CONTRACTUAL INSURANCE REQUIREMENTS

The information contained herein is to describe the contractual requirements that James E. Roberts-Obayashi Corp. 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

Low Voltage Security 5803 Skyline Blvd. Windsor, CA 95492

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 $ 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) $ 5,000,000
ANY AUTO BODILY INJURY (Per person) $
X ALL OWNED AUTOS BODILY INJURY (Per accident) $
SCHEDULED AUTOS PROPERTY DAMAGE (Per accident) $
X HIRED AUTOS
X NON-OWNED AUTOS
UMBRELLA /EXCESS LIABILITY X OCCUR EACH OCCURRENCE $ 1,000,000
Claims Made AGGREGATE $ 1,000,000
WORKERS COMP /EMPLOYEE LIABILITY X WC STATUTORY LIMITS OTHER
E.L. EACH ACCIDENT $ 1,000,000
E.L. DISEASE - EA EMPLOYEE $ 1,000,000
E.L. DISEASE - POLICY LIMIT $ 1,000,000
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


James E. Roberts-Obayashi Corp. C/O: myCOI P.O. Box# 501970, 8710 Bash Street Indianapolis, IN 46256

ADDITIONAL REQUIREMENTS


Division Name: 2160-Sacramento Street Apartments, Division Number: 2160, Division Location: 2118 Sacramento St. Vallejo, CA 94590.
- 30 Days Notice of Cancellation Required.
- Endorsement required to show General Liability, Automobile Liability and Umbrella/Excess are Primary and Non-Contributory.

General Liability


- Coverage to be provided for work and operations away from the project site only.
- Waiver of Subrogation endorsements shall be provided in addition to the certificate.
- Primary & Non-Contributory endorsements shall be provided in addition to the certificate of insurance.
- A physical copy of the Additional insured forms for both ongoing and completed operations (ISO CG 20 10 04 13 & CG 20 37 04 13 or equivalent) must be submitted.
- Project Name: and Project #: must be listed on certificate: 2160-Sacramento Street Apartments
- Waiver of Subrogation applies in favor of:James E. Roberts-Obayashi Corp., its subsidiaries, affiliates and their respective trustees, officers, employees and agents; The Owner, Vallejo PSH, L.P., Eden Housing Management, Inc., Eden Development, Inc., City of Vallejo, CREA SLP, LLC, CAP Solano JPA, FHL Bank San Francisco, State of California Department of Housing and Community Development, Silicon Valley Bank, and each of their respective lenders, investors, members, partners, officers, directors, employees, agents and assigns
- Please confirm on the certificate or by uploading endorsement(s) that Additional Insured applies to this policy.
- Additional Insured Names: James E. Roberts-Obayashi Corp., its subsidiaries, affiliates and their respective trustees, officers, employees and agents; The Owner, Vallejo PSH, L.P., Eden Housing Management, Inc., Eden Development, Inc., City of Vallejo, CREA SLP, LLC, CAP Solano JPA, FHL Bank San Francisco, State of California Department of Housing and Community Development, Silicon Valley Bank, and each of their respective lenders, investors, members, partners, officers, directors, employees, agents and assigns,
- Please confirm on the certificate or by uploading the schedule of forms, endorsements, and/or exclusions that the policy does not exclude explosion, collapse, and underground (XCU) coverage.
- 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


- Waiver of Subrogation endorsements shall be provided in addition to the certificate.
- Primary & Non-Contributory endorsements shall be provided in addition to the certificate of insurance.
- Project Name: and Project #: must be listed on certificate: 2160-Sacramento Street Apartments
- Automobile additional insured form (CA 20 48 10 13) must be submitted in addition to the certificate.
- Waiver of Subrogation applies in favor of:James E. Roberts-Obayashi Corp., its subsidiaries, affiliates and their respective trustees, officers, employees and agents; The Owner, Vallejo PSH, L.P., Eden Housing Management, Inc., Eden Development, Inc., City of Vallejo, CREA SLP, LLC, CAP Solano JPA, FHL Bank San Francisco, State of California Department of Housing and Community Development, Silicon Valley Bank, and each of their respective lenders, investors, members, partners, officers, directors, employees, agents and assigns
- Please confirm on the certificate or by uploading endorsement(s) that Additional Insured applies to this policy.
- Additional Insured Names: James E. Roberts-Obayashi Corp., its subsidiaries, affiliates and their respective trustees, officers, employees and agents; The Owner, Vallejo PSH, L.P., Eden Housing Management, Inc., Eden Development, Inc., City of Vallejo, CREA SLP, LLC, CAP Solano JPA, FHL Bank San Francisco, State of California Department of Housing and Community Development, Silicon Valley Bank, and each of their respective lenders, investors, members, partners, officers, directors, employees, agents and assigns,
- Additional Insured applies to Automobile.
- 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.

Umbrella Excess Liability


- Waiver of Subrogation endorsements shall be provided in addition to the certificate.
- Waiver of Subrogation applies in favor of:James E. Roberts-Obayashi Corp., its subsidiaries, affiliates and their respective trustees, officers, employees and agents; The Owner, Vallejo PSH, L.P., Eden Housing Management, Inc., Eden Development, Inc., City of Vallejo, CREA SLP, LLC, CAP Solano JPA, FHL Bank San Francisco, State of California Department of Housing and Community Development, Silicon Valley Bank, and each of their respective lenders, investors, members, partners, officers, directors, employees, agents and assigns
- Please confirm on the certificate or by uploading endorsement(s) that Additional Insured applies to this policy.
- Additional Insured Names: James E. Roberts-Obayashi Corp., its subsidiaries, affiliates and their respective trustees, officers, employees and agents; The Owner, Vallejo PSH, L.P., Eden Housing Management, Inc., Eden Development, Inc., City of Vallejo, CREA SLP, LLC, CAP Solano JPA, FHL Bank San Francisco, State of California Department of Housing and Community Development, Silicon Valley Bank, and each of their respective lenders, investors, members, partners, officers, directors, employees, agents and assigns,
- 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


- Waiver of Subrogation endorsements shall be provided in addition to the certificate.
- Project Name: and Project #: must be listed on certificate: 2160-Sacramento Street Apartments
- Waiver of Subrogation applies in favor of:James E. Roberts-Obayashi Corp., its subsidiaries, affiliates and their respective trustees, officers, employees and agents; The Owner, Vallejo PSH, L.P., Eden Housing Management, Inc., Eden Development, Inc., City of Vallejo, CREA SLP, LLC, CAP Solano JPA, FHL Bank San Francisco, State of California Department of Housing and Community Development, Silicon Valley Bank, and each of their respective lenders, investors, members, partners, officers, directors, employees, agents and assigns
- Please confirm on the certificate or by uploading endorsement(s) that Waiver of Subrogation applies to this policy.
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