Loading...
T-5558 - Certificate of Insurance - 12/6/2018A�ORo� CERTIFICATE OF LIABILITY INSURANCE 7/12/2019 7/12/2019 DATE 11/26/226/2018 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(les) must have ADD170NAL 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 Lockton Insurance Brokers, LLC 19800 MacArthur Blvd., Suite 1250 CONTACT NAM PHONE FAX Me Not: EMAIL ADDRESS. CA License #OF15767 Irvine 92612 949-252-4400 INsu s AFFORDING.OavERAt3E NAIC# INSURER A: * * * EE ATTACHMENT INSURER B : INSURED BMCH California, LLC 1416057 99 Almaden Blvd., Ste. 400 INSURER C: San Jose CA 95113 INSURER D: INSURER E: INSURER F: COVERAGES UCPBCO2 CERTIFICATE NUMBER: l i74R516 REVISION NUMBER: XXXXXXX vTHIS 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 .ADDLIr4SDSUHR VdVn POLICY NUMBER M[pp EFF V NpiaMluDq !:1[P LIMITS LTR I A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE t X l OCCUR Y Y CHF16/YF 16CP01/004 7/12/2016 7/12/2019EACH OCCURRENCE $ 10,000,000 -DAMAGE-TO F� PRE I E$(,EaooeumS 09) _ $ 100,000 MED EXP An oneperson) s Included X Silica - $ I,0� �0 PERSONAL & ADV INJURY $ 10,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 10.000,000 PRODUCTS - COMP/OP AGG $ 10 000 000 PRO ❑LOC X POLICY ID JECT $ OTHER: AUTOMOBILE LIABILITY NOT APPLICABLE eBIiJEerOil INGtE L1Ml $ XXXXXXX BODILY INJURY (Per person) $ XXXXXXX ANY AUTO BODILY INJURY (Per accident) $ XXXXXXX OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY OAMAGE $ XXXXXXX (Per accident) $ XXXXXXX B UMBRELLA LIAB OCCUR N N CFX16/YF16CP05/A/009 7/12/2016 7/12/2019 EACH OCCURRENCE $ 10.000.000 AGGREGATE $ IO 000 000 EXCESS LIAB HCLAIMS-MADE DED RETENTION $ $ XXXXXXX WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE —] NOT APPLICABLE SSTATUTE EL EACH ACCIDENT $ XXXXXXX EL DISEASE - EA EMPLOYE $ XXXXXXX OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A E.L DISEASE -POLICY LIMIT $XXXXXXX If yes, describe under DESCRIPTION OF OPERATIONS below C 2nd Excess Layer N N See Attached 7/12/2016 7/12/2019 Each Occurrence. $30.400,000 Aggregate: $30,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 707, Additional Remarks Schedule, may be attached N mord apace is required) RC; Subdivision Agreement Final Map of7'ract NSI. 5559 - Tap"" 2, N WC Wast I'lerdan Avenue and Norlh Rivorsidc DOVE. City of Fragna. lite C.Ity of Frcmu, im ofhecrx, officials, employees, agents and vnitlntEers are �dditioaal insured as respccls to General Liability insurance. This hulumnco is primary, and ata' obligations are not nlfcctEd by any other insornucc carried by such additional insured w}Icthcr primary, excess. contingent. or on ury outer bssis- Waiver of suhrngaliusl for Workors' Compensation insurance as respects Io the City of Fresno, its officers. officiais, employees, apents and volunteers. y RISK MANAGEMENT� W1S10G��y ,rdPN� ADVr�e��� CERTIFICATE HULUhK _..r A - 7 L" Z.MIr►,=L _M I IVI\ ucc I LLAT LILIMixa Cityof Fresno of ►r• " City of 2600 Fresno Street - Room 40§4 Da' Fresno CA 93721-3620 g}tsed SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED (n 14AR_7n14.1CQ1 ZD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD CONTINUATION DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS (Use only If more space Is required) GL Additional Insured: CG 20 12 05 09; GL Primary and Non -Contributory: CG 20 0104 13; GL Waiver of Subrogation: CG 24 04 10 93; WC Waiver of Subrogation: WC 04 03 06(4-84) ACORD 25 (2016/03) Certificate Holder ID: 15748536 Breakdown of Carriers: A. 45.45% International Insurance Co. of Hannover SE. UK Branch; 54.55% Certain Lloyd's of London Syndicates B. 25% International Insurance Co. of Hannover SE. UK Branch; 75% Certain Lloyd's of London Syndicates C� a. 16.66% Certain Lloyd's of London Syndicate 83.34% To Be Determined i. CFX16NF16CP05/B/004 ii. $5,000,000 b. Endurance Specialty Insurance Ltd. i. EXC10009563500 ii. $8,330,000 c. Markel Global Insurance i. 1349886-2031-XSOCC-2016 ii. $8,335,000 d. Aspen Insurance UK Limited i. KOA7J7K16A07 ii.$8,335,000 Attachment Code: D522634 Master ID: 1416057, Certificate ID: 15748536 POLICY NUMBER: CHF16NF16CP01/004 COMMERCIAL GENERAL LIABILITY CG 20 12 05 09 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: Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II - Who Is An Insured is amended to include as an 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 by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. CG 20 12 05 09 Attachment Code: D522483 Certificate ID: 15748536 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". (c) Insurance Services Office, Inc. 2008 Page 1 of 1 POLICY NUMBER: CHF16NF16CP01/004 COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 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 Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek 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 Attachment Code: D522489 Certificate ID: 15748536 (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. © Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: CHF16NF16CP01/004 COMMERCIAL GENERAL LIABILITY 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: (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 - COMMERCIAL 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 Attachment Code: D522490 Certificate ID: 15748536 Copyright, Insurance Services Office, Inc., 1992 Page 1 of 1 WORKERS' 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 0 % of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization Any person or organization for whom you are required by written contract or agreement to obtain this waiver of rights from us. Job Description Blanket Waiver of Subrogation This endorsement changes the policy 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 [IWCPEFF1 1] Insured: UCP Benchmark Communites Insurance Company WC 04 03 06 (Ed. 4-84) Attachment Code: D522525 Certificate ID: 15748536 Policy Endorsement No No. Additional Named Insureds f Other Named Insureds Benchmark Communities, LLC SMC Babbs Creek Gilroy, LL.0 BMC Freestone, LLC BMC HP, LLC BMC Pine Ridge, LLC BMC Pine ridge, LLC BMC Promise Way, LLC BMC Realty Advisors, Inc. BMC Stein, LLC BIMC Touchstone,. LLC BMC WP, LLC BMCH California BMCH California, LLC BMCH South Carolina, LLC BMCH Tennessee Fresno Land and Cattle Company Gipetti Property Masoni PICO Holdings, Inc. UCP Barclay I LLC UCP Barclay III LLC UCP Barclay IV LLC UCP Barclay II LLC UCP Brandywine LLC Attachment Code: D522556 Certificate ID: 15748536 UCP Chateau Grove LLC UCP Crekside Galt, LLC UCP East Garrison LLC UCP Jackson Tower LLC UCP Lovita, LLC UCP Kerman LLC UCP Meadowood III, LLC UCP Meadowood LLC UCP Montecito LLC UCP Poulsbo, LLC UCP Quail Run LLC UCP Sagewood, LLC UCP Santa Ana Hollister, LLC UCP Soledad LLC UCP Tapestry LLC UCP Tierra del Rey LLC UCP, LLC Attachment Code: D522556 Certificate ID: 15748536 CERTIFICATE OF LIABILITY INSURANCE DATE (MM/OD/YYYY) 11/30/2018 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 endorsement(s). PRODUCER 1-303-534-4567 CONTACT NAME' _ IMA, Inc. - Colorado Division PHONE FAX 1705 17th Street Apo55: DenAccountTechs®imacorp.com Suite 100 INSR TYPE OF INSURANCE ADDL .iUBR POLICY NUMBER MM/Dp/YYYY MY EFF P M1Ddf1'EYYP LIMITS LT INSURERS AFFORDING COVERAGE NAM # Denver, CO 80202 INSURERA:EVEREST NATL INS CO (AmWins) 10120 INSURED INSURER B: EVEREST NATL INS CO(AmWins) 10120 HMCH California, LLC CLAIMS -MADE F1 OCCUR INSURER C 8390 E. Crescent Parkway, Suite 650 INSURER D. DAMA01- IORLNTED p M ES Ea occurre $ MED EXP (Anyone person) $ INSURER E: Greenwood Village, CO 80111 INSURERF: rnvrQerrc r1=RT1FIrATF A11111,111I 54674208 REVISION NUMRFR! 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 ADDL .iUBR POLICY NUMBER MM/Dp/YYYY MY EFF P M1Ddf1'EYYP LIMITS LT COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE F1 OCCUR DAMA01- IORLNTED p M ES Ea occurre $ MED EXP (Anyone person) $ PERSONAL &ADV INJURY $ L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY El PRLOC r'OTHER- PRODUCTS - COMP/OP AGG $ $ AUTOMOBILE LIABILITY COMBINED SINGLELIMIT $ Ea acdden BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY BODILY INJURY (Per accident) $ PROPERTYDAMAG.E $ Par sccMant $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LAB CLAIMS -MADE DED RETENTION $ A H WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANYPROPRIETOR/PARTNERIEXECUTIVE F OFF ICER/MEMBEREXCLUDED? (Mandatory in NH) NIA CF2WC00003181-CO CF2WC00004181-CA 07/01/18 07/01/18 07/01/19 07/01/19 R STATUTE ERH E.L. EACH ACCIDENT $ 1,000,000 E.L DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below I I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Subdivision Agreement Final Map of Tract No. 5558 -Tapestry 2, NWC West Herdon Avenue and North Riverside Drive, Cit of Fresno. A Waiver of Subrogation is provided in favor of City of Fresno,its officers, officials, employees, agents and volunteer on the Workers Compensation Liability Policy if required by written contract or agreement subject to the policy terms and conditions. L;I= R I W IGA I h HULL)hK L.ANk tLLIA I IUIV 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 I USA © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD michael.sheinberg 54674208 CF2WC00004181 7/1/18-7/1/19 MRIMRS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 WAIVER OF OUR RIGHTTO 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. ('Chis 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 otherwise due on such remuneration. PERSON OR ORGANIZATION ANY PERSON OR ORGANIZATION FOR WHOM YOU ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT TO OBTAIN THIS WAIVER OF RIGHTS FROM US. % of the California workers' compensation premium SCHEDULE JOB DESCRIPTION 1998 by the Workers' Compensation Insurance Rating Bureau ofCaliforn#e. WI rights reserved - From the WCIRB's Calf mla Workers' Compensation Insurance Forms Manual , 1999. INSURED COPY