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COI - D.R. Horton Bay, Inc. - Expires 2024-07-01
ACOR[7® CERTIFICATE OF LIABILITY INSURANCE DATE(MWOONYYY) OBI2BI2023 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 have ADDITIONAL INSURED provisions or 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 Aon Risk Insurance Services West, Inc.PHONE Denver CO Office CONTACT INC. No. Ext): (866) 263-7122 FAX No.; (800) 363-0105 1900 16th Street, Suite 1000 Denver Co 80202 USA E-MAIL ADDRESS: INSURERS) AFFORDING COVERAGE NAICIf INSURED INSURER A: Liberty Insurance Corporation 42404 D.R. Horton Bay, Inc. 3000 Executive Parkway Suite 100 San Ramon CA 94583 USA INSURER B: AIG Specialty Insurance Company 26883 INSURER C: American Fire & Casualty Co 24066 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570100448062 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. Limits shown are as requested LTR TYPE OF INSURANCE INSD MD POUCYNUMBER MMIOD1YYY FULICYMAF MM N)1YYY LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑X OCCUR 0.MGGL SIR applies per policy terns & condi ions EACH OCCURRENCE $5,000,000 PREMISES Ea occurrence 550,000 MED EXP(Any one person) Excluded PERSONAL&ADV INJURY $5,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERALAGGREGATE $5,000,000 % POLICY ❑JEST LOG PRODUCTS - COMPIOPAGG $5,000,000 OTHER: A AUTOMOBILE LIABILITY A57-651-288173-033 07/01/202 3 07/01/2024 COMBINED SINGLE LIMB (E. ancX . n E2, 000, 000 BODILY INJURY( Per person) ANYAUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIREDAUTOS NON -OWNED ONLY AUTOS ONLY BODILY INJURY (Par accident) PROPERTY DAMAGE Par accident) C X UMBRELLALIAB EXCESS LIAR X OCCUR CLAIMS -MADE Excess AUtO/WC Only 07 O1 2023 07 O1 2024 EAOCCURRENCE EACH OCCURRENCE 10,000,000 AGGREGATE $10,000,000 DED1 RETENTION A A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/ PARTNER I EXECUTIVE OFFICERIMEMBER EXCLUDED? Efl (Mandatory In NH) If yyes, deace under DEnbSCRIPTK)N OF OPERATIONSbelow NIA WA765D 8173 13 ADS wc7651288173023 wI 07 Ol 2023 07/01/2023 07 1 07/01/2024 X PER STATUTE OTH. ER E.L EACHACCIDENT $1,000,000 E.L. DISEASE -EA EMPLOYEE $1,000,000 E.L. DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more apace to required) RE: Division/Location: BAD, Summerstone (Cottages at Kern), Site Grading & improvement for the Cottages at Kern aka Summerstone. city is included as Additional Insured in accordance with the policy provisions of the General Liability policy. General Liability policy evidenced herein is Primary and Non-contributory to other insurance available to an Additional Insured, but only in accordance with the policy's provisions. A Waiver of Subrogation is granted in favor of Certificate Holder in accordance with the policy provisions of the General Liability, Automobile Liability and Workers' Compensation policies. CERTIFICATE HOLDER ILnjLs(9LF.U\)M90I CANCELLATION JUL y / 2023 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE I POLICY PROVISIONS. City of Gilroy 7351 Rosanna Street GILROY MY CLERK'S OFFICE AUTHORIZED REPRESENTATIVE Gilroy CA 95020 USA e.J�'aRe ✓La7k✓frd/�Ata9ue c/cty� `/�i.�J�u a 6 01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <•F. , Aon Business Services +1 866 283 7122 Client Services Unit Acs.chicago@aon.com 4 Overlook Point Lincolnshire, IL 60069 Date June 30th 2023 Dear Valued Client, An error was made during the printing of your renewal certificate(s). Please find enclosed the corrected certificate(s) including all endorsements. We apologize for any inconvenience this may have caused you. We work hard to provide the best service possible, including fixing errors that occur. Sincerely, Aon Client Services Aon Risk Services Central, Inc. - Aon Risk Insurance Services Central, Inc. I CA License # OD04043 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement, effective: 12:01 A.M. 07/01/2023 Forms a part of Policy No.: RMGGL 159-54-49 Issued to D.R. Horton By: American International Specialty Lines Insurance Company ADDITIONAL INSURED - - OWNERS, LESSEES OR CONTRACTORS (FORM B) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE ; Name if Person or Organization: ANY PERSON OR ORGANIZATION FOR WHOM YOU ARE PERFORMING OPERATIONS WHEN YOU AND SUCH PERSON OR ORGANIZATION HAVE AGREED IN WRITING IN A CONTRACTOR AGREEMENT THAT SUCH PERSON OR ORGANIZATION BE ADDED AS AN ADDITIONAL INSURED ON YOUR POLICY. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of "your work" for that insured by or for you. PRIMARY/NON-CONTRIBUTORY WORDING: IT IS AGREED THAT THIS POLICY IS PRIMARY AS RESPECTS ANY INSURANCE MAINTAINED BY THE ADDITIONAL INSURED AND THAT SUCH INSURANCE MAINTAINED BY THE ADDITIONAL INSURED IS EXCESS AND NON-CONTRIBUTORY WITH THIS POLICY AS RESPECTS TO WORK PERFORMED BY THE NAMED INSURED. zed Representative or rsignature On states where a m THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY ENDORSEMENT # 115 This endorsement, effective:12:01A.M. 07/01/2023 Forms a part of Policy No.: RMGGL 159-54-49 Issued to: D. R. Horton, Inc. By: AIG Specialty Insurance Company WAIVER OF SUBROGATION (BLANKET) It is agreed that we, in the event of a payment under this policy, waive our right of subrogation against any person or organization where the insured has waived liability of such person or organization as part of a written contractual agreement between the insured and such person or organization entered into prior to the "occurrence" or offense. All other terms, conditions, and exclusions shall remain the same. POLICY NUMBER: AS7-651-288173-033 COMMERCIAL AUTO CA 04 4410 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. 19 SCHEDULE Name(s) Of Person(s) Or Organization(s): Any person or organization for whom you perform work under a written contract if the contract requires you to obtain this agreement from us, but only if the contract is executed prior to the injury or damage occurring. Premium: $ INCL Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss" under a contract with that person or organization. a 0 0 0 M co 0 0 1 0 CA 04 44 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT — CALIFORNIA 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.) 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 2% of the California workers' compensation premium otherwise due on such remuneration. Schedule Additional premium is a percent of the California Manual Workers Compensation premium. Subject to a minimum premium charge of $ 250 Person or Organization Job Description Where required by contract or written agreement prior to loss and allowed by law. Issued by Co 7 - Liberty Insurance Corporation For attachment to Policy No. WA7-65D-288173-013 Premium $ Effective Date 07/01/2023 Issued to D.R. Horton, Inc. WC 04 03 06 Page 1 of 1 Ed. 04/1984 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/D02YYYY) osr2sr2o23 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(les) must have ADDITIONAL INSURED provisions or 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 Aon Risk Insurance services west, Inc. Denver CO Office CONTACT NAME: PHONE (A/C. No. Ext): (866) 283-7122 (AtC. No.): (800) 363-0105 1900 16th Street, Suite 1000 Denver CO 80202 USA E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: Liberty Insurance Corporation 42404 D.R. Horton Bay, Inc. 3000 Executive Parkway suite 100 San Ramon CA 94583 USA INSURERS: AIG Specialty Insurance Company 26883 INSURER C: American Fire & Casualty Co 24066 INSURER D: INSURER E: INSURER F: u VERAuEb CERTIFICATE NUMBER: 570100448062 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. Limits shown are as requested LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYY MMIDDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY RM66L EACH OCCURRENCE $ 5 , 000 , 000 CLAIMS -MADE M OCCUR SIR applies per policy terns & conditions UAMAUE TO RENTED PREMISES Ea occurrence $50,000 MED EXP (Any one person) Excluded PERSONAL & ADV INJURY $ 5 , 000 , 000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $5 , 000, 000 X POLICY [—:]IPRO ❑ LOC JECT PRODUCTS- COMP/OP AGG $5,000,000 OTHER: A AUTOMOBILE LIABILITY AS7-651-288173-033 67/01/2023 07/01/2024 COMBINED SINGLE LIMIT Ea accident) S2,000,000 BODILY INJURY ( Per person) X ANY AUTO OWNED SCHEDULED BODILY INJURY (Per accident) AUTOS ONLY AUTOS HIREDAUTOS NON -OWNED PROPERTY DAMAGE ONLY AUTOS ONLY Per accident C UMBRELLA LIAB X OCCUR EU02455519698 07 O1/2023 07/01 ZO24 EACH OCCURRENCE $10,000,000 X EXCESS LIAB CLAIMS -MADE Excess AUtO/WC Only AGGREGATE $10,000,000 DED RETENTION A WORKERS COMPENSATION AND WA7 5D 8 17301 7 01 20 3 07/01/2024 X PER STATUTE OTH- EMPLOYERS' LIABILITY Y / N ADS ER E.L. EACH ACCIDENT $1, 000, 000 A ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBEREXCLUDED? a N/A WC7651288173023 07/01/2023 07/01/2024 E.L. DISEASE -EA EMPLOYEE $1, 000, 000 (Mandatory in NH) WI It yes, describe under E.L. DISEASE -POLICY LIMIT S1,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Division/Location: BAD, Summerstone (Cottages at Kern), site Grading & improvement for the Cottages at Kern aka Summerstone. City is included as Additional insured in accordance with the the General Liability policy provisions of policy. General Liability policy evidenced herein is Primary and Non -Contributory to other insurance available to an Additional Insured, but only in accordance with the policy's provisions. A waiver of Subrogation is granted in favor of Certificate Holder in accordance with the policy provisions of the General Liability, Automobile Liability and workers' Compensation policies. CERTIFICATE HOLDER 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. .I.; . City Of Gi 1 roy AUTHORIZED REPRESENTATIVE 7351 Rosanna street Gilroy CA 95020 USA J4 69 01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Aon Business Services +1 866 283 7122 Client Services Unit Acs.chicago@aon.com AON 4 Overlook Point Lincolnshire, IL 60069 Date June 30th 2023 Dear Valued Client, An error was made during the printing of your renewal certificate(s). Please find enclosed the corrected certificate(s) including all endorsements. We apologize for any inconvenience this may have caused you. We work hard to provide the best service possible, including fixing errors that occur. Sincerely, Aon Client Services Aon Risk Services Central, Inc. - Aon Risk Insurance Services Central, Inc. ( CA License # OD04043 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement, effective: 12:01 A.M. 07/01/2023 Forms a part of Policy No.: RMGGL 159-54-49 Issued to D.R. Horton By: American International Specialty Lines Insurance Company ADDITIONAL INSURED - - OWNERS, LESSEES OR CONTRACTORS (FORM B) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name if Person or Organization: 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 THAT SUCH PERSON OR ORGANIZATION BE ADDED AS AN ADDITIONAL INSURED ON YOUR POLICY. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of "your work" for that insured by or for you. PRIMARY/NON-CONTRIBUTORY WORDING: IT IS AGREED THAT THIS POLICY IS PRIMARY AS RESPECTS ANY INSURANCE MAINTAINED BY THE ADDITIONAL INSURED AND THAT SUCH INSURANCE MAINTAINED BY THE ADDITIONAL INSURED IS EXCESS AND NON-CONTRIBUTORY WITH THIS POLICY AS RESPECTS TO WORK PERFORMED BY THE NAMED INSURED. 0 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY ENDORSEMENT # 115 This endorsement, effective:12:01A.M. 07/01/2023 Forms a part of Policy No.: RMGGL 159-54-49 Issued to: D. R. Horton, Inc. By: AIG Specialty Insurance Company WAIVER OF SUBROGATION (BLANKET) It is agreed that we, in the event of a payment under this policy, waive our right of subrogation against any person or organization where the insured has waived liability of such person or organization as part of a written contractual agreement between the insured and such person or organization entered into prior to the "occurrence" or offense. All other terms, conditions, and exclusions shall remain the same. POLICY NUMBER: AS7-651-288173-033 COMMERCIAL AUTO CA04441013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. SCHEDULE Name(s) Of Person(s) Or Organization(s): Any person or organization for whom you perform work under a written contract if the contract requires you to obtain this agreement from us, but only if the contract is executed prior to the injury or damage occurring. Premium: $ INCL Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss" under a contract with that person or organization. CA04441013 © Insurance Services Office, Inc., 2011 Page 1 of 1 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT — CALIFORNIA 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.) 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 2% of the California workers' compensation premium otherwise due on such remuneration. Schedule Additional premium is a percent of the California Manual Workers Compensation premium. Subject to a minimum premium charge of $ 250 Person or Organization Job Description Where required by contract or written agreement prior to loss and allowed by law. Issued by Co 7 - Liberty Insurance Corporation For attachment to Policy No. WA7-65D-288173-013 Premium $ Effective Date 07/01/2023 Issued to D.R. Horton, Inc. WC 04 03 06 Page 1 of 1 Ed. 04/1984