COI - Tri Pointe Homes Holdings, Inc. - Expires 2023-07-07A`ORI' EVIDENCE OF COMMERCIAL PROPERTY INSURANCE
DATE 7/6/2022
THIS EVIDENCE OF COMMERCIAL PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS
UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER
THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN
THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE ADDITIONAL INTEREST.
PRODUCER NAME PHONE 949-252-4400
CONTACT PERSON AND ADDRESS (A/C. No. Ext):
COMPANY NAME AND ADDRESS
Ascot Insurance Company
IF MULTIPLE COMPANIES, COMPLETE
NAIC NO: 23752
Lockton Insurance Brokers, LLC
19800 MacArthur Blvd., Suite 1250
CA License #0F15767
Irvine 92612
SEPARATE FORM FOR EACH
FAX E-MAIL
(A/C. No): 949-252-4410 ADDRESS:
CODE: SUB CODE:
POLICY TYPE
Property
AGENCY
CUSTOMER ID #:
NAMED INSURED AND ADDRESS Tri Pointe Homes Holdings, Inc.
111 1485 Tri Pointe Homes, Inc.
19540 Jamboree Road, Suite 300
Irvine CA 92612
LOAN NUMBER
POLICY NUMBER
IMMA2210000477-03
EFFECTIVE DATE
7/7/2022
EXPIRATION DATE
7/7/2023
CONTINUED
UNTIL
IF CHECKED
TERMINATED
ADDITIONAL NAMED INSURED(S)
THIS REPLACES PRIOR EVIDENCE DATED:
PROPERTY INFORMATION (ACORD 101 maybe attached if more space is required) I=1 BUILDING OR ❑ BUSINESS PERSONAL PROPERTY
LOCATION/DESCRIPTION
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 EVIDENCE OF PROPERTY INSURANCE 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.
COVERAGE INFORMATION
PERILS INSURED I I BASIC
I
BROAD
X I SPECIAL
I
COMMERCIAL PROPERTY COVERAGE AMOUNT OF INSURANCE: $ 30,000,000 DED: $25,000
YES
NO
N/A
® BUSINESS INCOME ❑ RENTAL VALUE
X
If YES, LIMIT: Included Actual Loss Sustained; # of months:
BLANKET COVERAGE
X
If YES, indicate value(s) reported on property identified above: $
TERRORISM COVERAGE
X
Attach Disclosure Notice / DEC
IS THERE A TERRORISM -SPECIFIC EXCLUSION?
X
IS DOMESTIC TERRORISM EXCLUDED?
X
LIMITED FUNGUS COVERAGE
X
If YES, LIMIT: $100,000 DED:
FUNGUS EXCLUSION (If "YES", specify organization's form used)
X
REPLACEMENT COST
X
AGREED VALUE
X
COINSURANCE
X
If YES,
EQUIPMENT BREAKDOWN (If Applicable)
X
If YES, LIMIT: $2,500,000 DED: $25,000
ORDINANCE OR LAW - Coverage for loss to undamaged portion of bldg
X
If YES, LIMIT: Included DED: $25,000
- Demolition Costs
X
If YES, LIMIT: $5,000,000 ,
- Incr. Cost of Construction
X
If YES, LIMIT: Included DED:DED: $25$25,000000
EARTH MOVEMENT (If Applicable)
X
If YES, LIMIT: See Attached DED: See Attached
FLOOD (If Applicable)
X
If YES, LIMIT: See Attached DED: See Attached
WIND / HAIL INCL ® YES NO Subject to Different Provisions:
x
If YES, LIMIT: Included DED: $25,000
NAMED STORM INCL ® YES NO Subject to Different Provisions:
X
If YES, LIMIT: $20,000,000 DED: See Attached
PERMISSION TO WAIVE SUBROGATION IN FAVOR OF MORTGAGE
HOLDER PRIOR TO LOSS
x
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.
ADDITIONAL INTEREST
LENDER'S LOSS PAYABLE I XI LOSS PAYEE
NAME AND ADDRESS
597792 City of Gilroy
7351 Rosanna Street
Gilroy, CA 95020
RE
JUL 18 2022
GILROY CITY CLERK'S OFFICE
[D568469] [D523389]
LENDER SERVICING AGENT NAME AND ADDRESS
AUTHORIZED
TAT
•
ACORD 28 (2016/03)
J 3-20 5 ACORD CORPORATION. 2 All rights reserved.
The ACORD name and logo are registered marks of ACORD
Lockton Insurance Brokers, LLC
19800 MacArthur Blvd., Suite 1250
CA License #0F15767
Irvine 92612
1oz- #10 - Q12054 - 2447 - 5903
CITY OF GILROY
7351 ROSANNA ST
GILROY CA 95020-6141
Ii1II11iI11I111nI11n111IIIIII1..I.In1.I.InII.IIiIi
1oz - #10 - 2447 - 5903
EVIDENCE OF COMMERCIAL PROPERTY INSURANCE REMARKS - Including Special Conditions (Use only if more space is required)
Excess Builders Risk: Carrier: Lexington Insurance Company; Policy #11435793; Participation: $20,000,000 excess of
$10,000,000. Builders Risk: Catastrophe Limits: $30,000,000; $5,000,000 per dwelling; $10,000,000 any one building or
structure. Transit - $2,500,000. Temporary Storage - $2,500,000. Earth Movement Coverage Limits: $20,000,000, Deductible: 5%
of values at risk at the time of loss subject to minimum $100,000 (CA, AK, HI, PR), 2% of values at risk at the time of loss
subject to a minimum $100,000 (OR, WA), & $100,000 (AOS); Flood: Limits: $20,000,000 , Deductible: $500,000 (100 year Flood
Zones) $100,000 (All other zones). Named Storm Limits: $20,000,000, Deductible: 2% of values at risk at time of loss/minimum
of $100,000. City of Gilroy is loss payee as per the attached endorsement or policy language.
#10 - 2447 - 5904
ACORD 28(2016/03)
Certificate Holder ID: 597792
Arkactechineatcd::Dii69 trtetsCH64clitvS5,1rtificate ID: 597792
Loam
City of Gilroy
7351 Rosanna Street
Gilroy„ CA 95020
To whom it may concern:
In our continuing effort to provide timely certificate delivery, Lockton Companies is transitioning
to paperless delivery of Certificates of Insurance, thus this is your final hard -copy delivery.
To ensure electronic delivery for future renewals of this certificate, we need your email address.
Please contact us via one of the methods below, referencing Certificate ID 597792
• Email: LACertseDelivery@lockton.com
• Phone: (213) 334-4669
If you received this certificate through an internet link where the current certificate is viewable,
we have your email and no further action is needed.
In the event your mailing address has changed, will change in the future, or you no longer
require this certificate, please let us know using one of the methods above.
The above inbox and phone number is for automating electronic delivery of certificates only.
Please do NOT send future certificate requests to this inbox or contact the phone number below
with email updates.
Thank you for your cooperation and willingness in reducing our environmental footprint.
Lockton Companies
Lockton Companies
777 South Figueroa Street Los Angeles, CA 90017
Attachment Code : D523389 Certificate ID : 597792
AAIS
CO 1072 04 02
Page 1 of 1
POLICY NUMBER: IMMA2210000477-03
LOSS PAYABLE SCHEDULE
(The entries required to complete this endorsement will be shown below or on the "schedule of coverages".)
Indicate applicable provision:
Loss Payable
Lender's Loss Payable
Contract of Sale
SCHEDULE
Location
All
Covered
Property
All
Name and Address
of Loss Payee
Blanket Coverage for Loss Payees, Lender's Loss Payable and/pr Additional Insureds as listed on
ACORD Certificates of Insurance issued by the Agent/Broker and on file at their location.
CO 1072 04 02
Copyright, American Association of Insurance Services, 2002
1oz - #10 - 2447 - 5905