CONTRACTUAL INSURANCE REQUIREMENTS

The information contained herein is to describe the contractual requirements that Newco, LLC dba City Construction has indicated to myCOI. These contractual requirements should NOT be used to provide inaccurate information regarding current insurance policies. Questions regarding interpretation of this document can be directed to our support team at 317-759-9426.

INSURED

Mt. Vernon Construction 510 1st Ave. North Mt. Vernon, IA 52314

CARRIER REQUIREMENTS

A- or higher, VIII




POLICY LINE POLICY LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
CLAIMS MADE DAMAGE TO RENTED PREMISES (Ea occurrence) $
X OCCUR MED EXP (Any one person) $
PERSONAL & ADV INJURY $
GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ 2,000,000
POLICY X PROJECT LOCATION $
AUTO LIABILITY COMBINED SINGLE LIMIT (Ea accident) $
X ANY AUTO BODILY INJURY (Per person) $ 1,000,000
ALL OWNED AUTOS BODILY INJURY (Per accident) $ 1,000,000
SCHEDULED AUTOS PROPERTY DAMAGE (Per accident) $ 1,000,000
HIRED AUTOS
NON-OWNED AUTOS
UMBRELLA /EXCESS LIABILITY X OCCUR EACH OCCURRENCE $ 5,000,000
Claims Made AGGREGATE $ 5,000,000
WORKERS COMP /EMPLOYEE LIABILITY X WC STATUTORY LIMITS OTHER
E.L. EACH ACCIDENT $ 500,000
E.L. DISEASE - EA EMPLOYEE $ 500,000
E.L. DISEASE - POLICY LIMIT $ 500,000
Property Property Causes of Loss Deductibles Building $
Basic Building Personal Property $
Broad Contents Business Income $
Special Extra Expense $
Earthquake Rental Value $
Wind Blanket Building $
Flood Blanket Pers Prop $
Blanket BLDG & PP $
$
$
Boiler and Machine Boiler & Machinery /Equipment Break Down $
$

Certificate Holder


City Construction C/O: myCOI P.O. Box# 501970, 8710 Bash Street Indianapolis, IN 46256

ADDITIONAL REQUIREMENTS


Division Name: 1-159 North Liberty City Hall, Division Number: 1-159.
- 30 Days Notice of Cancellation Required.

General Liability


- Certificate language must confirm additional insured status endorsement CG 2010 and CG 2037 or equivalent.
--
Note: Additional Insured endorsement language that restricts Additional Insured status to contract signers, negligence clause, or exclusions does not qualify as an equivalent.
--
Certificate language must confirm Additional insured status for other parties endorsement CG 2038 or equivalent.
--
Certificate language must confirm CG 2404 Waiver of subrogation or equivalent.
--
Certificate language must confirm CG 2001 primary & non-contributory status or equivalent for additional insureds.
--
Certificate language must confirm policy provides 30 day notice of cancellation to Certificate holder.
--
Certificate language must confirm X / C / U exposures are not excluded from coverage.
--
Certificate language must confirm endorsement form CG 2294 (Exclusion - Damage to work Performed by Subcontractors on Your Behalf) or equivalent is NOT included in policy.
--
- Project number and name must be listed on certificate. Please see division name above for details.
- Waiver of Subrogation applies in favor of:City Construction Newco, LLC (Contractor); Owner ; And any other specified party.
- Please confirm on the certificate or by uploading endorsement(s) that Additional Insured applies to this policy.
- Additional Insured Names: City Construction Newco, LLC (Contractor); Owner ; And any other specified party.,
- Additional Insured applies to General Liability.
- Please confirm on the certificate or by uploading endorsement(s) that Waiver of Subrogation applies to this policy.
- Please confirm on the certificate or by uploading endorsement(s) that Primary & Non-Contributory applies to this policy.

Automobile Liability


- Certificate language must confirm CA 2048 Additional Insured or equivalent.
--
Certificate language must confirm CG 2404 Waiver of subrogation or equivalent.
--
Certificate language must confirm policy provides 30 day notice of cancellation to Certificate holder.
--
- Project number and name must be listed on certificate. Please see division name above for details.
- Waiver of Subrogation applies in favor of:City Construction Newco, LLC (Contractor); Owner ; And any other specified party.
- Please confirm on the certificate or by uploading endorsement(s) that Additional Insured applies to this policy.
- Additional Insured Names: City Construction Newco, LLC (Contractor); Owner ; And any other specified party.,
- Additional Insured applies to Automobile.
- Please confirm on the certificate or by uploading endorsement(s) that Waiver of Subrogation applies to this policy.

Umbrella Excess Liability


- Certificate language must confirm underlying scheduled policies.
--
Certificate language must confirm Additional Insured status follow form applies.
--
Certificate language must confirm CU 2404 Waiver of subrogation or equivalent.
--
Certificate language must confirm CU 2001 primary & non-contributory status or equivalent for additional insureds.
--
Certificate language must confirm policy provides 30 day notice of cancellation to Certificate holder.
--
- Project number and name must be listed on certificate. Please see division name above for details.
- Waiver of Subrogation applies in favor of:City Construction Newco, LLC (Contractor); Owner ; And any other specified party.
- Please confirm on the certificate or by uploading endorsement(s) that Additional Insured applies to this policy.
- Additional Insured Names: City Construction Newco, LLC (Contractor); Owner ; And any other specified party.,
- Additional Insured applies to Umbrella.
- Please confirm on the certificate or by uploading endorsement(s) that Waiver of Subrogation applies to this policy.
- Please confirm on the certificate or by uploading endorsement(s) that Primary & Non-Contributory applies to this policy.

Workers Compensation


- Certificate Language must confirm Waiver of Subrogation endorsement WC 00 03-13 or equivalent.
--
Certificate language must confirm "All Other States" coverage (AOS)
--
Certificate language must confirm policy provides 30 day notice of cancellation to Certificate holder.
--
- Project number and name must be listed on certificate. Please see division name above for details.
- Waiver of Subrogation applies in favor of:City Construction Newco, LLC (Contractor); Owner ; And any other specified party.
- Please confirm on the certificate or by uploading endorsement(s) that Waiver of Subrogation applies to this policy.
-*