dempsey construction inc subcontractor/vendor insurance ......dempsey construction inc...

Dempsey Construction Inc Subcontractor/Vendor Insurance Requirements

April 14, 2017

1

1. Subcontractor's Liability Insurance. Within ten (10) calendar days of signing this Agreement, and prior to commencing any work under this Agreement, Subcontractor and sub-Subcontractors shall furnish an executed Certificate of Insurance to Contractor specifying that Subcontractor has obtained and is covered by a Commercial General Liability policy, an Automobile Liability policy, and, unless specifically exempted by law, a Workers' Compensation and Employer Liability policy, applicable to the Work under this Agreement, issued by one or more properly licensed admitted insurance companies, each of which shall be rated A-VIII or higher by AM Best in at least the amounts set forth below:

General Liability---Commercial General Liability (occurrence-based) General Aggregate $2,000,000 Products- Comp/Ops Agg $2,000,000 Personal & Adv Injury $1,000,000 Each Occurrence $1,000,000 Policy shall not contain exclusions for mold and/or fungus damage. If policy contains such an exclusion, provide Contractor’s Pollution Liability. Include a Waiver of Subrogation endorsement in favor of Dempsey Construction, Inc. and Owner.

Subcontractor’s Commercial General Liability policy shall at a minimum provide liability coverage for bodily injury, property damage, products-completed operations, contractor’s protective and contractual liability for the liability assumed under the Subcontract Agreement, broad form property damage (including completed operations), explosion, collapse and underground hazards (including subsidence and any other earth movement), personal injury liability, independent contractors and its Workers Compensation Policy shall include coverage for Employer’s liability. The general aggregate limit shall apply separately to Subcontractor’s work under the Contract. The general aggregate limit shall be on a per project basis. For subcontracts in excess of $250,000 an additional $3,000,000 Excess Liability Insurance policy shall be maintained over the General Liability coverage. Such Excess coverage shall, at a minimum, include the items set forth above. Higher limits of liability may be required for hazardous work. Subcontractor shall maintain primary and excess products liability and completed operation coverage for at least four years following completion of the project and its acceptance by Owner and shall be maintained for (10) years if the project is residential or habitational. If Subcontractor believes that it is exempted by law from the obligation to provide Workers’ Compensation Insurance, Subcontractor shall submit evidence satisfactory to Contractor to establish its entitlement to such an exemption as condition precedent to performance of Work under this Agreement. Subcontractor shall ensure that their sub-subcontractors of every tier also carry insurance with the limits of liability specified above. Contractor may require written proof that the requisite insurance is being carried. Such written proof shall be furnished to the Contractor within ten (10) days after such request has been made. Contractor will require that the sub-subcontractor name Contractor and Owner as additional insured. Such naming shall be provided at no additional cost or expense to Contractor or Owner. Subcontractor shall not provide general liability insurance under any Claims-Made General Liability form without express prior written consent of Contractor. Any self-insurance program providing coverage in excess of $25,000 per occurrence requires the prior written consent of the contractor. If Subcontractor’s Scope of Work includes work within 50 feet of any railroad, Subcontractor’s Commercial General Liability policy shall be endorsed to delete the Contractual Liability exclusion for work performed within 50 feet of a railroad. A copy of such endorsement shall be provided to Contractor prior to commencement of such work.

Subcontractor shall name Contractor and Owner as an additional insured under Subcontractor's Commercial General Liability Policy, and shall, within ten (10) calendar days of signing this Agreement, and prior to commencing any work, provide to Contractor with ISO form CG 20 10 07 04 or its equivalent, and supplemented by ISO Form CG 20 37 07 04 or its equivalent, showing that Contractor and Owner are named as additional insured, including additional insured status for Products and Completed Operations claims under its Commercial General Liability Policy. The insurance required by virtue of this provision must be primary insurance and non-contributory, and must be fully collectible prior to any other insurance the Contractor may have or be entitled to. The insurance required above must be maintained in full force until the work required under this Agreement is completed. The Certificate of Insurance shall contain an endorsement providing that the policies of insurance required above shall not be cancelled by Subcontractor or Subcontractor's insurers without first giving Contractor thirty (30) calendar days advance notice in writing (ten (10) days for non-payment of premium). In the event Contractor has not received the Certificate of Insurance within the ten (10) calendar day period, or in the event that Contractor receives written notice from the Insurer(s) that Subcontractor's insurance has been cancelled, Subcontractor agrees that Contractor may procure the required insurance and charge Subcontractor for all premiums, plus twenty-five percent (25%) for Contractor’s overhead, and that Contractor may deduct such sums from any amounts due Subcontractor. However, nothing contained in this paragraph shall in any way relieve Subcontractor from the complete and absolute responsibility of obtaining and maintaining the insurance as specified in this Agreement.

Crane Subcontractors Riggers Liability with a limit of at least $10,000,000. Boom Coverage with a limit of at least $1,000,000. Aviation Insurance Subcontractor shall maintain insurance covering operation of aircraft with Bodily Injury and Property Damage Combined Single Limit of $1,000,000. Subcontractor shall name the Contractor, Owner, Property Manager, City etc as required by the project contract as an Additional Insured under the Aviation Liability

Automobile Liability Any Auto, Hired Autos, Non-Owned Autos - $1,000,000 (combined single limit) Include a Waiver of Subrogation endorsement in favor of Dempsey Construction, Inc. and Owner.

Workers' Compensation and Employer's Liability Workers' Compensation statutory coverage limits Employer's Liability $1,000,000 (each accident) $1,000,000 (disease-policy limit) $1,000,000(disease-each employee) If there is an exposure of injury to Subcontractor’s employees under the U.S. Longshoreman and Harbor Workers’ Compensation Act, the Jones Act or under laws, regulations or statutes applicable to maritime employees, coverage shall be included for such injuries or claims. Include a Waiver of Subrogation endorsement in favor of Dempsey Construction Inc and Owner.

Cont rac t or’s Pollut ion Liabilit y Per Claim $1,000,000 Provide CPL if CGL contains exclusion for mold and/or fungus damage.

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SEE SAMPLE CERTIFICATE OF INSURANCE (COI) ATTACHED

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Dempsey Construction Inc Subcontractor/Vendor Insurance Requirements

April 14, 2017

2

Property Insurance Contractor and Subcontractor waive all rights against each other and against all other subcontractors and Owner for loss or damage to the extent reimbursed by Builder's Risk or any other property or equipment insurance applicable to the work, except such rights as they may have to the proceeds of such insurance. If the policies of insurance referred to in this Section require an endorsement or consent of the insurance company to provide for continued coverage where there is a waiver of subrogation, the owners of such policies will cause them to be so endorsed or obtain such consent.

Upon written request of the Subcontractor, Contractor shall provide Subcontractor with a copy of the Builder's Risk policy of insurance or any other property or equipment coverage in force for the project and procured by Contractor. Subcontractor shall satisfy himself as to the existence and extent of such coverage prior to commencement of Subcontractor's work.

If Builder's Risk insurance purchased by Owner or Contractor provides coverage for Subcontractor for loss or damage to Subcontractor's work, Subcontractor shall be responsible for the insurance policy deductible amount applicable to damage to the Subcontractor's work and/or damage to other work caused by Subcontractor.

If not covered under the Builder's Risk policy of insurance or any other property or equipment insurance required by the Contract Documents, Subcontractor shall procure and maintain at his own expense property and equipment insurance for portions of Subcontractor's work stored off the site, in transit and Subcontractor’s tools, equipment or machinery used in the construction.

If Owner or Contractor has not purchased Builder's Risk or equivalent insurance including the full insurable value of Subcontractor's work, then Subcontractor may procure such insurance at his own expense as will protect the interests of Subcontractor, and his subcontractors in the work. Such insurance shall also apply to any of the Owner's or Contractor's property in the care, custody or control of Subcontractor.

Installation Floater or Personal Property of Others (if needed) Replacement value of project-specific materials and/or equipment stored at the jobsite or in an approved location or facility (bonded warehouse), or your company site, or in transit to the jobsite. Policy shall be written on a “Special” Broad Perils Form, covering “all risks” of direct physical loss or damage to the property. Include a Waiver of Subrogation endorsement in favor of Dempsey Construction Inc and Owner.

Subcontractor Equipment Subcontractor’s equipment shall be insured by an “all risk” Contractor’s equipment policy covering value of equipment used at jobsite. Include a Waiver of Subrogation endorsement in favor of Dempsey Construction Inc and Owner.

2. Design Services. If the work under this Contract requires the Subcontractor or licensed design professional to provide design services, Subcontractor and licensed design professional shall ensure the adequacy, accuracy and completeness of said design services. In addition, Subcontractor and licensed design professional shall provide Design Errors and Omissions and Professional Liability Insurance coverage for said design services in an amount not less than $1 million dollars (per claim and in the aggregate) and maintain said policy for four (4) years after completion of the project. Policy must be in place before design starts. Subcontractor shall indemnify and hold harmless Contractor as specified in Section 17,“Indemnification Of Contractor/Owner”, elsewhere in this Agreement. Subcontractor shall name Contractor and Owner as an additional insured under Subcontractor's Professional Design Liability Policy, and submit endorsement certificate within ten (10) calendar days of signing this Agreement.

3. Waiver Of Subrogation. Subcontractor waives all rights against Contractor, Owner and Architect and their agents, officers, directors and employees for recovery of damages to the extent these damages are covered by Commercial General Liability, Commercial Umbrella/Excess Liability, Business Auto Liability or Workers Compensation and Employers Liability insurance maintained per requirements stated above.

CERTIFICATE HOLDER

© 1988-2010 ACORD CORPORATION. All rights reserved.ACORD 25 (2010/05)

AUTHORIZED REPRESENTATIVE

CANCELLATION

DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE

LOCJECTPRO-POLICY

GEN'L AGGREGATE LIMIT APPLIES PER:

OCCURCLAIMS-MADE

COMMERCIAL GENERAL LIABILITY

GENERAL LIABILITY

PREMISES (Ea occurrence) $DAMAGE TO RENTEDEACH 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

INSRLTR TYPE OF INSURANCE POLICY NUMBER

POLICY EFF(MM/DD/YYYY)

POLICY EXP(MM/DD/YYYY) LIMITS

WC STATU-TORY LIMITS

OTH-ER

E.L. EACH ACCIDENT

E.L. DISEASE - EA EMPLOYEE

E.L. DISEASE - POLICY LIMIT

$

$

$

ANY PROPRIETOR/PARTNER/EXECUTIVE

If yes, describe underDESCRIPTION OF OPERATIONS below

(Mandatory in NH)OFFICER/MEMBER EXCLUDED?

WORKERS COMPENSATIONAND EMPLOYERS' LIABILITY Y / N

AUTOMOBILE LIABILITY

ANY AUTOALL OWNED SCHEDULED

HIRED AUTOSNON-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 PERIODINDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THISCERTIFICATE 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.

INSRADDL

WVDSUBR

N / A

$

$

(Ea accident)

(Per accident)

THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THISCERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIESBELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZEDREPRESENTATIVE 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 tothe terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to thecertificate holder in lieu of such endorsement(s).

The ACORD name and logo are registered marks of ACORD

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 BEFORETHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED INACCORDANCE WITH THE POLICY PROVISIONS.

X

DT22CO9C312011TCT13

1/1/2017

DTJUB9C31201113 5/1/2013 X

2,000,000

2,000,000

1,000,000

X

1,000,000

Prop. Dmg. Deduct.

A

300,000

1,000,000

James Schabarum

1,000,000

1/1/2018

/ /2017

XDT8109C312011TCT13A

10,000

1,000,000

1/1/2018

5/1/2014

X

Cross Liab/Sev of Int

1,000,000

X

X

263726

1/1/2017

X

25,000

EXIGIS - CAVIGNAC & ASSOCIATES 263726Page 2 of 5

X

X X

DEDUCTIBLE 0

123456789

123456789

987654321 1/1/2017 1/1/2018

Agent Signature

123456

1,000,000

X XCU

A X

X $0

X 123456789 1/1/2017 1/1/2018 1,000,000

1,000,000

Agency NameAgency AddressLicense No. 1111111

ABC Company, Inc.1234 Main StreetSan Diego, CA 92101 United States

Insurance Company A (A- VIII or Better) 12345

Insurance Company B (A- VIII or Better) 56789

Insurance Company C (A- VIII or Better) 98765

B

C Professional/Pollution 147258369 1/1/2017 1/1/2018 Each Claim $ 1,000,000Aggregate $ 1,000,000

DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)Re: Project Name and Number. Additional Insured coverage applies to General and Automobile Liability for Dempsey Construction, Inc. per policy form. Waiver of subrogation applies to General and Automobile Liability and Workers Compensation per policy form. Additional insured for General Liability per policy form CG 2010 11/85 or CG 2010 + CG 2037 (or equivalent for Ongoing and Completed Operations). Primary and Non-Contributory coverage applies to General Liability and Automobile Liability per policy form. If the insurance company elects to cancel or non-renew coverage a 30 days written notice of such cancellation or non-renewal will be provided per policy form.

Dempsey Construction, Inc. 1835 Aston Ave.Carlsbad, CA 92008

POLICY NUMBER: COMMERCIAL GENERAL LIABILITYCG 20 10 07 04

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

ADDITIONAL INSURED – OWNERS, LESSEES ORCONTRACTORS – SCHEDULED PERSON OR

ORGANIZATIONThis 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

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 toinclude 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; or2. 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) desig-nated above.

B. With respect to the insurance afforded to these additional insureds, the following additional exclu-sions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equip-

ment furnished in connection with such work,on the project (other than service, maintenanceor repairs) to be performed by or on behalf ofthe additional insured(s) at the location of thecovered operations has been completed; or

2. That portion of "your work" out of which theinjury or damage arises has been put to its in-tended use by any person or organizationother than another contractor or subcontractorengaged in performing operations for a princi-pal as a part of the same project.

CG 20 10 07 04 © ISO Properties, Inc., 2004 Page 1 of 1

Location(s) Ofon(s) Ofechedule, if if not shown above, wnot shown a

amured is amended tos amended nsured the person(s) or nsured the person(s) or

n the Schedule, but only n the Schedule, but oy for "bodily injury", "property or "bodily injury", "propal and advertising injury"and advertisi

rt, by: t by:or

ose actin

B. W

Where required by written contract.



CG 20 37 07 04 © ISO Properties, Inc., 2004 Page 1 of 1

ADDITIONAL INSURED – OWNERS, LESSEES ORCONTRACTORS – COMPLETED OPERATIONS

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

SCHEDULE

Name Of Additional Insured Person(s)Or Organization(s):

Location And Description Of Completed Opera-tions


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" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the "products-completed operations hazard". Sam

plemchedule, if if not shown above, wnot shown amamred is amended toamended toured the person(s) or ured the person(s) or

e Schedule, but only with e Schedule, but only witboddily injury" or "property ily injury" or "propee or in part, by "your work" or in part, by "yo

and described in thand describet performed for performed

in the "proin th



CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1

WAIVER OF TRANSFER OF RIGHTS OF RECOVERYAGAINST OTHERS TO US


COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART

SCHEDULE

Name Of Person Or Organization:


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 we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products-completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above.

Sample, will be shown in te shown in tele

ulery or

tions or orhat person son

e "products-uctswaiver applies r applies

on shown in the own in the

CG 20 01 04 13 Page 1 of 1© Insurance Services Office, Inc., 2012

COMMERCIAL GENERAL LIABILITY CG 20 01 04 13


PRIMARY AND NONCONTRIBUTORY – OTHER INSURANCE CONDITION


COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART

The following is added to the Other Insurance Condition and supersedes any provision to the contrary:

Primary And Noncontributory InsuranceThis insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured

under such other insurance; and

(2) You have agreed in writing in a contract oragreement that this insurance would be primaryand would not seek contribution from any otherinsurance available to the additional insured.

Sample

avai

POLICY #: COMMERCIAL AUTOCA 20 48 02 99


DESIGNATED INSURED This endorsement modifies insurance provided under the following:

BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM

With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi-fied by this endorsement.

This endorsement identifies person(s) or organization(s) who are “insureds” under the Who Is An Insured Provi-sion of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form.

This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below.

Endorsement Effective: Countersigned By:

Named Insured:

(Authorized Representative)

SCHEDULE

Name of Person(s) or Organization(s):

(If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.)

Each person or organization shown in the Schedule is an “insured” for Liability Coverage, but only to the extent that person or organization qualifies as an “insured” under the Who Is An Insured Provision contained in Section II of the Coverage Form.

CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998

Sample

ureds” undege provided in thvided in th

date of the policy unless ate of the policy unle

Countersigned By:ntersigned By: plemmmmpSCHEDULESCHEDUL

on(s): amSaormation required toation requ

n the


WORKERS COMPENSATIONAND

EMPLOYERS LIABILITY POLICY

ENDORSEMENT WC 99 03 76 (00)

POLICY NUMBER:

WAIVER OF OUR RIGHT TO RECOVER FROM OTHERSENDORSEMENT - CALIFORNIA

(BLANKET WAIVER)

We have the right to recover our payments from anyone liable for an injury covered by this policy. We willnot enforce our right against the person or organization named in the Schedule.

You must maintain payroll records accurately segregating the remuneration of your employees whileengaged in the work described in the Schedule.

The additional premium for this endorsement shall be % of the California workers' compensationpremium otherwise due on such remuneration.

Schedule

Person or Organization Job Description

yhedule.

uneration of your eon of your

% of the California workers' compalifornia workers'

Schedulele

Job Descriptionb DescriptiWhen required by written contract.

Sample

Named Insured

Policy Number Endorsement No.

Policy Period Endorsement Effective Date:

Producer Number:

AUTHORIZED REPRESENTATIVE DATE

IL EN GN 0004 09 11 Page 1 of 1

OLD REPUBLIC GENERAL INSURANCE CORPORATION

CANCELLATION OR NON-RENEWAL TO SPECIFIED PERSONS OR ORGANIZATIONS ENDORSEMENT


THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING:

BUSINESS AUTO COVERAGE FORM COMMERCIAL GENERAL LIABILITY COVERAGE FORM PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART

If we cancel or non-renew this policy for any reason other than non-payment, we will deliver notice of the cancellation or non-renewal to all Specified Persons or Organizations on file with us Thirty ( 30 ) daysprior to the effective date of cancellation or non-renewal.

If notice is mailed, proof of mailing will be sufficient proof of notice.

Sample

Named Insured

Policy Number Endorsement No.

Policy Period Endorsement Effective Date:

Producer�s Name:

Producer Number:

Authorized Representative Date

WC 99 03 73 (01/11

OLD REPUBLIC GENERAL INSURANCE CORPORATION

WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY

Cancellation or Non-Renewal to Specified Persons or Organizations Endorsement California


THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING:WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE

If we cancel or non-renew this policy for any reason other than non-payment, we will deliver notice of the cancellation or non-renewal to all Specified Persons or Organizations on file with us Thirty (30) days prior to the effective date of cancellation or non-renewal.

If notice is mailed, proof of mailing will be sufficient proof of notice.