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HomeMy WebLinkAboutCOI_ Jeremy Harris Construction Inc_ 12.17.24The ACORD name and logo are registered marks of ACORD CERTIFICATE HOLDER © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) AUTHORIZED REPRESENTATIVE CANCELLATION DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE LOCJECTPRO-POLICY GEN'L AGGREGATE LIMIT APPLIES PER: OCCURCLAIMS-MADE COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence)$DAMAGE TO RENTED EACH OCCURRENCE $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $RETENTIONDED CLAIMS-MADE OCCUR $ AGGREGATE $ EACH OCCURRENCE $UMBRELLA LIAB EXCESS LIAB DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) INSRLTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)LIMITS PERSTATUTE OTH-ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $ $ $ ANY PROPRIETOR/PARTNER/EXECUTIVE If yes, describe under DESCRIPTION OF OPERATIONS below (Mandatory in NH) OFFICER/MEMBER EXCLUDED? WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED HIRED AUTOS NON-OWNED AUTOS AUTOS AUTOS COMBINED SINGLE LIMIT BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE $ $ $ $ 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. INSD ADDL WVD SUBR N / A $ $ (Ea accident) (Per accident) OTHER: 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). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: INSURED PHONE(A/C, No, Ext): PRODUCER ADDRESS:E-MAIL FAX(A/C, No): CONTACTNAME: NAIC # INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : INSURER(S) AFFORDING COVERAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 12/17/2024 SIP Insurance Services -Orange 790 The City Drive South,Suite 210 Orange CA 92868 Brigitte Leber 626-214-7919 626-564-6565 brigitte@sipbrokers.com License#:0M93299 Gemini Insurance Company 10833 JEREHAR-02 Security National Insurance Company -AmTrust 19879JeremyHarrisConstructionInc. PO Box 668 Riverside CA 92502 Navigators Specialty Insurance Company 36056 State Compensation Insurance Fund 35076 1626754728 A X 1,000,000 X 100,000 5,000 1,000,000 2,000,000 X Y Y VCGP032843 10/24/2024 10/24/2025 2,000,000 B 1,000,000 X XX SPP181805001 12/9/2024 12/9/2025 C X 4,000,000 X SF24EXCZ0JG13IC 4,000,000 10/24/2024 10/24/2025 D Y 9242155-2024 12/1/2024 12/1/2025 X 1,000,000 1,000,000 1,000,000 Subject to all policy terms,exclusions and conditions. San Bernardino County Flood Control District and County of San Bernardino and its officers,employees,and volunteers are an Additional Insured with respects to attached General Liability endorsement if required by written contract.General Liability Primary and Non-Contributory endorsement attached.General Liability Waiver of Subrogation endorsement attached.Attached Workers Compensation Waiver of Subrogation endorsement applies if required by written contract. San Bernardino County and San Bernardino County Flood Control District Flood Control Permit Section 825 E.Third St.,Room 108 San Bernardino CA 92415 Policy Number: VCGP032843 Insured Name: Jeremy Harris Construction Inc Number: CG 24 041219 Effective Date: 10/24/2024 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: Commercial General Liability Coverage Part Schedule Name Of Person(s) Or Organization(s): Any person or organization you have agreed in a written and executed contract, prior to an "occurrence", that you would provide such person or organization a waiver of transfer of rights of recovery against others to us on your policy. Information required to comolete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV -Conditions: We waive any right of recovery against the person(s) or organization(s) shown in the Schedule above because of payments we make under this Coverage Part. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person(s) or organization(s) prior to loss. This endorsement applies only to the person(s) or organization(s) shown in the Schedule above. All other terms and conditions of this Policy remain unchanged. CG 24 0 4 1219 © Insurance Services Office, Inc., 2018 Page 1 of 1 VE 09 73 04 20 Policy Number: VCGP032843 Insured Name: Jeremy Harris Construction Inc Number: Effective Date: 10/24/2024 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: Commercial General Liability Coverage Part The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other Commercial General Liability insurance available to an additional insured under your policy, but only if: (1)The additional insured is a Named Insured under such other Commercial General Liability insurance; and (2)You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other Commercial General Liability insurance available to the additional insured. Coverage granted to an additional insured remains subject to all terms, conditions, limitations, and exclusions set forth in the endorsement form that conferred the additional insured status. In the event of conflict between this endorsement and an endorsement conferring additional insured status, then the endorsement conferring additional insured status shall govern the scope of coverage available to the additional insured. All other terms and conditions of this Policy remain unchanged. VE 09 73 04 20 Includes copyrighted material of Insurance Services Office, Inc. with its permission Page 1 of 1 Policy Number: VCGP032843 Insured Name: Jeremy Harris Construction Inc Number: CG 2010 0413 Effective Date: 10/24/2024 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: Commercial General Liability Coverage Part SCHEDULE Name Of Additional Insured Person(s} Or Organization(s): Location(s) Of Covered Operations Any person or organization when you have agreed All locations for which you have agreed in a written in a written and executed contract prior to an "occurrence", that such person or organization be and executed contract prior to an "occurrence." added as an additional insured on your policy. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A.Section II -Who Is An Insured is amended to include as an additional insured the person(s} or organization(s} shown in the Schedule, but 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(s} at the location(s} designated above. However: 1.The insurance afforded to such additional insured only applies to the extent permitted by law; and 2.If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B.With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1.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 CG 20 10 0413 © Insurance Services Office, Inc., 2012 Page 1 of2