance Services Office, Inc., 1997 CA 71 10 03 07 Page 1 of 6 EP ""REPRINTED FROM THE FORMS LIBRARY--- (6) "(6) The coverage provided will not exceed the PERSONAL EFFECTS COVERAGE lesser of: A. SECTION III — PHYSICAL DAMAGE COVER- (a) The coverage and/or limits of this policy; AGE, A.4. COVERAGE EXTENSIONS, is or amended by adding the following: (b) The coverage and/or limits required by c, Personal Effects Coverage the insured contract". For any Owned "auto" that is involved in a (7) A person's or organization's status as an covered "loss", we will pay up to $500 for "insured" under this subparagraph d ends "personal effects" that are lost or damaged when your operations for that "insured" are as a result of the covered "loss", without completed. applying a deductible. EMPLOYEE AS INSURED EXTRA EXPENSE — BROADENED COVERAGE Under Paragraph A. of Section If — LIABILITY COV- Paragraph A. — COVERAGE of SECTION III — ERAGE item f. is added as follows: PHYSICAL DAMAGE COVERAGE is amended to add: Your "employee" while using his owned "auto", or an "auto" owned by a member of his or her household, 5. We will pay for the expense of returning a stolen in your business or your personal affairs, provided you covered "auto" to you. do not own, hire or borrow that "auto". This coverage is excess to any other collectible insurance coverage. AIRBAG COVERAGE FELLOW EMPLOYEE COVERAGE Under paragraph B. — EXCLUSIONS of SECTION III — PHYSICAL DAMAGE COVERAGE, the following is Exclusion 5. FELLOW EMPLOYEE of SECTION fl — added: LIABILITY COVERAGE — B. EXCLUSIONS is amended by the addition of the following: The exclusion relating to mechanical breakdown does not apply to the accidental discharge of an airbag. However, this exclusion does not apply if the "bodily injury" results from the use of a covered "auto" you NEW VEHICLE REPLACEMENT COST own or hire, and provided that any coverage under this provision only applies in excess over any other Under Paragraph C — LIMIT OF INSURANCE of collectible insurance. Section III — PHYSICAL DAMAGE COVERAGE sec- tion 2 is amended as follows: BLANKET WAIVER OF SUBROGATION 2. An adjustment for depreciation and physical con- We waive the right of recovery we may have for pay- dition will be made in determining actual cash ments made for "bodily injury" or "property damage" value in the event of a total loss. However, in the on behalf of the persons or organizations added as event of a total loss to your "new vehicle" to "insureds" under Section II — LIABILITY COVERAGE which this coverage applies, as shown in the — AA.D. BROAD FORM NAMED INSURED and declarations, we will pay at your option: A.1.e. BLANKET ADDITIONAL INSURED. a. The verifiable "new vehicle" purchase price PHYSICAL DAMAGE — ADDITIONAL TRANS- you paid for your damaged vehicle, not in- cluding any insurance or warranties pur- PORTATION EXPENSE COVERAGE chased; The first sentence of paragraph A.4. of SECTION III b. The purchase price, as negotiated by us, of — PHYSICAL DAMAGE COVERAGE is amended as a new vehicle of the same make, model and follows: equipment, not including any furnishings, parts or equipment not installed by the We will pay up to $50 per day to a maximum of manufacturer or manufacturer's dealership. $1,500 for temporary transportation expense incurred If the same model is not available pay the by you because of the total theft of a covered "auto" purchase price of the most similar model of the private passenger type. available; Page 2 of 6 ""REPRINTED FROM THE FORMS LIBRARY"" c. The market value of your damaged vehicle, a. Actual cash value of the damaged or stolen not including any furnishings, parts or equip- property as of the time of the 'loss", less an ment not installed by the manufacturer or adjustment for depreciation and physical manufacturer's dealership. condition; or This coverage applies only to a covered "auto" b. Balance due under the terms of the loan or of the private passenger, light truck or medium lease that the damaged covered "auto" is truck type (20,000 lbs or less gross vehicle subject to at the time of the "loss", less any weight) and does not apply to initiation or set up one or all of the following adjustments: costs associated with loans or leases. (1) Overdue payment and financial TWO OR MORE DEDUCTIBLES penalties associated with those payments as of the date of the Under SECTION III — PHYSICAL DAMAGE COV- "loss". ERAGE, if two or more "company" policies or cover- (2) Financial penalties imposed under a age forms apply to the same accident, the following lease due to high mileage, exces- applies to paragraph D. Deductible: sive use or abnormal wear and tear. a. If the applicable Business Auto deduct- (3) Costs for extended warranties, Cre- ible is the smaller (or smallest) deduct- dit Life Insurance, Health, Accident ible it will be waived; or or Disability Insurance purchased b. If the applicable Business Auto deduct- with the loan or lease. ible is not the smaller (or smallest) de- (4) Transfer or rollover balances from ductible it will be reduced by the amount previous loans or leases. of the smaller (or smallest) deductible; (5) Final payment due under a "Balloon or Loan". c. If the loss involves two or more Busi- (6) The dollar amount of ' any ness Auto coverage forms or policies un-repaired damage that occurred the smaller (or smallest) deductible will prior to the "total loss" of a covered be waived. "auto". For the purpose of this endorsement (7) Security deposits not refunded by a "company" means: lessor. a. Safeco Insurance Company of America (g) All refunds payable or paid to you b. American States Insurance Company as a result of the early termination c. General Insurance Company of America of a lease agreement or any war- ranty or extended service agree- d. American Economy Insurance Company ment on a covered "auto". e. First National Insurance Company of (9) Any amount representing taxes. America (10) Loan or lease termination fees f. American States Insurance Company of Texas GLASS REPAIR — WAIVER OF DEDUCTIBLE g. American States Preferred Insurance Under paragraph D. — DEDUCTIBLE of SECTION III Company — PHYSICAL DAMAGE COVERAGE, the following is h. Safeco Insurance Company of Illinois added: LOAN/LEASE GAP COVERAGE No deductible applies to glass damage if the glass is repaired rather than replaced. Under paragraph C — LIMIT OF INSURANCE of SECTION III — PHYSICAL DAMAGE COVERAGE, AMENDED DUTIES IN THE EVENT OF ACCI- the following is added: DENT, CLAIM, SUIT OR LOSS 4. The most we will pay for a total "loss" in any one The requirement in LOSS CONDITION 2.a. — .accident" is the greater of the following, subject DUTIES IN THE EVENT OF ACCIDENT, CLAIM, to a$1,500 maximum limit: SUIT OR LOSS — of SECTION IV — BUSINESS AUTO CONDITIONS that you must notify us of an CA 71 10 03 07 Page 3 of 6 EP . REPRINTED FROM THE FORMS LIBRARY" "accident" applies only when the "accident" is known deductible and excess provisions, we will provide to: coverage equal to the broadest coverage applicable (1) You, if you are an individual; to any covered "auto" you own. (2) A partner, if you are a partnership; or HIRED AUTO PHYSICAL DAMAGE COVERAGE - LOSS OF USE (3) An executive officer or insurance manager, if you are a corporation. SECTION III — PHYSICAL DAMAGE AA.b. Form does not apply. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS Subject to a maximum of $1,000 per accident, we will cover loss of use of a hired "auto" if it results from SECTION IV — BUSINESS AUTO CONDITIONS — an accident, you are legally liable and the lessor in- B.2. is amended by the addition of the following: curs an actual financial loss. If you unintentionally fail to disclose any hazards ex- RENTAL REIMBURSEMENT COVERAGE isting at the inception date of your policy, we will not A. We will pay for rental reimbursement expenses deny coverage under this Coverage Form because of incurred by you for the rental of an "auto" be- such failure. However, this provision does not affect cause of a covered "loss" to a covered "auto". our right to collect additional premium or exercise our Payment applies in addition to the otherwise ap- right of cancellation or non-renewal. plicable amount of each coverage you have on a HIRED AUTO — LIMITED WORLD WIDE COVER- covered "auto". No deductibles apply to this AGE coverage. B. We will pay only for those expenses incurred Under Section IV — Business Conditions, Paragraph during the policy period beginning 24 hours after 13.7.b.e(1) is replaced by the following: the "loss" and ending, regardless of the policy's (1) The "accident" or "loss" results expiration, with the lesser of the following number from the use of an "auto" hired for of days: 30 days or less. 1. The number of days reasonably required to repair or replace the covered "auto". If RESULTANT MENTAL ANGUISH COVERAGE "loss" is caused by theft, this number of days is added to the number of days it takes SECTION V — DEFINITIONS — C. is replaced by the to locate the covered "auto" and return it to following: you. "Bodily injury" means bodily injury, sickness or dis- 2• 30 days. ease sustained by a person including mental anguish C. Our payment is limited to the lesser of the fol- or death resulting from any of these. lowing amounts: HIRED AUTO PHYSICAL DAMAGE COVERAGE 1. Necessary and actual expenses incurred. If hired "autos" are covered "autos" for Liability cov- 2. $50 per day. erage and if Comprehensive, Specified Causes of D. This coverage does not apply while there are Loss or Collision coverages are provided under this spare or reserve "autos" available to you for your Coverage Form for any "auto" you own, then the operations. Physical Damage Coverages provided are extended to "autos" you hire or borrow. E. If "loss" results from the total theft of a covered "auto" of the private passenger type, we will pay The most we will pay for loss to any hired "auto" is under this coverage only that amount of your $50,000 or Actual Cash Value or Cost of Repair, rental reimbursement expenses which is not al- whichever is smallest, minus a deductible. The de- ready provided for under the PHYSICAL DAM- ductible will be equal to the largest deductible appli- AGE COVERAGE Coverage Extension. cable to any owned "auto" of the private passenger or light truck type for that coverage. Hired Auto Phy- F. The Rental Reimbursement Coverage described sisal Damage coverage is excess over any other col- above does not apply to a covered "auto" that is lectible insurance. Subject to the above limit, described or designated as a covered "auto" on Page 4 of 6 —REPRINTED FROM THE FORMS LIBRARY•"' Rental Reimbursement Coverage Form the manufacturer for the installation of a CA 99 23. radio. AUDIO, VISUAL AND DATA ELECTRONIC C. Limit of Insurance EQUIPMENT COVERAGE With respect to this coverage, the LIMIT OF IN- A. Coverage SURANCE provision of PHYSICAL DAMAGE COVERAGE is replaced by the following: 1. We will pay with respect to a covered "auto" 1. The most we will pay for "loss" to audio, vi- for "loss" to any electronic equipment that receives or transmits audio, visual or data sual or data electronic equipment and any signals and that is not designed solely for the accessories used with this equipment as a " reproduction of sound.This coverage applies result of any one accident" is the lesser of: only if the equipment is permanently installed a. The actual cash value of the damaged in the covered "auto" at the time of the or stolen property as of the time of the "loss" or the equipment is removable from a "loss"; or housing unit which is permanently installed in the covered "auto" at the time of the b. The cost of repairing or replacing the "loss", and such equipment is designed to damaged or stolen property with other be solely operated by use of the power from property of like kind and quality. the "auto's"electrical system, in or upon the c. $1,000. covered "auto". 2. An adjustment for depreciation and physical 2. We will pay with respect to a covered "auto" condition will be made in determining actual for "loss" to any accessories used with the cash value at the time of the "loss". electronic equipment described in paragraph A.I. above. 3. If a repair or replacement results in better than like kind or quality, we will not pay for However, this does not include tapes, the amount of the betterment. records or discs. D. Deductible 3. If Audio, Visual and Data Electronic Equip- ment Coverage form CA 99 60 or CA 99 94 1. If "loss" to the audio, visual or data elec- is attached to this policy, then the Audio, Vi- tronic equipment or accessories used with sual and Data Electronic Equipment Cover- this equipment is the result of a `loss" to the age described above does not apply. covered "auto" under the Business Auto Coverage Form's Comprehensive or Colli- B. Exclusions sion Coverage, then for each covered "auto" The exclusions that apply to PHYSICAL DAM- our obligation to pay for, repair, return or re- AGE COVERAGE, except for the exclusion relat- place damaged or stolen property will be re- ing to Audio, Visual and Data Electronic duced by the applicable deductible shown in Equipment, also apply to this coverage. In addi- the Declarations. Any Comprehensive Cov- tion, the following exclusions apply: erage deductible shown in the Declarations does not apply to "loss" to audio, visual or We will not pay for either any electronic equip- data electronic equipment caused by fire or ment or accessories used with such electronic lightning. equipment that is: 2. If "loss" to the audio, visual or data elec- t. Necessary for the normal operation of the tronic equipment or accessories used with covered "auto" for the monitoring of the this equipment is the result of a "loss" to the covered "auto's" operating system; or covered "auto" under the Business Auto 2. Both: Coverage Form's Specified Causes of Loss Coverage, then for each covered "auto" our a. an integral part of the same unit housing obligation to pay for, repair, return or replace any sound reproducing equipment de- damaged or stolen property will be reduced signed solely for the reproduction of by a$100 deductible. sound if the sound reproducing 3. If "loss" occurs solely to the audio, visual or equipment is permanently installed in data electronic equipment or accessories the covered "auto"; and used with this equipment, then for each cov- b. permanently installed in the opening of ered "auto" our obligation to pay for, repair, the dash or console normally used by CA 71 10 03 07 Page 5 of 6 EP *—REPRINTED FROM THE FORMS LIBRARY— return or replace damaged or stolen property SECTION V — DEFINITIONS is amended by adding will be reduced by a$100 deductible. the following: 4. In the event that there is more than one ap- Q. "Personal effects" means your tangible plicable deductible, only the highest deduct- property that is worn or carried by you, ex- ible will apply. In no event will more than one cept for tools, jewelry, money, or securities. deductible apply. R. "New vehicle" means any "auto" of which you are the original owner and the "auto" has not been previously titled and is less than 365 days past the purchase date. Page 6 of 6 CERTHOLDER COPY NE • TE COMPFNSATION P.O. BOX 8192, PLEASANTON, CA 94588 FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 08-06-2012 GROUP: POLICY NUMBER: 1901663-2011 CERTIFICATE ID: 62 CERTIFICATE EXPIRES: 12-01-2012 12-01-2011/12-01-2012 THIS CERTIFICATE SUPERSEDES AND CORRECTS CERTIFICATE # 60 DATED 07-24-2012 CITY OF FRESNO . NE JOB:TRACT 5597 2600 FRESNO ST FRESNO CA 93721-3620 This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 10 days advance written notice to the employer. We will also give you 10 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy. Authorized Representative President and CEO EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #1600 - ASSEMI, DARIUS VICEPRES - EXCLUDED. ENDORSEMENT #1600 - ASSEMI, FARID PRESIDENT - EXCLUDED. ENDORSEMENT #1600 - ASSEMI, FARSHID DIRECTOR - EXCLUDED. ENDORSEMENT #2570 ENTITLED WAIVER OF SUBROGATION EFFECTIVE 2012-08-06 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. THIRD PARTY NAME: CITY OF FRESNO EMPLOYER GRAntiiLLE HO�i'.S, INC NE 1396 W HERNDOV AVE STE 101 FRESNO CA 93711 [B10,NEj IREv.1-20121 PRINTED : 08-06-2012 ENDORSEMENT AGREEMENT WAIVER OF SUBROGATION REP 02 STATE 1901663-12 COMPFrvSATION RENEWAL INSURAMCS NE FUND 1-74-31-79 PAGE 1 HOME OFFICE SAN FRANCISCO EFFECTIVE DECEMBER 1, 2012 AT 12 . 01 A.M. ALL EFFECTIVE DATES ARE AND EXPIRING DECEMBER 1, 2013 AT 12 . 01 A.M. AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME GRANVILLE HOMES 1396 W HERNDON AVE STE 101 FRESNO, CA 93711 ANYTHING IN THIS POLICY TO THE CONTRARY NOTWITHSTANDING, IT IS AGREED THAT THE STATE COMPENSATION INSURANCE FUND WAIVES ANY RIGHT OF SUBROGATION AGAINST, CITY OF FRESNO WHICH MIGHT ARISE BY REASON OF ANY PAYMENT UNDER THIS POLICY IN CONNECTION WITH WORK PERFORMED BY. GRANVILLE HOMES IT IS FURTHER AGREED THAT THE INSURED SHALL MAINTAIN PAYROLL RECORDS ACCURATELY SEGREGATING THE REMUNERATION OF EMPLOYEES WHILE ENGAGED IN WORK FOR THE ABOVE EMPLOYER. IT IS FURTHER AGREED THAT PREMIUM ON THE EARNINGS OF SUCH EMPLOYEES SHALL BE INCREASED BY 03%. NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS OF THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: DECEMBER S, 2012 2570 F�- AUTHORIZED REPRESENTA IVE PRESIDENT AND CEO SCIF FORM 10217 IREV.1-2012) OLD DP 217