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ALEXA RUBIO
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Last modified
6/13/2022 9:53:36 AM
Creation date
1/7/2021 4:27:01 PM
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Contracts
Company Name
ALEXA RUBIO
Contract #
N-2021-003
Agency
Community Development
Expiration Date
1/31/2021
Destruction Year
2026
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Burns& <br />Wilcox <br />101 California Street, Suite 975, San Francisco, CA 94111 <br />Phone: (415) 421-4244 OR (800) 759-4855 Fax: (415) 421-0620 <br />DATE:11/19/2020 INSURANCE BINDER Page 3of4 <br />*"ENDORSEMENTS & EXCLUSIONS: <br />UNLPFD1 - COMMON POLICY DECLARATIONS. <br />AF001772 -CLAIM REPORTING INFORMATION. <br />AF100 - POLICY JACKET. <br />AF3380 - FRAUD & MISREPRESENTATION ENDORSEMENT. <br />AF3550 - MINIMUM EARNED PREMIUM & CANCELLATION CLAUSE. <br />AF900 -SERVICE OF SUIT. <br />IL0017 -COMMON POLICY CONDITIONS. <br />SOFAE -SCHEDULE OF FORMS & ENDORSEMENTS. <br />AF000839 -INJURY TO EMPLOYEES, SUBCONTRACTORS, INDEPENDENT CONTRACTORS, TEMPORARY WORKERS, <br />LEASED WORKERS OR VOLUNTEERS EXCLUSION. <br />AF001007 - COMBINED COVERAGE & EXCLUSION ENDORSEMENT: ASBESTOS EXCLUSION; LEAD EXCLUSION; <br />CONTRACTOR'S SPECIAL CONDITIONS; EMPLOYMENT RELATED PRACTICES EXCLUSION; NUCLEAR ENERGY LIABILITY <br />EXCLUSION; PROFESSIONAL SERVICES AND MALPRACTICE EXCLUSION; SEXUAL / PHYSICAL ABUSE EXCLUSION; <br />TOTAL POLLUTION EXCLUSION WITH HOSTILE FIRE EXCEPTION; ASSAULT & BATTERY EXCLUSION, ANTI -STACKING <br />AND NONDUPLICATION OF LIMITS OF INSURANCE; TENDERING OF APPLICABLE LIMIT OF INSURANCE. <br />AF001396 -INFRINGEMENT, MISAPPROPRIATION AND UNFAIR COMPETITION EXCLUSION. <br />AF001707 -AMENDMENT OF NONPAYMENT CANCELLATION CONDITION. <br />AF001729 - CONDITIONAL EXCLUSION OF LIABILITY/CLAIMS IN THE STATE OF MISSOURI -ONLY APPLIES IF MISSOURI <br />IS PRINCIPLE PLACE OF BUSINESS OR RISK CONDUCTS MORE THAN 10% OF OPERATIONS IN MISSOURI, <br />AF001752 -AMERICANS WITH DISABILITIES ACT AND DISCRIMINATION EXCLUSION. <br />AF3378 -AMENDATORY ENDORSEMENTS: CANCELLATION, CANCELLATION OF FINANCED POLICY, AUDIT <br />CONDITIONS. <br />AF3400 - SILICAOR SILICARELATED DUST EXCLUSION. <br />UNLPFSDI L -COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS. <br />AF001788 -TOTAL CANNABIS AND RELATED PRODUCTS EXCLUSION. <br />CG0001 - COMMERCIAL GENERAL LIABILITY COVERAGE FORM - C00001 04-13. <br />CG2107 -ACCESS OR DISCLOSURE OF CONFIDENTIAL OR PERSONAL INFORMATION AND DATA -RELATED LIABILITY <br />EXCLUSION. <br />CG2167 -FUNGI OR BACTERIA EXCLUSION ((DOES NOT APPLY TO GOODS OR PRODUCTS INTENDED FOR BODILY <br />CONSUMPTION). <br />CG2426 - AMENDMENT OF INSURED CONTRACT DEFINITION. <br />AF001401 -DAMAGE TO PREMISES RENTED TO YOU LIMITATION -FIRE LEGAL LIABILITY COVERAGE. <br />AF000873 -KNOWN INJURY OR DAMAGE EXCLUSION FOR PERSONAL & ADVERTISING INJURY. <br />AF000899 -CLARIFICATION AMENDMENT TO POLICY AIRCRAFT, AUTO OR WATERCRAFT EXCLUSION. <br />D2 -CALIFORNIA SURPLUS LINES NOTICE. <br />CAPRNOTICE -CALIFORNIA PREMIUM REFUNDS NOTICE -POLICIES CANCELED BY INSURED MAY INCUR A 10% <br />SHORT RATE PENALTY. <br />CG3234-CACHANGES. <br />AF001740 -DESIGNATED OPERATIONS -STATE OF NEW YORK EXCLUSION. <br />AF001741 -DESIGNATED OPERATIONS -STATE OF WASHINGTON EXCLUSION. <br />AF33509 - ASSAULT & BATTERY EXCLUSION REMOVAL (ENDORSEMENT TO REMOVE A&B EXCLUSION). <br />AF33510- CLASSIFICATIONLIMITATION. <br />AF33515A - NEW RESIDENTIAL CONSTRUCTION EXCLUSION. <br />AF33530- SUBSIDENCEEXCLUSION. <br />AF3397 - EIFS EXCLUSION & DRYWALL EMISSION EXCLUSION. <br />CGO300 - DEDUCTIBLE LIABILITY. <br />CG2144 - LIMITATION OF COVERAGE TO A DESIGNATED PREMISES / PROJECT. <br />TYPIST: IN THE PROJECT BOX, TYPE THE FOLLOWING "ELECTRICAL / UTILITY BOX PAINTING FOR CITY OF SANTA ANA' <br />CG2154 - OCIPANRAP-UP EXCLUSION, <br />GLS 261s - ADDITIONAL INSURED - INDPENDENT CONTRACTOR (SCOTTSDALE FORM - SEE NEXT PAGE) <br />CONDITIONS: <br />�� RinlxManag��nnlEpivls�nn <br />REVIEWED&APPROVED BY. <br />Im. Ris k Nlanagement Analyst <br />
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