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PROOF OF INSURANCE (2015) CLOSED
0 DATE [MM/DD ACCMV Y CERTIFICATE OF LIABILITY INSURANCE 7/14/2014 ) 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 ME: Robert Romar B & B Premier Insurance Solutions PHONE (818)223 -8383 FAX (818)223 -8181 5008 Chesebro Road Suite 200 "MAI robertr bbpremierins.com INSURER(S) AFFORDING COVERAGE NAIC # Agoura Hills CA 91301 INSURED Bino Construction, DBA: James McNary 9520 Topanga Canyon Blvd # 204 INSURERA:Gemini Insurance Company INSURER B Mercury Insurance Group INSURERC:National Union Fire Ins. Co. INSURER D: INSURER E Chatsworth CA 91311 1 u� f"nVFPAC'FA rF:PTIFIrATF M11MIRF14aCL145205971 RFVII.gl N Nll IM,'F' PP. 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, LILT RR LT TYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PR MI. E orc rr • $ 300,000 A CLAIMS -MADE � OCCUR B GR1001576 -01 /29/2014 4/29/2015 MED EXP An one person) $ 5,000 Pollution Liability PERSONAL & ADV INJURY $ 1,000,000 PG1 GENERAL AGGREGATE $ 2,000,000 'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG S 2 , 000 , 000POLICY PRO- LOC $ AUTOMOBILE LIABILITYa a.IdeDq,.. VN a E -I IT $ 1,000,000 BODILY INJURY (Per person) $ B ANY AUTO ALL OWNED SCHEDULED AUTOS X AUTOS 040000006286 5/1/2014 5/1/2015 BODILY INJURY (Per accident) $ PeracEedentDAMAGE $ X HIRED AUTOS X AUTOS D Medical payments $ 5,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1,000,000 X AGGREGATE $ 1,000,000 G. EXCESS LIAB CLAIMS -MADE 66561861 7/14/2014 04/29/2015 $ DED RETENTION $ WORKERS COMPENSATION WC STATU- OTH- T��.�S '.. ER AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR /PARTNER/EXECUTIVE E. L, EACH ACCIDENT $ OFFICER /MEMBER EXCLUDED? NIA EL. DISEASE - EA EMPLOYE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below EL. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate Holder is named as an additional insured as per policy terms, limits, conditions, coverages and exclusions as their interests may appear in the operation of the named insured. CERTIFICATE HOLDER y A V 6ANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of El Segundo, its officrs, offic ls ACCORDANCE WITH THE POLICY PROVISIONS. employees, agents and volunteers 350 Main Street AUTHORIZED REPRESENTATIVE E1 Segundo, CA 90245 -3813 J Wishengrad /JAMES��` ACORD 25 (2010/05) ©1988 -2010 ACORD CORPORATION. All rights reserved. INS025 (201005).01 The ACORD name and logo are registered marks of ACORD ENDORSEMENT — ADDITIONAL INSURED COMPLETED OPERATIONS — SCHEDULED PERSON OR ORGANIZATION — PRIMARY COVERAGE THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: FIRE AND WATER DAMAGE RESTORATION CONTRACTOR'S LIABILITY POLICY CITY OF EL SEGUNDO, ITS OFFICERS, OFFICIALS, I AS REQUIRED BY WRITTEN CONTRACT PRIOR EMPLOYEES, AGENTS AND VOLUNTEERS I TO THE COMMENCEMENT OF WORK :1 A. SECTION V —Who is an Insured is amended to include as an additional insured the person(s) or organization(s) shown In the Schedule above but only with respect to liability for "bodily injury" or "property damage" 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 tangoing operations and in connection with "your work" and included in the "products -com feted operations hazard" you have done on behalf of the additional insured(s) at the locations) designated above. B. With respect to the Insurance afforded to the additional insured(s), the following additional exclusion applies: This insurance does not apply to "bodily injury" or "property damage" occurring before: 1. The contract or agreement has been executed. Execution of the contract or agreement will be considered to happen when your performance begins or when the contract or agreement is signed, whichever happens first; or 2. The inception of this insurance. C. This insurance for the benefit of the additional insureds) shown in the Schedule is primary insurance. Any other insurance maintained by the additional insureds shall be excess and noncontributory but only as respects "bodily Injury" or "'property dama a" caused by your operations if the injury or damage is determined to be the result of your negligence or sole y your responsibility. THIS ENDORSEMENT MUST BE ATTACHED TO A CHANGE ENDORSEMENT WHEN ISSUED AFTER THE POLICY IS WRITTEN. CG 75 75 05 07 © 2007 Gemini Insurance Company Page 1 of 1 Includes material copyrighted by ISO Properties, Inc., with its permisslon ENDORSEMENT - ADDITIONAL INSURED - OWNERS, LESSEES, OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: FIRE AND WATER DAMAGE RESTORATION CONTACTOR'S LIABILITY POLICY A, SECTION V —WHO IS AN INSURED Is amended to include as an additional insured any Person or organization for whore you are performing operations when you and such person or organization have agreed in writin in a contract or agreement that such person or organization be added as an additional insured on your poky. Such person or organization is an additional insured only with respect 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 this endorsement ends when your operations for that additional insured are completed. B. EXCLUSION —With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: 1. "Bodily injury ", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: a. The preparing, approving, or failing to prepare or approve, reaps, shop drawings, opinions, reports, surveys, field orders, Change orders or drawings and specifications; 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 service, maintenance or repairs) to be performed' by or on behalf of the additional insured(s) 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 subcontractor engaged in performing operations for a principal as a part of the same project. THIS ENDORSEMENT MUST BE ATTACHED TO A CHANGE ENDORSEMENT WHEN ISSUED AFTER THE POLICY IS WRITTEN. CG 75 44 07 04 0 2005 Gemini Insurance Company Page 1 of 1 Includes material copyrighted in 2004 by ISO Properties, Inc., with its permission ENDORSEMENT — WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: FIRE AND WATER DAMAGE RESTORATION CONTRACTOR'S LIABILITY POLICY SCHEDULE Name of Person or Organization: Address: ANY PERSON OR ORGANIZATION FOR WHOM YOU ARE PERFORMING OPERATIONS WHEN YOU AND SUCH PERSON OR ORGANIZATION HAVE AGREED IN WRITING IN A CONTRACT OR AGREEMENT. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) SECTION VI — COMMON CONDITIONS — Condition N., Transfer of Rights of Recovery Against Others to Us Condition 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 damaga arising out of our ongoing operations or "your work" done under a contract with that person or organizatlon and included In the "products -completed operations hazard ". This waiver applies only to the person or organization shown in the Schedule above. THIS ENDORSEMENT MUST BE ATTACHED TO A CHANGE ENDORSEMENT WHEN ISSUED AFTER THE POLICY IS WRITTEN. CG 75 3910 93 0 2005 Gemini Insurance Company Page 1 of 1 Includes material copyrighted In 1992 by ISO Properties, Inc., with its permission . y " DATE (MMIDDIYYW) t�J CERTIFICATE OF LIABILITY INSURANCE 05/23/2014 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 Bouchard Insurance for Frank Crum 101 Starcrest Drive Clearwater, FL 33758 INSURER A: American Zurich Insurance Company 140142 INSURED INSURER B CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS; FrankCrum 11, Inc. Labor Contractor, for leased workers to: James McNary .e -..... .---- . ............- ...... ...--- ......__ dba: Bino Construction INSURER....... c _ .A... ...... . 100 South Missouri Avenue INSURER D: Clearwater, FL 33756 rJSURE.a..E...__ � .,�......- _..._�_..�...�...__.- INSURER F COVERAGES CERTIFICATE NUMBER: 14FLO80850944 REVISION NUMBER: 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. .T R TYPE OF INSURANCE POLICY NUMBER MM DD1YYYY •M.MIDDYYYY LIMITS I.TR GENERAL LIABILITY EACH OCCURRENCE $ . COMMERCIAL GENERAL LIABILITY PREMIS P $ CLAIMS -MADE 0 OCCUR MED EXP Any one erson $ .. ........ ...........................�^.� PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ POLICY PRO LOC $ AUTOMOBILE LIABILITY L Ar 11 R acrlJB _ ,.• _ ANY AUTO BODILY INJURY (Per person) $ - T. -� -• ..........._ ALL OWNED SCHEDULEDaccident) BODILY INJURY Per ( $ AUTOS AUTOS WNED ""° ' ._mm.m.,.�. (Pea --- ..... $ HIRED AUTOS AUTOS ., tDAMAd;ff' cRden „) $ UMBRELLA LAB OCCUR .._.,,. EACH OCCURRENCE $ .. _ .............. ._...,. ..... .... EXCESS LAB CLAIMS -MADE _ ......... .............. _ AGGREGATE $ DED RETENTION... $ WORKERS COMPENSATION X WC STATU �OTH- AND EMPLOYERS' LIABILITY 1RA.LIIvt.T A ANY PRO PRIETOR/PARTNER/EXECUTIVE NIA �( WC 54 -70- 649-02 06/01 /2014 06/0112015 E.L. F�4CH ACCIDENT ---- $ 1,000'000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE EA EM_ .. - EMPLOYEE $.... _..�. 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L, DISEASE - POLICY LIMIT $ 1,000,000 Location Coverage Period: 06/01/2014 06/01/2015 Client# 11329 -CA DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) James McNary dba: Bino Construction Coverage is provided for 9520 Topanga Canyon Blvd STE 204 only those employees Chatsworth, CA 91311 leased to but not subcontractors of: Endorsements: Waiver of Subrogation Ill CITY OF EL SEGUNDO ATTEN: ARIANNE BOLA 350 MAIN STREET EL SEGUNDO, CA 90245 %,Ml' ,r_LLAI IVN 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 ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD WORKERS' COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT — CALIFORNIA WC 04 03 06 (Ed. 4 -84) 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 per- form 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 Job Description IN FAVOR OF: CITY OF EL SEGUNDO ATTEN: ARIANNE BOLA 350 MAIN STREET EL SEGUNDO, CA 90245 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: 06/01/2014 Policy No: WC 54- 70- 649 -02 Endorsement No: Insured: FrankCrum 11, Inc, Labor Contractor, for leased workers to: James McNary dba: Bino Construction Insurance Company: American Zurich Insurance Company Countersigned by WC 04 03 06 Copyright 1983 National Council on Compensation Insurance Shillin , Mona From: Garcia, Angelina Sent: Tuesday, May 20, 2014 9:09 AM To: Shilling, Mona Subject: FW: On -Call Carpentry Services - BINO CONSTRUCTION Attachments: EICert.pdf Angelina Garcia From: James Wishengrad [mailto:JamesW @bbpremierins.com] Sent: Tuesday, March 18, 2014 2:49 PM To: Garcia, Angelina Cc: james @binoconstruction.com Subject: RE: On -Call Carpentry Services - BINO CONSTRUCTION Angelina, Please see attached completed operations endorsement. The NAIC number has also been included. Thanks! Your One Stop Insurance Solution for All of Your Business, Commercial and Personal Needs From: James Wishengrad Sent: Tuesday, March 18, 2014 1:08 PM To: 'Garcia, Angelina' Cc: james @binoconstruction.com Subject: RE: On -Call Carpentry Services - BINO CONSTRUCTION Hi Angelina, I am working on getting the NAIC with the carrier as well as confirmation on the completed operations coverage. I will get back to you once I have more info. Thanks, James Wishengrad — Commercial Lines Account Manager B &B Premier Insurance Solutions Inc. 5008 Chesebro Road I Suite 200 1 Agoura Hills, CA 91301