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Last modified
8/24/2022 10:59:02 AM
Creation date
5/6/2021 12:04:28 PM
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Contracts
Company Name
CRISSELLE MENDIOLA
Contract #
N-2021-086
Agency
Community Development
Expiration Date
6/30/2021
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: 4/7/2021 INSURANCE BINDER Page 3 of 4 <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 />UNLPFSDIL -COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS. <br />AF001788 -TOTAL CANNABIS AND RELATED PRODUCTS EXCLUSION. <br />C00001 - COMMERCIAL GENERAL LIABILITY COVERAGE FORM - CG0001 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 - CLASSIFICATION LIMITATION. <br />AF33515A -NEW RESIDENTIAL CONSTRUCTION EXCLUSION. <br />AF33530 - SUBSIDENCE EXCLUSION. <br />AF3397 - EIFS EXCLUSION & DRYWALL EMISSION EXCLUSION. <br />CG0300 - DEDUCTIBLE LIABILITY. <br />"CG2144 -LIMITATION OF COVERAGE TO A DESIGNATED PREMISES / PROJECT <br />PROJECT: ELECTRICAL / UTILITY BOX PAINTING FOR CITY OF SANTA ANA """ <br />CG2154 - OCIPANRAP-UP EXCLUSION. <br />CG2503 -PER PROJECT AGGREGATE:*** TYPIST INCLUDE THE FOLLOWING WORDING: "LOCATIONS AS REQUIRED <br />BY SPECIFIC WRITTEN CONTRACT" *** <br />AF001397 - BLANKET PRIMARY & NON CONTRIBUTORY WORDING:[TYPING -ADD THE FOLLOWING WORDING TO <br />FORM: "ANY PARTY FOR WHOM THE INSURED IS PERFORMING SERVICES, AT A SPECIFIED PROJECT SET FORTH IN A <br />WRITTEN CONTRACT, THAT: (1) HAS BEEN SIGNED BY ALL PARTIES, INCLUDING THE NAMED INSURED AND THE PARTY <br />SEEKING COVERAGE UNDER THIS ENDORSEMENT: AND (2) HAS BEEN ENTERED INTO BEF <br />of Risk MmtagmmEDMalan <br />�� I/ t REVIEWED&APPROVED BY. <br />�' <br />Risk Management Analyst <br />
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