Senior Project Manager Brailsford & Dunlavey, Inc. From: Greg Stortstrom Director of Insurance Date: June 19,2013 Re: ACPS Jefferson Houston ES Turner's Contractor Controlled Insurance Program Turner Construction Company 1110VermontAvenue, NW Suite 200 Washington, DC 20005 Office: (202) 789-0770 Fax: (202) 898-2531 It is Turner Construction Company's risk management philosophy to implement our Contractor Controlled Insurance Program (CCIP) on all projects greater than $5,000,000 in volume. Similar "Wrap Up" type insurance programs have been very common in the construction industry for several years now, and are often placed by clients for projects as Owner Controlled Insurance Programs (OCIP). These programs provide the benefit of single source coverage tor all contractors on the project often more competitively than if individually provided. The downside to these OCIP programs for clients is they require a fair amount of administration on the part ofthe client. Turner's (CCIP) program was designed to provide clients the benefits of an OCIP competitively, without the need for client administration. The benefits of our CCIP include: $200,000,000 project specific excess liability (for projects with volume greater than $25,000,000) Blanket Additional Insured Waiver of Subrogation as required by contract XCU (Explosion, Collapse, Underground) Hazards Independent Contractors Liability Broad Form Contractual Liability and Broad Form Property Damage Product Completed Operations Claims handling expenses included Guaranteed Costs, not a loss sensitive program, GL & WC losses do not impact project costs Return to work program No Deductibles; No Self Insured Retention Uniform coverage - gaps and overlaps are eliminated Single Defense $50,000,000 Pollution and Mold Liability coverage (with $250,000 deductible) Turner In terms of pricing, our CCIP has been compared to many OCCIP programs and has proven to be competitive. Our approach leverages the total volume of the Turner Construction Company in lieu of just one project and involves a number of different insurance carriers providing these coverages: On-site general liability and workers compensation Excess liability Pollution liability Off- site general liability and workers compensation Automobile liability. Turner's corporate Risk Management group, in conjunction with our insurance broker, blends the price from various carriers into volume and payroll rates for the specific project. To simplify matters, a single CCIP rate based upon volume is determined. This alleviates the Owner from the risk of paying insurance premium caused by an overrun of on-site payroll since the rate is "locked in" from the project's onset and based on total volume. In the event that a subcontractor expends more onsite labor to complete their scope of work, the Owner is protected from the risk of additional worker's compensation and general liability on that work. For the Jefferson Houston project, a CCIP rate of 2.098% has been establ ished based upon the projected blended labor and volume of each trade. This rate is calculated on the sum of the direct work, general conditions and other insurances (above the CCJP line). This is a fixed rate that will not change for the life of the project and will be used for the original GMP as well as any scope changes to the GMP. Both parties acknowledge tbat there is no single insurance company invoice that equates to that single rate (based on its blended nature and multiple caniers), however the corresponding rate letters are in support of each component that is the format for the blended fixed rate. This is due in part to Turner's risk management philosophy and our dedication to a safe working environment in that our insurance rates have decreased over the past several years and we are able to pass that benefit along to our respected Owner partners. It was not long ago that a project of this nature would have an insurance rate on volume of approximately 3 percent. Please advise ifthere arc other questions about the Turner's Contractor Controlled Insurance Program. Turner Construction Company CCIP Rate and Premium for the ACPS Jefferson Houston School Rate Exposure General liability 0.85932% $36,656,745 Workers Compensation 3.86910% $10,861,318 Premium Price Direct Costs, GCs, Other Insurance, Contingency CCIP as a Percent of the above Notes: General liability Exposure is the Total Project Volume Workers Compensation Exposure is on-site salary payroll Premium $314,999 $420,235 $735,234 $35,781,679 2.05478% Turner June 11,2013 Mr. Greg Stortstrom Turner Construction Company 1110 Vermont Avenue NW, Suite 200 Washington, D.C. 20005 Turner Construction Company 3 Paragon Drive Montvale, NJ 07645 Phone: 201.722.3800 Fax: Re: lllsurance Rate A CPS Jefferson Houston Pre K-8 #130013 Dear Greg, As you requested, we have provide the following insurance rate documentation. Coverage Document Confirmed Rate Worker's Compensation Rate Letter $3.8691 $100 of payroll General Ljability Primary GL Rate Letter $2.208 Excess Liability Rate letter $3.1752 Pollution Rate Letter $.82 Administration Fee- TSIB Rate Letter $1.79 Administration Fee- Turner Rate Letter $.60 Total General Liability $8.5932 per thousand dollars of volume If you have any questions, please do not .hesitate to contact me. The information contained within this documentation is confidential and proprietary; please do not share this proposal with entities outside of the in-house project without consulting with me. Please do not hesitate to contact me with any questions or concerns. Sincerely,
Susan Hughes Sr. Insurance Manager BUILD I NG ASSURANCE June 10, 2013 Ms. Kim Parra Turner Construction Company 3 Paragon Drive Montvale, NJ 07645 Re: ACPS Jefferson Houston Pre K- 8 School Job#130013 6/20/13 -1/27/15 DearKim- Regarding the above captioned project, the General Liability rate is $2.208 per $1,000 of construction volume, and the Worker"s Compensation rate is $3.8691, Inclusive of assessments and surcharges. Please feel free to contact me should you have any questions. Sincere'ly, P ~ ~ ~ o Barbara Lemanowicz Customer Service Representative BUILD I N G .-.s s Uk.O. NC f November 9; 2012 Ms. Susan Hughes Senior Insurance Manager Turner Construction 3 Paragon Drive Montvale, NJ RE: C:CIP Excess Rate Verification Effective: November ~ , 2012 to November 1, 2013 Dear Ms. Hughes: This letter will serve to confirm the CCIP Excess liability premium for Turner Construction Company for the policy period of-November 1, 2012 to November 1, 2013. The tot al premium paid by Turner for the CCC!P Excess program referenced above was $9,072,209.35 .. The. premium includes total brokerage fees of $895,091.i2 payable to Turner Surety and Insurance Brokerage, Int., McGriff, Selbels & Williams, tnc. and Price Forbes Partners, limited. Please feel free to contact me if you have any questions. Sincerely, -, * Footnote added by Turner Construction Company: The premium of $9,072, 209 . 35 when applied to the estimated enrollment volume for Turner ' s Construction CCIP 'peojects for the period 11-1-12 t o 10-.31 - 13 equals a rate of $3.1752 per $1000 of construction volume . 300 Tice Boulevard 2"' Floor North, Suite 250 I Wooddlff La!le, NJ 07677 I phone 201 644 2500 l fax 201.644r2532 BUILDING AqiJI\ANCE January 14, 201} Ms. Susan Hughes Senior Insurance Manager Turner Construction Company 3 Paragon Drive Montvale, New Jersey 07645 RE: Turner Construction Company Contractor's Pollution Legal liability December 31, 2012 to December 31, 2013 Dear Ms. Hughes: Turner Surety and Insurance Brokerage, Inc. (TSJB) and McGriff, Seibles and Williams (MSW) have placed Contractor's Pollution legal liability Coverage on behalf of Turner Construction Company for the period of 12/31/2012 to 12/31/2013. The premium to Turner Construction Company for the cQverage is $4,517,019.82. This figure is inclusive of NJ Pl)GA Assessment, Excess and Surplus Lines Taxes, Stamping Fees and the Brokerage Fee paid. to TSffi and MSW, respectively. The total 8(okerage Fee paid was $350,000. If you have any questions or concerns, please feel free to contact me at 203.283,2022. Sincerely, "'-7P ,
{vt--. ::2-z::_ _ _ __..
.. laurJ Laurenzi _, . .. __ ..... Senior Direct9r_...... .. .BJl. rner Construction Company: The pretltl.ut'il-of $4, 517, 019. 82 when applied to the estimated work in pl ace volume for Turner construction Company for the policy year equals a rate of $. 82 per $1,000 . 300 Tice Boulevard I Woodcliff Lake, NJ 07677 I phone 201 644 2500 ! www.tsibinc.com BUILDING ASS U RANCE February 14, 2013 Mr. Mike Capizzano Turner Construction 3 Paragon Drive Montvale, NJ 07645 RE: Turner Construction Company's Contractor Control1ed Insuralice Program Administration Fee Dear Mike: Per your.request, Turner Surety and Insurance Brokerage, Inc. are pleased to confirm our Fee for Wrap-Up Administration Services for the Turner Construction Contractor Controlled Insurance Program. For the twelve month period from 1/1./2013 to 12/31/2013, Turner ConstructiOn Company will pay Turner Surety and In.surance Brokerage, Inc. (TSJB) compensation of $568;083 fQr admi'nistrative and operational support for all enrolled projects, both active and closed, in the Tnrner Constmction Company CCIP Program for the states of Alaska, .Arlcansas, Colorado, District. of Columbia, Kansas, Maryland, Minnesota, Oregon, South Carolina, South Dakota, Tennessee, Virginia, Washington, Wyoming and Turner's Pittsburgh business unit. Sincerely, c ~ ~ ~ . . . . L - . - Chris Smith Managing Director- Wrap-Up Operations Footnote added by Turner Construction Company: When applied-t o Turner Construct ion's CCIP estimated volume for the above. referenced s.tat es, the fee of $568,083 results in an approximate rate of $1.79 Jler $1,000 of constr.uction volume. Page 1 oil Turner Surely and trm:srance Srokera_ge, Inc. 300 Tice Soulevord, 3"' Floor 1 Woodcliff Lake, NJ 07677 I phone 201 644 2500 ! www.lslbinc.com Turner March 28, 2013 RE: Project Administration Fee To Whom It May Concern.: Turner Construction Company 3 Paragon Drive Montvale, NJ 07645 phone: 201-722-3800 fax: 201-722-3835 This letter will serve to confirm that Turner's Risk Management Department administration fee for Turner construction's CCIP projects incepted during the 11/1/12-11,11/13 period in the states and territories of Alaska, Alabama, Arkansas, Colorado, District of Columbia, Kansas, Marytand, Minnesota, Oregon, South Carolina, South Dakota, Tennessee, VIrginia, Washington, Wyoming and Turner's Pittsb\.irgh business unit is based on a rate of $0.60 per $1,000 of total Construction Volume. /.1 /' lo .. e . ./-' l.rsa Ba Ia ne Vice Pres! ent Turner Construction Company Turner June 11, 2013 Mr. Greg Stortstrom Turner Construction Company 1110 Vermont Avenue NW, Suite 200 Washington, D.C. 20005 Re: SDI Rate ACPS Jefferson Houston Pre K-8 #130013 Dear Greg, Turner Construction Company 3 Paragon Drive Montvale, NJ 07645 Phone: 201.722.3800 Fax: 201.722.3835 As you requested, we have provide the following insurance rate documentation. Coverage Document Confirmed Rate Zurich Premium Rate Letter $10.50 Surplus Lines Tax Rate letter $0.53 TSIB Brokerage Fee Rate Letter $0.47 Total SDI $11.50 per thousand dollars of volume If you have any questions, please do not hesitate to contact me. The information contained within this documentation is confidential and proprietary; please do not share this proposal with entities outside of the in-house project without consulting with me. Please do not hesitate to contact me with any questions or concerns. Sincerely, ~ t l ~ ~ Susan Hughes Sr. Insurance Manager ~ ZURICH TSJB201 108 Zuri ch American Insurance Company (A stock company herein called the Company) 1400 American Lane; Schaumburg, Illinois 60196-1056 CERTIFICATE OF INSURANCE CERTIFICATE PERIOD 06/20/13 to 01/27/15 CERTIFICATE NUMBER CRT 4999723-00 This Certificate follows the terms and conditions of ZURICH AMERICAN INSURANCE COMPANY Policy MBR 4550345-09 This certificate neither affirmatively nor negatively amends, extends or alters the coverage, limits, terms or conditions of the Master policy unless express! stated herein. NAMED TURNER CONSTRUCTION COMPANY Premium Annual Term Term Total INSURED 3 Paragon Drive $46,352 rate/ rate/ (include address) Montvale, NJ 07645 $100 $100 Builders Risk .0728 .1169 $43,373 Delay In $0 Completion .0000 Coastal Windstorm .0000 .0000 $0 ADDITIONAL To the extent required by any contract or subcontract for Earthquake .0000 .0000 $0 INSUREDS the 130013-ACPS Jefferson-Houston Pr eK-8 School Flood .0000 .0000 $0 (include address) proj ect, and then only as their respective interests may Damage To appear, all owners, all contractors and subcontractors of Existing Property every tier, and tenants at the proj ect location, are Mold .0000 .0000 $0 recogni zed as Additional Named Insureds hereunder . As Certified/Non- .0080 $2,978 respects architects, engineers, manufacturers and Certified Terrorism .0050 suppliers, their interest is l imi ted to their site activities State Surcharge $0 only. 0 0 LOSS PAYEE (include address) MORTGAGEE (include address) PROJECT 130013-ACPS Jefferson-Houston PreK-8 School LOCATION 1501 Cameron Street (include address) Alexandria, VA 22314 PROJECT Project includes preconstruction and construction of a new school of approximately 120,000 square feet DESCRIPTION housing 700-800 students on a 10 acre site, and the demolition of the 83,385 square foot existing school and (Structural type, a 12,000 square foot Head Start building a size, material type, Construction Type: New Construction occupancy, etc.) (If renovation or Scope of Work: Schools rehab, be specific) Term (Days):586 Project Value: $37,090,274 COVERAGE Contractor's Wrap (Place X in all applicable coverage blocks) Page 1 of 4 CERTIFICATE NUMBER: CRT 4999723-00 STANDARD COVERAGE TERMS (Coverage shall only apply under this Certificate to those individual Limits, Sub-limits and Aggregate Limits for which a value is entered below, but in no event these Sub-limits and Aggregate Limits shall exceed the limit of liability.) LIMIT OF LIABILITY $ 37,090,274 Any One OCCURRENCE During The Certificate Period SUB-LIMITS OF LIABILITY $ 37,090,274 Physical Damage to the INSURED PROJECT (Sublimits per OCCURRENCE $ 0 Delay In Completion (see coverage terms below for specific sublimits) except Delay In Completion as $ 5,000,000 Physical Damage To Property In Transit- Any One Conveyance Certificate Aggregate) $ 5,000,000 Physical Damage To Property In Offsite Storage- Any One Location $ 1,000,000 Architects and Engineers Fees $ 2,500,000 Or 20% of the amount of insureds physical loss or damage to property insured,whichever is less- Expediting Expense and Contractor's Extra Expense, combined $ 250,000 Mold Per Occurrence/ $250,000 Per Project Aggregate $ 500,000 Physical Damage To Plans, Blueprints, Drawings, Renderings, Specifications Or Other Contract Documents And Models At The Insured Project $ 20,000,000 Ordinance of Law I Demolition & Increased Cost of Construction $ 2,000,000 Damage To Existing Property 25.0% Of the amount of insured physical loss or damage to Covered Property, whichever is less - Debris Removal Coverage $ 100 000 Emergency Property Protection Expense - in the Certificate Term $ 250,000 Fire Department Service Charges $ 5,000 Fire Protective Equipment Refills $ 250,000 Claims Preparation Costs $ 250,000 Pollution/Contaminant Clean up $ 250,000 Maximum any one item -Trees, Plants, and Shrubs $ 250,000 Better Green Coverage ANNUAL AGGREGATES $ 37,090!274 By The Peril Of EARTHQUAKE (Aggregate limits apply to each annual period within this $ 37!090,274 By The Peril Of NAMED STORM Certificate beginning on the Certificate inception date) $ 37,090,274 By The Peril Of FLOOD DEDUCTIBLES $ 10,000 Physical Damage, Except (Deductibles apply per $ 10,000
% EARTHQUAKE
OCCURRENCE) $ 10,000
% NAMED STORM I (When% is entered, the% is
I applied against the total insured $ 10,000 I % FLOOD physical damage values at risk at the time and place of loss I subject to the dollar minimum) $ 50,000 % WATER DAMAGE $ nla HOT TESTING 30 Calendar Day Deductible Period- Delay In Completion - Standard Coverage 30 Calendar Day Deductible Period- Delay In Completion - Optional Coverage HOT TESTING PERIOD TERMS (If an X is entered in the coverage block on page one the followingmust be provided) HOT TESTING PERIOD: Days Page 2 of4 CERTIFICATE NUMBER: CRT 4999723-00 ZURICH DELAY IN COMPLETION COVERAGE TERMS (Coverage for Delay In Completion shall only apply under this Certificate when this section is completed in its entirety.) *This scrtion only needs to be completed folimits in excess of$500,000. NAMED INSURED & I BUSINESS ADDRESS ANTICIPATED DATE OF PERIOD OF INDEMNITY Calendar COMPLETION Days Subject to individual Certificate Aggregate sublimits shown below, the total $ Certificate Aggregate sublimit for which the Company shall be liable is CERTIFICATE Loss Of Gross Earnings $ AGGREGATE SUB- Loss Of Rental Income $ LIMITS OF LIABILITY Soft Costs I Additional Expense $ When a Certificate Aggregate Sub-limit Is entered for Soft Costs I Additional Interim Interest Expense $ Expense above, coverage shall be further limited to the individual Realty Taxes I Ground Rents $ Certificate Aggregate Sub-limits entered to the right Advertising Expense $ Commission Expense $ Architect I Engineer Fees $ Project Administration Expense $ Legal/ Accounting Fees $ Insurance Premiums $ OTHER COVERAGE TERMS I CONDITIONS (Identify other terms and conditions below that apply to this Certificate) COVTRAGI' INI'ORI\.fATION THIS iS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED HEREIN HAVE BEEN ISSUED TO THF. lNSURF.D NAMED HEREIN FOR TilE POLICY PERIOD INDICATED. NO"lWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTIIER DOCUMENT wrrn RESPECT TO WIUCII TilE CERTlFICA TE MAY BE ISSUED OR MAY PERTAIN, TIIE INSURANCE AFFORDED BY "!liE POI.lCJES LISTED HEREIN IS SUBJECT TO ALL TERMS, CONDITIONS AND EXCLUSiONS OF SUCH POLICIES. UM1TS SHOWN MAY IIA VE BF.F.N REDUCED BY PAID CLAfMS. CI\NCFU ATION Tllli COMPANY MAY ONLY CANCEL TillS POLICY IN THE EVENT OF NON PAYMENT OF TilE PREMJUM DUE BY MAILING WRilTEN NOTICE STATlNG WHEN, NOT LESS "JliAN TEN (10) DAYS THEREAJ-TER SUCH CANCELLATION SHALL BE EFFECTIVE, TO TilE NAMED lNSURCD AT THE ADDRESS SJIOWN IN THE POLICY. Turner Surety & Insurance Brokerage. By: ~ a J j - - lssued By: BL - 5/2/13 Page 3 of4 nnr BUILD I NG ASS U RANCE January 14, 2013 Ms. Susan Hughes Senior Insurance Manager Tumer Construction Company 3 Paragon Drive Montvale, New Jersey 07645 RE: Turner Construction Company SGD 3495454-13 Subguard Policy- All States Except for New Hampshire, New York and Oregon Effective : December 31,2012 to Dec. 31,2013 Dear Ms. Hughes: The Subguard Policy referenced above was issued to Tumer Construction Company by Zurich Insurance Group utilizing Steadfast Insurance Company- a non-admitted tarrier. The premium paid to Zurich is exclusive of any surplus lines taxes, stamping fees and broker placement fees. The rate charged to Turner Construction Company by TSIB is $11.50 per $1,000 of subcontractor volume. The $11.50 is broken down as follows: $10.50 $ .53 $ .00 s .47 $11.50 Zurich Premium Surplus Lines Taxes Stamping Fee TSIB Brokerage Fee Total Subguard Rate If you have any questions or concerns, please feel free to contact me at 203.283.2022. .. . / /__ ' / C./""1_., / _... (_ __ _ .. _..-- uralaurenzi Senior Director 300 nee Boulevard 1 Woodcliff Lake, NJ 076n I phone 201644 2500 I www.tsibinc.com IMPORTANT DISCLOSURE NOTICE We are making the following informational disclosures in compliance with The Terrorism Risk Insurance Act of2002. No action is required on your part. Disclosure of Terrorism Premium The premium charge for risk of loss resulting from acts of terrorism (as defined in the Act) under the policy(ies) This amount is $2,978. Disclosure of Availability of Coverage for Terrorism Losses As required by the Terrorism Risk Insurance Act of 2002, the member companies of Zurich North America make available coverage for losses resulting from acts of terrorism (as defined in the Act) with terms, amounts, and limitations that do not differ materially as those for losses arising from events other than acts of terrorism. Disclosure of Federal Share of Insurance Company's Terrorism Losses The Terrorism Risk Insurance Act of2002 establishes a mechanism by which the United States government will share in insurance company losses resulting from acts of terrorism (as defmed in the Act) after an insurance company has paid losses in excess of an annual aggregate deductible. For 2002, the insurance company deductible is I% of direct earned premium in the prior year; for 2003, 7% of direct earned premium in the prior year; for 2004, l 0% of direct earned premium in the prior year; and for 2005, 15% of direct earned premium in the prior year. The federal share of an insurance company's losses above its deductible is 90%. In the event the United States government participates in losses, the United States government may direct insurance companies to collect a terrorism surcharge from policyholders. The Act does not currently provide for insurance industry or United States government participation in terrorism losses that exceed $100 billion in any one calendar year. Definition of Act of Terrorism The Terrorism Risk Insurance Act defmes "act of terrorism" as any act that is certified by the Secretary of the Treasury, in concurrence with the Secretary of State and the Attorney General of the United States: 1. to be an act of terrorism; 2. to be a violent act or an act that is dangerous to human life, property or infrastructure; 3. to have resulted in damage within the United States, or outside of the United States in the case of an air carrier (as defmed in section 40102 oftitle 49, United 17 States Code) or a United States flag vessel (or a vessel based principally in the United States, on which United States income tax is paid and whose insurance coverage is subject to regulation in the United States), or the premises of a United States mission; and 4. to have been committed by an individual or individuals acting on behalf of any foreign person or foreign interest as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. But, no act shall be certified by the Secretary as an act of terrorism if the act is committed as part of the course of a war declared by Congress (except for workers' compensation) or property and casualty insurance losses resulting from the act, in the aggregate, do not exceed $5,000,000. These disclosures are informational only and do not modify the policy or affect your rights under the policy. Page4 of4 Steadfast lnsuran<:e Company One liberty Plaza New Yom, NY 10006 WWtN.%JJrichna.com January 11, 2013 Mrs. Usa Ballantyne Vtce President & General Manager Turner Construction Company 3 Paragon Drive Montvale, NJ 07645 RE: Zurich Subguard Policy# SGD 3495454-13 Dear Mrs. Ballantyne: @ ZURICH The Zurich Subguard policy bound with Turner Construction for the policy period 12/31/12 through 12/31/13 provides subcontractor default Insurance coverage for projects reported to Zurich during the policy effective dates. Please reference the attached declarations page for the Turner Subguard policy structure. As shown on the declarations page, the deductible on the policy Is $0 and the co-pay on the policy is $0. Subguard coverage is provided to Turner in accordance with the terms, conditions, and limitations set forth in Turner's Zurich Subguard policy. A premium rate of $10.50 per thousand of covered subcontract volume is paid to Zurich upfront based upon estimated subcontract exposure at the beginning of the project. This rate does not include broker commission, excess and surplus lines tax, or stamping fee. Turner Construction Company does not receive return premium and Is not assessed additional premium, except for audit adjustments that are calculated at a rate of$10.50 per thousand of covered subcontract volume. Should you have any que tions-please do not hesitate to contact me. CERTIFICATE OF COVERAGE Subcontractor Default Insurance Issued Date: 5/2/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PRODUCER Turner Surety and Insurance Brokerage, Inc. 300 Tice Boulevard COMPANY AFFORDING COVERAGE Steadfast Insurance Company 2"" Floor North Suite 250 Woodcliff Lake, NJ 07677 INSURED Turner Construction Company 3 Paragon Drive Montvale NJ 07645 POLICY LThUTS 1400 American Lane Schaumburg,IL 60196-1056 POLICY NU!\ffiER SGD3495454-13 $1 OO,OOO,OOO(US) Aggregate limit of liability $50,000,000(US) Subcontractor/Supplier limit of liability COVERAGES POLICY PERIOD 12-31-12 to 12-31-13 This is to certify that a Subcontractor Default Insurance Policy has been issued to the insured named above and applies to the project indicated below. This Policy covers all Subcontractors and Purchase Orders associated with the Project identified below, even if the subcontract or purchase order is awarded after the expiration date of the policy, and will remain in effect until fulfillment of all tenns, conditions, and specifications of covered subcontracts and/or purchase orders, including any related warranty periods, subject to all terms, exclusions, and conditions of the Policy. The insurance afforded by the captioned policy is subject to all their terms, exclusions and conditions and is not altered by any requirement, tenn or condition of any contract or other document with respect to which this certificate may be issued. Projects incepted during the policy period will be covered by this policy period and will be coYered by this policy for the life of the projecl PROJECT INFORMATION Name: 130013-ACPS Jefferson-Houston PreK-8 School Owner: Alexandria City School Board Location: Alexandria, VA Description: Project includes preconstruction and construction of a new school of approximately 120,000 square feet housing 700-800 students on a 10 acre site, and the demolition of the 83,385 square foot existing school and a 12,000 square foot Head Start building a Date of Contract between Owner and Insured: Effective Date of Coverage: Date of Contract between Owner and Insured OTHER INFORMATION CERTIFICATE HOLDER Alexandria City School Board 2000 North Beauregard Street Alexandria, VA 22311 Authorized Representative: IUILOUU i AJS Uk A HCI TURNER SURETY AND INSURANCE BROKERAGE. INC. TURNER SURETY AND INSURANCE rr:ttr IUilOING AIJU OANCI BROKERAGE. INC. 300 Tice Boulevard 2nd Floor North Suite 250 Woodcliff Lake, NJ 07677 Phone 201-644-2500 Fax 201-644-2532 TO: Turner Construction Company Business Unit 300340 DESCRIPTION Gross Rate per $1,000 of Covered Subcontracts & P.O.'s Value of Covered Subcontracts: Total SOl Premium: FOR: Carrier: Steadfast Insurance Company Policy Number: SGD3495454-13 INVOICE INVOICE# DATE: MAY 2, 2013 Project:130013-ACPS Jefferson-Houston PreK-8 School Locatlon:Aiexandria,VA Owner:Aiexandria City School Board AMOUNT $11.500 $32,000,000 $368,000.00 TOTAL $368,000.00
I ACORD CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY)
06/ 18/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certi ficate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Turner Surety and Insurance Brokerage, Inc. I rlJgNtl'o Ext\: 201-644-2500 I rM Nol: 300 Tice Boulevard - Suite 250 Woodcliff Lake, NJ 07677 E-MAIL ADDRESS: INSURER($) AFFORDING COVERAGE NAJC# INSURER A :Zurich American Insurance Co INSURED INSURERS:. Turner Corporation Turner Construction Company INSURERC : 3 Paragon Drive INSURERD: Montvale, NJ 07645 INSURERE : INSURERF: COVERAGES CERTIFICATE NUMBER9DH7LBZ6 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. INSR TYPE OF INSURANCE I LJ.MITS LTR POLICY NUMBER A GENERAL LIABILITY 5899308-00 06/20/2013 01/27/2015 EACH OCCURRENCE $ 2,000,000 f-.-
X DMERCIAL GENERAL LIABILITY $ 1,000,000 f-.- CLAIMS-MADE 0 OCCUR MED EXP (Any ooe pers2n) s 10,000 f-.- f-.- PERSONAL & ACN INJURY s 2,000,000 4,000,000 GENERAL AGGREGATE $ f-.- 4,000,000 r-3ft AGGREn LIMIT APnS PER: PRODUCTS - COMPIOP AGG $ POLICY LOC $ AUTOMOBILE LIABILITY I LIMIT $ 1- ANY AUTO BODILY INJURY (Per person) $ 1- ALL OWNED .--- SCHEDULED BODILY INJURY (Per accident) $ 1- AUTOS f-.- AUTOS NON-OWNED $ f-.- HIRED AUTOS f-.- AUTOS s B UMBRELLA UAB
SEE ADDENDUM EACH OCCURRENCE $ f-.- EXCESS LIAS CLAIMS-MADE AGGREGATE $ OED I I RETENTIONs $ A WORKERS COMPENSATION 5899309-00 06/20/2013 01/27/2015 X I I I AND EMPLOYERS' LIABILITY YIN 2,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE D E.L. EACH ACCIDENT s OFFICER/MEMBER EXCLUDED? NIA 2,000,000 (Mandatory In NH) E.L. DISEASE EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE POLICY LIMIT s 2,000,000 ; $ $ $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) WORK PERFORMED UNDER THE TURNER CONSTRUCTION CONTRACTOR CONTROLLED INSURANCE PROGRAM: ACPS JEFFERSON-HOUSTON PREK-8 SCHOOL, 1501 CAMERON STREET, ALEXANDRIA, VA. CERTIFICATE PROVIDED FOR PERMIT PURPOSES. JOB #130013 ADDITIONAL INSURED: CITY OF ALEXANDRIA 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. CITY OF ALEXANDRIA ALEXANDRIA CITY HALL AUTHORIZED REPRESENTATIVE 301 KING STREET
ALEXANDRIA, VA 22314 Page 1 of 1 1988-2010 ACORD CORPORATION. All nghts reserved. ACORD 25 (201 0/05) The ACORD name and logo are registered marks of ACORD Ac-c;;;b CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDIYYYY)
06/18/2013 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 CERTI FICATE 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 pol icies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in l ieu of such endorsement(s). PRODUCER
Turner Surety and Insurance Brokerage. Inc. r1jgHNEo Ext : 201-644-2500 jFAX 300 Tice Boulevard - Suite 250 Nol : Woodcliff Lake. NJ 076n E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAICt INSURER A :Zurich American Insurance Co INSURED INSURERS :. Turner Corporation Turner Construction Company INSURERC : 3 Paragon Drive INSURERD : Montvale, NJ 07645 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBERA3MREBYX 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. 'msRr- TYPE OF INSURANCE
SUBR I UMITS LTR wvo POUCY NUMBER A GENERAL LIABILITY f5899308-00 06120/2013 01/27/2015 EACH OCCURRENCE $ 2,000,000 f-.-
DMERCIAL GENERAL LIABILITY $ 1,000,000 CLAIMS-MADE 0 OCCUR MED EXP (Any one pe<son) s 10,000 f-.- f-.- PERSONAL & ArN INJURY $ 2.000,000 1-- GENERAL AGGREGATE $ 4,000,000 4,000,000 m'l LIMIT APnS PER: PRODUCTS- COMP/OP AGG $ POLICY LOC s AUTOMOBILE LIABILITY LIMIT s 1-- ANY AIJTO BODILY INJURY (Pet person) s 1-- ALL OWNED ..--- SCHEDULED 1---- BODILY INJURY (Pet accident) s f-.- AIJTOS f-.- AIJTOS NON.QWNEO
s HIRED AIJTOS AIJTOS f-.- f-.- s B UMBRELLA LIAS
SEE ADDENDUM EACH OCCURRENCE $ f- EXCESS LIAS CLAIMSMAOE AGGREGATE $ OED I I RETENTION$ $ A WORKERS COMPENSATION 5899309-00 06/20/2013 01/27/2015 X I I AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE D E.L. EACH ACCIDENT $ 2,000,000 OFFICER/MEMBER EXCLUDED? N /A (Mandatory In NH) E.L. DISEASE EA EMPLOYEE S 2,000,000 o"nlPERATIONS below E.L. DISEASE POLICY LIMIT s 2,000,000
s s s DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attaeh ACORD 101, Additional Remarits Schedule, if more space is required) WORK PERFORMED UNDER THE TURNER CONSTRUCTION CONTRACTOR CONTROLLED INSURANCE PROGRAM: ACPS JEFFERSON-HOUSTON PREK-8 SCHOOL, 1501 CAMERON STREET, ALEXANDRIA. VA. JOB#130013 ADDITIONAL INSURED: ALEXANDRIA CITY SCHOOL BOARD, ALEXANDRIA CITY PUBLIC SCHOOLS, AND THEIR RESPECTIVE DIRECTORS. MEMBERS, OFFICER, EMPLOYEES AND AGENTS (EXCLUDING ARCHITECTS. ENGINEERS, DESIGN PROFESSIONALS). COVERAGE IS PRIMARY AND NON-CONTRIBUTORY. WAIVER OF SUBROGATION APPLIES. I (oontinued next paqe) 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. ALEXANDRIA SCHOOL BOARD ATTN.; PROCUREMENT OFFICER AUTHORIZED REPRESENTATIVE 2000 NO. BEAUREGARD STREET
ALEXANDRIA, VA 22311 Page 1 of 2 1988-2010 ACORD CORPORATION. All rrghts reserved. ACORD 25 (201 0/05) The ACORD name and logo are registered marks of ACORD AGENCYCUSTOMERID: __________________________________ __ LOC#: ______________ _ ADDITIONAL REMARKS SCHEDULE Page 2 of2 PRODUCER Turner Surety and Insurance Brokerage, Inc. POUCY NUMBER CARRIER I NAICCODE ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: FORM TITLE: (continued from previous page) EXCESS LIMITS OF LIABILITY: NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA POLICY # BE 15808885 EFFECTIVE: 6/20/ 13 - 1/27/15 $25 ,000,000 PER OCCURRENCE/$25,000,000 AGGREGATE ACORD 101 (2008/01) INSURED Turner Corporation Turner Construction Company ISSUE DATE: 06/1812013 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CERTIFICATE NUMBER: A3MREBYX ACORD 8 CERTIFICATE OF LIABILITY INSURANCE I DATE(MMIDDIYYYY)
06/18/2013 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, certai n 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
Turner Surety and Insurance Brokerage. Inc. -Wc:Jn l'rtl- 201-644-2500 300 Tice Boulevard - Suite 250 Woodcliff Lake, NJ 07677 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAICif INSURER A :Uberty Mutual Insurance Company 23043 INSURED INSURER a :Liberty Mutual Fire Insurance Company 23035 Turner Corporation Turner Construction Company INSURER c Insurance 42404 3 Paragon Drive INSURER D :National Union Fire Insurance Company of Pittsburgh, PA 19445 Montvale, NJ 07645 INSURER E: - INSURER F: COVERAGES CERTIFICATE NUMBERL5NXVQ76 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. 1 1NSR .- TYPE OF INSURANCE IINSR l wvo POLICY NUMBER L.IMITS LTR A GENERAL LIABILITY [TB1-625-<l92815-042: Ea. Occ. Dam 11/01/2012 11/01/2013 EACH OCCURRENCE s 2,000,000 f-- m Rent Prem. Pers & Adv l nj: $250k& 5MERCIAL GENERAL LIABILITY L 1-625-<l92815-<l82: Ea. Occ, Pers s 2,000,000 lnj, Dam to Prem: $1 .75mm. Total f-- CLAIMS..MADE 0 OCCUR at right. MED EXP (Any one pe<son) s 10,000 & ArN INJURY $ 2,000,000 f-- 5,000,000 GENERAL AGGREGATE $ r-- 12,500,000 GEN"L AGGRE 0 LIMIT APnS PER: PRODUCTS COMP/OP AGG $ 0 POLICY X rrtr LOC $ B AUTOMOBILE LIABILITY f'\S2-625-<l92815-012 11/01/2012 11/01/2013 LIMIT $ 2,000,000 r-- ANY AIJTO BODILY INJURY {Per petSOn) s 7 AU OWNED - SCHEDULED BODILY INJURY {Per aecic!enl) s r-- AIJTOS X AIJTOS X NON-owNED
s HIRED AIJTOS AIJTOS r-- s 0
UMBRELLA LIAS
15808884 11/01/2012 11/01/2013 EACH OCCURRENCE $ 25,000,000 - _--::-:-::-c:- EXCESS LIAB CLAIMS-MADE AGGREGATE $ 25,000,000 f-- - I RETENTION$ OED I $ c WORKERS COMPENSATION :yyc1 -625-0g2815-032 11/01/2012 11/01/2013 x I I I AND EMPLOYERS" LIABILITY Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE D H, N . WA, WV, E.L. EACH ACCIDENT s 2,000,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE S 2,000,000 {fti)PEHATIONS below E.L DISEASE -POLICY LIMIT s 2,000,000 ; s s s DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Romarks Sehodulo, if more space Is requirod) LOCATION: ACPS JEFFERSON-HOUSTON PREK-8 SCHOOL, 1501 CAMERON STREET, ALEXANDRIA, VA. JOB #130013 ADDITIONAL INSURED: ALEXANDRIA CITY SCHOOL BOARD, ALEXANDRIA CITY PUBLIC SCHOOLS, AND THEIR RESPECTIVE DIRECTORS, MEMBERS, OFFICER, EMPLOYEES AND AGENTS (EXCLUDING ARCHITECTS, ENGINEERS, DESIGN PROFESSIONALS). COVERAGE IS PRIMARY AND NON-CONTRIBUTORY. WAIVER OF SUBROGATION APPLIES. WORKERS' COMPENSATION AND GENERAL LIABILITY COVERAGES APPLY TO OFFSITE OPERATIONS ONLY. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICEWILIL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ALEXANDRIA CITY PUBLIC SCHOOLS ATIN.: PROCUREMENT OFFICER AUTHORIZED REPRESENTATIVE 2000 NO. BEAUREGARD STREET
ALEXANDRIA, VA 22311 Page 1 of 1 1988- 2010 ACORD CORPORATION. All rights reserved. ACORD 25 {2010/05) The ACORD name and logo are r egistered marks of ACORD Policy Number TB1-625-092815-042 Issued by Liberty Mutual Insurance Co. THIS ENDORSEMENTCHANGES THE POUCY. PLEASE READ ITCAREFULLY. BLANKET ADDITIONAL INSURED This endorsement mocflfies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM SECTION II - WHO IS AN INSURED is amended to include as an insured any person or organization for whom you have agreed In writing to provide liabRity insurance. But The insurance provided by this amendment 1. Applies only to " b o d ~ y Injury" or "property damage arising out of (a) your work" or (b) premises or other property owned by or rented to you; 2. Applies only to coverage and minimum limls of insurance required by the written agreement. but in no event exceeds either the scope of coverage or the limits of insurance provided by this policy; and 3. Does not apply to any person or organization for whom you have procured separate liabHity insurance while such insurance is in effect. regardless ofwhetherthe scope of coverage or limits of insurance ofthis policy exceed those of such other insurance or whether such other insurance is valid and collectible. The following provisions also apply: 1. Where the applicable written agreement requires the insured to provide liability insurance on a primary, excess, contingent, or any other basis, this policy will apply solely on the basis required by such written agreement and Item 4. Other Insurance of SECTION N of this policy will not apply. 2. Where the applicable written agreement does not specify on what basis the liabHity insurance wnt apply, the provisions of Item 4. Other Insurance of SECTION IV of this policy will govem 3 This endorsement shall not apply to any person or organization for any "bodHy injury or property damage if any other additional insured endorsement on this policy applies to that person or organization with regard to the "bodHy injury or "property damage. 4. If any other additional insured endorsement applies to any person or organization and you are obligated under a written agreement to provide llabBity insurance on a prinary, excess, contingent, or any other basis for that additional insured, this policy wDI apply solely on the basis required by such written agreement and Item 4. Other Insurance of SECTION N of this policy will not apply, regardless of whether the person or organization has available other valid and collectible insurance. If the applicable written agreement does not specify on what basis the liability insurance will apply, the provisions of Item 4. Other Insurance of SECTION IV of this policy will govern. LN 20010605 ACORD 8 CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDIYYYY)
06/18/2013 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). PRODUCER Turner Surety and Insurance Brokerage, Inc. r.!JgNNEn l'vt\ 201-644-2500 1rffc No): 300 Tice Boulevard - Suite 250 Woodcliff Lake, NJ 07677 EMAIL ADDRESS: INSURERISl AFFORDING COVERAGE NAIC# INSURER A :liberty Mutual Insurance Company 23043 INSURED INSURER s :liberty Mutual Fire Insurance Comoanv 23035 Turner Corporation Turner Construction Company INSURER c :liberty Insurance Corporation 42404 3 Paragon Drive INSURERD : Montvale, NJ 07645 INSURERE : INSURERF: COVERAGES CERTIFICATE NUMBERFVYXYWF8 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. LI MITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY NUMBER LIMITS LTR A GENERAL LIABILITY rB.1-625-092815.Q42: Ea. Occ, Dam 11/01/2012 11/01/2013 EACH OCCURRENCE s 2,000.000 r- o Rent Prem, Pars & Adv lnj : GENERAL LIABILITY U-625-092815-082: Ea. Occ, Pars s 2,000,000 A.dv lnj, Dam to Prem: $1.75mm. Total ,...- CLAIMS-MADE 0 OCCUR Aggs at right. MED EXP (Any one person) s 10,000 PERSONAL & ADV INJURY s 2,000,000 ....._ GENERAL AGGREGATE s 5,000,000 - 12,500,000 GEN'L LIMIT APnS PER: PRODUCTS COMPIOP AGG s POLICY X LOC s B AUTOMOBILE LIABILITY AS2-625-092815-012 11/0112012 11/01/2013 LIMIT s 2,000,000 - ANY AUTO BODILY INJURY (Per person) s - ALL OWNED ,...- SCHEDULED X AUTOS AUTOS BODILY INJURY (Per accident) s - r- NON ..OWNED
X HIRED AUTOS
AUTOS s - $ UMBRELLA LIAS HOCCUR EACH OCCURRENCE s - EXCESS LIAS CLAIMS-MADE AGGREGATE s OED I I RETENTION$ s c WORKERS COMPENSATION !'vVC7 625-092815-032 11/01/2012 11/01/2013 X I I AND EMPLOYERS' LIABILITY YIN Emplotrrs ANY PROPRIETOR/PARTNER/EXECUTIVE 0 OH, N , WA, WV, E.L. EACH ACCIDENT s 2,000,000 OFFICER/MEMBER EXCLUDED? NIA (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ 2,000,000 II yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT s 2,000,000
$ 5 s DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) LOCATION: ACPS JEFFERSON-HOUSTON PREK-8 SCHOOL, 1501 CAMERON STREET, ALEXANDRIA, VA. CERTIFICATE PROVIDED FOR PERMIT PURPOSES. JOB#130013 ADDITIONAL INSURED: CITY OF ALEXANDRIA WORKERS' COMPENSATION AND GENERAL LIABILITY COVERAGES APPLY TO OFFSITE OPERATIONS ONLY. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCEWITHTHE POLICY PROVISIONS. CITY OF ALEXANDRIA ALEXANDRIA CITY HALL AUTHORIZED REPRESENTATIVE 301 KING STREET
ALEXANDRIA, VA 22314 Page 1 of 1 1988-2010 ACORD CORPORATION. All nghts reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD Policy Number TB1-625-092815-042 Issued by Liberty Mutual Insurance Co. THIS ENDORSEM:NTCHANGES THE POUCY. PLEASE READ ITCAREFULLY. BLANKET ADDITIONAL INSURED This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM SECTION II -WHO IS AN INSURED is amended to include as an insured any person or organization for whom you have agreed in writing to provide liabDity insurance. But The insurance provided by this amendment 1. Applies only to "bodDy injury" or "property damage arising out of (a) "your work" or (b) premises or other property owned by or rented to you; 2. Applies only to coverage and minimum limits of insurance required by the writen agreement, but in no event exceeds either the scope of coverage or the limits of insurance provided by this policy; and 3. Does not apply to any person or organization for whom you have procured separate liability ilsurance while such insurance is in effect. regardless of whether the scope of coverage or limits of insurance of this policy exceed those of such other insurance or whether such other insurance is valid and collectible. The following provisions also apply: 1. Where the applicable written agreement requires the Insured to provide liabHity insurance on a primary, excess, contingent, or any other basis, this policy will apply solely on the basis required by such writen agreement and Item 4. Other Insurance of SECTION IV of this policy wt11 not apply. 2. Where the applicable written agreement does not specify on what basis the liability insurance will apply, the provisions of Item 4. Other Insurance of SECTION IV of this policy will govern. 3 This endorsement shall not apply to any person or organization for any "bodily injury or "property damage if any other additional insured endorsement on this policy applies to that person or organization with regard to the "bondy Injury" or "property damage. 4. If any other additional insured endorsement applies to any person or organization and you are obligated under a written agreement to provide liabaity insurance on a primary, excess, contingent. or any other basis for that additional insured, this policy will apply solely on the basis required by such written agreement and Item 4. Other Insurance of SECTION rv of this policy will not apply, regardless of whether the person or organization has available other valid and collectible Insurance. If the applicable written agreement does not specify on what basis the liability insurance will apply, the provisions of Item 4. Other Insurance of SECTION IV of this policy will govern. LN 2001 0605