Loading...
HomeMy WebLinkAboutT-5987 - Certificate of Insurance - 5/24/2011 ACORD CERTIFICATE OF LIABILITY INSURANCE 5�iij2011 PRODUCER (303)388-5688 FAX: (303)388-5585 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Beecher Carlson Insurance Services, LLC ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 8390 E. Crescent Parkway, Suite 200 Greenwood Village CO 80111 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA:Lexington Insurance Co. Wathen-Castanos Hybrid Homes, Inc. INSURER B: Wathen-Castanos, Inc. INSURER c: 7259 N. First, #101 INSURER D: Fresno CA 93720 INSURER E: OVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING AN 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. REG\TE LIMITS SHOWN MAY HAVE BE U ID CLAIMS, INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION TYPE OF INSURANCE POLICY NUMBER DATE MM/DD DATE MMIDD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 10,000,000 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ A X CLAIMS MADE FX7 OCCUR 2214131 1/1/2010 1/1/2012 MED EXP(Any oneperson) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ 10,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 10,000,000 X POLICY J COT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident)AUTOS ALL Pp )URY SCHEDULED AUTOS RIS,. ! ly�E ENT DIVISION ererson HIRED AUTOS Ap $ l., BODILY INJURY NON-OWNED AUTOS Ap `t)'' `I,Ir`fa� �S� L-/ rf (Peraccldenl) $ J J 1 I PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY v AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN M 8CC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY BENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION WORKERS COMPENSATION AND WC SLAT1�- OTH- TORY S ER EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE 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 DESCRIPTION OF OPERATIONSJLOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Named Insured Includes: Old Fig, LP, The City of Fresno, its officers, officials, employees, agents and volunteers are listed as additional insureds. 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. Regarding Tract 5987: lot 4 - 5657 North Hamlet Lane, Lot 5 - 5649 North Hamlet Lane, Lot 19 - 2133 West Juliet Way, Lot 20 - 2125 West Juliet Way, Lot 21 - 5657 North Romeo Lane, Lot 22 - 5649 North Romeo Lane CERTIFICATE HOLDER CANCELLATION (559)498-4357 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE City of Fresno EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL % Department of Public Works 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT Attn: Maryann Lewis FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE 2600 Fresno Street Third Floor, Room 4019 INSURER,ITS AGENTS OR REPRESENTATIVES. Fresno, CA 93721 AUTHORIZED REPRESENTATIVE Sally Hayes/BRENDH ACORD 25(2001/08) ©ACORD CORPORATION 1988 11JCn7 r.rn�no�no,. D.—1 of� Kerry Trost From: Healy, Brendan [bhealy@beechercarlson.com] Sent: Thursday, May 19, 2011 11:00 AM To: Kerry Trost Cc: Patty Grigsby; markw@wathen-castanos.com Subject: RE: Wathe-Castanos Hybrid Homes, Inc. Kerry, The requested additional insured and primary insurance endorsements for Wathen-Castanos Hybrid Homes, Inc. will name the City of Fresno, its officers, officials, employees, agents and volunteers and will also extend coverage for ongoing operations and completed operations. Kerry,once the endorsements are received I will forward them directly to your attention. Please let me know if you need anything else. Regards, -Brendan Brendan Healy,CRIS,ARM Risk Analyst 8390 E.Crescent Parkway,Suite 200 Greenwood Village,CO 80111 T:303.996.5448 1 F:303.388.5585 bhealy@beechercarison.com www.beechercarlson.com BEECH E- ' �"__ARLSON Risk management without passion,innovation and accountability is just buying insurance From: Patty Grigsby [mailto:Pattyg@wathen-castanos.com] Sent:Thursday, May 19, 201110:41 AM To: Mark Wathen Cc: Kerry Trost; Jon Bartel Subject: RE: Wathe-Castanos Hybrid Homes, Inc. Mark, Our agent has replied below and/also spoke with him. Brendan has called and left a message for Kerry Trost and will discuss it and let us know what the next step is. Thank you Patty& Wathen-Castanos Hybrid Homes, Inc. Accounting Department Assistant 802 W Pinedale Ave Ste#104 Fresno, Ca 93711 E-mail: pattyg@wathen-castanos.com Office: 559-432-8181 ext 125 1 From: Healy, Brendan [mailto:bhealy@beechercarlson.com] Sent:Thursday, May 19, 201110:14 AM To: Patty Grigsby Subject: RE: Wathe-Castanos Hybrid Homes, Inc. Patty, I have requested the endorsement from Lexington in London. It could take up to 30 days to receive. I have left a voice message for Kerry Trost to inform. We had to do this for Housing Capital and it took a while to get. I will call or send you an update once I have spoken to the City of Fresno. Regards, -Brendan Healy (303) 996-5448—Direct From: Patty Grigsby [mailto:Pattyg@wathen-castanos.com] Sent:Thursday, May 19, 201110:19 AM To: Healy, Brendan Subject: FW: Wathe-Castanos Hybrid Homes, Inc. Importance: High Brendan, Please see below e-mail--looks like we didn't complete#2 to their satisfaction. . . Please advise and or revise and send the actual endorsements. They needed it yesterday . . . sorry PattyG. Wathen-Castanos Hybrid Homes, Inc. Accounting Department Assistant 802 W Pinedale Ave Ste#104 Fresno, Ca 93711 E-mail: pattyg@wathen-castanos.com Office: 559-432-8181 ext 125 From: Kerry Trost Sent:Thursday, May 19, 20117:27 AM To:Jon Bartel Subject: RE: Wathe-Castanos Hybrid Homes, Inc. Item 2) below is still outstanding.This item shall apply to both ongoing operations and completed operations.Thank you. From: Kerry Trost Sent: Wednesday, May 18, 20119:48 AM To:Jon Bartel Subject:Wathe-Castanos Hybrid Homes, Inc. Insurance is not approved. Risk Management will require the following to approve: 2 1) Certificate holder should appear as follows: City of Fresno Department of Public Works,Attn: Maryann Lewis 2600 Fresno Street, Room 4019 Fresno, CA 93721 2) Additional insured endorsement, with primary and non-contributory language or primary insurance endorsement, for General Liability insurance. The additional insured should read, "The City of Fresno, its officers, officials, employees, agents and volunteers". Examples of primary insurance 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 carried by such additional insured whether primary, excess, contingent, or on any other basis" . 3) Waiver of subrogation endorsement for Workers' Compensation insurance. Thank you. Kerry Trost Senior Risk Analyst City of Fresno 2600 Fresno Street, Room 1070 Fresno, CA 93721-3612 (559)621-6902 (559)264-4215 (FAX) kerry.trost@fresno.gov CONFIDENTIALITY NOTICE: This e-mail message, including any attachment(s), is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized use, disclosure or distribution of this e-mail and its attachment(s) is prohibited. If you are not the intended recipient, please notify sender by reply e- mail, delete this message and any attachment(s), and destroy all copies. Thank you for your cooperation. This email has been scanned by our e-mail security system. NOTICE:This e-mail message and all attachments transmitted with it may contain confidential information intended solely for the use of the addressee. If the reader of this message is not the intended recipient, you are hereby notified that any reading, dissemination, distribution,copying,or other use of this message or its attachments is strictly prohibited. If you have received this message in error, please notify the sender and delete this message and all copies and backups thereof. Thank you. 3 This email has been scanned by our e-mail security system. NOTICE:This e-mail message and all attachments transmitted with it may contain confidential information intended solely for the use of the addressee. If the reader of this message is not the intended recipient, you are hereby notified that any reading, dissemination,distribution, copying, or other use of this message or its attachments is strictly prohibited. If you have received this message in error, please notify the sender and delete this message and all copies and backups thereof. Thank you. This email has been scanned by our e-mail security system. NOTICE: This e-mail message and all attachments transmitted with it may contain confidential information intended solely for the use of the addressee. If the reader of this message is not the intended recipient, you are hereby notified that any reading, dissemination, distribution, copying, or other use of this message or its attachments is strictly prohibited. If you have received this message in error,please notify the sender and delete this message and all copies and backups thereof. Thank you. This email has been scanned by our e-mail security system. NOTICE: This e-mail message and all attachments transmitted with it may contain confidential information intended solely for the use of the addressee. If the reader of this message is not the intended recipient, you are hereby notified that any reading, dissemination, distribution, copying, or other use of this message or its attachments is strictly prohibited. If you have received this message in error, please notify the sender and delete this message and all copies and backups thereof. Thank you. 4 I WATHINC-02 SASU ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) rx 5118/2011 PRODUCER (559)432-0222 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION DiBuduo&DeFendis Insurance Brokers,LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE License#DED2098 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O.Box 5479 Fresno,CA 93765.5479 INSURERS AFFORDING COVERAGE MAIC# INSURED Wathen Castanos Hybrid Homes,Inc. INSURERA:Nationwide Mutual Insurance Company 802 W Pinedale Ave,Ste,104 INSURER B:Topa Insurance Company Fresno, CA 93711- INSURERC: _ I INSURER D: ` INSURER E: SII 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. POLICY NUMBER POLICY EFFEC POLI YDATEMMIDDUY) AT,EXP(MnON LIMITS _TYPE OF INSURANCE I GENERAL LIABILITY EACH OCCURRENCE S tLNIED COMMERCIAL GENERAL LIABILITY PREMISES Ea occurence $ CLAIMS MADE ❑OCCUR MED EXP(Any oneperson) S PERSONAL&ADV INJURYr7 S '. GENERAL AGGREGATE $ GEN'LAGGREGATFLIMIT APPLIES PER; PRODUCTS-COMPf0PAGG $ POLICY PR El LOC AUTOMOBILE-LIABILITY coMaTNEDSINOLELIMIT $ 11000,000 A X X ANY AUTO ACP7871148649 8/15/2010 8115/2011 (EaacWon0 ALL OWNED AUTOS BODILYINJURY SCHEDULED AUTOS i�I 1\ [VI W r + (Per parson) $ I HIRED AUTOS A.o p rc V e d. BODILY INJURY NON-OWNED AUTOS Appy v hangers: (Perseddent) $ . PROPERTY DAMAGE $ C)IC (Per accident) GARAGE LIABILITY J' AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ i AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ 5,000,00 B X OCCUR CLAIMS MADE XL6601579 8115/2010 8/1512011 AGGREGATE $ 5,000,00 $ I DEDUCTIBLE $ RETENTION $ TATU $ TH- WORKERS COMPENSATION AND WCSIIMIT ER I;MPIAYERS'LIABILITY ANY PROPRIETORlPARTNER/EXECUTNE.L.EACH ACCIDENT $E i OFFICERIMEMBER EXCLUDED? EL,DISEASE-EA EMPLOYEE t Ryes describe under SPECIAL PROVISIONS NIOW E.L.DISEASE-POLICY LIMIT $ OTHER i DESCRIPTIDN OF OPERATIONS I LOCATIONS I VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Cancellation for non-payment of premium shall be 10 days. RG: Models at Old Fig,LP r The City of Fresno,Its officers,officials,agents,employees and volunteers are named additional insured perthe attached AC01020309. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION i City of Fresno DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN I clo Department of Public Works,Attn:Maryann Lewis I 2600 Fresno Street,Room 4019 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Fresno,CA 53721- IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORED REPRESENTATIVE ACORD 25(2001108) 0 ACORD CORPORATION 1988 i WATHINC-02 SASU 1 1 I 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 certiflcate holder In Ileu 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]leu of such endorsement(s). I i 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. I •f I i I I i I I II I I I ACORD 25(2001108) I BUSINESS AUTO AC 0102 03 08 _,. _.. ...THIS.ENDORSEMENT CHANGES THE POLICY,PLEASE READ 1T CAREFULLY...___..... i • s BUSINESS AUTO ENDORSEMENT FORM I This endorsement Wdlftes Insurance provided under the following: i BUSINE88 AUTO COVERAGE FORM i I A. CHANGES FOR TRAILERS AND FARM or oroanizallon qualifies as an"Insured"urr EQUIPMENT der the Who Is An Insured Provision con- 1. Under SECTION I-COVERED AUTOS,the talned In Section I[— LIABILITY following are added to Pemgraph C.Certain COVERAGE of the Coverage Form Trailers, Mobile f=qu'pment and Temporary D. REPLACED EXCLUSIONS I Substitute Autos; The Expected or Intended Injury Exclusion } 4. "TrelleW'daslgnod to be towed by a pri- IN SECTION 11 —LIABILITY COVERAGE is vate passenger type"auto"or a plokup, replaced by the following: � ! panel truck or van.R.not.used-fol bueL---. - Expected-or.lntended.Injury_ nese purposes, other then farming or "Bodily injury'or"properly damage"which Is rsncNng. expected or intended by the"Insured".This 5. Farm wagons or farm Implements while exclusion applies even 4 the resulting"bod being towed by a covered"auto". ly Injury"or"property darnage": S. CHANGES FOR ADDITIONAL NEWLY a, is of a different kind,quality or degree ACQUIRED VEHICLES than initially expected or Intended;or 2, Peragraph 8.2 of SECTION 1 —COVERED b. Is sustained by a different person,entity, AUTOS Is replaced.by the following: Taal property, or personal property than 2. If Symbol 7 Is entered next;to a cover- that Initially expected or intended. , age in Item Two of the Declarations, an E. ADDITIONAL EXCLUSIONS "auto' you acquire will be a covered The following exclusions are added to auto"for coverage only If, SECTION It—LIASILITY COVERAGE. a, We already cover at least one"auto" Damage to Named Insured's Property you own for that coverage or it rye- "suit" places an 'auto" you pmvlousiy Any claim or cult for"property damage by owned that.had that coverage;and you or on your behalf against any other peri b. You tell us within 80 d after you eon or entity that Is also a Named Insured Y under this policy, acquire It teat you want us to cover Abuse or Molestation K for that coverage. j The most war will pay for physics] Damage 2�pb+ Injury" or"property damage" prising i Coverage.far'loss'under this Coverage Ex- torsion Is $100,000 per"auto', subject to a. The actual or threatened abuse or mo- lhe largest deductfblo applicable to any lestetion by anyone or any person while 'auto'for that Coverage. in the care,custody or control of any'in- C. BLANKETADDITIONALINSURED cured",or Any person or o b. The neglbent: rganlzation which you have , agreed to name as an additional Insured Ina 1) Employment; written contract, executed prior to an =I- 2) Invesltpatlon; dent, other thm o contract for the [ease or 3) Supervision; i Wtei of a vehicle Is an"Insured"for Liability Coverage, but only to the extent that person 4) Reporting to the proper authorities, ortallure to so report;or AC 0102 03 ag Includes copyrighted material of Insurance Services Offlce,.lnc:, Page 1 of 4 with Its permission. ! i i i r i I r AC 0102 03 09 b} Retantion; b. "Lola" to TV antennas, awnings or ca- f -• • of a person for-whom any"Insured"Is or banns, _. ever was legally responsible end whose c, "Loss"to equipment designed to create cvriduct would be excluded by Para- added living facilities, ! graph a.above. However, these exclusions do not apply N Abuse means an act which Is committed Miscellaneous Personal Property Coverage with the Intent to Cause harm, Is provided by endorsement to this policy. Exploelvee G. ACCIDENTAL AiRBAG DISCHARGE i 'Bodily Injury'or"property damage"caused COVERAGE y by the explosion of explosives you make, Under Paragraph B.3.a. of SECTION 111 sell or transport_ PHYSICAL i]AMA©E,the followlrig Is added: RofYng Stores Mechanical breakdown does not include the ac- If a covered"auto"Is a rolling store, "bocilly cldemal discharge of an alrbap. Injury" or 'property damage" resulting from H. PHYSICAL DAMAGE OMIT OP INSURANCE the handling, use or condition of any Item paragraph C. Limit of Insurance of SECTION IIi i the "Insured" makes, sella or distribute* if -PHYS)M DAMAGI1 INSURANCE is replaced the Injury or damage occurs sifter the "in- by the following; � sured"has given up possesslon of the Item. C. Umit Of Insurance - Wrong Delivery of Liquid-Products - - - _ _ .__ "Bodily INury"or*property damage result- 1. The mbst we will Ptylor"Mss" Its ' 9 any one Nacciderif is the lesser of Ing from the delivery of any liquid Into the ! wrong receptacle or to the wrong addre®a, a. The actual cash value of the or from the delivery of one liquid for another, dwsoad or stolen property as { If the Wily injury" or "property damage" of the time of the."loss';or �. j occurs alter the delivery has been com- b. The cost of repalring or rapiao- i plated, Ing the damaged or stolen prop- f Delivery Is considered completed even if tLr- arty, d then service or maintenance work,or correc- 2. An adjustment for dapreclaton and tion, repair or replaoemeM Is required be- physical condition will be made in i rause of wrong delivery, determining actual cash value In the `j I'nofe8siortal Service, event of total"loss. i "Bodily injury"; 3. The cost of repairing or replacing s may; a- resulting from the providing or the fall- a. Be based on an estimate which i urn to provide a medical o ca or that co- , any P f®sslonal services includes pada furnished by the j origirnal equipment manufacturer b. Resul*g from foal or drink furnished or other sources including non- with these services. original equipment manufactur• l 1 { "Bodlly Injury"or "property damage" result• ors and ' h Ing iron the handling of corpses. b. Include a deduction for better- F. MOTOR HUMS CONTENT$COVERAGE ment for a pan or parts that aro 1. For a covered "auto"that Is a motor home normally subject io repair or re- the following exclusions are added TO placement during the useful life I SECTION III PHYSICAL OAMAOE: of the "Faute, such as, but not Motor Home ConteMe omitted to tires and batteries. This Insurance does not apply to: Betterment means the dlfferenco between the actual cash value of a I a. "Loss"to the covered"auto's"contents, part initm(liateiy before the "loss" except equipment uaual to trucks or pri- and the coal to replace that pad with vale passenger"sofas". a new part. j ! d � I k Page 2 of 4 includes copyrighted material of Insurance Sen Us Office,ina., AC 0102 03 00 with its permisslon, ; a I I AC 0102 03 00 4. If we offer to pay the actual cash If hired or rented'autos'are covered'autos' on _._ value of .the damaged or stolen this pocky,the following provisions apply.. .. . _ property,we will value auto advertis- A,Changes In Liability Coverage i Ing wraps, paint customization, and The following is added to the Who Is An In- similar business related advertising cured provision In SECTION It--LIABILITY modifications, In addiUvn to the ace COVERAGE: Wal cash value of the property, Auto advertising wraps, paint cus- An"employes"of yours Is an"Insured"while tomlzatlon, and atmilar business re- operating an "auto" hired or rented under a lated advertising modiftcatlons will contract or agreement In that 'employee's" be valued at the cost to replace name,with your permisslon,while performing them with an adjustment made for dutles related to the conduct of your busi- depreciuWn and physical condition, nese, I. GLASS REPAIR—WAIVER OF DEDUCTIBLE B.Changes In General Conditions , Under Paragraph D. Deductible of SECTION Ili paragraph 61. of the Other Insurance ' i —PHYSICAL DAMAGE COVERAGE,the follow- Condition In the Business Auto Coverage i ing Is added: Form is replaced by the following; No deductible apps to glass damage if the For Hired Auto Physical Damage Coverage, glass is repaired rather than replaced. the following are deemed to be covered i J. AMM090 BS IN EVENT'OF ACGII)ENT, "autos"you own _ _ _ _ CLAiM,SLAT,OR LOSS 1. Any covered "auto" you lease, hire, rent The requirement In lose Condition 2,a.Dulles in or borrow;and Tlis Even Of Accident,Clahn,Suit Or Loss—of 2. Any covered "auto" hired or ranted by SECTION IV—BUSINESS AUTO CONDITIONS your"employee" under a contract In that that you muss notify us of an'accldenC,'clalm", individual "employee's" name, with your ; I "auiV,or"lose"applies only when tha'aWdent", permisalon, while performing duties ro- a "claim°,"suN",or'loss"Is known to: fated to the conduct of your business, ' 1. You,if you are an individual However, any "auto" that Is leased, hired, 2. A partner,it you are a partnership; rented or borrowed with a driver Is not a 3. An exaoutivs officer or the employee desig- covered"auto nated by you to give such notice if you are a M. EMERGENCY LOCKOUT — PRIVATE 1 corporation;or PASSENGER VEHiCUS 4. A member, If you are a limited liability can- We will relmburse you up to$80 for reasonable ° patsy. expanse incurred for the services of a locksmith ; K. UNINTENTIONAL. FAILURE TO DISCLOSE to gain entry Into your covered"auto of the pd- HAZARDS vate d-HAZARDSvate passenger type subject to these provisions: SECTON IV—BUSINESS AUTO CONDITIONS 9.Your door key or key entry pad has been lost, —8.2, Is amended by the addition of the follow- stolen or baked ih your covered"auto" end Ing: you are unable to enter such'auto",or if you unintentionally fait to dledose any hazards 2. Your key or key entry pad has been lost or existing at the Inception date of your polloy, we stolen and you have changed the lock to will not deny coverage under this Coverage prevent an unauthorized entry;and Form because of such #allure. However, this 3, Original copies of receipts for services of s t provlslon does not affect our right to collect addl- locksmith must be provided before relm- tionsl premium or w erolse out right of cancella- bursement Is payable. ; tion ornonreneual. ; L AUTOS HIRED OR RENTED BY i EMPLOYEES ; I AC 0102 03 09 Includes copyrighted material of Insurance Services Office,Inc., page 3 of 4 r with Its permission. I I I i l r AC 0102 03 09 N. LIBERAL17A'nON If we adopt any revision that would broaden the -•� ra oi'ttie'Otfiei Inauranca Condition aoverage•underthls pollay.wlthvut addltiorfW. . _ In the Business Auto coverage Form is replaced premium within 00 days prior to cr during the j by the following: policy period,the broadened coverage WE Iro. mediately apply to this policy. All terms and condhions of this policy apply unless modified by this endorsemonl: . t ,I a i f i 1 1 .f ,I i I � f i I i i I i i I � I I i 1 Pago 4 of includes copyrighted material of Insurance Services Oftice,Inc., AC 0102 03 09 i I with Its permission. i I I i i ' DATE(MM/DD/YYYY) QCORQ� CERTIFICATE OF LIABILITY INSURANCE o5/ig/zo11 PRODUCER (559)436-0633 FAX (559)1'58-6590 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Artbur J. Gallagher & Co. Ins. pokers of CA Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 45 East River Park Place {A�st 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 %then Castanos Hybrid Humes, Inc. INSURERA: IWerilmlInsurance Company 802 W Pinedale Ave. #104 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 EFFECTIVEPOLICY EXPIRATION LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ CLAIMS MADE F—]OCCUR MED EXP(Any one person) $ PERSONAL 8 ADV INJURY $ GENERALAGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY PJECTRO LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS 1 f, 1: d!1 �[ i I I ( L r` : 4 BODILY INJURY $ NON-OWNED AUTOS a �•/ (Per accident) ad: PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY I AUTO ONLY-EA ACCIDENT $ ANY AUTO Da OTHER THAN EAACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR ❑CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND 041F0l111-2001-105 10/01/2010 10/01/2011 X WC STATU- O R EMPLOYERS'LIABILITY A ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000, OFFICERIMEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 1,000, If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 1,0()0,00( OTHER 10 day notice of cancellation applies in the event of non-payment of prenium DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT!SPECIAL PROVISIONS Old Fig LP Tract $987 Viltiver of Subrogation applies to the workers conpenoation per attached W 040306 endorsenent. 'Replaces certificate issued 5/11/1111 CERTIFICATEL SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE City of Fresno EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL Department of Public Wrks 010 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Attn: Mbryain Lentis 2600 Fresno Street BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY Roomy 41119 OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. Fresno, CA 93721 AUTHORIZED REPRESENTATIVE IDanette llYbod/EANEPr 1lJL Jlhdu��/ ACORD 25(2001108) ©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. r ACORD 25(2001/08) i 15:42 MAY iB, 2011 FAX N0: 277-4943 4322369 PAGE: 2/2 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 0403 06 (Ed.4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA We have the right to recoverfrom our payments from anyone liablefor an injury covered by this policy.We will not enforce our right against the person or organization named In the Schedule.(This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged In the work described In the Schedule. The additional premium for this endorsement shall be 2%of the California workers compensation premium otherwise due on such remuneration. SCHEDULE Person or Organization Job Description Blanket Waiver All California Operations 2%of the total classirrcation Minimum Premium$500 This endorsement changes the pollcy to which It Is attached and Is effective on the date issued unless otherwise stated. (The information below Is required only when this endorsement is issued subsequent to preparation of the policy.: Endorsement Effective 5/18/2011 Policy No. 04DKRM1-2001-105 Endorsement No.3 Insured Wathen-Castanos,Inc Insurance Company:Delos Insurance Company-35408 Countersigned By: dM998bythe WorkQrVComparcatlonlnsurancoRatYigBumau&Callfomla Allrighteroaorvoct. From the WCIRB's California Workers'Compensation Insurance Forms Manual©2001. 5118011 cw City of E31 A 1111ITeQ15%kar D U M DEVELOPMENT AND RESOURCE MANAGEMENT DEPARTMENT-DEVELOPMENT SERVICES DIVISION-2600 FRESNO STREET-FRESNO,CA 93721 DATE: May 17, 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 EARLY ISSUANCE OF MODEL HOME BUILDING PERMITS FOR THE FINAL MAP OF TRACT NO. 5987 Attached are certificates of liability insurance required for the covenant for early issuance of model home building permits for the Final Map. Please review for conformity to City acceptance policies. If you have any questions, please contact me at 621-8076. Thank you, Jonathan Bartel