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HomeMy WebLinkAboutCertificate of Liability InsuranceACC?RG� CERTIFICATE OF LIABILITY INSURANCE DATE IMMfDDfYYYY) 03/02/2011 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 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 Marsh USA Inc. 1166 Avenue of the Americas New York, NY 10036,2774 107767-LA-LL--10-11 ................................................ INSURED Bovis Lend Lease, Inc. 800 West 6th Street 161h Floor Los Angeles, CA 90017 762260 CONTACT NAME: PHONE FAX (AIC,N):),Ezt) .........._..... ------- ___. (A.IC,No): E-MAIL ADDRESS;..,. .. _._.. PRODUCER _CUSTOMER ID NI ....................... INSURERIS) AFFORDING COVERAGE INSURER A : insurance Company 0f The State 0f PA INSURER 13 : NIA INSURER C ; NIA .................................. INSURER D : NIA INSURER E INSURER F : V TIFICATE NUMBER: NYC.005211142.01 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR 1 1ARDL-SUBRi. ............... .................. ....._..... .....POLICY EFF I POLICY EXP ................ LTR TYPE OF INSURANCE 1INSR 1 WVD POLICY NUMBER IMMfDDIYYYYI i IMMIDDIYYYY) NAMED ABOVE FOR THE POLICY PERIOD DOCUMENT WITH RESPECT TO WHICH THIS HEREIN IS SUBJECT TO ALL THE TERMS, ................ L.M.T. A GENERAL X X GEN'L LIABILITY Gt.458.13-85 COMM5RC1AL GENERAL LIABILITY i CLAIMS -MADE X OCCUR 1. PER PROJECT (See Pg 2) SIR 81 000,000 EA OCC AGGREGATE LIMIT APPLIES PER: i 'I , POLICY; I I I LOC i 1 05I30I2010 106/30/2011 I EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES (Ea occurrence). ..? --- MED F-XP (My one person) I 5 PERSONAL 5 ADV INJURY , s GENERAL AGGREGATE s AGM S PRODUCTS COMPIOP _-.. 5 2,000,000 500,000 .... ..... 10,000 2,000,000 10,000,000 10,000,000 AUTOMOBILE --.I ,fP;ROECT- LIABILITY . ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON.OWNE.DAUTOS 3 � 1 , I ° ' ' i COMBINED SINGLE LIMIT (Ea accident) s BODILY INJURY (Per person) j 5 .._............ - —__- _..__.... BODILY INJURY (Per accident) i 5 _._.. PRO PERTY YD__. ... PRODAMAGE. (Per 31 ci(lerlt) 5 ..__ 5 .........._,.. ..................._.. -- ...... ._. ._...- UMBRELLA LIAR EXCESS LIAR DEDUCTIBLE: RETENTION S OCCUR I CLAIMS MADE , EACH OCCURRENCE 5 AGGREGATE i S 15 _. I WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY E'�ROPRIE'E'ORfPAR7NE ! OFFICERIMEMBER EXCLUDED?)NIA! (Mandatory In NH) '- If yea, describe (alder DESCRIPTION OF OPERATIONS Y 1 N RfEXECUTIVE i ? ? ? I i . WC STATU- TH 1 __._,-TORY.LIMITS.I ............1 ..._........ ! G.L. EACH ACCIDENT 5 ', -----_ ....._....... ...... ........_.. I E.L. DISEASE - EA EMPLOYEE: 5_.- f I E.L. DISEASE - POLICY LIMIT 5 -___ ....... _.__. _......... below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Romarks Schodule, if snore spaco is rot;uiro RE: 76226088 - 7-Eleven National City, 151 N. Highland Ave., National City, CA 91950 City of National City are hereby named as additional insureds but oniy to the extent that Iheir interest may appear. CERTIFICATE HOLDER CANCELLATION City of National City 140 East 12th Streel National City, CA 91950-3312 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 REPRESENTATIVE of Marsh USA Inc. Steven Jeffery ACORD 25 (2009/09) ©'1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ADDITIONAL INFORMATION PRODUCER Marsh USA Inc. 1466 Avenue of the Americas New York, NY 10036-2774 107767-LA-LL--10-11 --------- ------- INSURED Bevis Lend Lease, Inc. 800 West 6111 Street 161h Floor Los Angeles, CA 90017 762260 NYC-005211142-01 DATE (MM/000(Y) 0310212011 INSURERS AFFORDING COVERAGE INSURER G: INSURER H: INSURER I: INSURER J: NAIC # TEXT Note: Products Completed Operations Aggregate is capped at $110h1 CERTIFICATE HOLDER City of National City 140 I7as1121h Street National City, CA 91950-3312 A11THORILI:t) RLYR0SENrnriv[ of Marsh USA Inc. Steven Jeffery Page 2 GL 458-13-85 COMVMMERCIAL GENERAL LIABILITY CG 20 33 07 04 THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY, ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABtIJTY COVERAGE PART A. Section it — Who Is An Insured Is amended to Include as an additional insured any person or or- ganization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an addi- tional Insured on your policy. Such person or or- ganization is an additional insured only with re- spect to liability for "bodily injury", "property damage" or "personal and advertising Injury" caused, In whole or in part, by: ' 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional Insured. A person's or organization's status as an additional Insured under thls endorsement' ends when your operations for that additional Insured are com- pleted. CO20330704 B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance;floes not apply to, . "Bodily injury", "property damage" or "personal and advertising injury" arising out of the render- ing of, or th:e failure to render, any professional architectural, engineering or surveying ser- vices, Including: a, The preparing, approving, or failing to pre- pare or approve, .maps, shop drawings, opinions. reports, surveys, field orders, change orders or drawings and specifica- tions; or b. Supervisory, Inspection, architectural or engineering activities. 2. "Bodily injury" or "property damage" occurring after: a. All work, Including materials, parts or equipment furnished in connection with such work, on the project (other than ser- vice, maintenance or repairs) to be per- formed by or on behalf of the additional In- sured(sj° at the location of the covered operations has been completed; or b. That portion of "your work" out of which the injury or damage arises has been put to its Intended use by any person or organization other than another contractor or subcontrac- tor engaged in performing operations for a principal as a part of the same project. © 150 Properties, Inc., 2004 Page 1 of 1 0