Loading...
HomeMy WebLinkAboutT-5710 - Certificate of Insurance - 12/11/2008 DATE(MM/DDIYYYY) ACORD. CERTIFICATE OF LIABILITY INSURANCE 12/31/2008 12/11/2008 PRODUCER Lockton Companies,LLC-L Los Angeles THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 19800 MacArthur Blvd.,Suite 550 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE CA License#OF1 5767 HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Irvine CA 92612 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 949-252-4400 INSURERS AFFORDING COVERAGE NAIC# INSURED Granville Homes,Inc. INSURER A: Steadfast Insurance Company 26387 1072889 1396 W.Herndon Ave.,Ste.101 INSURER 6: Fresno CA 93711 INSURER C: INSURER D: INSURER E: COVERAGES GRAH001 OG THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERS AUTHOR ZED REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER. 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. INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YY) DATE(MM/DD/YY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 5,000,000 A X COMMERCIAL GENERAL LIABILITY HBP9140836-00 12/31/2006 12/3[/2008 DAMAGES( RENTED PREMISES Ea occurence $ 100,000 CLAIMS MADE 7XI OCCUR MED EXP(Any one person) $ 25,000 PERSONAL 8 ADV INJURY $ 5,000,000 GENERAL AGGREGATE $ 10,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS-COMP/OP AGG $ 10,000,000 PRO- X1 POLICY F7 JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ XXXXXXX ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ XXXXXXX SCHEDULED AUTOS NOT APPLICABLE (Per person) HIRED AUTOS n pp A BODILY INJURY $ XXXXXXX NON-OWNEDAUTOS RISK MA GEMEN D1VISIO get accident) Ar roved. PROPERTY DAMAGE $ XXXXXXX (Per accident) AW GARAGE LIABILITY TO ONLY-EA ACCIDENT $ XXXXXXX NOT APPLICAB, ANY AUTO �" - THER THAN EA ACC $ XXXXXXX 0:0 qvtg� Date AUTO ONLY: AGG $ XXXXXXX EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ XXXXXXX OCCUR FICLAIMS MADE AGGREGATE $ XXXXXXX UMBRELLA NOT APPLICABLE $ XXXXXXX El DEDUCTIBLE FORM $ XXXXXXX RETENTION $ $ XXXXXXX WORKERS COMPENSATION AND WC STAT U- OTH- TORY LIMITS ER EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE NOT APPLICABLE E.L.EACH ACCIDENT $ XXXXXXX OFFICERIMEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ XXXXXXX If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ XXXXXXX OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Re:Tract#5710.Phase 1.The City of Presno,its officers,officials,employees,agents and Volunteers are additional insured as respects to general and auto liability insurance.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. CERTIFICATE HOLDER CANCELLATION [M87342] 3988880 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Fresno DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN Construction Management Division NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Attn:Maryann Lewis IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 1721 Van Ness Avenue Fresno CA 93721 REPRESENTATIVES. AUTHORIZED REPRES //,PW,7 '/e -//dasp-- ACORD 25(2001108) For questions regarding this certificate,contact the number listed in the'Producee section above and s city the clAff cod GRAHOot'. ©ACORD CORPORATION 1988 Home Builders Protective Insurance Policy Endorsement Steadfast Insurance Company Dover, Delaware Administrative Offices- 1400 American Lane,Schaumburg, Illinois 60196-1056 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Poliev No. Eff.Date of Pol. Exp.Date of Pot. Eff.Date of End. Producer Code Add'I Prem. Return Prem. HB9140836-00 12-31-2006 12-31-2008 75428-000 -0- -0- NAMED INSURED: GRANVILLE HOMES INC. PER THE NAMED INSURED SCHEDULE ADDRESS: 1396 W. HERNDON AVE.,STE. 101 FRESNO,CA 93711 Endorsement This endorsement modifies insurance provided by the following: Home Builders Protective Insurance Policy Form Additional Insured - Scheduled - Owners, Lessees or Contractors - Broad Form SCHEDULE Name of Person or Organization: (If no entry appears above,information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. WHO IS AN INSURED(Section 11)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 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 Coverage B,PERSONAL AND ADVERTISING INJURY LIABILITY, but only if: 1. The"bodily injury"or "property damage" results from your negligence;and 2. The"bodily injury", "property damage"or"personal and advertising injury" results directly from: a. Your ongoing operations;or b. "Your work"completed as included in the"products-completed operations hazard", performed for the additional insured, which is the subject of the written contract or written agreement. Miscellaneous Attachment: M87342 Certificate ID : 3988880 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 does not apply to: 1. 'Bodily injury", "property damage" or "personal and advertising injury" that results solely from negligence of the additional insured;or 2. '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: a. The preparing,approving,or failing to prepare or approve maps,shop drawings,opinions,reports, surveys,field orders,change orders or drawings and specifications;and b. 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"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 also has rights as an insured or additional insured. F. The insurance provided by this endorsement is primary insurance and we will not seek contribution from any other insurance available to the person or organization shown in the Schedule unless the other insurance is provided by a contractor other than you for the same operations and job location. Then we will share with that other insurance by the method described in paragraph Ln.(3)of SECTION V-HOME BUILDERS PROTECTIVE CONDITIONS Any provisions in this Coverage Part not changed by the terms and conditions of this endorsement continue to apply as written. STF-GL-113-A-CW(1/97) Miscellaneous Attachment:M87342 Certificate ID :3988880 ®CORDM CERTIFICATE OF LIABILITY INSURANCE DATE PRODUCER (559)436-0833 FAX (559)256-6590 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Arthur 1. Gallagher & Co. Ins. Brokers of CA Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 45 East River Park Place West HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 408 Fresno, CA 93720 INSURERS AFFORDING COVERAGE NAIC# INSURED Granville Homes, Inc. INSURERA: American States Insurance 19704 1396 W. Herndon Ave #101 INSURER B: Fresno, CA 93711 INSURER C: INSURER D: INSURER E: COVERAGES 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. INSR ADDT TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS Lau DATE(MMIDDfYY) GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ CLAIMS MADE ❑OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICYF_j PROECT LOC J AUTOMOBILE LIABILITY 01CH83535910 04/01/2008 04/01/2009 COMBINED SINGLE LIMIT X ANYAUTO (Ea accident) $ 1,000,000 ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ A HIRED AUTOS BODILY INJURY $ NON-OW NED AUTOS n/� (Per accident) [� f `11( MA GE ENT DIVISION (P OPE de DAMAGE $ GARAGE LIABILITY //'� I.)fOUt? AUTO ONLY-EA ACCIDENT $ ANYAUTO A, . ved w Chan eS. 1 OTHER THAN EA ACC $ 4` AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY C Dot EACH OCCURRENCE $ OCCUR F-1 CLAIMS MADE J AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND T.WC STATU- OTH- LIMIT FR. EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE _ OFFICERIMEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYE $ If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ OTHER Ten Day Notice Of Cancellation Would Apply in the Event of Cancellation for Non-Payment DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Re. Tract 5710 The City of Fresno, its officers, officials, employees, agents & volunteers are included as additional insureds per CA7110 03/07 attached CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL City of Fresno c/o Construction Management Division 030 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Attn• Maryann Lewis BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 1721.Van Ness I OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. Fresno, CA 93721 AUTHORIZED REPRESENTATIVE Donna Smith/DONNA ACORD 25(2001/08) ©ACORD CORPORATION 1988 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 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). 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) ""REPRINTED FROM THE FORMS LIBRARY" s j wjlj S[r COMMERCIAL AUTO CA 7110 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 ADDI[TIONAL INSURED Paragraph 2.b. of the CANCELLATION Common SECTION II LIABILITY COVERAGE — A.I.WHO Policy Condition is replaced by the following: IS AN INSURED provision is amended by the addition b. 80 days before the effective date of cancellation of the following: If we cancel for any other reason. o. Any person or organization for whom you are re- quired by an insured contract" to provide Ir=r- 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 rations, 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" R Physloal 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. destniction. (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 negil- 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 tendered by this person or organization as business entity Is not separately Insured for soon as practicable to all other Insurers Business Auto Coverage. Coverage is extended which potentially provide Insurance for such up to a maximum of 180 days following acquW- claim or "suit". tion or formation of the business entity.Coverage 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 Safeco end the Safeco logo are registered trademarks of Safeco Corpo eton CA 71 10 03 07 Page 1 of 6 EP REPRINTED FROM THE FORMS LIBRARY (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, A4. 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 "foss", without completed. applying a deductible. EMPLOYEE AS INSURED EXTRA EXPENSE — BROADENED COVERAGE Under Paragraph A.of Section II — 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, S. 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 S. FELLOW EMPLOYEE of SECTION II — added: LIABILITY COVERAGE — B. EXCLUSIONS la 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 seo- tion 2 Is amended as follows: BLANKET WAVER OF SUBROGATION 2. An adfisstment for depreciation and physical con- We walve the right of recovery we may have for pay- dftion 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 lass to your "new vehicle" to "Insureds" under Section II —LIABILITY COVERAGE which this coverage applies, as shown in the — A.I.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 In- PHYSICAL DAMAGE — ADDITIONAL TRANS- you paid for your damaged , not Irr- PORTATION EXPENSE COVERAGE chiding any insurance or warranties pur- chased; The first sentence of paragraph A4. 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 avallable 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 Df 6 REPRINTED FROM THE FORMS LIBRARY— c. The market value of your damaged vehicle, a. Actual cash value of the damaged or olden 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 tnxk 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 adXadrnents: casts 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 SEC11ON 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- applles to paragraph D. Deductible: sive use or abnormal wear and tear. a. If the applicable Business Auto deduct- (8) 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. able 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; (S) Final payment due under a "Balloon or Loan„ c. If the loss Involves two or more Busi- ness Auto coverage forms or policies (8) The dollar amount of any rm the smaller(or smallest) deductible will prior to hered damage that covered be waived. prior to the "total loss" of a covered ,auto,. For the purpose of this endorsement (7) Security deposits not refunded by a "company"means: lessor. a. Safeco Insurance Company of America (8) AN 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 E 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, ft following Is h. Safeco Insurance Company of Illinois added: LOAN/LEASE GAP COVERAGE No deductible applles 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. — "accldent" 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 0 EP ^"REPRINTED FROM THE FORMS LIBRARY `accident"applies only when the "accident"Is(mown deductible and excess provislons, we will provide to: coverage equal to the broadest coverage applicable to any covered "auto" you own. (1) You, ff you are an IndivWual; (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& Form does not apply. UNINTENTIONAL FAILURE TO DISCLOSE SDS Subjed to a maximum of$1,000 per accident,we will cover loss of use of a hired "auto" If it remits 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 fall to disclose any hazards ex RENTAL REIMBURSEMENT COVERAGE Isting at the Inception date of your policy, we will not deny coverage under this Coverage Form because of A We will pay for rental reimbursement expenses such failure. However, this provision does not affect Incurred by you for the rental of cause of a covered "loss" to a covered auto""auto" b9. our right to collect additional Payment applies in addition to the otherwise ap- premium or exercise our right of cancellation or non-renewal. Pay 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 B.7.b.e(1) is replaced by the following: the "loss" and ending, regardless of the policy's (1) The "accident" or "loss" rmfts expiration,with the lesser of the folowing number from the use of an "auto" hired for of days: 30 days or less. 1. The number of days reasonably required to RESULTANT MENTAL ANGUISH COVERAGE repair Is replace the covered "auto If Is'loss" caused by then, 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 retum It to following: yo„_ "Bodily Injury" means bodily Injury, sickness or dls- 2. 30 days. ease sustained by a person including mental anguish C. Our or death resulting from any of these. paymentIs limited the lesser of the fol - or amounts: m HIRED AUTO PHYSICAL DAMAGE COVERAGE 1. Necessary and actual expenses incurred. ti hired "autos" are covered "autos" for Liability crov- 2. $50 per day. erage and tf 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 deducible. The de- ready provided for under the PHYSICAL DAM- dudibis 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 descrbed sicai Damage coverage is excess over any other col- above does not appy 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. Umlt of Insurance EQUIPMENT COVERAGE With respect to this coverage, the LIMIT OF IN- A. Coveraps 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,vE ss for "lo " to any electronic equipment that sual or data electronic equipment and any receives or transmits audio, visual or data accessories used with this equipment as a signals and that is not designed solely for the result of any one "accident"Is the lesser of: reproduction of sound.This coverage applies 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 Ike 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.1.above. 3. If a repair or replacement results In battier 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 Eiectronk: Equip- ment Coverage form CA 99 80 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 Electrons; Equipment Cover- this equpment 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 Coll B. Exclusions sion Coverage, then for each covered "auto" The exclusions that apply to PHYSICAL DAIS- our obligation to pay for, repair, return or re- AGE COVERAGE, except for the exclusion resat- 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 add- 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 "lass" to the audio, visual or data elec- 1. Necessary for the normal operation of the tronic equipment or accessories used with covered "auto" for the monitoring of the this equlpment Is the result of a "ksss"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$1 DO deductible. sound If the sound reproducing 3. If "loss" occurs solely to the audio,visual or equpment is permanently installed in data electronic equipment or accessories the covered "auto";and used with this equipment,than 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 deducible. the following: 4. In the event that there Is more than one ap- Q. `Personal effects" means your tangible plloable 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 385 days past the purchase date. Page 6 of 6 CERTHOLDER COPY NE STATE P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 COMPENSATION INSURANCE FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 12-10-2008 GROUP: POLICY NUMBER: 1901663-2008 CERTIFICATE ID: 31 CERTIFICATE EXPIRES: 12-01-2009 12-01-2008/12-01-2009 CITY OF FRESNO, CONSTRUCTION MNMGT DIVISID JOB:TRACT 5710 MARYANN LEMS 1721 VAN NESS AVE FRESNO CA 93721-1130 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. tTHORIZE1 REPRESENTATI PRESIDENT 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. EMPLOYER GRANVILLE HOMES, INC AND/OR GRANVILLE REALTY, INC AND/OR ASSEMI AND SONS, INC 1396 W HERNDON AVE STE 101 FRESNO CA 93711 [817,NE] (REV.2-06) PRINTED 12-10-2008 CERTHOLDER COPY NE STATE P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 COMPENSATION INSURANCE FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 12-11-2008 GROUP: POLICY NUMBER: 1901663-2008 CERTIFICATE ID: 32 CERTIFICATE EXPIRES: 12-01-2009 12-01-2008/12-01-2009 THIS CERTIFICATE SUPERSEDES AND CORRECTS CERTIFICATE # 31 DATED 12-10-2008 CITY OF FRESNO NE JOB:TRACT 5710 CONSTRUCTION MANAGEMENT DIVISION 1721 VAN NESS AVE FRESNO CA 93721-1130 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. �THORIZEDREPRESENTATI PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #1500 - ASSEMI, DARIUS VICEPRES - EXCLUDED. ENDORSEMENT #1600 - ASSEMI, FARID PRESIDENT - EXCLUDED. ENDORSEMENT #1600 - ASSEMI, FARSHID DIRECTOR - EXCLUDED. ENDORSEMENT #2570 ENTITLED WAIVER OF SUBROGATION EFFECTIVE 2008-12-11 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. THIRD PARTY NAME: CITY OF FRESNO RISK MA AGEMENT DIVI%�)' .- - I Ap Oved'.� Appr ed Changes: 1"d Signe EMPLOYER GRANVILLE HOMES, INC NE 1396 W HERNDON AVE STE 101 FRESNO CA 93711 [B 10,N E] (REV.2-05) PRINTED : 12-11-2008