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HomeMy WebLinkAboutInsuranceACo orr DATE (MM/DD/YYYY) 11/21/2010 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. CERTIFICATE OF LIABILITY INSURANCE 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 Ames and Gough 450 Northridge Parkway Suite 102 Atlanta INSURED GA 30350 Kimley-Horn and Associates, Inc. P.O. Box 33068 Raleigh COVERAGES NC 27636 CONTACT Jerry Y Noyola PHONE (770) 552 4225 I FAX __._.._....................._.. (AIC,.Ho,Ex..t)jz__._..._...._......._..-'--------.._..................------.._ 1_(A/C,.N4}_.._._......._...._. a�EMgRAILgss; Ysough com 'n0 ola@ameS _.......................... 7-_......._--.._...._.___..__ PRODUCER......._.._....._.._........_._........._..._.............._............._...._...—. 00001398 INSURER(S) AFFORDING COVERAGE NAIC ifINSURERA:Travelers Indemnity Co. of CT 25682 INSURER a :Travelers Indemnity.Company 25658...- INSURER cTravelersProper ty Casualty Co 25674.. INSURER o_Phoenix Insurance Company 125623 lusuaEnE,Lexington Insurance Company 1943.7 INSURERF:Travelers Prop. Cas. Co America 125674 , riCV/01VIV IVuwwIbtti: 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. — i ._... ......_.. ---t INSR-"Tkoof. suw i POLICY EFF POLICY EXP : LTR i TYPE OF INSURANCE I INSR WVD I POLICY NUMBER ! (MM/DD/YYYY) : (MM/DD/YYYY) ; LIMITS A GENERAL LIABILITY -"-'• X !COMMERCIAL. GENERAL LIABILITY I j CLAIMS -MADE I X OCCUR 1 •-- ( •' ---- - ---- -- GEM AGGREGATE LIMIT APPLIES PER: POLICY 1 X ? I JEC7 X ! LOC I I i { ! i P-630-8193B99A-TCT-10 12/1/2010 112/1/2011 i I 1 i ' ! {I I i EACH OCCURRENCE DAMAGE TGRENTED PREMISES poccurrence MED EXP M one person)S PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS • COMP/OP AGG .._..__................._................._..__....__..._...... 1 S 1,000,000 ___.,"_'•'".'.-"-'----_. I . S 1,000, 000 10, 000 $ 1, 000, 000 S 2,000, 000 S 1, 000, 000 ... _...._... S B I AUTOMOBILE LIABILITY X I ANY AUTO I ALL OWNED AUTOS i I iSCHEDULED AUTOS HIRED AUTOS - -- XI NON -OWNED AUTOS i 1 1 I t ! ;COMBINED SINGLE LIMIT S 1,000,000 (Ea accident} I -810-5724B497-IND-10 12/1/2010 2/1/2011 !BODILY INJURY Per person) IS i !BODILY INJURY (Per accident) S j I PROPERTY DAMAGE -.__. - _........ 1 + $ 1 (Per accident I ! Underinsured motorist BI split I S 0rt 1.. S I Uninsured motorist property C 1 X L X !UMBRELLA LIAR ' X 1 OCCUR — , EXCESS LIAR ) CLAIMS -MADE DEDUCTIBLE RETENTION S 10,000 ! 1 f IILLPSM-CUP-8193B99A-TIL-10 i12/1/2010 112/1/2011 EACH OCCURRENCE ; S 5,000,000 I....... i. AGGREGATE 5,000,000 I IS D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY I ANY PROPRIETOFVPARTNERI! XECUTIVE Y/N i ' OFFICER/MEMBER EXCLUDED? I N) F II yes(Mand, tory II yes. describe under and DESCRIPTION OF OPERATIONS below ! N / A i 1eNUB-8193B99A-10 112/1/2010 112/1/2011 ' ' WCSTATU- i LOTH-• t I I ! I X I T.Q.BY.LI.ML7S_(_.......i_.8...._........__._.....__..............._...._.. ! i I E.L. EACH ACCIDENT S 500 0_00 PNUB-8193B99A-10 WA} 12/1/2010 12/1/2011 iELDiSEASE EA EMPLOYEES S00'000 ( ._...... __...._._ ,. _....._.. ! ; E.L. DISEASE . POLICY LIMIT S 500,000 E Professional Liability .': i 1016017332 112/9/2010 112/1/2011 ? Per Claim $2,000,000 !1 i Aggregate $2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Re: All City of National City Projects The City of National City, its elected officials, officers, agents & employees are named as Additional Insureds on the above referenced liability policies with the exception of workers compensation & professional liability. Waiver of Subrogation is applicable where required by written contract & allowed by law. CANCELLATION City of National City c/o City Attorney's Office 1243 National City Blvd. National City, CA 91950-4301 SHOULD ANY OF THE ABDVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Matias Ormaza/NOYOLA ACORD 25 (2009/09) INS025 (200909) O 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD .20 Policy Number: P-630-8193B99A-TCT-10 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - WRITTEN CONTRACTS (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. The following is added to SECTION It — WHO IS AN INSURED: Any person or organization that you agree in a "written contract requiring insurance" to include as an additional insured on this Coverage Part, but: a. Only with respect to liability for "bodily injury", "property damage" or "personal injury'; and b. lf, and only to the extent that, the injury or damage is caused by acts or omissions of you or your subcontractor. in the performance of "your work" to which the "written contract requiring insurance" applies. 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 insurance provided to such additional insured is limited as follows: c. In the event that the Limits of Insurance of this Coverage Part shown in the Declarations exceed the limits of liability required by the "written contract requiring insurance", the in- surance provided to the additional insured shall be limited to the limits of liability required by that "written contract requiring insurance". This endorsement shall not increase the limits of insurance described in Section III — Limits Of Insurance. d. This insurance does not apply to the render- ing of or failure to render any "professional services" or construction management errors or omissions. e. This insurance does not apply to "bodily in- jury" or "property damage" caused by "your work" and included in the "products - completed operations hazard" unless the "written contract requiring insurance" specifi- cally requires you to provide such coverage for that additional insured, and then the insur- ance provided to the additional insured ap- CGD4140408 005635 plies only to such "bodily injury" or "property damage" that occurs before the end of the pe- riod of time for which the "written contract re- quiring insurance requires you to provide such coverage or the end of the policy period, whichever is earlier. 2. The following is added to Paragraph 4.a. of SEC- TION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: The Insurance provided to the additional insured is excess over any valid and collectible "other in- surance, whether primary, excess, contingent or on any other basis, that is available to the addi- tional insured for a Toss we cover. However, if you specifically agree in the "written contract requiring insurance" that this insurance provided to the ad- ditional insured under this Coverage Part must apply on a primary basis or a primary and non- contributory basis, this insurance is primary to ether insurance available to the additional in- sured which covers that person or organization as a named insured for such loss, and we will not share with that "other insurance", But this insur- ance provided to the additional insured still is ex- cess over any valid and collectible "other insur- ance", whether primary, excess, contingent or on any other basis, that is available to the additional insured when that person or organization is an additional insured under any "other insurance". 3. The following is added to SECTION IV — COM- MERCIAL GENERAL LIABIUTY CONDITIONS: Duties Of An Additional Insured As a condition of coverage provided to the addi- tional insured: a: The additional insured must give us written notice as soon as practicable of an "occur- rence" or an offense which may result in a claim. To the extent possible, such notice should include: © 2008 The Travelers Companies, Inc. Page 1 of 2 21 COMMERCIAL GENERAL LIABILITY i. How, when and where the "occurrence" or offense took place; ii. The names and addresses of any injured persons and witnesses; and Hi. The nature and location of any injury or damage arising out of the "occurrence" or offense. b. If a claim is made or "suit' is brought against the additional insured, the additional insured must: i. Immediately record the specifics of the claim or "suit" and the date received; and ii. Notify us as soon as practicable. The additional insured must see to it that we receive written notice of the claim or "suit" as soon as practicable. c. The additional insured must immediately send us copies of all legal papers received in con- nection with the claim or "suit', cooperate with us in the investigation or settlement of the claim or defense against the "suit", and oth- erwise comply with ail policy conditions. d. The additional insured must tender the de- fense and indemnity of any claim or "suit" to Page 2 of 2 any provider of other insurance which would cover the additional insured for a loss we cover. However, this condition does not affect whether this insurance provided to the addi- tional insured is primary to that other insur- ance available to the additional insured which covers that person or organization as a named insured. 4. The following is added to the DEFINITIONS Sec- tion: "Written contract requiring insurance" means that part of any written contract or agreement under which you are required to include a person or or- ganization as an additional insured on this Cover- age Part, provided that the "bodily injury" and "property damage" occurs and the "personal in- jury" is caused by an offense committed: a. After the signing and execution of the contract or agreement by you; b. While that part of the contract or agreement is in effect; and c. Before the end of the policy period. © 2008 The Travelers Companies, Inc. CG D4 94 04 08 22 Policy Number: P-810-5724B497-IND-10 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT 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 modi- fied by the endorsement. GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only, Limitations and exdusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. BROAD FORM NAMED INSURED B. BLANKET ADDITIONAL INSURED C. EMPLOYEE HIRED AUTO D. EMPLOYEES AS INSURED E. SUPPLEMENTARY PAYMENTS —INCREASED LIMITS F. HIRED AUTO — LIMITED WORLDWIDE COVERAGE — INDEMNITY BASIS G. WAIVER OF DEDUCTIBLE — GLASS PROVISIONS A. BROAD FORM NAMED INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — LIABILITY COV- ERAGE: Any organization you newlyacquire or form dur- ing the policy period over which you maintain 50% or more ownership interest and that is not separately insured for Business Auto Coverage. Coverage under this provision is afforded only un- til the 180th day after you acquire or form the or- ganization or the end of the policy period, which- ever is earlier, B. BLANKET ADDITIONAL INSURED The following is added to Paragraph c. in A.1., Who Is An Insured, of SECTION II — LIABILITY COVERAGE: Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and CAT3530609 H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT J. PERSONAL EFFECTS K. AIRBAGS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS M. BLANKET WAIVER OF SUBROGATION N. UNINTENTIONAL ERRORS OR OMISSIONS executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to be named as an addi- tional insured is an "insured" for Liability Cover- age, but only for damages to which this insurance applies and only to the extent that person or or- ganization qualifies as an "insured" under the Who Is An Insured provision contained in Section II. C. EMPLOYEE HIRED AUTO 1. The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — LI- ABILITY COVERAGE: An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in that "employee's" name, with your permission, while performing duties related to the conduct of your busi- ness. ©2009 The Travelers Companies, Inc. Page 1 of 4 Includes the copyrighted material of Insurance Services Office, Inc. with its permission. 23 COMMERCIAL AUTO 2. The following replaces Paragraph b. in B.5., Other Insurance, of SECTION IV — BUSI- NESS AUTO CONDITIONS: b. For Hired Auto Physical Damage Cover- age, the following are deemed to be cov- ered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee" under a contract in that individual "employee's" name, with your permission, while perform- ing duties related to the conduct of your business. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto", D. EMPLOYEES AS INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — LIABILITY COV- ERAGE: Any "employee" of yours is an "insured" while us- ing a covered "auto" you don't own, hire or borrow in your business or your personal affairs. E. SUPPLEMENTARY PAYMENTS —INCREASED LIMITS 1. The following replaces Paragraph A.2.a.(2), of SECTION 11— LIABILITY COVERAGE: (2) Up to $3,000 for cost of bail bonds (in- cluding bonds for related traffic law viola- tions) required because of an "accident" we cover. We do not have to furnish these bonds. 2. The following replaces Paragraph A.2.a.(4), of SECTION II — LIABILITY COVERAGE: (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day be- cause of time off from work. F. HIRED AUTO — LIMITED WORLDWIDE COV- ERAGE — INDEMNITY BASIS The following replaces Subparagraph e. in Para- graph B.7., Policy Term, Coverage Territory, of SECTION IV — BUSINESS AUTO CONDITIONS: e. Anywhere in the world, except any country or jurisdiction while any trade sanction, em- bargo, or similar regulation imposed by the United States of America applies to and pro- hibits the transaction of business with or within such country or jurisdiction, for Liability Coverage for any covered "auto" that you lease, hire, rent or borrow without a driver for a period of 30 days or less and that is not an "auto" you lease, hire, rent or borrow from any of your "employees", partners (if you are a partnership), members (if you are a limited liability company) or members of their house- holds. (1) With respect to any claim made or "suit" brought outside the United States of America, the territories and possessions of the United States of America, Puerto Rico and Canada: (a) You must arrange to defend the "insured" against, and investigate or settle any such claim or "suit" and keep us advised of all pro- ceedings and actions. (b) Neither you nor any other in- volved "insured" will make any settlement without our consent. (c) We may, at our discretion, par- ticipate in defending the "insured" against, or in the settlement of, any claim or "suit". (d) We will reimburse the "insured": (i) For sums that the "insured" legally must pay as damages because of "bodily injury" or "property damage" to which this insurance applies, that the "insured" pays with our consent, but only up to the limit described in Paragraph C., Limit Of Insurance, of SECTION II — LIABILITY COVERAGE; (ii) For the reasonable expenses incurred with our consent for your investigation of such claims and your defense of the "insured" against any such "suit", but only up to and included within the limit de- scribed in Paragraph C., Limit Of Insurance, of SECTION II — LIABILITY COVERAGE, Page 2 of 4 © 2009 The Travelers Companies, Inc. CA T3 53 06 09 Includes the copyrighted material of Insurance Services Office, Inc. with its permission. 24 (3) and not in addition to such limit. Our duty to make such payments ends when we have used up the applicable limit of insurance in payments for damages, settlements or defense expenses. (2) This insurance is excess over any valid and collectible other insurance available to the "insured" whether primary, excess contingent or on any other basis. This insurance is not a substitute for re- quired or compulsory insurance in any country outside the United States, its ter- ritories and possessions, Puerto Rico and Canada. You agree to maintain all required or compulsory insurance in any such coun- try up to the minimum limits required by local law. Your failure to comply with compulsory insurance requirements will not invalidate the coverage afforded by this policy, but we will only be liable to the same extent we would have been liable had you complied with the compulsory in- surance requirements. (4) It is understood that we are not an admit- ted or authorized insurer outside the United States of America, its territories and possessions, Puerto Rico and Can- ada. We assume no responsibility for the furnishing of certificates of insurance, or for compliance in any way with the laws of other countries relating to insurance. G. WAIVER OF DEDUCTIBLE — GLASS The following is added to Paragraph D., Deducti- ble, of SECTION III — PHYSICAL DAMAGE COVERAGE: No deductible for a covered "auto" will apply to glass damage if the glass is repaired rather than replaced. H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT The following replaces the last sentence of Para- graph A.4.b., Loss Of Use Expenses, of SEC- TION III — PHYSICAL DAMAGE COVERAGE: However, the most we will pay for any expenses for loss of use is $65 per day, to a maximum of $750 for any one "accident". CA T3 53 06 09 L. COMMERCIAL AUTO PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT The following replaces the first sentence in Para- graph A.4.a., Transportation Expenses, of SEC- TION III — PHYSICAL DAMAGE COVERAGE: We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense in- curred by you because of the total theft of a cov- ered "auto" of the private passenger type. PERSONAL EFFECTS The following is added to Paragraph A.4., Cover- age Extensions, of SECTION 111 — PHYSICAL DAMAGE COVERAGE: Personal Effects We will pay up to $400 for "loss" to wearing ap- parel and other personal effects which are: (1) Owned by an "insured"; and (2) In or on your covered "auto". This coverage applies only in the event of a total theft of your covered "auto". No deductibles apply to this Personal Effects coverage. AIRBAGS The following is added to Paragraph B.3., Exclu- sions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Exclusion 3.a. does not apply to "loss" to one or more airbags in a covered "auto" you own that in- flate due to a cause other than a cause of "loss" set forth in Paragraphs A.1.b. and A.1.c., but only: a. If that "auto" is a covered "auto" for Compre- hensive Coverage under this policy; b. The airbags are not covered under any war- ranty; and c. The airbags were not intentionally inflated. We will pay up to a maximum of $1,000 for any one 'loss". NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS The following is added to Paragraph A.2.a., of SECTION IV — BUSINESS AUTO CONDITIONS: Your duty to give us or our authorized representa- tive prompt notice of the "accident" or "loss" ap- plies only when the "accident" or "loss" is known to: (a) You (if you are an individual); © 2009 The Travelers Companies, Inc. Page 3 of 4 Includes the copyrighted material of Insurance Services Office, Inc. with its permission. 25 COMMERCIAL AUTO (b) A partner (if you are a partnership); (c) A member (if you are a limited liability com- pany); (d) An executive officer, director or insurance manager (if you are a corporation or other or- ganization); or (e) Any "employee" authorized by you to give no- tice of the "accident" or "loss". M. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A.5., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — BUSINESS AUTO CONDI- TIONS: 5. Transfer Of Rights Of Recovery Against Others To Us We waive any right of recovery we may have against any person or organization to the ex - Page 4 of 4 tent required of you by a written contract signed and executed prior to any "accident" or "loss", provided that the "accident" or "loss" arises out of operations contemplated by such contract. The waiver applies only to the person or organization designated in such contract. N. UNINTENTIONAL ERRORS OR OMISSIONS The following is added to Paragraph B.2., Con- cealment, Misrepresentation, Or Fraud, of SECTION IV — BUSINESS AUTO CONDITIONS: The unintentional omission of, or unintentional error in, any information given by you shall not prejudice your rights under this insurance. How- ever this provision does riot affect our right to col- lect additional premium or exercise our right of cancellation or non -renewal. © 2009 The Travelers Companies, Inc. CA T3 53 06 09 Includes the copyrighted material of Insurance Services office, Inc. with its permission. 26 TRAVELERS J~ WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 03 76 (00) — 001 POLICY NUMBER: PNUB - 819 3 B 9 9A- 10 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA (BLANKET WAIVER) 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. 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 pre- mium otherwise due on such remuneration. Schedule Person or Organization Job Description ANY PERSON OR ORGANIZATION FOR WHICH THE NAMED INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. DATE OF ISSUE: 10-04-10 STASSIGN: 27 AMEs & GOUGI-H tNovetilber 22, 2010 R.e: Updated Certificate of Insurance Dear Certificate Holder: You are receiving a new certificate of insurance from KImley-Horn and Associates because they arc consolidating all of their insurance policy expiratioI elates to December Is' anniversary. There has been no change in insurer, no reduction in coverage or change in policy limits. The enclosed certificate replaces any certificates you have received in 2010. If you have any questions, please give us a call. Best Regards h. r/ )'erryioyo a(/ ( mes &- Gough 4.50 Northridge Parkway; Suite 102 A Atlanta, GA 30350 Telephone: (770) 330-g327 Facsimile: (866) 550-4082 28