CONTRACTUAL INSURANCE REQUIREMENTS

The information contained herein is to describe the contractual requirements that ZZ [Inactive] Hernandez Construction LLC 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

Omar Contractors, Inc. 12347 NW 27th Place Coral Springs, FL 33065

CARRIER REQUIREMENTS



POLICY LINE POLICY LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
CLAIMS MADE DAMAGE TO RENTED PREMISES (Ea occurrence) $ 50,000
X OCCUR MED EXP (Any one person) $ 5,000
PERSONAL & ADV INJURY $ 1,000,000
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) $
ANY AUTO BODILY INJURY (Per person) $
ALL OWNED AUTOS BODILY INJURY (Per accident) $
SCHEDULED AUTOS PROPERTY DAMAGE (Per accident) $
HIRED AUTOS
NON-OWNED AUTOS
UMBRELLA /EXCESS LIABILITY X OCCUR EACH OCCURRENCE $ 2,000,000
Claims Made AGGREGATE $ 2,000,000
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


GPT NW 96th Street Owner LLC C/O: myCOI P.O. Box# 501970, 8710 Bash Street Indianapolis, IN 46256

ADDITIONAL REQUIREMENTS


Division Name: 65-04600 - Sycamore Logistics A & B.
- Contract ID: 65-04600-14.
- 30 Days Notice of Cancellation Required.
- Endorsement required to show General Liability is Primary and Non-Contributory.

General Liability


- Contractual Liability coverage is required.
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Confirm that the following exclusions are not part of the policy: (1) Prior Acts, (2) Residential Construction & (3) Work Performed by a Subcontractor.
- A physical copy of the additional insured forms for both ongoing and completed operations (CG 2010 11/85 OR CG 2010 10/01 & CG 2037 10/01) must be submitted.
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A Physical copy of the per project aggregate endorsement is required.
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A physical copy of the Primary & Non-Contributory endorsement is required.
- Project number, name & address (enter project #/name/address) must be listed on certificate.
- A physical copy of waiver of subrogation endorsement must be submitted.
- Waiver of Subrogation applies in favor of:GPT NW 96th Street Owner LLC; Hernandez Construction LLC; EQ Management, LLC; BRE 312 Skydeck LLC; BRE Conference LLC; BRE 312 Health Club LLC; BRE 312 Restaurants LLC; BRE 312 HOLDCO LLC; BRE 312 Pledgor LLC; the Restaurant Operator; the Architect; Owner's Lender and Property Manager, the parent and subsidiaries of each of them, and each of their respective members, directors, officers, employees, successors and assigns
- Please confirm on the certificate or by uploading endorsement(s) that Additional Insured applies to this policy.
- Additional Insured Names: GPT NW 96th Street Owner LLC; Hernandez Construction LLC; EQ Management, LLC; BRE 312 Skydeck LLC; BRE Conference LLC; BRE 312 Health Club LLC; BRE 312 Restaurants LLC; BRE 312 HOLDCO LLC; BRE 312 Pledgor LLC; the Restaurant Operator; the Architect; Owner's Lender and Property Manager, the parent and subsidiaries of each of them, and each of their respective members, directors, officers, employees, successors and assigns,
- Coverage for Independent Contractors-Copy of Endorsement Form Required.
- Additional Insured applies to General Liability.
- Please confirm on the certificate or by uploading endorsement(s) that Waiver of Subrogation applies to this policy.

Umbrella Excess Liability


- Must follow form over General Liability, Auto & Workers' Compensation.

Workers Compensation


- If subcontractor is utilizing labor that is provided or managed by an employee leasing firm then an Minimum Premium policy aka “If any” policy must be provided” (this is indicated in your sub agreement section 28.1.1).
- A physical copy of waiver of subrogation endorsement must be submitted.
- Waiver of Subrogation applies in favor of:GPT NW 96th Street Owner LLC; Hernandez Construction LLC; EQ Management, LLC; BRE 312 Skydeck LLC; BRE Conference LLC; BRE 312 Health Club LLC; BRE 312 Restaurants LLC; BRE 312 HOLDCO LLC; BRE 312 Pledgor LLC; the Restaurant Operator; the Architect; Owner's Lender and Property Manager, the parent and subsidiaries of each of them, and each of their respective members, directors, officers, employees, successors and assigns
- Please confirm on the certificate or by uploading endorsement(s) that Waiver of Subrogation applies to this policy.
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