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HomeMy WebLinkAboutT-5869 - Certificate of Insurance - 2/7/2011 City of MEMORANDUM 69 DEVELOPMENT AND RESOURCE MANAGEMENT DEPARTMENT•DEVELOPMENT SERVICES DIVISION•2600 FRESNO STREET•FRESNO,CA 93721 DATE: January 25, 2011 TO: KERRY TROST Personnel Services Department FROM: JONATHAN BARTEL Development and Resource Management Department SUBJECT: REQUEST FOR CERTIFICATE OF LIABILITY AND ENDORSEMENT OF INSURANCE APPROVAL FOR THE FINAL MAP OF TRACT NO. 5869 Attached are certificates of liability insurance required for the subdivision agreement for the Final Map. Please review for conformity to City acceptance policies. Final Map is scheduled for Council action on February 17, 2011. If you have any questions, please contact me at 621-8076. Thank you, Q �G Jonathan Bartel DATE(MM/DD/YY W) Ac�vRL�� CERTIFICATE OF LIABILITY INSURANCE F 01/31/2011 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. ui 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 w certificate holder in lieu of such endorsement(s). CONTACT o PRODUCER NAME: Aon Risk Insurance Services West, Inc. PHONE (866) 283-7122 FAX (847) 953-5390 `y LOS An eles CA Office (AIC.No.Ext): AIC.No.: 707 Wilshire Boulevard E-MAIL 0 sui Ce 2600 nnRFqq. PRODUCER Angeles CA 90017-0460 USA CUSTOMER ID p; 570000046288 LOS INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: Underwriters At Lloyds London 15792 Lennar Corporation INSURER B: Old Republic Ins Co 24147 and all its Sudsidiaries 25 Enterprise INSURER C: Zurich American Ins Co 16535 Aliso Viejo CA 92656 USA INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:570041512861 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. Limits shown are as requested INSIR LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER POLICY EFF POLICY EXP MMIDDMMIDD LIMITS �ffi 84p GENERAL LIABILITY MwZY EACH OCCURRENCE $7,500,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $2,000,000 CLAIMS-MADE X❑OCCUR MED EXP(Any one person) PERSONAL&ADV INJURY $7,500,000 (p GENERAL AGGREGATE $7,500,000 co $10,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOP AGGV POLICY X PRO LOC o C AUTOMOBILE LIABILITY 2 Y i 1 . OMBINED SINGLE LIMIT t. accident $1,000,000 X ANY AUTOp�ryrOv� BODILY INJURY(Per person) 0 ALL OWNED AUTOS ./,oprove p SCHEDULED AUTOS Ar 3' rove _ (Chang S. BODILY INJURY(Per accident) °1 PROPERTY DAMAGE X HIRED AUTOS (Per accident) o X NON OWNED AUTOS A X UMBRELLA LIAB X OCCUR 5xo030860Y 1 1 EACH OCCURRENCE $4,000,000 SIR applies per policy terms & condi ions AGGREGATE $4,000,000 EXCESS LIAB CLAIMS-MADE DEDUCTIBLE X RETENTION $1,000,000 WC B WORKERS COMPENSATION AND MWC11 76400 09/01/2010 09/01 2011 TORLIMITU- TS ER SMOTH- X TOY EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L EACH ACCIDENT $2,000,000 0 OFFICER/MEMBER EXCLUDED? N N1 A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $2,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Job: City of Fresno Early Model Home Agreement for Tract No. 5869. Primary wording is included under policy. See attached. ti. 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. a City Of Fresno AUTHORIZED REPRESENTATIVE fly C/o Construction Management Division Attn: Maryann Lewis ry � '11 Y`u� 2600 Fresno street, Room 4019 �O Fresno CA 93720 USA ©1988-2009 ACORD CORPORATION.All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD INSURED Lennar Corporation and all its sudsidiaries 25 Enterprise Aliso Viejo CA 92656 USA Attachment Model: 5385 N. San Miguel Avenue (Lot 48) 5373 N. San Miguel Avenue (Lot 49) 5361 N. San Miguel Avenue (Lot 50) 7273 W. San Carlos Avenue (Lot 51) 7257 W. San Carlos Avenue (Lot 52) The City of Fresno, it's officers, officials, agents, employees and volunteers are included as Additional Insured with respect to General Liability and Auto Liability policies where required by written contract. 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. A waiver of subrogation is granted in favor of Additional insured on the workers' compensation policy where required by written contract. Ten (10) Days Notice for Non-Payment of Premium. see attached CG 20 10 07 04, CG20370704, CA20 48 02 99, we 00 03 13. Certificate No: 570041512861 INSURED Lennar Corporation and all its sudsidiaries 25 Enterprise Aliso Viejo CA 92656 USA CG 20 10 07 04 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 or Organization: The City Of Fresno, its officers, officials, employees, agents and volunteers it is further agrees that such insurance as is affordedny this policy for th benefit of the additional insured shall be primary insurance, and any insurance maintained by the additional insured shall be excess and non-contributory with the insurance provided hereunder. Location of Covered operations: On File with Company information required to complete this schedule, if not shown above, will be shown in the Declarations. A. Section II - who Is An Insured is amended to include as an additional insured the person or organization shown in the schedule, 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; in the performance of your ongoing operations for the additional insured at the location designated above. B. with respect to the insurance afforded to these additional insureds, the following additional exclusions apply: Certificate No: 570041512861 INSURED Lennar Corporation and all its Sudsidiaries 25 Enterprise Aliso Viejo CA 92656 USA CG 20 37 07 04 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 SCHEDULE Name of Additional insured Person(s) or organizations: The City of Fresno, its officers, officials, employees, agents and volunteers It is further agrees that such insurance as is afforded ny this policy for th benefit of the additional insured shall be primary insurance, and anyinsurance maintained by the additional insured shall be excess and non-contributory with the insurance provided hereunder. section II - who Is An Insured is amended to include as an additional insured the person(s) or organization(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 designated and described in the schedule of this endorsement performed for that additional insured and included in the "products-completed operations hazard". CG 20 37 07 04 (c) ISO Properties, Inc., 2004 Certificate No: 570041512861 INSURED Lennar Corporation and all its Sudsidiaries 25 Enterprise Aliso Viejo CA 92656 USA CG 20 10 07 04 This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the in7'ury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. The insurance provided shall be primary and any other insurance maintained by the Additional Insured is excess and Non-Contributory. CG 20 10 07 04 (c) I50 Properties, Inc., 2004 Certificate No: 570041512861 INSURED Lennar Corporation and all its Sudsidiaries 25 Enterprise Aliso Viejo CA 92656 USA CA 20 48 02 99 COMMERCIAL AUTO CA 20 48 02 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM with respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the who Is An Insured Provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Lennar Corporation SCHEDULE Name of Person(s) or organizationts): The City of Fresno, its officers, officials, employees, agents and volunteers (if no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) Each person or organization shown in the schedule is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the who Is An Insured Provision contained in section II of the Coverage Form. CA20 48 02 99 insurance Services office, Inc., 1998 Certificate No: 570041512861 INSURED Lennar Corporation and all its sudsidiaries 25 Enterprise Aliso Viejo CA 92656 USA w COO 03 13 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT we have the right to recover our payments from anyone liable for an injury covered by this policy. we will not enforce our right against this person or organization named in the schedule. (This agreement applies only to the extent that you perform work under a written contract that required you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit any one not named in the schedule. schedule AS REQUIRED BY CONTRACT OR AGREEMENT (Ed. 04/84) Certificate No: 570041512861