Loading...
HomeMy WebLinkAboutT-5956 - Certificate of Insurance - 6/25/2010 ACORDrDATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 12/31/2010 12131/200$ PROOuCER Lockton Insurance Brokers,LLC THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 19800 MacArthur Blvd.,Suite 550 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE CA License t10F15767 TETHEVERECFFREOTHEPEBEALLR COAGAOD BYOLIICISLOW Irvine 92612 949-252-4400 INSURERS AFFORDING COVERAGE NAIC# INSURED Grarwille Homes,Inc. INSURER A, Steadfast Insurance Company 26387 1072889 1396 W.Herndon Ave.,Ste.101 INSURER B. Fresno CA 93711 INSURER C: INSURER D. INSURER E. COVERAGES GRAHOOI OG S C EO I SU C ES 0 CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURE 9 AUrA 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 ADVL POUCYEFFECTIVE POLICY EXPIRATION LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE(MMIDDYY) DATE(MM/DDM') LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 5,000,000 A X COMMERCIAL GENERAL UAfiN-RY HBP9140836.01 12/31/2008 12131/2010 �A i0 RENTED PREMISES Ea oocurenoe, $ 100,000 CLAIMS MADE D OCCUR MED EXP(Anyone person) $ 25,000 X Silica:SIM ea.occ. PERSONAL 8 ADV IN URY $ 5,000,000 GENERAL AGGREGATE $ 10,000,000 RGENLAGGREGATELMATAPPLIES PER: PRODUCTS-COMPIOPAGG $ 10000,000 X POLICY F JECOT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ } � ANY AUTO (Ea socident) ALL OWNED AUTOS BODILY INJURY $ LXXX}fir SCHEDULED AUTOS NOT APPLICABLE (Per person) HIREDAUTOS BODILY INJURY $ XXXXXXX NON-OWNED AUTOS (Per accident) 1 - .1` -i\,O L.i'� (..f V I L✓t Y 1 OBERTt DAMAGE $ XXX (Pereccident) GARAGE LIABILITY �,` AUTO ONLY-EA ACCIDENT $ XJ`YXXXXX ANY AUTO NOT APPLICABLE.: hang $: THER XXXXX EA ACC $ XX TOONL AGG $ XXXXXXX EXCESSA)MBRELLALIABILITY `fit Iv LJOTeEACH OCCURRENCE $ XXXXXXX OCCUR EICLAIMS MADE AGGREGATE $ XXL UMBRELLA NOT APPLICABLE $ XXX)= DEDUCTIBLE 1 FORM $ XX.'."= RETENTION $ $ XXXXX.XX WORKERS COMPENSATION AND I WC S ATU- OI'H- EMPLOYERS'LIABILITY YIN TORL Y IMfrS ER v'trtywv ANY PROPRIETORIPARTNERIEXECUTIVE ❑ EL.EACH ACCIDENT $ XX�1/1.,e1i1n OFFICERQAENISEREXCLUDED? NOT APPLICABLE (Mandatoryln NH) E.L.DISEASE-EA EMPLOYEE $ 3CKX0CX0X o yes.descow unser SPECIAL PROASIONSbeI— E.L.DISEASE-POLICY LIMIT $ XX3{XJCX�i OTHER DESCRIPTION OF OPERATIONSILOCATIO ICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS Re:Tract#5956.Phase 1.The City of Fresno,its officers,officials,employees,aaggents and Volunteers are additional insured as respects to ggeneral liability insurance.This insurance Is primary,end our obligations are not affectedby any other insurance carried by such additional insuredwhethcr primary, excess,contingent,or on any other basis. CERTIFICATE HOLDER CANCELLATION M448453J 10897601 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$0 SHALL Attn:Maryann Lewrs IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 1721 Van Ness Avenue Fresno CA 93721 REPRESENTATIVES. AUTHORIZED REPREs ACORD 25(2009101) 1988- 9 CRd CORPORATION.All rights reserved The ACORD name and logo are registered marks of ACORD ea FIV quaena Mgardingthil eeN IWk—ft tlM numbw II Min the'F uae'teetlen slew and xpeW the UMnteode•ORAHDeP, Home Builders Protective Policy Endorsement ZURICH Steadfast Insurance Cormpany Dover,Delaware Administrative Offices-1400 American Lane,Schaumburg,Illinois 60196-1056 Policy No Eff Date of Pol. Exp.Date of Pol. Eff.Date of End Producer No. Addl.Prem, Return Prem. HBP9140836-01 12/31/2008 12131/2010 12/31/2008 Named Insured/Mailing Address: Producer: GRANVILLE HOMES,INC. LOCKTON COMPANIES (PER NAMED INSURED SCHEDULE) 19800 MACARTHUR BLVD.,STE 550 1396 HERNDON AVE,STE 101 IRVINE,CA 92612 FRESNO,CA 93711 TI-IIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: The City of Fresno,its officers,officials,employees,agents and volunteers".Examples of primary insurance Home Builders Protective Policy language are"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"and'This insurance is primary,and our obligations are not affected by any other insurance carded by such additional insured whether primary,excess,contingent,or on any other basis BLANKET ADDITIONAL INSURED IT IS AGREED THAT SECTION II-WHO IS AN INSURED,IS AMENDED TO INCLUDE,AS AN ADDITIONAL INSURED,ANY PERSON OR ORGANIZATION YOU ARE REQUIRED BY WRITTEN CONTRACT TO INCLUDE AS AN ADDITIONAL INSURED,INSURANCE FOR THESE PERSONS OR ORGANIZATIONS SHALL BE LIMITED TO THE EXTENT OF THE COVERAGE AND LIMITS OF LIABILITY REQUIRED BY THE WRITTEN CONTRACT AND ONLY WITH RESPECT TO LIABILITY ARISING OUT OF"YOUR WORK"WHETHER.PERFORMED FOR THAT INSURED BY OR FOR YOU.THE WRITTEN CONTRACT MUST BE EXECUTED PRIOR TO THE OCCURRENCE OF ANY LOSS. THE EXTENT OF COVERAGE AND THE LIMITS OF LIABILITY OF THIS CONTRACT SHALL NOT INCREASE THE LIMITS STATED IN SECTION III-LIMITS OF INSURANCE,OF THE EXTENT OF COVERAGE STATEDN THIS POLICY. STF-GL-10096-A-CW(11106) Page 1 of 1 Includes copyrighted material of Insurance Services Office,Inc,with its permission. Miscellaneous Attachment:M448453 Certificate ID: 10897601 entitled to the insured's rights against all those If other valid and collectible insurance is available other insurers. to the Insured for a loss we cover under Coverages A, B, C or D of this policy; our When this insurance Is excess over other obligations are limited as follows- insurance, we will pay only our share of the amount of loss, If any, that exceeds the sum (1) Primary Insurance of: This insurance is primary except when (2) (1) The total amount that all such other below applies. If this insurance is primary,our insurance would pay for the loss in the obligations are not affected unless any of the absence of this insurance;and other insurance is also primary. Then,we will share with all that other insurance by the (it) The total of all deductible and self-insured method described in(3)below. amounts under aft that other insurance. (2) Excess Insurance We will share the remaining loss, if any, with any other insurance that Is not described in This insurance Is excess over: this Excess Insurance provision and was not bought specifically to apply In excess of the (a) Any of the other insurance, whether Limits of Insurance shown in the primary, excess, contingent or on any Declarations of this policy. other basis: (3) Method of Sharing I. That is Fire, Extended Coverage, Builder's Risk, Installation Risk or If all of the other insurance permits similar coverage for"your work"; contribution by equal shares, we will follow this method also. Under this approach each Ii. That is Fire Insurance for premises insurer contributes equal amounts until it has rented to you or temporarily occupied paid its applicable limit of insurance or none of by you with permission of the owner, the loss remains,whichever comes first. Ili.That is insurance purchased by you to If any of the other insurance does not permit cover your liability as a tenant for contribution by equal shares, we will "property damage"to premises rented contribute by limits. Under this method, each to you or temporarily occupied by you insurer's share is based on the ratio of Its with permission of the owner; applicable limit of insurance to the total applicable limits of insurance of ail insurers. iv. If the loss arises out of the maintenance or use of aircraft,"autos" 2• Conditions that apply only to Coverages A, B, D or watercraft to the extent not subject and E to Exclusion 7. of Section I — Common Exclusions-Coverages A a, Duties in the Event of Occurrence, and D;or Construction Occurrence, Offense, Claim or Suit- (b) That is any other primary Insurance available to you covering liability for (1) You must see to it that we are notified as soon damages arising out of the premises or as practicable of an "occurrence", operations, or the products and "construction occurrence"or an offense which completed operations,.for which you have may result In a claim. To the extent possible, been added as an additional insured by notice should include: attachment of an endorsement. (a) How, when and where the "occurrence, When this insurance is excess, we will have "construction occurrence' or offense took no duty under Coverages A, B, C or D to place; defend the Insured against any "suit" if any other insurer has a duty to defend the Insured (b) The names and addresses of any injured against that"sulf. If no other insurer defends, persons and witnesses;and we will undertake to do so, but we will be 18 STF-GI,-624-A CW(10106) Includes copyrighted material of Insurance Services Office,Inc.with its permission. A RD CERTIFICATE OF LIABILITY INSURANCE 06/24/2010 PRODUCER (559)436-0833 FAX (559)256-6590 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 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 DATE(MMIDDIYY) GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ CLAIMS MADE El OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG S PR POLICY -ELl JECT LOC AUTOMOBILE LIABILITY 01-CI-321748-1 04/01/2010 04/01/2011 COMBINED SINGLE LIMIT X ANY AUTO (Ea accident) $ 1,000,000 ALL OWNED AUTOS BODILY INJURY $ A SCHEDULED AUTOS RISK MA AGE MENT Dl ISION (Per person) HIRED AUTOS BODILY INJURY NON-OWNED AUTOS Aper ved: (Per accident) $ Appr ve Cha ges: !� PROPERTY DAMAGE (Per accident) GARAGE LIABILITY gne a e AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY, AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ 1,000,000 X OCCUR ❑CLAIMS MADE 01X515637320 04/01/2010 04/01/2011 AGGREGATE $ 19000,000 A $ DEDUCTIBLE $ RETENTION $ $ WC STATUOTH- WORKERS COMPENSATION AND T- IR EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 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 Would Apply in Event of Cancellation for NonPayment DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS Re: Tract 5956 The City of Fresno, its officers, officials, employees, agents and volunteers are included as additional insureds per CA7110 0307 attached with primary wording per CA0001 0306 attached s respects auto liability coverage. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL iL�(XXd(�4JEX MAIL City of Fresno c/o Construction Management Division 030 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Maryann Lewis XIXI'*XIXIUXXIX9XIXXIOI KN*XU XX)6XIXMXN)6 EXIXNK%XXX 1721 Van Ness Avenue md6DExm)i xxxmxxl IA xK*XVMKKXK rXX*XXXXXXXXXX Fresno, CA 93721 AUTHORIZED REPRESENTATIVE Donna Smith/DONNAn.CJ� -•T 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(2001108) REPRINTED FROM THE FORMS LIBRARY«« COMMERCIAL AUTO CA 7110 03 07 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ R 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. Y. 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- rations, and must have been executed prior to the "bodily Injury" or 'property damage". following Is added: (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 "aoddertt" occurring while a covered "auto" covered "auto" you own that is out of service be- Is being driven by you or one of your am- cause of its breakdown, repair, servicing, 'loss" or ploy 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.I.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 lite extent of your negll- gence or fault according to the applicable d. Any business entity newly acquired or formed by principles of comparative negllgence 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 pr this person or organization rs Business Auto Coverage. Coverage is extended soon as praclly proble to all other Insurers up to a maximum of 180 days following acquisi- which r "suit". provide Insurance for such 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, Ino.,with its perrrtissdon. Copyright, Insurance Services Office, Inc., 1997 CA 71 10 03 07 Pago 1 D1 8 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, AA. COVERAGE EXTENSIONS, is or amended by adding the folowing: (b) The coverage and/or limits required by c. Personal Effects Coverage the "Insured contract". For any Owned "auto" that Is Involved In a (T1 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 resutt of the covered "toss", 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 6. FELLOW EMPLOYEE of SECTION II — added: LIABILITY COVERAGE — B. EXCLUSIONS Is amended by the addition of the following: The exclusion relating to mechanical breakdown does not appy to the accidental discharge of an airbag. However, this exclusion does not appy 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 WAIVER OF SUBROGATION 2. An a*stment for depreciation and physical con- We waive the right of recovery we may have for pay- dation 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 — A.1.0. 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 you paid for your damaged vehicle, not In- PHYSICAL DAMAGE — ADDITIONAL TRANS- cluding any insurance or warranties pur- PORTATION EXPENSE COVERAGE coed; The first sentence of paragraph AA. 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 ma)dmum 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 Pew associated with those payments as of the date of the Under SECTION III — PHYSICAL DAMAGE COV- "loss . ERAGE, H 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: stere use or abnormal wear and tear. a. H the applicable Business Auto deduct- (S) 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. H 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) deductlbls; or (5) Final payment due under a "Balloon Loan". c. H the loss Involves two or more Busi- (0) The dollar amount of any now Auto coverage fomes 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 "company"means: (7) Security deposits not refunded by a lessor. a. Safeco Insurance Company of America (9) Al refunds payable or paid to you b. American States Insurance Company as a result of the earty 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, the following Is h. Safeco Insurance Company of Illinois added: LOANIL-EASE GAP COVERAGE No deductible,applies to glass damage H the glass Is repaired rather than replaced. Under paragraph C — LIMIT OF INSURANCE of SECTION 111 — 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 N — BUSINESS AUTO CONDI110NS that you must notify us of an CA 71 10 03 07 Page 3 of 6 EP REPR NTED 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 SDS 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 addltlon 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 poky, 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 coiled 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 B.7.b.e(1) is replaced by the following: the 'ym" 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 dam: 30 days or less. 1. The number of days reasonably required to RESULTANT MENTAL ANGUISH COVERAGE repair ifepair replace the covered "auto". loss" Is caused by theft, this number of days Is added to the number of days it takes SECTION V —DEFINMONS —C. Is replaced by the to locate the covered `auto" and return it to following: YOU. 'Bodily Injury" means bodily Injury, sickness or dls- 2. 30 days• ease sustained by a person Including mental anguish C. Our payment Is limited to the lesser of the fob or death resulting from any of these. owing 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 spar 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" remits 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 appl- 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 sical Damage coverage is excess over any other col- above does not apply to a covered "auto"that is lectibie 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. Llmlt of Insurance EQUIPMENT COVERAGE With respect to this coverage, the LIMIT OF IN- A Cov"o SURANCE provision of PHYSICAL DAMAGE COVERAGE Is replaced by the following: 1. We will pay with respect to a covered "auto" for "kiss" b any electronic equipment that 1. The most we will pay for "loss" b audio,� receives or transmits audio, visual or data suel or data electronic equipment and any signals and that is not designed solely for the result of ries used with this equipment r a reproduction of sound.This coverage applies result 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 b. The cost of repairing or replacing the In the covered "auto" at the time of the aged or stolen property with other "loss", and such equipment is designed to be solely operated by use of the power from property of Ike kind and quality. time "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.shave. 8. If a repair or replacement results In better than like Idnd or quality, we will not pay for However, this does not Include tapes, the amount of the betkument. records or discs. 8. If Audio, Visual and Data Electronic Equip- D. Deductible ment Coverage form CA 99 60 or CA 99 94 1. If "Ices" to the audio, visual or data elect 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 CoIIF- B. Exclusions slon 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 resat- piece aged 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- erage deductible shown In the Declarations tion,the following exclusions apply: 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 elect 1. 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 "Ices"to the covered "auto's" operating system;or covered "auto" under the Business Aub 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 g, 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 Bred "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- Ibis will apply. In no event will more than one cept for tools,Jewelry,money, or securities. deductible apply. R. "low vehicle" means any "auto" of which you are the original owner and the "auto" has not been previously titled and Is less than 985 days past the purchase date. Page 6 of 6 '""REPRINTED FROM THE FORMS LIBRARY 5. Transfer Of Rights Of Recovery Against (1) Excess while it is connected to a Otlws To Us motor vehicle you do not own. If any person or organization to or for whom (2) Primary while it Is connected to a we make payment under this Coverage Form covered "auto"you own. has rights to recover damages from another, b. For Fired Auto Physical Damage-Cov- those rights are transferred to us. That per- erage, any covered "auto" you lease, son or organization must do everything neo- hire, rent or borrow Is deemed to be a essary to secure our rights and must do covered "auto" you own. However, any nothing after "accident" or "lass" to Impair "auto" that Is leased, hired, rented or gym. borrowed with a driver Is not a covered B. General Conditions "auto". 1. Bankruptcy c. Regardless of the provisions of Para- graph a. above, this Coverage Form's Bankruptcy or Insolvency of the `Insured"or Liability Coverage is primary for any li- the ynsured's" estate will not relieve us of ability assumed under an "Insured any obligations under this Coverage Form. contract". 2. Concealment, Mhu"resentation Or d. When this Coverage Form and any Fraud other Coverage Form or policy covers This Coverage Form is void In any case of on the same basis, either excess or pd- fraud by you at any time as it relates to this maty, we will pay only our share. our Coverage Form. it Is also void K you or any share Is the proportion that the Limit of other "insured", at any time, intentionally Insurance of our Coverage Four bears conceal or misrepresent a material fact con- to the total of the limits of all the Cover- canning: age Fortes and policies covering on the same basis. s. This Coverage Fonn; 8. Premium Audit b. The-covered "auto"; a. The estimated premium for this Cover- c. Your Interest In the covered "auto"; or age Form Is based on the exposures d. A claim under this Coverage Form. you told us you would have when this policy began.We will compute the final 8. Liberalization premium due when we determine your If we revise this Coverage Form to provide actual exposures. The estimated total more coverage without additional premium premium will be credited against the fl- charge,your policy will automatically provide nal premium due and the first Named the additional coverage as of the day the re- Insured will be billed for the balance, If vision Is effective In your state. any.The due date for the final premium or retrospective premium Is the date 4. No Benefit To Balks — Physical Damage shown as the due date on the bill. If the Coverages estimated total premium exceeds the fl- We will not recognize any assigrment or nal premium due, the first Named In- gram any coverage for the beneftt of any sured will get a refund. person or organization holding, storing or b. If this policy Is Issued for more than one transporting property for a fee regardless of year, the premium for this Coverage any other provision of this Coverage Form. Form will be computed annually based 5. O#w Insurance on our rates or premiums in effect at the beginning of each year of the policy. a. For any covered "auto" you own, this Coverage Form provides primary Insur- T. Policy Period,Coverage Territory encs. For any covered "auto"you don't Under this Coverage Form, we cover own, the Insurance provided by this "accidents" and `losses" occurring: Coverage Form Is excess over any a. Duri the period shown In the other collectible Insurance. However, n9 nd Declarstions; and while a covered "auto" which Is a "traler"Is connected to another vehicle, b. Within the coverage territory. the Liability Coverage this Coverage Form provides fare* "haler" is: The coverage territory a: a. The United States of America; CA 00 01 03 06 Pae 9 of 12 EP CERTHOLDER COPY NE STATECOMPENSATION P.O. BOX 420807, SAN FRANCISCO,CA 94.142-0807 INSURANCE FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 06-25-2010 GROUP: POLICY NUMBER: 1901663-2009 CERTIFICATE ID: 45 CERTIFICATE EXPIRES: 12-01-2010 12-01-2009/12-01-2010 THIS CERTIFICATE SUPERSEDES AND CORRECTS CERTIFICATE # 44 DATED 06-25-2010 CITY OF FRESNO, CONSTRUCTION MANAGEMENT NE JOB:TRACT 5956 DIVISION, ATTN: MARYANN LEWIS 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, (r and conditions, of such policy. V� thorized Representative Interim 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 2010-06-25 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. THIRD PARTY NAME: CITY OF FRESNO, CONSTRUCTION MANAGEMENT I:I6K MNqAGEMENT DIV JiON APpr ved. ha /C Appv nges: �.��� 0 [gne Date EMPLOYER GRANVILLE HOMES, INC NE 1396 W HERNDON AVE STE 101 FRESNO CA 93711 [810,NE] PRINTED : 06-25-2010 (REV.1-2010)