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HomeMy WebLinkAboutT-6165 - Certificate of Insurance - 3/1/2019 A`"R" CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 2/27/2019 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(tes) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME:. .., Kelley Gubernlck Gore Lieske&Associates Insurance Brokers, LP PHONE FAX 15901 Red Hill Ave Suite 100 lac NQ Ex h 714-505-7000 I.(ArC,Hol:714-573 1770 E-MAII. Tustin CA 92780 ADDRESs_ k u_,g bemick oreiieske-com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Underwriters at ggds 15792 INSURED LENNA-1 INSURER B:OLD REPUBLIC INS CO 24147 Lennar Corporation and all its Subsidiaries INSURERC:RLI INS CO 13056 15131 Alton Parkway, Suite 345 Irvine, CA 92618 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1186574478 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. INSIR ADDL SUBRT —-- PICY EFF POLICY EXP L TYPE OF INSURANCE POLICY NUMBER ! MMIOLOD7YYYY 11AM/DD/YYYY LIMITS B X COMMERCIAL GENERAL LIABILITY Y MWZY314149 ! 9/1/2018 9/1/2019 EACH OCCURRENCE $5,000,000 -6A' ACE 7t} CLAIMS-MADE ...X.. OCCUR PREMISES(EappAp %e $2,000,000 MED EXP JAg oneperson) $WA PERSONAL&ADV INJURY $5,ODQ000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $7.500,000 POLICY PRO LOC PRODUCTS-COMP>OPAGG $1QOOQODO X JECr OTHER: $ C AUTOMOBILE LIABILITY Y CAP9505843 9/1/201B 9/1/2019 COM 8WED SINGLE LIMIT $LQrrLQf)D X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ X H RTEDSAUTOS X A AUTOS O OS WNED DPPROPERTYDAMAGE $ A UMBRELLA LIAR F OCCUR B0595XR5178017 9/1/2017 9/1/2020 EACH OCCURRENCE $2.500.000 X EXCESS LIAR CLAIMS-MADE AGGREGATE $2.500.000 DED RETENTION$ $ B WORICERS COMPENSATION ! Y - MVVC31414800 9/1/2018 9/1/2019 X I P� H- AND EMPLOYERS'LIABILITY Y/N 7A7 IE ER ANY PROPRIETORIPARTNERIEXECUTIVE ❑ NIA E 1.EACH ACCIDENT $2,0D0,000 D?OFFICERIMEMBER EXCLUDE (Man$etory In NH) E.L.DISEASE-EA EMPLOYEE $2.000.000 It yes,deseflbe under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE: Tract 6165 The City of Fresno,its officers,agents,employees and volunteers are named as additional insured on the General Liability per attached endorsement CG 20 12 04 13 as required by written contract subject to the terms and conditions of the policy- The City of Fresno,its officers,agents,employees and volunteers are named as additional insured on the Auto per attached endorsement TRS 601 11 06 as required by written contract sub-ect to the terms and conditions of the policy. Primary and Nan-Contributory applies on the General Liability per attached endorsement CG 20 01 04 13 and uto Liability per attached endorsement MANC 662 03 13, Waiver of Subrogation applies to the Workers'Compensation per attached endorsement WC 00 03 13. Notice of Cancellation applies on General Liability per attached endorsement PIL 029 10 10,Auto Liability per attached endorsement MAN 671 02 16,and Workers Compensation per attached endorsement PC 009 05 10 subject to the terms and conditions of the policies. ISK AAANIAGENAFNiT \/ CERTIFICATE HOLDER IT, 414! CANCELLATION Approve hanges I]SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE PP hang THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fresno 2600 Fresno Street, R AUTHORIZED REPRESENTATIVE Fresno CA 93621-36 Signed Date ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: MWZY 314149 COMMERCIAL GENERAL LIABILITY CG 20 12 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL 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 or agreement Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to 2. This insurance does not apply to: include as an additional insured any state or a. "Bodily injury", "property damage" or governmental agency or subdivision or political "personal and advertising injury" arising out subdivision shown in the Schedule, subject to the of operations performed for the federal following provisions: government, state or municipality; or 1. This insurance applies only with respect to b. "Bodily injury" or "property damage" operations performed by you or on your behalf included within the "products-completed for which the state or governmental agency or operations hazard", subdivision or political subdivision has issued a permit or authorization. B. With respect to the insurance afforded to these additional insureds, the following is added to However: Section III— Limits Of Insurance: a. The insurance afforded to such additional If coverage provided to the additional insured is insured only applies to the extent permitted required by a contract or agreement, the most we by law; and will pay on behalf of the additional insured is the b. If coverage provided to the additional amount of insurance: insured is required by a contract or 1. Required by the contract or agreement; or agreement, the insurance afforded to such additional insured will not be broader than 2. Available under the applicable Limits of that which you are required by the contract Insurance shown in the Declarations; or agreement to provide for such additional whichever is less. insured. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 12 04 13 ©Insurance Services Office, Inc., 2012 Page 1 of 1 MWZY 314149 Lennar Corporation 0910112018-0910112019 POLICY NUMBER: MWZY 314149 COMMERCIAL GENERAL LIABILITY CG 20 01 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL_GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance (2) You have agreed in writing in a contract or Condition and supersedes any provision to the agreement that this insurance would be contrary: primary and would not seek contribution Primary And Noncontributory Insurance from any other insurance available to the This insurance is primary to and will not seek additional insured. contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and CG 20 01 0413 ©Insurance Services Office, Inc., 2012 Page 1 of 1 MWZY 314149 Lennar Corporation 0910112018-0910112019 Policy Number: CAP9505843 RLI Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 30 Day Notice of Cancellation and Nonrenewal Endorsement Effective: 09/01/18 Endorsement Issue Date: 09/01/18 Named Insured: Lennar Corporation 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 this endorsement. A. It is agreed that Certificate Holder shall be provided a 30 day written notice of cancellation or nonrenewal of this policy should we cancel or nonrenew the policy based on the provisions set forth by the coverage forms and endorsements attached to this policy. In the event of cancellation due to non-payment of premium, Certificate Holder shall be provided a 10 day written notice of cancellation. B. We will mail or physically deliver our written notice to the following address: Lennar Corporation 25 Enterprise Aliso Viejo,CA 92656 ALL OTHER TERMS,CONDITIONS AND EXCLUSIONS REMAIN UNCHANGED. MAN 671 (02/16) Page 1 of 1 Policy Number: CAP9505843 RLI Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: TRUCKERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM GENERAL LIABILITY COVERAGE FORM EXCESS INDEMNITY COVERAGE FORM MOTOR TRUCK CARGO COVERAGE FORM COMMERCIAL EXCESS LIABILITY POLICY MOTOR CARRIER COVERAGE FORM The provisions of the Coverage Form apply unless modified by this endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Endorsement Effective: 09/01/2018 Named Insured: Lennar Corporation Additional Insured shall include any organization where shown on a Certificate of Insurance or to whom the Named Insured is obligated by virtue of a written contract or agreement to provide insurance but only as respects the operations of the Named Insured. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. TRS 601 (11/06) Page 1 of 1 POIIC� \Llllll)Cl-: CAP9505843 RH 111sur'llice Uolllpall\ TMS EN DO RSENIENT Cl IA NG ES THE' POLICY. PLEASE READ ITUARE.PTIAN, PREMARY .AND NONCON'rRIBUTORY - OTHER INSURANCE CONDITION 1.1-Aidorsement EtTective: 09/01/2018 Iindt>rsenttltt Is"lle Oale:. Named histred: Lenmir CoI-po ,,,Lll[()Il Thi.-, Clld(ll-1,Cl1IClI1 111oLlilleS, ill',t1l_,l1ICC j)1_(1VidCd LHILICl- HIC F0141\61111: C(AINIERCTNI, AUTO LIABILITY COVERA61" PART The I'01)(A-01111' is added to the Otllff 1111,111-LUICC Condition and super"edes any prilvisioll to the colln-ary Primary And Noncontributory IllsLll`WI(:C This insurance is prlmLiry to and will not seek contrihmion from LHIV 00ICl' illstil-ill)CC ji\,(ijlI1jv to 111 'Idditi011ill iflNUNLI tinder}our 110110 III-OViLIC11 that: i I i The additional insured is it Named 111SLII-CLI under such other insurance: and (2 1 YOU flax e agreed in writinp, i - C_ - In a Contract or au'reellient (hilt this inSL)l"tW:e w(luld be primary and 1\0L1ILI 1101 SCA C01111-1hLiti011 t"j-011) jllly ()LI)cl' illstil-illikx il\LlIkIble W the additional ill'All-Ld. ALL OTHER TERMS. CONDITIONS AND EXCLUSIONS REMAIN UNCHANGED. N,IAN(.' o62 (03/I3i pa-oc I of I IL 10 (12/06) OLD REPUBLIC INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION TO CERTIFICATE HOLDERS This endorsement modifies the notice of cancellation of insurance provided hereunder by adding the following: A. In the event this policy is cancelled for any permissible reason, other than for nonpayment of premium, we shall endeavor to provide advance written notice of cancellation to certificate holders set out in the schedule on file with the Company, after notifying the first Named Insured of such cancellation. Notice of cancellation to certificate holders may be made by any commercially reasonable means, including mail, electronic mail, facsimile transmission or courier service. B. This advance written notification of a cancellation of coverage is intended as a courtesy only. Our failure to provide such advance written notification will not extend the policy cancellation date, nor negate cancellation of the policy. All other terms and conditions of this policy remain unchanged. PIL 029 10 10 MWZY314149 Lennar Corporation WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSLFIANCE POLICY WC 00 0313 POLICY NUMBER: MWC 314148 00 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against 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.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Sched u le AS REQUIRED BY CONTRACT OR AGREEMENT 0 1983 National Council on Compensatlon Insurance. INSURED COPY POLICY NUMBER: MWC 314148 00 IL 10 (12106) OLD REPUBLIC INSURANCE COMPANY tNORKERS'COMPENSATION AND EMPLOYERS'LIABILITY INSURANCE POLICY NOTICE OF CANCELATION TO CERTIFICATE HOLDERS This endorsement modifies the notice of cancelation of insurance provided hereunder by adding the following: A. In the event this policy is canceled for any permissible reason, other than for nonpayment of premium. we shall endeavor to provide advance written notice of cancelation to certificate holders set out in the schedule on file with the Company, after notifying the Insured first named in item t of the Information Page of such cancelation. Notice of cancelation to certificate holders may be made by any commercially reasonable means, including mail. electronic mail, facsimile transmission or courier service. B. This advance written notification of a cancelation of coverage is intended as a courtesy only. Our failure to provide such advance written notification will not extend the policy cancelation date, nor rieyate cancelaton of the policy. All other terms and conditions of this policy remain unchanged. PC 010 1010 INSURED DOPY