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HomeMy WebLinkAboutInsuranceACORR,0s CERTIFICATE OF LIABILITY INSURANCE 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. DATE (MMIDDfYYYY) 08/01/2011 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). :-F4 0757776 1-800-877-4560 ltus International Insurance Services Inc. P.O, Box 4047 Concord, CA 94524 INSURED Harris & Associates Inc. Attn: Susan Mandilag 1401 Willow Pass Road, Suite 500 Concord, CA 94520 CONTACT NAME Dina Afkhami (ACNENo. EA 925609-6500 (AiC E•MA1L .No) 925 609 6550 _. _... .__. ADDRESS: diva.afkhami@hubinternational.com INSURERS AFFORDING COVERAGE NACU INSURERA: Massachusetts Bay Insurance Co INSURER B: Wausau Underwriters Insurance Company INSURERc: Colony National Insurance Company 1NSURERD: Travelers Property Casualty Co of Amer. INSURERE: Continental Casualty Company INSURER F : COVERAGES CERTIFICATE NUMBER: 22567764 REVISION NUMBER: THIS INDICATED. CERTIFICATE EXCLUSIONS INSR LTR IS TO CERTIFY THAT THE POLICIES NOTWITHSTANDING ANY REQUIREMENT, MAY BE ISSUED OR MAY AND CONDITIONS OF SUCH __. ...... ......... ............ __...... ... TYPE OF INSURANCE OF INSURANCE PERTAIN, POLICIES. ADOL INSR SUBR I WVD LISTED BELOW HAVE BEEN ISSUED TO TERM OR CONDITION OF ANY CONTRACT THE INSURANCE AFFORDED BY THE POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY _..._. ..... _-.. ...... .. _... _. _.-iPOLICY EFF POLICY NUMBER I (MMIDDfYYYY) THE INSURED OR OTHER DESCRIBED PAID CLAIMS. POLICY EXP .. (MMIDDfYYYY) NAMED ABOVE FOR THE POLICY PERIOD DOCUMENT WITH RESPECT TO WHICH THIS HEREIN IS SUBJECT TO ALL THE TERMS, ....._ ...,.... _...-_ ._....__.._... .... ......... ... ... ..... _.__..... LIMITS A GENERALLIABILITY _X Ti--bed: GENt COMMERCIAL GENERAL LABILITY J CLAIMS -MADE I X J OCCUR 10,000 per OcC AGGREGATE LIMIT APPLIES PER: X PRO. I 1 POLICY j JECT LOC ZHF920172200 j 08/01/1l I i 08/01/12 _EACH OCCURRENCE ' _AMWOrTO a occurre -_.__._ PREMISES (Ea occurrence)____ MED EXP (Any ono person) PERSONAL &ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG $ 1,000,000 500,000 �_.....__-._._ $ 10,000 $ 1,000,000 S 2,000,000 $ 2,000,000 $ B AUTOMOBILE __— X __, X LIABILITY ANY AUTO ALL OWNED AUTOS AUTOS Ded: 0 I..._ . ..._X.._._...__.111 SCHEDULED AUTOS NON -OWNED AUTOS ASJZ91455034011 ': 08/01/11 i! I Ob/ 1712 COMBINEDSINGLEI.IMIT Ea accident BODILY INJURY (Por person) .-.-P.BODILY INJURY._-....__(P.._.e...r.._.a. c_..c...i_i_d....e.._ nt) PROPERTY DAAGE Per,apcidentI— 1 000 000 $ _...._.............__.._...._.. _._.$ ._...._..._.. $HIRED $ C X UMBRELLALIAB EXCESS LIAR DEO 1 X I RETENTIONS X OCCUR CLAIMS -MADE 0 AR6460401 i 08/01/11 08/01/12 EACH OCCURRENCE AGGREGATE $ 10,000,000 $ 10,000,000 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOWPARTNEWEXECUTIVE Y I N OFFICER/MEMBER EXCLUDED? I (Mandatory in NH) IIyes, describe under DESCRIPTION OF OPERATIONS below N f A ** j PJUB8166N36A11 OB/01/14 , I 08/01/12 WC STATU- 1OTH- Xl_T_QBY.S.tfgu,.__....J...ER_._.._.._.._ E.L. EACH ACCIDENT .._....__._.._-._.-.._......__......__..........__.. ... E.L. DISEASE - EA EMPLOYEE, ....._.........__......____..................__...__....____......._...__.........____.__......... E.L. DISEASE - POLICY LIMIT ..................._...................... $ 1, 000, 000 _._.._.. ..._.._..._ ......._...___........._. $ 1,000,000 $ 1 , 000 , 00 D E Professional Liability AEA113822501 08/01/11 08/01/12 Per Claim: 10,000,000 Aggregate: 15,000,000 Ded. Each Claim: 150,000 DESCRIPTION ** Workers General forms 1.E: As OF OPERATIONS I Compensation & Auto Liability 421-0778 0909 -Needed Engineering LOCATIONS I VEHICLES (Atlach ACORD 101, Addltlonal Remarks Schedule, If more space Is requIred) policy excludes monopolistic states ND, OH, WA, WY. Additional Insured status granted, if required by written contract/agreement, per attached & CA2048 0299. Ser.vices (1L? ff082--0270) CERTIFICATE HOLDER 082-0270 City of National City Ginny Orcutt c/o City Attorney's Office 1243 National City Blvd. National City, CA 91950-4301 ACORD 25 (2010/05) dgarcia 22567764 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. USA © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 3:12 POLICY NUMBER: ZHF920172200 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Other Insurance — Primary and Non -Contributory (Additional insured) -his endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The following is added to Section IV — Commercial General Liability Conditions 4. Other Insurance a. Additional Insureds If you agree in a written contract, written agreement or permit that the insurance provided to any person or organization included as an Additional Insured under Section II — Who is An Insured, is primary and non-contributory, the following applies: If other valid and collectible insurance is available to the Additional Insured for a loss we cover under Coverages A or B of this Coverage Part, our obligations are limited as follows: 1.Primary Insurance This insurance is primary to other insurance that is available to the Additional Insured which covers the Additional Insured as a Named Insured. We will not seek contribution from any other insurance available to the Additional Insured except: i. For the sole negligence of the Additional Insured; ii. when the Additional Insured is an Additional Insured under another primary liability policy; or ill. when 2. below applies. If this insurance is primary, our obligations aro not affected unless any of the other Insurance is also primary. Then, we will share with all that other insurance by the method described in 3. below. 2. Excess Insurance This insurance is excess over: (1) Any of the oilier insurance, wl leth Or primary, excess, contingent or on any other basis: 421-0452 06 07 (a) That is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for "your work"; (b) That is Fire insurance for premises rented to the Additional Insured or temporarily occupied by the Additional Insured with permission of the owner; (c) That is insurance purchased by the Additional Insured to cover the Additional Insured's liability as a tenant for "property damage" to premises rented to the Additional Insured or temporarily occupied by the Additional with permission of the owner; or (d) If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to Exclusion g. of Section I — Coverage A — Bodily Injury And Property Damage Liability. When this insurance is excess, we will have no duly under Coverages A or B to defend the insured against any "suit" if any other insurer has a duly to defend the insured against that "suit". It no other insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers. When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: Includes copyrighted material of Insurance Services Offices, Inc., will) Its permission Page 1 of 2 5:12 POLICY NUMBER: ZHF920172200 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 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 PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: AS REQUIRED BY CONTRACT Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: 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. CG24040509 © Insurance Services Office, Inc., 2008 Page 1 of 1 7: R o!cy Number: ASJZ91455034011 Insurer: Wausau Underwriters Insurance Company Policy Period: August 1, 2011 to August 1, 2012 Excerpts from: Form CA0001 0306 BUSINESS AUTO COVERAGE FORM 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 9:12 TRAVELERS J WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 00 03 13 (00)-01 POLICY NUMBER: (PJUB-8166N36-A-11) 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: 07-29-11 ST ASSIGN: 11:12