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HomeMy WebLinkAboutT-5592 - Certificate of Insurance - 2/8/2019 AC�RL?� of/08/2019 n CERTIFICATE OF LIABILITY INSURANCE 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. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDIITIONAL. INSURED provisions or 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 certificate holder in lieu of such endorsement s). PRODUCER 1-303-534-4567 NAME T IMA, Inc. - Colorado Division PHONE (FRIC No EMAIL 1705 17th Street ADDRESS: DenAeCountTechsivimacoEe.com Suite 100 INSD 8 AFFORDING COVERAGE NAIL# Denver, CO 80202 INSURERA: Lloyd'e of London(AmWins)NAIC#901344 INSURED INSURERB: LLOYDS OF LONDON(AmWins)NAIC#901344 BMCH California, LLC INSURER C- 8390 E. Crescent Parkway, Suite 650 INSURER D: INSURER E! ... Greenwood Village, CO 80111 INSURERF: COVERAGES CERTIFICATE NUMBER: 55336389 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. INSR TYPE OF INSURANCE DDL.RUBR POLICYNUMBER M POLICY LV= M dDOIYYYY LIMITS LTRAisn vivo A X COMMERCIAL GENERAL LIABILITY B0595XN5631018 07/01/18 07/01/20 EACHOCCURRENCE $ 10,000,000 CLAIMS-MADE Fx7 DAMAGE OCCUR PR 1 S Ea❑ r $ EXCLUDED X BI/PD Ded:$500,000v�S�O + MEDEXP An one person) $ EXCLUDED 1SK MANAGE MEN {0 ; oe PERSONAL&ADV INJURY $ 10,000,000 Approved Gk�1 C}n 10,000,000 M L AGGREGATE LIMIT APPLIES PER: �� � GENERAL AGGREGATE $POLICY❑jE ❑ LOC Approved.-w ha IgeS ❑ _k-�k- PRODUCTS-COMP/OPAGG $ 10,000,000 OTHER: AUTOMOBILE LIABILITY �' I ` COMBIJEA HGLELIMIT $ ANY AUTO BODILY INJURY(Per person) $ esd DateOWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY E $ AUTOS ONLY AUTOS ONLY Per eCcldan B UMBRELLA LIAB X OCCUR B0595XN5632018 07/01/18 07/01/20 EACH OCCURRENCE $ 10,000,000 X EXCESS LIAB AGGREGATE $ 10,000,000 _ CLAIMS-MADE DED I I RETENTION $ WORKERS COMPENSATION TTAT TE EORH AND EMPLOYERS'LIABILITY YIN ANYPROPRIETOR/PARTNER/EXECUTIVE --I N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached If more space Is required) RE: Subdivision Agreement Final Map of Tract No. 5592, Phase 1 of Vesting Tentative Tract Map No. 5592 - Locan Pointe, SWC East Shields Avenue and North Locan Avenue, City of Fresno. City of Fresno, its officers, officials, employees, agents and volunteers are included as Additional Insureds on the General Liability Policy if required by written contract or agreement and with respect to work performed by Insured subject to the policy terms and conditions (CG 20 12 04 13) . A Waiver of Subrogation is provided in favor of Additional Insureds on the General Liability Policy if required by written contract or agreement and with respect to work performs subject to the policy terms and conditions (CG 24 04 10 93). This Insurance is Primary and Non-Contributory on the CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fresno THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 2600 Fresno Street-Room 4064 AUTHORIZED REPRESENTATIVE //�/�/j� Fresno, CA 93721-3620 / /.,# USA L ! ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD michael.sheinberg 55336389 SUPPLEMENT TO CERTIFICATE OF INSURANCE 02/DATE 08/2019 NAME OF INSURED: BMCH California, LLC General Liability Policy subject to the policy terms and conditions (CGU 12W). SUPP(10100) ATTACHING TO AND FORMING PART OF POLICY NUMBER BOSSSXN5631018 ISSUED TO:Century Communities Endorsement No.37 07/01/2018-07/01/2021 ADDITIONAL INSURED-STATE OR GOVERNMENTAL.AGENCY OR SUBDIVISION OR POLIUCAL SUBDIVISION-PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE State Or Governmental Agency Or Subdivision Or Political Subdivision: AS REQUIRED BY WRITTEN CONTRACT Inforniation r uir hedult%if n h wn above,will qg hewn in the❑eclaralions A. Section 11-Who Is An Insured is amended to include as an additional insured any state or governmental agency or subdivision or political subdivision shown in the Schedule, subject to the following provisions: 1. This insurance applies only with respect to operations performed b you or on your behalf for which the state or governmental agency or subdivision or politica�subdivision has issued a permit or authorization. however: a. The insurance afforded to such additional insured only applies to the extent permitted by law; and b. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. 2. This insurance does not apply to: a. 'Bodily injury","property damage"or"personal and advertising injury"arising out of operations performed for the federal government,state or municipality;or b. 'Bodily injury"or"property damage"included within the"products-completed operations hazard". B. With respect to the insurance afforded to these additional insureds, the following is added to Section III-Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of Insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less, This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 12 04 13 0 Insurance Services Office, Inc., 2012 Page 1 of 11 ATTACHING TO AND FORMING PART OF POLICY NUMBER B0595XN5631018 ISSUED TO:Century Communities Endorsement No.4 07/01/2018-07/01/2021 PRIMARY INSURANCE ENDORSEMENT Where you are named as an additional Insured on the policy(ies)of others,this insurance shall only apply in excess of and shall not be contributory with other said policy(ies). Notwithstanding the above or any other clauses contained within this insurance where required by written contract this insurance shall be primary to any other valid and collectable insurance. cGU 12w Includes copyrighted material of Insurance Services Office, Page 1 of 1 Inc., with its permission POLICY NUMBER B0595XN5631018 COMMERCIAL GENERAL LIABILITY 07/01/2018-07/0 l!2021 CG 24 04 10 93 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: As Required by Written Contract (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition (Section IV — COMMER- CIAL GENERAL LIABILITY CONDITIONS) is amended by the addition of the following: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your Ongoing operations or"your work" done under a contract with that person or organization and included in the "products-completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 0410 93 Copyright, Insurance Services Office, Inc., 1992 Page 1 of 1 0 ® DATE(MMIDDNYYY) A�a�D CERTIFICATE OF LIABILITY INSURANCE 02/68/2019 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. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or 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 certificate holder in lieu of such endorsements. PRODUCER 1-303-534-4567 CONTACT NAME:- IMA, Inc. - Colorado Division PHONE F1Ut C.No.M1 WC,No. _ 1705 17th Street AA RESS: DenACCo=tTBChl*i=&COZ'P.CCm Suite 100 INSURE S AFFORDING COVERAGE NAIC# Denver, CO 80202 INSURER A: EVEREST NATL INS CO (AmWins) 10120 INSURED INSURERS: EVEREST NATL INS CO(AmWins) 10120 BMCH California, LLC INSURERC: 8390 E. Crescent Parkway, Suite 650 INSURER D: INSURER E: Greenwood Village, CO 80111 INSURERF: COVERAGES CERTIFICATE NUMBER: 55336268 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. 1NSR TYPE OF INSURANCE ADDL UBR POLICY NUMBER MMIO YYY MMIOO EXP LIMITS LTAINS wwo COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ MMAGE TO RENT rF-- CLAIMS-MADE OCCUR Ea occurr $ MED EXP(Any one pernni $ PER90NAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO- ❑ LOC PRODUCTS-COMP/OP AGG $ .. JECT $ OTHER' AUTOMOBILE LIABILITY Ea accident)SINGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS PROPERTY DAMAGE HIRED NON-OWNED Per acd ent $ AUTOS ONLY AUTOS ONLY $ 4EXCESS MBRELLALIAB OCCUREACHOCCURRENCE 5 LIAB CLAIMS-MADE AGGREGATEEO RETENTION S WORKERS COMPENSATION OYH AAND EMPLOYERS'LIABILITYCF2WC00003181-CO 07/O1/18 07/O1/19 ST 7 TE ER YIN 1,000,000 B AI•lYS�ttOPRIETflRIPARTNERIEJfECLITIVE � N/A CF2WC00004181-CA 07/O1/18 107/0 1/19 E.L EACH ACCIDENT $ OFF,CF.RfM[MBEREXCLUDED? 1,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If y SosCRV PT,describeION unde OFr OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 OE DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) RE: Subdivision Agreement Final Map of Tract No. 5592, Phase 1 of Vesting Tentative Tract Map No. 5592 - Locan Pointe, SWC East Shields Avenue and North Locan Avenue, City of Fresno. A Waiver of Subrogation is provided in favor of City of Fresno, its officers, officials, employees, agents and volunteers on the Workers Compensation Liability Policy if required by written contract or agreement and with respect e work performed by Insured subject to the policy terms and conditions (WC 04 03 06). CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fresno THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 2600 Fresno Street-Room 4064 AUTHORIZED REPRESENTATIVE Fresno, CA 93721-3620 USA !!! ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD michael.sheinberg 55336268 CF2WC00004181 7/1/18-7/1/19 WORIMRS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT- CALIFORNIA 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 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 % of the California workers' compensation premium otherwise due on such remuneration. SCHEDULE PERSON OR ORGANIZATION JOB DESCRIPTION ANY PERSON OR ORGANIZATION FOR WHOM YOU ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT TO OBTAIN THIS WAIVER OF RIGHTS FROM US. -1998 by to Workard Compensation Insumnee Rating EkAmu of Calif Wa. All dgwa reserved. From the WCIRWs Callfomia Wbria W Compensaitlon Insurance Forms Manual-1M. INSURED COPY