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Home My WebLink AboutInsurance CertificateACORD. CERTIFICATE OF LIABILITY INSURANCE PRODUCER 0757776 1-800-877-4560 HUB International Insurance Services Inc. P.O. Box 4047 Concord, CA 94524 DATE (MM/DD/YY) 08/03/2010 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 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURED Harris & Associates Inc. Attn: Susan Mandilag 1401 Willow Pass Road, Suite 500 Concord, CA 94520 COVERAGES INSURER A:OneBeacon America Insurance Co. INSURERB:Wausau Underwriters Insurance Company INSURER C: Colony National Insurance Company INSURER D: Travelers Property Casualty Co of Amer. INSURER E: Continental Casualty Company 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 LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YY1 POLICY EXPIRATION DATE (MM/DD/YY1 LIMITS A GENERALLIABILITY X COMMERCIAL GENERAL LIABILITY 7180096900004 - - 08/01/10 08/01/11 EACH OCCURRENCE $1,000,000 FIRE DAMAGE (Any one fire) $ 1,000,000 CLAIMS MADE X OCCUR MED EXP (Any one person) $ 10,000 X X GEN'L "X" "C" "U" PERSONAL &ADV INJURY $ 1,000,000 Separation of Insureds GENERAL AGGREGATE $2,000,000 AGGREGATE LIMIT APPLIES PER: POLICY X VT- LOC PRODUCTS - COMP/OP AGG $ 2,000,000 B AUTOMOBILE X X X LIABILITY ANY AUTO ASJZ91455034010 08/01/10 08/01/11 COMBINED SINGLE LIMIT (Ea accident) $ 1, 000, 000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE UABIUTY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG $ C EXCESSUABILITY X OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ AR6460401 08/01/10 08/01/11 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ** PJUB8166N36A10 08/01/10 08/01/11 X ORY LIMITS I ER E.L. EACH ACCIDENT $ 1, 000, 000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 E OTHER Professional Liability AEA113822501 08/01/10 08/01/11 Per Claim: S 10,000,000 Aggregate: $ 15,000,000 Ded. Each Claim: $150,000 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS ** Workers Compensation policy excludes monopolistic states ND, OH, WA, WY. General & Auto Liability Additional Insured status granted, if required by written contract/agreement, per attached forms ASC0010 0198 & CA2048 0299. RE: 8th Street Corridor Smart Growth Revitalization Project (HA #0820816) ERTIFICATE HOLDER 082-0816 City of National City c/o Maryam Babaki, PE Engineering Department 1243 National City Blvd. National City, CA 91950 1 ADDITIONAL INSURED; INSURER LETTER: USA CANCELLATION Ten Day Notice for Non -Payment of Premium SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL Eki MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, ECIVFSSI XIIFKX16X1147079¢#1MKX Xalria6ll 4157tE7ti¢Q[K3IXOS XIAZIOSMXiXXOWKIIMXfk7 IXIU }(#]MCIC}DYXXICSQ5KX XgMAXp(rLgxXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX AUTHORIZED REPRESENTATIVE ACORD 25-S (7/97) dgarcia 16914452 o ACORD CORPORATION 1988 11 POLICY #: 7180096900004 EFFECTIVE: 08/01/2010 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY ADDITIONAL INSURED This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART and GL CONTRACTORS EXTENDER FORM VCG 206 02 05 a. COMMERCIAL GENERAL LIABILITY COVERAGE FROM CG 00 01 12 04 is amended by the following wording. b. GL CONTRACTORS EXTENDER paragraph I. ADDITIONAL INSURED — REQUIRED IN CONTRACT, AGREEMENT OR PERMIT is deleted and replaced by the following wording. WHO IS AN INSURED — (Section II) is amended to include as an additional insured any person or organization you are required to add as an additional insured under this policy in a written contract or written agreement in effect during this policy period and signed and executed by you prior to the loss for which coverage is sought. The person or organization does not qualify as an additional insured with respect to the independent acts or omissions of such person or organization. The person or organization is only an additional insured with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused by "your work" performed under the written contract or written agreement. 2. The insurance provided to the additional insured is limited as follows: a) This endorsement shall not increase the limits stated in Section III — LIMITS OF INSURANCE. b) The insurance provided to the additional insured does not apply to "bodily injury", "property damage", or "personal and advertising injury" arising out of an architect's, engineer's or surveyor's rendering of or failure to render any professional services including: I. The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders, or drawings and specifications: and II. Supervisory or inspection activities performed as part of any related architectural or engineering activities. c) This insurance does not apply to "bodily injury: or "property damage" caused by "your work" included in the "products -completed operations hazard" unless you are required to provide such coverage for the additional insured by a written contract or written agreement in effect during this policy period and signed and executed by you prior to the loss for which coverage is sought. 3. Subpart (1)(a) of the Pollution exclusion (Section I — Coverages, part 2. f. of the Commercial General Liability Coverage form) does not apply to you if the "bodily injury" or "property damage" arises out of "your work" performed on premises which are owned or rented by the additional insured at the time "your work" is performed. 4. Any coverage provided by this endorsement to an additional insured shall be excess over any other valid and collectible insurance available to the additional insured whether primary, excess, contingent or on any other basis unless a written contract or written agreement in effect during this policy period and signed and executed by you prior to the loss for which coverage is sought specifically requires that this insurance apply on a primary and/or non- contributory basis. 5. As a condition of coverage, each additional insured must: a) Give us prompt written notice of any "occurrence" or offense which may result in a claim and prompt written notice of "suit". b) Immediately forward all legal papers to us, cooperate in the defense of any actions, and otherwise comply with policy conditions. ASC 00 10 01 98 Page 1 of 1 12 Excerpts from: OneBeacon Form VCG 206 02 05 @VANTAGE FOR GENERAL LIABILITY - CONTRACTORS COMMERCIAL GENERAL LIABILITY COVERAGE FORM Policy Number: 7180096900004 Insurer: OneBeacon America Insurance Company Policy Period: August 1, 2010 to August 1, 2011 5. BLANKET WAIVER OF SUBROGATION Section IV - Transfer of Rights of Recovery Against Others to Us Condition is amended to add the following: We will waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of your ongoing operations done under a written contract or agreement with that person or organization and included in "your work" or the "products -completed operations hazard". This waiver applies only to persons or organizations with whom you have a written contract, executed prior to the "bodily injury" or "property damage", that requires you to waive your rights of recovery. Page 1 of 1 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi-fled by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. SCHEDULE Name of Person(s) or Organization(s): ANY PERSON OR ORGANIZATION WHERE THE NAMED INSURED HAS AGREED BY WRITTEN CONTRACT TO INCLUDE SUCH PERSON OR ORGANIZATION AS A DESIGNATED INSURED. Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in SECTION II of the Coverage Form. This endorsement is executed by the Wausau Underwriters Insurance Company Premium $ Effective Date 08/01/2010 For attachment to Policy No. Audit Basis Issued To Expiration Date 08/01/2011 ASJZ91455034010 Harris & Associates Inc. 12 r SECRETARY + Parsl)ENT Countersigned by Authorized Rcprescntativc CA 20480299 Copyright, Insurance Services Office, Inc., 1996 14 Excerpts from: Liberty Mutual form AC 84 07 05 09 Liberty EXPRESS SM Auto Enhancement Endorsement BUSINESS AUTO COVERAGE FORM Policy Number: ASJZ91455034010 Insurer: Wausau Underwriters Insurance Company Policy Period: August 1, 2010 to August 1, 2011 XXIV - WAIVER OF SUBROGATION Paragraph A.5. in SECTION IV — BUSINESS AUTO CONDITIONS does not apply to any person or organization where the Named Insured has agreed, by written contract executed prior to the date of accident, to waive rights of recovery against such person or organization. Page 1 of 1 15 Excerpts from: Form CA0001 0306 BUSINESS AUTO COVERAGE FORM Policy Number: ASJZ91455034010 Insurer: Wausau Underwriters Insurance Company Policy Period: August 1, 2010 to August 1, 2011 5. Other Insurance a. For any covered "auto" you own, this Coverage Form provides primary insurance. For any covered "auto" you don't own, the insurance provided by this Coverage Form is excess over any other collectible insurance. However, while a covered "auto" which is a "trailer" is connected to another vehicle, the Liability Coverage this Coverage Form provides for the "trailer" is: (1) Excess while it is connected to a motor vehicle you do not own. (2) Primary while it is connected to a covered "auto" you own. b. For Hired Auto Physical Damage Coverage, any covered "auto" you lease, hire, rent or borrow is deemed to be a covered auto" you own. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". c. Regardless of the provision of Paragraph a. above, this Coverage Form's Liability Coverage is primary for any liability assumed under an "insured contract". d. When this Coverage Form and any other Coverage Form or policy covers on the same basis, either excess or primary, we will pay only our share. Our share is the proportion that the Limit of Insurance of our Coverage Form bears to the total of the limits of all the Coverage Forms and policies covering on the same basis. Page 1 of 1 16 MONINIMM 0= 001362 TRAVELERS] WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 00 03 13 (00)-01 POLICY NUMBER: (PJ-UB-8166N36-A-10) 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 any one not named in the Schedule. SCHEDULE DESIGNATED PERSON: DESIGNATED ORGANIZATION: ANY PERSON OR ORGANIZATION FOR WHOM THE NAMED INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. DATE OF ISSUE: 08-02-10 ST ASSIGN: 17