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HomeMy WebLinkAboutT-5935 - Certificate of Insurance - 9/2/2008 ACO RDM CERTIFICATE OF LIABILITY INSURANCE 08/14/20 g PRODUCER (559)436-0833 FAX (559)436-1047 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Arthur J. Gallagher & Co. Ins. Brokers of CA Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 7910 N. Ingram, Suite 201 HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 9 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Fresno, CA 93711 Donna Smith INSURERS AFFORDING COVERAGE NAIC# INSURED BN5312 LP, JPJ, Inc. INSURERA: American Internat Specialty Li 2109 W. Bullard 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 CONDFFION OF ANY CONTRACT OR OTHER DOCUMENT WFFH 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 WWI. TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS DATE(MMIDDNY) DATE(MMIDDffY) GENERAL LIABILITY 7113467 10/30/2006 10/30/2009 EACH OCCURRENCE $ 2000000 COMMERCIAL GENERAL LIABILITY SIR $10, 'IF M O RENTED 000 PER DAMAGE T $ [&eneral CLAIMS MADE F—]OCCUR OCCURRENCE MED EXP(Any one person) $ A Llab. PERSONAL&ADV INJURY $ Reimbursement INDEMNIFICATION GENERAL AGGREGATE S 2000000 GEN'LAGGREGATELIMITAPPLIES PER: OF NAMED INSURED ONLY PRODUCTS-COMP/OP AGG $ POLICYF—j JE° Loc COV PERIOD $2M AGG AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS r (Per accident) 1�V PROPERTY DAMAGE $ 1 f .AG HENT D VISION (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S ANY AUTO Alpp. JVed /Ch nges: �f f OTHER THAN EA ACC $ 11 AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY Sidine ! —Uate EACH OCCURRENCE d $ OCCUR ❑CLAIMS MADE v AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND WC STATUS O R EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYE $ If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ OTHER Ten day notice of cancellation applies to non-payment of premium. DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS PJ INCORPORATED, BONADELLE DEVELOPMENT CORPORATION AND DEYOUNG COMMUNITIES INCORPORATED, TEAM 5 ROPERTIES INCORPORATED, BONADELLE HOMES INCORPORATED, AND ALL THEIR AFFILIATED ENTITIES ARE COVERED Y THIS POLICY AND ALL OF THESE ENTITIES SHALL SHARE THE SAME PER OCCURRENCE AND AGGREGATE LIMIT OF IABILITY. RE: Tract 5901/5935. Additional Insured Endt #3 including Primary attached. EE SPECIAL PROVISIONS 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: Kerry Trost BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 1721 Van Ness Avenue OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. Fresno, CA 93721 AUTHORIZED REPRESENTATIVE Donna Smith/JOANN <.���h•� 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) City of Fresno Certificate issued to City of Fresno 08/14/2008 Arthur J. Gallagher & Co. Ins. Brokers of CA Inc. 08/14/2008 Special Provisions: This certificate of insurance contains a broad outline of the policy coverage and does not include all terms, conditions and exclusions of the policy. The policy is a claims made and reported policy. The policy will reimburse the named insured only and will not make payments to any other party. The policy is subject to commutation any time after July 31, 2010 at the sole option of the named insured and will automatically commute on October 30, 2016. In the event of commutation, the insurer will not be responsible for any further payments of any kind under the policy, and shall have no liability of any kind or nature, or arising out of or related to, any claims whatsoever, regardless of whether such claims are outstanding claims or future claims or whether arising from past, present or future losses or occurrences. The insurer does not provide any representation on the adequacy of the limits of liability for the exposures covered by this policy. The insured has a self-insured retention of $10,000 on each and every occurrence under the policy. JPJ Incorporated, Bonadelle Development Corporation, DeYoung Communities Incorporated, Team 5 Properties Incorporated, Bonadelle Homes Incorporated, and all of their affiliated entities are covered by this policy and all of these entities share the same per occurrence and aggregate limit of liability. Notwithstanding any notice required by this certificate, in the event of cancellation or non-renewal , it will be the responsibility of the named insured, its surplus lines broker or its other authorized representative, and not the responsibility of the issuing insurer, to provide notice of cancellation or non-renewal . AISLIC Policy No. 7113467 ,,�S\)RA&C, AMERICAN INTERNATIONAL SPECIALTY LINES INSURANCE COMPANY A CAPITAL STOCK INSURANCE COMPANY dISL 70 PINE STREET NEW YORK, NEW YORK 10270 cpMPPt�l THIS INSURER IS NOT LICENSED IN THE STATE OF NEW YORK A Member AND IS NOT SUBJECT TO ITS SUPERVISION. Company Of American International Group, Inc. GENERAL LIABILITY REIMBURSEMENT POLICY POLICY NUMBER: 7113467 ENDORSEMENT NO. 3 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY This endorsement,effective as of 12:01 a.m. (EST)on August 8, 2008 forms a part of the General Liability Reimbursement Policy, Policy No. 7113467(the"folic ') issued by American International Specialty Lines Insurance Company to JPJ Incorporated. For purposes of this Endorsement, "JPJ Parties"means the Named Insured, Bonadelle Development Corporation, De Young Communities Incorporated,Team 5 Properties Incorporated, Bonadelle Homes Incorporated and any subsidiaries, affiliates,associated or allied companies, corporations, partnerships, joint ventures or limited partnerships that exist now or which may hereafter be constituted or acquired and which are owned, financially controlled or managed or in which the Insured has either an insurable interest or an obligation to insure to the extent of that obligation(other than an obligation that is solely a contractual obligation relating to any contract or agreement the Insured enters into); provided, however, that Land Dynamic and Sierra Inland Incorporated shall not be considered JPJ Parties. It is understood and agreed that the Policy is hereby amended as follows: 1. In"SECTION II-DEFINITIONS": The definition of"Insured" is amended to include as an additional insured City of Fresno,CA, and each of its officers,officials, employees, agents and volunteers, as required by the contract or agreement entered into by the JPJ Parties and the City of Fresno, CA, but in each instance only with respect to liability arising out of(i)the JPJ Parties' operations or (ii)premises owned by or rented to the JPJ Parties;provided, however,that the insurance provided by this Endorsement will not exceed the lesser of the coverage and/or limits of the Policy or the coverage and/or limits required by said contract or agreement_ 2. Notwithstanding "SECTION VIII -OTHER INSURANCE"of the Policy,the insurance provided to the City of Fresno, CA, and each of its officers, officials, employees, agents and volunteers under this Endorsement shall be primary and any other insurance available to the City of Fresno, CA, and each of its officers, officials, employees, agents and volunteers shall be excess and not contribute. All defined terms used in this Endorsement and not otherwise defined herein shall have the meaning set forth in the Policy. The provisions of this Endorsement supersede any contrary or conflicting provision contained in the Policy, or any other endorsement thereto. All other terms,conditions and exclusions shall remain unchanged. By aCorizedRN epresentaa Date: s D8 ACOV CERTIFICATE OF LIABILITY INSURANCE 06/105%o 8 PRODUCER (559)436-0833 FAX (559)436-1047 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 7910 N. Ingram, Suite 201 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 9 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Fresno, CA 93711 INSURERS AFFORDING COVERAGE NAIC# INSURED Bonadel a Homes, Inc. INSURERA: Peerless Insurance Company BN5312 LP INSURERB: 7030 N. Fruit, Suite 101 INSURER C: Fresno, Ca 93711 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, INSROD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS I TR GENERAL LIABILITY EACH OCCURRENCE 5 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ CLAIMS MADE F-1OCCURMED EXP(Any one person) $ PERSONAL&ADV INJURY S GENERAL AGGREGATE S GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG S POLICY PROJECT LOC ALITOMCBILELIABIL1 Y CBP 8364480 12/31/2007 12/31/2008 COMBINED SINGLE LIMIT X ANY AUTO (Ea accident) $ 1,000,000 ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ A X HIREDAUTOS BODILY INJURY $ X NON-OWNED AUTOS {/.�. (Per accident) RINKMANN + - V] PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITYAUTO ONLY-FA ACCIDENT $ Ap �Chani ANY AUTO yti r{ – OTHER THAN EA ACC $ UU l AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE S OCCUR FICLAIMS MADE AGGREGATE S S DEDUCTIBLE 5 RETENTION $ $ WC STATU- OTH- WORKERS COMPENSATION AND TORY I IMITS FR EMPLOYERS'LIABILITY ANY PRO PRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ 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 Event of Cancellation for Non-Payment DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Re: Tract 5901/5935 rhe City of Fresno, its officers, officials, employees, agents and volunteers are included as additional, insured as per GECA701 01/07 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 Avenue OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES, Fresno, CA 93721 AUTHORIZED REPRESENTATIVE Donna Smith/DONNA ACORD 25(2001108) ©ACORD CORPORATION 1988 COMMERCIAL AUTO GOLD ENDORSEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies Insurance provided under the following, BUSINESS AUTO COVERAGE FORM SECTION II—LIABILITY COVERAGE A. COVERAGE 1. WHO IS AN INSURED The following is added: d. Any organization, other than a partnership or joint venture, over which you maintain ownership or a majority interest on the effective date of this Coverage Form, if there is no similar insurance available to that organization. e. Any organization you newly acquire or form other than a partnership or joint venture, and over which you maintain ownership of a majority interest. However, coverage under this provision does not apply: (1) If there is similar insurance or a self-insured retention plan available to that organization;or (2) To "bodily Injury" or "property damage" that occurred before you acqulred or formed the organization. f. Any volunteer or employee of yours while using a covered"auto"you do not own, hire or borrow in your business or your personal affairs. Insurance provided by this endorsement is excess over any other insurance available to any volunteer or employee. g. Any person, organization, trustee, estate or governmental entity with respect to the operation, maintenance or use of a covered "auto"by an insured, If: (1) You are obligated to add that person, organization, trustee, estate or governmental entity as an additional insured to this policy by: (a) an expressed provision of an"insured contract",or written agreement;or (b) an expressed condition of a written permit issued to you by a governmental or public authority. (2) The"bodily Injury"or"property damage"is caused by an"accident"which takes place after: (a) You executed the"insured contract"or written agreement;or (b) the permit has been Issued to you. 2. COVERAGE EXTENSIONS a. Supplementary Payments. Subparagraphs (2) and(4) are amended as follows: (2) Up to $2504 for cost of ball bonds (including bonds for related traffic law violations) required because of an"accident'we cover. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the "Insured" at our request, including actual loss of earning up to$500 a day because of time off from work. Includes copyrighted material of Insurance Services Offices,Inc.with Its permission GECA 701 (01107) Page 1 of 3 INSURED COPY 12/31/2007 8364480 NEMDMA1504 PGOM0600 J14130 GCAFPPN 00000220 Page 13 SECTION III—PHYSICAL DAMAGE COVERAGE A. COVERAGE The following is added: 5. Hired Auto Physical Damage a. Any"auto"you lease, hire, rent or borrow from someone other than your employees or partners or members of their household is a covered"auto"for each of your physical damage coverages. b. The most we will pay for"loss" In any one"accident'is the smallest of; (1) $50,000 (2) The actual cash value of the damaged or stolen property as of the time of the"loss";or (3) The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality. If you are liable for the "accident',we will also pay up to$500 per"accident' for the actual loss of use to the owner of the covered"auto". c. Our obligation to pay for, repair, return or replace damaged or stolen property will be reduced by an amount that is equal to the amount of the largest deductible shown for any owned "auto" for that coverage. However, any Comprehensive Coverage deductible shown in the Declarations does not apply to"loss"caused by fire or lightning. d. For this coverage, the insurance provided is primary for any covered "auto" you hire without a driver and excess over any other collectible insurance for any covered "auto"that you hire with a driver. 6. Rental Reimbursement Coverage We will pay up to $75 per day for up to 30 days, for rental reimbursement expenses incurred by you for the rental of an"auto" because of"loss"to a covered "auto". Rental Reimbursement will be based on the rental of a comparable vehicle, which in many cases may be substantially less than $75 per day, and will only be allowed for a period of time it should take to repair or replace the vehicle with reasonable speed and similar quality, up to a maximum of 30 days. We will also pay up to$500 for reasonable and necessary expenses incurred by you to remove and replace your materials and equipment from the covered "auto". If "loss" results from the total theft of a covered"auto"of the private passenger type,we will pay under this coverage only that amount of your rental reimbursement expenses which is not already provided under paragraph 4.Coverage Extension. 7. Lease Gap Coverage If a long-term leased "auto" is a covered "auto" and the lessor is named as an Additional Insured — Lessor, In the event of a total loss, we will pay your additional legal obligation to the lessor for any difference between the actual cash value of the "auto" at the time of the loss and the 'outstanding balance"of the lease. "Outstanding balance" means the amount you owe on the lease at the time of loss less any amounts representing taxes; overdue payments; penalties, interest or charges resulting from overdue payments; additional mileage charges; excess wear and tear charges; and lease termination fees. B. EXCLUSIONS The following is added to Paragraph 3 The exclusion for "loss" caused by or resulting from mechanical or electrical breakdown does not apply to the accidental discharge of an airbag. Includes copyrighted material of Insurance Services Offices,Inc,with Its permission GECA 701 (01107) Page 2 of 3 INSURED COPY 12/3112007 8364480 NEUSXDMA1504 PODMOBOD J14130 GCAFPPN 00000221 Page 14 Paragraph 4 Is replaced with the following: 4. We will not pay for"loss"to any of the following: a. Tapes, records, disks or other similar audio, visual or data electronic devices designed for use with audio,visual or data electronic equipment. b. Equipment designed or used for the detection or location of radar, c. Any electronic equipment that receives or transmits audio,visual or data signals. Exclusion 4.c does not apply to: (1) Electronic equipment that receives or transmits audio, visual or data signals, whether or not designed solely for the reproduction of sound, if the equipment is permanently installed in the covered "auto"at the time of the"loss"and such equipment is designed to be solely operated by use of the power from the"auto's"electrical system, in or upon the covered "auto";or (2) Any other electronic equipment that is: (a) Necessary for the normal operation of the covered "auto" or the monitoring of the covered "auto's"operating system;or (b) An integral part of the same unit housing any sound reproducing equipment described in(1) above and permanently installed in the opening of the dash or console of the covered"auto" normally used by the manufacturer for Installation of a radio. D. DEDUCTIBLE The following is added: No deductible applies to glass damage if the glass is repaired rather than replaced. SECTION IV.BUSINESS AUTO CONDITIONS A. LOSS CONDITIONS Item 2.a. and b. are replaced with: 2. Duties In The Event of Accident,Claim, Suit,or Loss a. You must promptly notify us. Your duty to promptly notify us is effective when any of your executive officers, partners, members, or legal representatives is aware of the accident, claim, "suit", or loss. Knowledge of an accident, claim, "suit", or loss, by other employee(s) does not imply you also have such knowledge. b. To the extent possible, notice to us should include: (1) How, when and where the accident or loss took place; (2) The names and addresses of any injured persons and witnesses; and (3) The nature and location of any injury or damage arising out of the accident or loss. The following is added to 5. We waive any right of recovery we may have against any additional insured under Coverage A. 1. Who Is An Insured g.,but only as respects loss arising out of the operation, maintenance or use of a covered "auto" pursuant to the provisions of the"insured contract",written agreement,or permit. B. GENERAL CONDITIONS 9. is added 9. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS Your unintentional failure to disclose any hazards existing at the effective date of your policy will not prejudice the coverage afforded. However, we have the right to collect additional premium for any such hazard. COMMON POLICY CONDITIONS 2.b. is replaced by the following: b. 60 days before the effective date of cancellation if we cancel for any other reason. Includes copyrighted material of Insurance Services Offices,Inc.with its permission GECA 701 (01107) Page 3 of 3 INSURED COPY 12!3112007 8364480 NEUMMm504 PGDM06010 J14130 GGAFPPN 00000222 Page 15 IMPORTANT If the certificate holder Is an ADDITIONAL INSURED,the policy(les)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. ACORN 25(2001108) CERTHOLDER COPY NE STATE P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 COMPENSATION INSURANCE FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 08-07-2008 GROUP: 000260 POLICY NUMBER: 0009320-2006 CERTIFICATE ID: 24 CERTIFICATE EXPIRES: 10-01-2008 10-01-2007/10-01-2008 CITY OF FRESNO NE JOB:TRACT 5901 & 5935 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 30 days advance written notice to the employer. We will also give you 30 days advance notice should this oolicy 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. THORIZEI REPRESENTATI PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #1600 - BONADELLE, JOHN A PRESIDENT SECRETARY - EXCLUDED. ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 10-01-2007 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. ENDORSEMENT #2570 ENTITLED WAIVER OF SUBROGATION EFFECTIVE 2008-08-07 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. THIRD PARTY NAME: CITY OF FRESNO RISK MAN GEMENT DIVIS6v.� Apps ed: ,Aper Changes: `o Signe "date EMPLOYER BONADELLE DEVELOPMENT CORPORATION AND/OR NE BONADELLE HOMES INC 7030 N FRUIT AVE STE 101 FRESNO CA 93711 [B16,NF] IREV.2-051 PRINTED : 08-07-2008