Certificates of Insurance
Certificate of Insurance
This certificate is issued as a matter of information only and confers no rights upon you the certificate holder. This certificate is not an insurance policy
and does not amend, extend, or alter the coverage afforded by the policies listed below,
Named Insured(s):
TAFF LEASING, L.P., BY STAFF ACQUISITION, INC., THE
ENERAL PARTNER, AND THE AFFILIATED LIMITED
ARTNERSHIPS OF WHICH STAFF ACQUISITION, INC. IS THE
ENERAL PARTNER AND STAFF LEASING, INC IS THE LIMITED
ARTNER.
00 301 BOULEVARD WEST, SUITE 202
RADENTON, FL 34205
f:NA
RISK MANA~EMENT
Coverages:
Insurer Affordin Coverage
Continental Casualty Company
The policy(ies) of insurance listed below have been issued to the insured named above for the policy period indicated. The insurance
afforded by the policy(ies) described herein is subject to all the terms, exclusions and conditions of such policy(ies).
Type of Insurance
Certificate Exp. Date
o CONTINUOUS
o EXTENDED
* iii POLICY TERM
Policy Number
Limits
Workers'
Compensation
1-1-2001
WC 189165165
WC 189165182
Employers liabilit
Bodily Injury By Accident
$1,000,000 Each Accident
Bodily Injury By Disease
$1,000,000
Policy Limit
Other:
Bodily Injury By Disease
$1,000,000
Each Person
~r:
Employees Leased To:
11360.Tom Ryan Inc
Ryan Construction Services
Effective Date: 01-JAN-2000
REF: MARATHON CLERK OF COURT RENOVATIONS
The above referenced workers' compensation policy provides statutory benefits only to employees of the Named Insured(s) on the 'policy, not to employees
of any other employer.
*If the certificate expiration date is continuous or extended term, you will be notified if coverage is terminated or reduced before the
certificate expiration date. However, you will not be notified annually of the continuation of coverage.
~N,\
Certificate Holder
~ ac/J~~
-
MONROE COUNTY
ATTN:STACY
5100 COLLEGE ROAO
STOCK ISLAND
Key West, FL 33040-4399
Martin Oosterbaan
Authorized Representative
51. Louis, MO (877)427-5567
Office Phone
If-JUN-2000
Date Issued
/ i
I~Pl~IA' _.,$.. ___"__
!.'!.. J~ ~_~_./ _~
1'\ Q'i
--...-~-~
DATE_._.
. A.~.tltlt@ CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDNY)
06/21100
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTEA OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTlRCATE
USI Florida - Lakeland HOLDER. THIS CERTIFICATE DOES NOT AM~ND. EXTEND OR
P. O. Drawer 1398 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
402 S. Kentucky Ave., 41h Fl. COMPANIES AFFORDING COVeRAGE
Lakeland FL 33802-1398 COMPANY
MONROE COUNTY
A Ohio Casually Ins Co flrlN MENT
INSURED COMPANY
Tom Ryan, Inc. B United National JUN 23 2000
and 'tan ConsIJUc:tion Services COMPANY TIM~ ?~
P.O. x 555 C ZUrich
Big Pine Key FL 33043 "~"'~, ,~, tjy.
COMPANY
D ~
COVERAGES :;~
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLlC 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 TEJRMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
co TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POUCY EXPIRAl10N LIMITS
LTR DATE (MM/DDNY) DATE (MM/DDNY)
B GENERAL LIABILITY 86GOOO1465 01/22/00 01/22/01 GENERAL AGGREGATE $ 1,000,000
~ COMMERCIAL GENERAL LIABILITY PRODUCTS. COMP/OP AGG $ 1,000,000
I CLAIMS MADE o OCCUR PERSONAL & ADV INJURY $ 1,000,000
I-- OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ 1 ,000,000
FIRE DAMAGE (Anyone fire) $ 50,000
MED EXP (Anyone person) $ 1,000
A ~OMOBILE LIABILITY BAW52221956 01/22/00 01/22/01 1,000,000
COMBINED SINGLE LIMIT $
- ANY AUTO
ALL OWNED AUTOS BODILY INJURY
--- $
-!- SCHEDULED AUTOS (Per person)
X HIRED AUTOS BODILY INJURY
X "'rr "TiG '; 'J< $
NON-OWNED AUTOS ... '. ..- . -<of' ,.; (Per accident)
- "V (\ . /, ~-;
$1,000 OOMP/OOLL DEDUCT ~
PROPERTY DAMAGE $
- f .~ -
~RAGE LIABILITY rHE _lV. JVJ Y2 AUTO ONLY - EA ACCIDENT $
ANY AUTO OTHER THAN AUTO ONLY:
-
(~,1,~: 'tTR: ~,;: .. _ Yrs EACH ACCIDENT $
AGGREGATE $
EXCESS LIABILITY EACH OCCURRENCE $
R UMBRELLA FORM AGGREGATE $
OTHER THAN UMBRELLA FORM $
WORKERS COMPENSATION AND I T~~Y~llltWq I 10FW'
EMPLOYERS' LIABILITY
-_/__/_- _/_/- EL EACH ACCIDENT $
THE PROPRIETOR! RINCL EL DISEASE . POLICY LIMIT $
PARTNERS/EXECUTIVE
OFFICERS ARE: EXCL EL DISEASE - EA EMPLOYEE $
OTHER
A In land Mar ine 8,1,1052221956 01/22/00 01/22/01 Scheduled
A Auto Phys Damage BAW52221956 01/22/00 01/22/01 Scheduled
C Bui Iders Risk BR 97001300 10/18/99 10/18/00 168,500
8ESCRIPTION OF OPERATIONS/LQCATIONS/VEHICLES/SPECIAL JIEMS
ert i I icate holder, Its employees and i rectors are listed as additional
insured as respects ~eneral liability and auto liabilitS'
Insured location: 3 17 Oversees Hwy, Marathon, FL 330 0
lax 305-872-3769
CERTlRCATE HOLDER CANCElLATION I
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
Monroe County Board of County Commissioners EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
---1.Q. DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IM__ '" L1A~L1\y , 1
OF ANY KIND UPON THE COMPANY, ~ OR REPRESEtiTATIVES~_~ V.
AUTHORIZED REPRESENTATIVE , "T
~~
ACORD 25-S (1195) @ ACORD CORPORATION 1988
The Inland Marine Declarations and INLAND MARtNE DECLARATIONS
endorsements, it any, issued to form a part
thereof, completes the Commercial
Insurance Policy numbered as follows:. . SR' . 99 5 512 37
~ New Policy
o Renewal of
In return for the payment of the premium, and subject to all the terms of this
policy, we agree with you to provide the insurance as stated in this policy.
THIS IS A COINSURANCE CONTRACT. Please read your policy.
1. Named Insured and Mailing Address:
TOM nAIf INC DBA RUB CONSTlllJC'tIOlf SERVICE
P.O. BOX 555
BIG PINE ux, FL
. ZURICH
OF AMERICA
0038
2. Producer Informati~n (complete A-D)
A) Name: USI Q.oKIDA
1>.0 'RAWER 1398
, FL 33802-1398
B) Telephone (~3)686-1161
C) Maryland Producer #: 02086460
D) Field Office Name:
E) Field Office Code:
3. Policy Period - From EffectIve Date Of: 06119/00
To (check one): 0 Continuous Reporting. !:X One Year From Effective Oate
12:01 a.m. Standard Time at your mailing address above.
o Other
4. Form of Business: 0 Individual 0 Partnership Ij Corporation 0 Joint Venture
5. limits of Insurance (select either One-Shot or Reporting Form option below)
o Reporting Form (continuous policy)
A)
B)
C)
D)
o Annual Rate
o Monthly Rate (HBIS - 4)
$1,000,000
o One-Shot (non-reporting form/single structure policy) HBIS-1
o 1-8 Family Dwelling ~ Commercial Structure
Property Location 3117 OVERSEES HWY
MARATHON, FL 33050
Anyone structure $ 193,995.
Property temporarily at
any other premises
Property in transit
All covered property
at all locations (same
as A unless otherwise
noted) $
Rate $
Premium $
Tax (applicable in KYonly) $
Total Fully Earned Policy Premium $
($250 minimum premium applicable)
A)
B)
$
$
10,000
25,000
Anyone structure
Property temporarily at
any other premises
Property in transit
All covered property
at all locations
$ 10,000
$ 25,000
$5,000,000
C)
D)
E)
F)
G)
H)
.40
776.
E)
F)
G)
H)
Rate
Premium
Tax (applicable in KYonly)
Total Fully Earned Policy Premium
Per Report
Per Report
Per Report
Per Report
776.
6. Deductible (minimum $250 unless otherwise indicated): 0 $500
7. Forms Applicable To All Coverage Parts:
I:8J 40471 Builders Risk Coverage Form
I:8J 47681 Comm. Inland Marine Coverage Part
I:8J CM0001 Comm. Inland Marine Conditions
I:8J IL0017 Common Policy Conditions (IL0146 in WA)
o 9H0003 Florida Builders Risk Declarations
o HBI5-4 Monthly Rate Endorsement
o HBIS-35 Windstorm or Hail Exclusion
o HBIS-37 Existing Building(s) or Structures(s) Cov.
Co \ \ Co , 00
Oate
Countersigned:
FM170001 REV. 1/97
00 $1,000 0 $2,500 0 $5,000 Other
o HBIS-42 Florida Fraud Statement
o HBIS-43 Windstorm Percentage Deductible
o HBIS-44 New York Fraud Statement
Other Forms: (list other applicable state and/or HBIS
forms; all required state forms applicable)
~~;..~'~:r"
,.r'" ~
'~""". ~
'..
'. .
By:
Authorized Representative
COMMON POLICY CONDITION
All Coverage Parts included in this policy are
A. CANCELLATION
1. The first Named Insured shown in the
Declarations may cancel this policy by
mailing or delivering to us advance written
notice of cancellation.
2. We may cancel this policy by mailing or
delivering to the first Named Insured
written notice of cancellation at least:
a. 10 days before the effective date of
cancelration if we cancel for nonpay-
ment of premium; or
b. 30 days before the effective date of
cancel ration if we cancel for any other
reason.
3. We will mail or deliver our notice to the
first Named Insured's last mailing address
known to us,
4. Notice of cancellation will state the ef-
fective date of cancellation. The policy
period will end on that date
5. If this policy is cancelled, we will send
the first Named Insured any premium re-
fund due. If we cancel. the refund will
be pro rata. If the first Named Insured
cancels, the refund may be less than pro
rata. The cancellation will be effective
even if we have not made or offered a
refund.
6, If notice is mailed, proof of mailing will
be sufficient proof of notice,
B, CHANGES
This policy contains all the agreements be-
tween you and us concerning the insurance
afforded. The first Named Insured shown in
the Declarations is authorized to make
changes in the terms of this policy with our
consent. This policy's terms can be amended
or waived only by endorsement issued by
us and made a part of this policy.
C. EXAMINATION OF YOUR BOOKS AND RE-
CORDS
We may examine and audit your books and
records as they relate to thiS policy at any
time during the policy period and up to three
years afterward.
IL 00 17 1 1 85
D. INSPECTIONS AND SURVEYS
We have the right but are not obligated to:
1. Make inspections and surveys at any time;
2. Give you reports on the conditions we
find; and
3. Recommend changes,
Any inspections, survey's, reports or rec-
ommendations relate only to insurability and
the premiums to be charged. We do not
make safety inspections We do not under-
take to perform the duty of any person or
organization to provide for the health or
safety of workers or the public, And we
do not warrant that conditions:
1. Are safe or healthful; or
2. Comply with laws, regulations, codes or
standards.
This condition applies not only to us, but also
to any rating, advisory, rate service or similar
organization which makes insurance in-
spections, surveys, reports or recommen-
dations,
E. PREMIUMS
The first Named Insured shown in the Dec-
larations:
1. Is responsible for the payment of all
premiums, and
2. Will be the payee for any return premi-
ums we pay.
F. TRANSFER OF YOUR RIGHTS AND DUTIES
UNDER THIS POLICY
Your rights and duties under this policy may
not be transferred without our written con-
sent except in the case of death of an in-
dividual Named Insured.
If you die, your rights and duties will be
transferred to your legal representative but
only while acting within the scope of duties
as your legal representative Until your legal
representative is appointed. anyone having
proper temporary custody of your property
will have your rights and duties but only with
respect to that property.
Copynght Insurance Services Office, Inc, 1983, 1992
o
,
^
_ TheMaryland@
Commercial Insurance Group
BUILDER'S RISK COVERAGE FORM
This form is subject to the information in the Declarations and the Policy Conditions, Schedules and
Endorsements.
Throughout this policy, the words you and your refer to the Named Insured shown in the
Declarations. The words we, us and our refer to the Company providing this insurance.
Words and phrases that appear in italics have special meaning. Refer to Section F. DEFINITIONS.
A. COVERAGE
We will pay for direct physical/oss to Covered Property from any Covered Cause of Loss
described in this Coverage Form.
1. COVERED PROPERTY, as used in the Coverage form means:
a. Property which has been installed, or is to be installed in any commercial
structure and/or anyone (1) to eight (8) family dwelling, private garage, or
other structures that will be used to service the dwelling at the location which
you have reported to us. This includes:
(1) Your property;
(2) Property of others for which you are legally responsible;
(3) Paving, curbing, fences, trees, shrubs, plants, lawns and outdoor
fixtures; and
(4) Completed dwelling(s) which is being used as a Model Home
when reported to us as such on monthly reports with an
amount shown.
2. PROPERTY NOT COVERED
Covered Property does not include:
a. Existing building or structure to which an addition, alteration, improvement,
or repair is being made, unless specifically endorsed;
b. Plans, blueprints, designs or specifications, except as provided in Additional
Coverage section of this Coverage Form; and
c. Land.
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, ,
. ,
3 COVERED CAUSE OF LOSS
Covered Cause of Loss means risk of direct physical/ass to Covered Property,
except those causes of loss listed in the Exclusions.
4. ADDITIONAL COVERAGE
a. Collapse
We will pay for direct loss caused by or resulting from direct physical/ass
involving collapse of all or part of a building or structure caused by one of more
of the following:
(1) Fire; lightning; windstorm; hail; explosion; smoke; aircraft; vehicles; riots;
civil commotion; vandalism; breakage of glass; falling objects; weight of
snow, ice or sleet; water damage; but only if the causes of loss are
otherwise covered in this coverage Form;
(2) Hidden decay;
(3) Hidden insect or vermin damage;
(4) Weight of people or personal property;
(5) Weight of rain that collects on a roof;
(6) Use of defective materials or methods in construction, remodeling or
renovation if the collapse occurs during the course of the construction,
remodeling or renovation.
This Additional Coverage does not increase the Limits of Insurance provided in
this Coverage Form.
b. Scaffolding, Construction Forms and Temporary Structures
(1) We will pay for direct physical/ass which is caused by or results from a
Covered Cause of Loss, to scaffolding, construction forms and
temporary structures, but only while they are at a location you have
reported to us.
(2) We will also pay for the cost of re-erection of the scaffold if the loss of
the scaffolding is caused by or results from a Covered Cause of Loss.
The most we will pay for the re-erection of scaffolding is $5,000.
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c. Debris Removal
We will pay your expenses to remove debris of Covered Property. This debris
must result from a loss that we cover under this form. The expenses will be
paid only if they are reported to us in writing within 180 days of the date of
direct physical/ass. If the sum of the loss and debris removal expenses
exceeds the limit of insurance applicable to the property, we will pay an
additional amount of debris removal expenses you incur up to, but not
exceeding $10,000.
This Additional Coverage does not apply to costs to:
(1) Extract pollutants from land or water; or
(2) Remove, restore or replace polluted land or water.
d. Back-up or overflow of Sewers, Drains or Sumps
You may extend the insurance that applies to Covered Property to apply to
loss caused by water that backs up or overflows from a sewer, drain or sump
from within the reported location.
The most we will pay for loss caused by water that backs up or overflows from
a sewer, drain or sump is $5,000.
e. Fire Department Service Charge
When the fire department is called to save or protect Covered Property from a
Covered Cause of Loss, we will pay up to $10,000 for your liability for fire
department service charges which are:
(1) Assumed by contract or agreement prior to loss; or
(2) Required by local ordinance.
No deductible applies to this Additional Coverage.
f. Valuable Papers
You may extend the insurance that applies to Covered Property to apply to
your costs to research, replace or restore the lost information on lost or
damaged valuable papers and records due to a Covered Cause of Loss,
including those which exist on electronic or magnetic media, for which
duplicates do not exist. Valuable Papers means inscribed, printed or written
40471
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Copyright, Insurance Services Office, Inc 1995
Page 3 of 15
. '.
documents, records including deeds, drawings, maps, mortgages. The most
we will pay under this Additional Coverage is $10,000.
g. Pollutant Clean-up and Removal
We will pay your expense to extract pollutants from land or water at locations
reported to us if the discharge, dispersal, seepage, migration, release or
escape of the pollutants is caused by or results from a Covered Cause of
Loss that occurs during the policy period. The expenses will be paid only if
they are reported to us in writing within 180 days of the date on which the
Covered Cause of Loss occurs.
This Additional Coverage does not apply to costs to test for, monitor, or assess
the existence, concentration or effects of pollutants. But, we will pay for
testing which is performed in the course of extracting the pollutants from land
or water.
The most we will pay under this Additional Coverage is $15,000 for the sum of
all expenses which are incurred as a result of all Covered Causes of Loss
during each separate 12 month period from the effective date of the policy.
h. Reward
At our discretion, we may pay up to $10,000 as an additional amount of
insurance for information which leads to conviction in connection with a
Covered Cause of Loss. The Named Insured and their employees are not
eligible under this Additional Coverage.
B. EXCLUSIONS
1. We will not pay for a loss caused directly or indirectly by any of the following. Such
loss is excluded regardless of any other cause or event that contributes concurrently
or in any sequence to the loss.
a. Governmental Action
Seizure or destruction of property by order of any governmental authority. But
we will pay for acts of destruction ordered by governmental authority and taken
at the time of a fire to prevent its spread, if that fire would be covered under
this Coverage Part.
b. NuclearHaza~
Nuclear reaction or radiation, or radioactive contamination, however cause.
40471
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Copyright, Insurance Services Office, Inc 1995
Page 4 of 15
But if loss by fire results, we will pay for that resulting loss.
c. War and Military Action
(1) War, including undeclared or civil war;
(2) Warlike action by a military force, including action hindering or
defending against an actual or expected attack by any government,
sovereign or other authority using military personnel or other agents; or
(3) Insurrection, rebellion, revolution, usurped power or action taken by
government authority in hindering or defending against any of these.
d. Earth Movement
(1) Any earth movement (other than sinkhole collapse), such as an
earthquake, landslide, mine subsidence or earth sinking, rising or
shifting. But if earth movement results in fire or explosion, we will pay
for the loss caused by that fire or explosion.
(2) Volcanic Action
Volcanic eruption, explosion or effusion. But if volcanic eruption,
explosion or effusion results in fire, building glass breakage or Volcanic
Action, we will pay for the loss caused by that fire, building glass
breakage or Volcanic Action.
Volcanic Action means direct loss resulting from the eruption of a
volcano when the loss is caused by:
(a) Airborne volcanic blast or airborne shock waves;
(b) Ash, dust or particulate matter; or
(c) Lava flow.
All volcanic eruptions that occur within any 168 hour period will
constitute a single occurrence.
Volcanic action does not include the cost to remove ash, dust or
particulate matter that does not cause direct physical loss to the
described property.
This exclusion does not apply to property while in transit.
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. "
e. Water
(1) Flood, surface water, waves, tides, tidal waves, overflow of any body of
water or their spray, all whether driven by wind or not;
(2) Mudslide or mudflow;
(3) Water that backs up or overflows from a sewer, drain or sump, except
as provided in the Additional Coverage section in this Coverage Form;
(4) Water under the ground surface pressing on, or flowing or seeping
through:
(a) Foundations, walls, floors or paved surfaces;
(b) Basements, whether paved or not; or
(c) Doors, windows or other openings.
But if Water, as described in e.(1) through e.(4) above, results in fire, explosion
or sprinkler leakage, we will pay for the loss caused by that fire, explosion or
sprinkler leakage.
2. We will not pay for a loss caused by or resulting from any of the following:
a. Delay, loss of use, loss of market. This does not include profit if reported in
compliance with the Reporting Provision section of this Coverage Form;
b. Dishonest or criminal act by you, any of your partners, employees, directors,
trustees, authorized representatives or anyone to whom you entrust the
property for any purpose. This exclusion does not apply to Covered Property
while it is entrusted to others who are carriers for hire.
This exclusion applies:
(1) while acting alone or in collusion with others; or
(2) Whether or not occurring during the hours of employment.
This exclusion does not apply to acts of destruction by your employees; but
theft by employees is not covered.
c. Voluntary parting with any property by you or anyone entrusted with the
property if induced to do so by any fraudulent scheme, trick, device, or false
pretense.
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d. Unauthorized instructions to transfer property to any persons or to any place.
e. Unexplained or mysterious disappearance except for property in custody of a
carrier for hire.
f. Shortage of property found on taking inventory.
g. Penalties for noncompliance with contract conditions.
h. Collapse, except as provided in the Additional Coverage section in this
Coverage Form.
I.
(1 )
Wear and tear;
(2) Any quality in the property itself that causes it to damaQ'e or destroy
itself; gradual deterioration;
(3) Insect, vermin, rodents;
(4) Corrosion, rust, fungus, mold, rot;
(5) Dampness, changes in or extremes of temperatures, freezing;
However, we will cover freezing loss to property in the building if you
have shut off the water supply and drained the plumbing systems and
appliances or made a reasonable effort to maintain heat in the building.
(6) Settling, cracking, shrinking, or expansion to any covered property.
j. Rain, snow, sleet, sand, dust if property is in the open. This does not apply to
property in the custody of a carrier for hire.
k. Artificially generated electrical current; mechanical breakdown; rupturing or
bursting caused by centrifugal force.
3. We will not pay for a loss caused by or resulting from any of the following. But if loss
by a Covered Cause of Loss results, we will pay for the resulting loss caused by
that Covered Cause of Loss.
a. Weather conditions which contribute in any way to a cause or event excluded
in paragraph 1. above to produce the loss.
b. Acts or decisions, including the failure to act or decide, of any person, group,
or organization representing a governmental, regulatory or controlling body.
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. .,
c. Faulty, inadequate or defective:
(1) Planning, zoning, development, surveying, siting;
(2) Design, specifications, workmanship, repair, construction, renovation,
remodeling, grading, compaction;
(3) Materials used in repair, construction, renovation or remodeling; or
(4) Maintenance of all or part of any property wherever located.
d. The discharge, dispersal, seepage, migration, release or escape of pollutants,
except as provided under Additional Coverages.
C. LIMITS OF INSURANCE
The most we will pay for loss to anyone structure is the lesser of the Limit of Insurance
shown in the Declarations for that structure or the total estimated completed value that
was reported to us for that structure. The most we will pay in anyone occurrence is the limit
shown in the Inland Marine Declarations for all Covered Property at all locations.
D. DEDUCTIBLE
We will not pay for loss in anyone occurrence until the amount of covered loss exceeds the
Deductible shown in the Declarations. We will then pay the amount of covered loss which
exceeds the Deductible, up to the applicable Limit of Insurance.
E. ADDITIONAL CONDITIONS
The following conditions apply in addition to the Commercial Inland Marine Conditions and
the Common Policy Conditions:
1. COVERAGE TERRITORY
The coverage territory is:
a. United States of America;
b. Puerto Rico; and
c. Canada.
40471
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Copynght, Insurance Services Office, Inc 1995
Page 8 of 15
2. WHERE COVERAGE APPLIES
This coverage applies to Covered Property while within the Coverage Territory while:
a. At any construction site you have reported;
b. Temporarily at other premises, if the property has been designated to be
installed at a location you have reported to us; or
c. In transit except imports or exports while ocean marine coverage applies.
3. WHEN COVERAGE BEGINS AND ENDS
We will cover risk of loss from the time when you are legally responsible for the
property on or after the effective date of this policy if all other conditions are met.
Coverage will end at the earliest of the following:
a. Once your interest in the property ceases;
b. Ninety days after occupancy of the building unless:
(1) that building is being used as a Model Home;
(2) that building is being remodeled; or
(3) that building is being used as a Model Home Leaseback.
c. When the building is leased to or rented to others (if a multiple family or
commercial structure, when more than 50% is leased to or rented to others);
d. When you abandon the reported location with no intention to complete it;
e. At the end of 12 months from the month when you first reported the location to
us unless you report the location again and pay an additional premium. If the
location is reported again and the additional premium is paid, coverage will end
at the end of 12 months from the month when you re-reported the location to
us as described in the reporting provision below;
f. When permanent property insurance applies; or
g. Once the Covered Property is accepted by the owner or buyer.
40471
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4. REPORTING PROVISIONS
a. By the last day of each month you will report to us the total estimated
completed values of all Covered Property at the locations you started
construction during the previous month. This report is to be made on the form
we provide for this purpose and must include the total estimated completed
value (labor, overhead and materials) and, if coverage is desired, profit.
The starting date for the purpose of the report is the date when you first put the
building materials (which includes the foundation) on the construction site.
b. Dwelling being used as a Model Home should be reported and identified as a
Model Home.
c. If at the time of loss you have not made the report as required in this
provision, we cover only those location(s) previously reported.
d. You must pay premiums based on the total estimated completed value of
the Covered Property using the rate we furnish. Premium payment must
accompany the report in order for the reported locations to be covered.
e. The premium charged is fully earned and no refund is due you when coverage
ends.
f. You will keep accurate construction records regarding property we cover under
this policy. This includes the total estimated completed value of the
Covered Property and a record of all contracts of sale dealing with the Covered
Property.
g. If at the end of 12 months from the time you first reported a start to us, you still
have that location in your inventory, you may report that location to us a
second time.
h. Our acceptance of a report of value does not waive or change any part of this
policy nor stop us from asserting any right we have under the terms of this
policy.
5. MORTGAGE HOLDERS CLAUSE
a. The term "mortgage holder" includes trustees.
b. We will pay for covered loss of or damage to buildings or structures to each
mortgage holder shown on a Certificate of Insurance issued by the current
Agent of Record.
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c. The mortgage holder has the right to receive loss payment even if the
mortgage holder has started foreclosure or similar action on the building or
structure.
d. If we deny your claim because of your acts or because you hawe failed to
comply with the terms of this Coverage Part, the mortgage holder will still have
the right to receive loss payment if the mortgage holder:
(1) Pays any premium due under this Coverage Part at our request if you
have failed to do so;
(2) Submits a signed, sworn proof of loss within 60 days after receiving
notice from us of your failure to do so;
(3) Has notified us of any change in ownership, occupancy,or substantial
change in risk known to the mortgage holder.
All of the terms of this Coverage Part will then apply directly to the
mortgage holder.
e. If we pay the mortgage holder for any loss or damage and deny payment to
you because of your acts or because you have failed to comply with the terms
of this Coverage Part:
(1) The mortgage holder's rights under the mortgage will be transferred to
us to the extent of the amount we pay; and
(2) The mortgage holder's rights to recover the full amount of the mortgage
holder's claim will not be impaired.
At our option, we may pay to the mortgage holder the whole principal on the
mortgage plus any accrued interest. In this event, your mortgage and note will
be transferred to us and you will pay your remaining mortgage debt to us.
f. If we cancel this policy, we will give written notice to the mortgage holder at
least:
(1) 10 days before the effective date of cancellation if we camcel for your
non-payment of premium; or
(2) 30 days before the effective date of cancellation if we call1cel for any
other reason.
g. We will not notify the mortgage holder if:
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(1) You cancel this policy, or
(2) Coverage ends for any reason other than if we cancel the policy.
6. VALUATION
General Conditions E. Valuation in the Commercial Inland Marine Conditions is
replaced by the following:
In the event of loss, the value of the property will be determined as of the time of the
loss.
a. The value of the property will not be more than the amount necessary to
replace the structure or repair the structure to the same point of completion
that had been achieved immediately before the loss.
b. If the loss involves building materials which have not been installed, the value
of the property will not be more than the amount necessary to replace the
materials with comparable type or quality.
7. COINSURANCE
If the reported value is less than the total completed value, you will bear a portion of
any loss. The amount we will pay is determined by the following steps:
a. Divide the reported value by the total completed value of the Covered
Property;
b. Multiply the total amount of the covered loss before the application of any
deductible by the percentage determined in step "a";
c. Subtract the deductible from the figure determined in step "b".
Example No.1
(This example assumes there is J1Q penalty for underinsurance.)
Deductible
Reported Value
Total Completed Value
Amount of loss
$1000
$100,000
$100,000
$60,000
A. Reported ValuefTotal Completed Value
$100,000/$100,000 = 1.00
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B. Amount of Loss x Percentage in A
$60,000 x 1.00 = $60,000
C. Deductible Amount Subtracted from results of B
$60,000 - $1,000 = $59,000
Total Amount of Loss Payable = $59,000
Example No.2
(This example assumes there ~a penalty for underinsurance)
Deductible
Reported Value
Total Completed Value
Amount of Loss
$1000
$100,000
$120,000
$60,000
A. Reported Valuerrotal Completed Value
$100,000/$120,000 = .833
B. Amount of Loss x Percentage in A
$60,000 x .833 = $49,980
C. Deductible Amount Subtracted from results of B
$49,980 - $1,000 = $48,980
Total Amount of Loss Payable = $48,980
8 CANCELLATION
a. The following is added to the Cancellation Condition in the Common Policy
Conditions and applies only to the coverage provided in this Coverage Form:
Cancellation of this policy will not affect the insurance in force on any location
which you have reported to us or on any location which starte~ before the
effective date of the cancellation notice if that location is reported on the report
due and payment is made. However, you cannot report any location currently
in your inventory a second time after the effective date of canc~lIation.
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. "
However, coverage may be canceled on any location if notice is given in
writing in accordance with the cancellation provision in the Common Policy
Conditions, or state amendatory endorsements.
b. Common Policy Conditions IL0017 Section A Cancellation Paragraph 5 is
replaced by the following:
5. The premium for this coverage is fully earned and no refund is due
when the policy is canceled.
9. LIBERALIZATION CLAUSE
If we adopt any revision which would broaden the coverage under this Coverage
Form without additional premium within 60 days prior to or during the policy period,
the broadened coverage will immediately apply to this policy.
10. INTEREST OF SUBCONTRACTORS, SUB-SUBCONTRACTORS, SUPPLIERS
We cover the interest which your subcontractors, your sub-subcontractors and your
suppliers have in the covered property, but only while such property is situated at
construction sites you have reported to us. This condition does not impair any right of
subrogation we would otherwise have.
11. RIGHTS OF RECOVERY
If any act or agreement of yours after loss impairs your right to recover from others,
we will not cover the loss, nor will we cover any loss which you settle or compromise
without written consent.
12. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS
Your failure to disclose all hazards existing as of the inception date of the policy shall
not affect the coverage afforded by this policy, provided such failure to disclose all
hazards is not intentional and the hazard is reported to us as soon as practicable
after you learn about it.
13. UNINTENTIONAL DELAYIINADVERTENT OMISSION IN REPORTING
This insurance shall not be prejudiced by any unintentional delay or inadvertent
omission in reporting under this policy or any unintentional error in the description of
the property at risk; provided prompt notice is given the company in all such
instances as soon as said delay or omission or error becomes known to the insured,
and provided that you pay any premium due under this coverage part at our request.
This condition only applies if, in the twelve month period immediately preceding notice
to the company said delay or omission or error, the insured properly reported by the
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due date and paid the correct premiums on all property eligible to be reported under
the provisions of this policy.
F. DEFINITIONS
1. Loss means accidental loss and accidental damage.
2. Overhead means those business expenses, other than materials and labor, incurred
either directly or indirectly due to the construction of a dwelling or structure including
soft costs.
3. Pollutants means any solid, liquid, gaseous or thermal irritant or contaminant. This
includes, but is not limited to: smoke, vapor, soot, fumes, acids, alkalis, chemical and
waste. Waste includes, but is not limited to, materials to be recycled, reconditioned or
reclaimed.
4. Profit means the difference between the value of the completed structure (selling
price of that property and structure, including labor) and your financial interest in the
property and the completed structure. If you do not have a signed contract for the
sale of the completed structure and property, the allowance for profit will be limited to
no more than 20% of the cost of the property and completed structure.
5. Total Estimated Completed Value means all costs associated with the building and
designing of the property covered including labor, overhead and materials and if
coverage is desired, profit.
6. Water Damage means accidental discharge or leakage of water or steam as the
direct result of the breaking apart or cracking of any part of a system or appliance
(other than a sump system including its related equipment and parts) containing
water or steam.
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Commercial Inland Marine Coverage Part Quick Reference
READ YOUR POLICY CAREFULLY
DECLARATIONS PAGE
Names Insured and Mailing Address
Policy Period
Description of Business and Location
Coverages and Limits of Insurance
COVERAGE FORM(S)
A.COVERAGE
1) Covered Property
2) Property Not Covered
3) Covered C~uses of Loss
4) Additional toverage -- Collapse
5) Coverage Extensions (if applicable)
C. LIMITS OF INSURANCE
D. DEDUCTIBLE (if app.licable)
J
E. ADDITIONAL CONDITIONS
F. DEFINITIONS
B. EXCLUSIONS
Earthquake (if applicable)
Governmental Action
Nuclear Hazard
War and Military Action
Water (if applicable)
Other Exclusions
ENDORSEMENTS (if applicable)
COMMERCIAL INLAND MARINE CONDITIONS
LOSS CONDITIONS
A. Abandonment
B. Appraisal
C. Duties in the Event of Loss
D. Insurance Under Two or More Coverages
E. Loss Payment
F. Other Insurance
G. Pair, Sets or Parts
H. Privilege to Adjust With Owner
I. Recoveries
J. Reinstatement of Limit After Loss
K. Transfer of Rights of Recovery Against Others to Us
GENERAL CONDITIONS
A. Concealment, Misrepresentation or Fraud
B. Legal Action Against Us
C. No Benefit to Bailee
D. Policy Period
E. Valuation
COMMON POLICY CONDITIONS
A. Cancellation
B. Changes
C. Examination of Your Books and Records
D. Inspection and Surveys
E. Premiums
F. Transfer of Your Rights and Duties Under This Policy
47681 Rev. 9-93
Copyright, Insurance Services Office, Inc., 1982, 1984
../,
COMMERCIAL INLAND MARINE
CM 00 01 0695
COMMERCIAL INLAND MARINE CONDITIONS
The following conditions apply in addition to the Common Policy Conditions and applicable Additional Conditions in Commercial
Inland Marine Coverage Forms:
LOSS CONDITIONS
A. ABANDONMENT
There can be no abandonment of any property to us.
B. APPRAISAL
Ifwe and you disagree on the value of the property or the
amount of'10ss," either may make written demand for
an appraisal of the '10ss." In the event, each party will
select a competent and impartial appraiser. The two
appraisers will select an umpire. If they can not agree,
either may request that selection be made by a judge of a
court having jurisdiction. The appraisers will state
separately the value of the property and amount of'10ss."
If they fail to agree, they will submit their differences to
the umpire. A decision agreed to by any two will be
binding. Each party will:
1. Pay its chosen appraiser; and
2. Bear the other expenses of the appraisal and
umpire equally.
If there is an appraisal, we will still retain our right to
deny the claim.
C. DUTIES IN THE EVENT OF LOSS
You must see that the following are done in the event of
'10ss"to Covered Property:
1. NotifY the police if a law may have been broken.
2. Give us prompt notice of the '10ss." Include a
description of the property involved.
3. As soon as possible, give us a description of how,
when and where the '10ss" occurred.
4. Take all reasonable steps to protect the Covered
Property from further damage and keep a record of
your expenses necessary to protect the Covered
Property, for consideration in the settlement of the
claim. This will not increase the Limit ofInsurance.
However, we will not pay for any subsequent '10ss"
resulting from a cause of loss that is not a Covered
Cause of Loss. Also iffeasible, set the damaged
property aside and in the best possible order for
examination.
5. Make no statement that will assume any
obligation or admit any liability, for any '10ss" for
which we may be liable, without our consent
Copyright, Insurance Services Office, Inc., 1994
6. Permit us to inspect the property and records
proving '10ss."
7. If requested, permit us to question you under
oath, at such times as may be reasonably required,
about any matter relating to this insurance or your
claim, including your books and records. In such
event, your answers must be signed.
8. Send us a signed, sworn statement of'10ss"
containing the information we request to settle the
claim. You must do this within 60 days after our
request. We will supply you with the necessary
forms.
9. Promptly send us any legal papers or notices
received concerning the '10ss."
10. Cooperate with us in the investigation or
settlement ofthe claim.
D. INSURANCE UNDER TWO OR MORE
COVERAGES
If two or more of this policy!> coverages apply to the
same '10ss," we will not pay more than the actual amount
of the '10ss."
E. LOSS PAYMENT
We will payor make good any '10ss" covered under this
Coverage Part within 30 days after:
1. We reach agreement with you;
2. The entry of final judgement; or
3. The filing of an appraisal award.
We will not be liable for any part of a '10ss" that has been
paid or made good by others.
F. OTHER INSURANCE
If you have other insurance covering the same '10ss" as
the insurance under this Coverage Part, we will pay only
the excess over what you should have received from the
other insurance. We will pay the excsss whether you can
collect on the other insurance or not.
CM 00 01 06 95
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G. PAIR, SETS OR PARTS
1. Pair or Set. In case of 'loss" to any part of a p~ir or
set we may:
a. Repair or replace any part to restore the pair or set
to its value before the 'loss;" or
b. Pay the difference between the value of the pair or
set before and after the 'loss."
2. Parts. In case of'loss"to any part of Covered
Property consisting of several parts when complete, we
will only pay for the value of the lost or damaged part.
H. PRIVILEGE TO ADJUST WITH OWNER
In the event of 'loss" involving property of others in your
care, custody or control, we have the right to:
1. Settle the 'loss" with the owners of the property. A
receipt for payment from the owners of that property will
satisfy any claim of yours.
2. Provide a defense for legal proceedings brought
against you. Ifprovided, the expense of this defense will
be at our cost and will not reduce the applicable Limit of
Insurance under this insurance.
I. RECOVERIES
Any recovery or salvage on a 'loss" will accrue entirely
to our benefit until the sum paid by us has been made up.
J. REINSTATEMENT OF LIMIT AFTER LOSS
The Limit ofInsurance will not be reduced by the
payment of any claim, except for total 'loss" of a
scheduled item, in which event we will refund the
unearned premium on that item.
K. TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US
If any person or organization to or for whom we make
payment under this insurance has rights to recover
damages from another, those rights are transferred to us
to the extent of our payment. That person or organization
must do everything necessary to secure our rights and
must do nothing after 'loss" to impair them.
Copyright, Insurance Services Office, Inc., 1994
GENERAL CONDITIONS
A. CONCEALMENT, MISREPRESENTATION OR
FRAUD
This Coverage Part is void in any case of fraud,
intentional concealment or misrepresentation of a
material fact, by you or any other insured, at any time,
concerning:
1. This Coverage Part;
2. The Covered Property;
3. Your interest in the Covered Property; or
4. A claim under this Coverage Part.
B. LEGAL ACTION AGAINST US
No one may bring legal action against us under this
Coverage Part unless:
1. There has been full compliance with all the
terms of this Coverage Part; and
2. The action is brought within two years after you
first have knowledge of the 'loss."
C. NO BENEFIT TO BAILEE
No person or organization, other than you, having
custody of Covered Property, will benefit from this
insurance.
D. POLICY PERIOD
We cover 'loss" commencing during the policy period
shown in the Declarations.
E. VALUATION
The value of property will be the least of the following
amounts:
1. The actual cash value of that property;
2. The cost of reasonably restoring that property to
its condition immediately before 'loss;" or
3. The cost of replacing that property with
substantially identical property.
In the event of'loss,"the value of the property will be
determined as of the time of , loss."
CM 00 01 0695
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