(project name) ccip insurance manual - · pdf file(project name) – insurance manual...

(Project Name) – Insurance Manual 2015-2017 Alliant Version 02 1

CCIP Insurance Manual

(Project Name)

Policy Year: 2015-2017


Table of Contents

1.0 INTRODUCTION ................................................................................................................. 3

1.1 Overview ............................................................................................................... 3

1.2 About this Manual ................................................................................................. 4

2.0 PROJECT DIRECTORY .......................................................................................................... 5

3.0 CCIP INSURANCE COVERAGE ............................................................................................... 7

3.1 Description of CCIP Coverages ................................................................................ 8

3.2 CCIP Termination or Modification ........................................................................... 9

4.0 SUBCONTRACTOR REQUIRED COVERAGE .......................................................................... 10

4.1 Subcontractor Maintained Coverage ...................................................................... 11

5.0 SUBCONTRACTOR RESPONSIBILITIES ................................................................................ 14

5.1 Subcontractor Bids ............................................................................................... 14

5.2 Calculation of Insurance Credits ........................................................................... 15

5.3 Enrollment .......................................................................................................... 16

5.4 Safety Guidelines ................................................................................................. 16

5.5 Assignment of Return Premiums .......................................................................... 17

5.6 Change Order Procedures .................................................................................... 17

5.7 Close-Out and Audit Procedures ........................................................................... 17

6.0 CLAIMS PROCEDURES ...................................................................................................... 18

6.1 Liability Claims ..................................................................................................... 18

6.2 Property and Builder’s Risk Claims ........................................................................ 19

6.3 Automobile Claims ............................................................................................... 19

6.4 Pollution Claims ................................................................................................... 19

7.0 PROJECT FORMS ......................................................................................................... 20


INTRODUCTION

1.0 INTRODUCTION

1.1 Overview

Bernards Bros. Inc. or Bernards Builders Inc. (hereinafter “Bernards”) has arranged for its construction projects to be insured under its Contractor Controlled Insurance Program (CCIP). A CCIP is a single insurance program that insures the P r o j e c t Owner (hereinafter “Owner”), Bernards, Construction Managers (if any), all Enrolled Subcontractors under Contract with Bernards and other designated parties for Work performed at the (Project Name) Project Site. (For simplicity’s sake, the term “Subcontractor” as used in this Insurance Manual shall refer to and include Subcontractors of any tier and any Contractor under contract to Bernards.) Certain Subcontractors are excluded from this program. These parties are identified in Section 3 of this manual.

Coverage under the CCIP includes General Liability and Excess Liability.

There is no Workers’ Compensation coverage under the CCIP.

Bernards will initially pre-pay insurance premiums for the CCIP coverage described in this manual. You should notify your insurance broker/insurer(s) of the coverages provided under this Program for “on-site” activities to avoid the duplication of coverage and the related costs. (For purposes of this Insurance Manual, “On-site” shall mean at the (Project Name) project site; “off-site” shall mean away from the (Project Name) project site.) Each bidder is required to include in its bid price and, if successful, later include in its original subcontract amount, its normal cost for insurance coverage. The credit for CCIP-provided insurance is then deducted as described in Section 5, Calculation of Insurance Credits.

NOTE: Insurance coverages and limits provided under the CCIP are limited in scope and are specific to work performed after the inception date of your enrollment into this program. Your insurance representative should review this information. Any additional coverage you may wish to purchase will be at your option and expense.

SECTION

1


INTRODUCTION

1.2 About this Manual The Insurance Manual was prepared by Alliant Insurance Services (Alliant) and Bernards. Alliant is the insurance broker and CCIP Administrator for this program. The manual is designed to identify, define and assign responsibilities for the administration of the (Project Name) CCIP.

This Manual: • Generally describes the structure of the CCIP • Identifies responsibilities of the various parties involved in the project • Provides a basic description of CCIP Coverage • Describes audit and administration procedures • Provides answers to basic questions about the CCIP • Will be updated as necessary

This Manual does not: • Provide coverage interpretations • Provide complete information about coverage • Provide answers to specific claims questions

Specific questions about the CCIP, its administration, or the coverage provided should be referred to the CCIP Program Manager identified in the Project Directory section immediately following this introduction.

DISCLAIMER: The information in this manual is intended to outline the Wrap-up Program. If any conflict exists between this manual and the Wrap-up insurance policies or Contracts between Bernards and the Contractor/Subcontractor, the policies or Contracts will govern.


PROJECT DIRECTORY

2.0 PROJECT DIRECTORY

Alliant Insurance Services Construction Services Group 333 S. Hope St., Suite 3750

Los Angeles, CA 90071

PROGRAM MANAGER PROGRAM ADMINISTRATOR

Martin Cunningham Office: 213-443-2468 Fax: 866-867-5811

[email protected]

Austin Cohen Office: 213-443-2445 Fax: 866-867-5811

[email protected]

SAFETY DIRECTOR CLAIMS DIRECTOR

Moe Davis Cell: 213-361-6708 [email protected]

Bob Dixon Office: 213-443-2453 Fax: 213-443-2485 [email protected]

CCIP BROKER

SECTION

2

mailto:[email protected]





PROJECT DIRECTORY

Bernards 555 First Street

San Fernando, CA 91340 Main Line: 818-898-1521

Project Executive Project Manager

TBD Office: 818-898-1521 Mobile: xxx-xxx-xxxx

TBD

Office: 818-898-1521 Mobile: xxx-xxx-xxxx

Safety Manager CCIP Coordinator

Mike Stelmasek Office: 818-898-1521 Mobile: 626-625-9506

Christine Philips Office: 818-898-1521 Mobile: 818-434-5756


WRAP-UP INSURANCE COVERAGE

3.0 CCIP INSURANCE COVERAGE

This chapter provides a brief description of CCIP Coverage. You should refer to the actual policies for details concerning coverage, exclusions and limitations.

Enrolled Parties

Enrolled Parties are "named insureds" on the CCIP policies and include Owner, General Contractor, and Enrolled Subcontractors of every tier. In addition, there may be parties named as additional insured that include other parties Bernards is contractually required to add. These parties are also referred to as insureds.

Excluded Parties

Excluded Parties: The Program does not provide any insurance coverage to the following Excluded Parties:

1. Hazardous materials remediation, removal and/or transport companies and their consultants;

2. Architects, surveyors, engineers, and soil testing engineers, and their consultants; 3. Vendors, suppliers, fabricators, material dealers, truckers, haulers, drivers, and

others who merely transport, pick up, deliver, or carry materials, personnel, parts, or equipment or any other items or persons to or from the Project site;

4. Subcontractors whose primary scope of work is demolition for which the initial subcontract amount is $500,000 or greater. Demolition Subcontractors whose initial subcontract amount is less than $500,000, once properly enrolled, will be covered as an Enrolled Party;

5. Any Subcontractor that does not perform any actual labor on the Project site, and; 6. Any parties or entities excluded by Contractor even if they are otherwise eligible.

Evidence of Coverage

The CCIP Administrator will provide a Certificate of Insurance evidencing general liability insurance to each Enrolled Subcontractor, each of whom will be a named insured on the policies. A Certificate of Insurance is a document providing evidence of existing coverage for a particular insurance policy or policies. Other documentation including forms, etc., will be furnished to each Enrolled Subcontractor. Complete copies of policies will be furnished to an authorized representative of each Enrolled Subcontractor upon request.

SECTION

3



3.1 Description of CCIP Coverages

The following sections describe the policies that Bernards has arranged for its projects.

The CCIP provides no Workers’ Compensation coverage.

Commercial General Liability Limits of Liability

Shared by All Insureds for All Projects General Aggregate $ 4,000,000 Products/ Completed Operations Aggregate $ 4,000,000 Personal/ Advertising Injury $ 2,000,000 Each Occurrence Limit $ 2,000,000 Fire Damage Legal Liability (any one fire) $ 100,000

See Section 5.2 – for deductible information. A Single General Liability policy will be issued covering all insureds.

• Underwritten by Lloyds of London/Hanover Insurance Company under policy #CCF14/YF14CP03/001

• Ten (10) Year/Statute of Limitation Products/Completed Operations Extension Endorsement for homes that close escrow during each annual policy period.

Deductible Reimbursement policy: Bernards has established a Deductible Gap policy to help mitigate any costs associated with a policy deductible greater than $5,000. Please contact your Bernards representative for more information.

IF A GENERAL LIABILITY CLAIM RESULTS FROM ANY CONSTRUCTION ACTIVITY, THE RESPONSIBLE CONTRACTOR, SUBCONTRACTOR, OR SUB-SUBCONTRACTOR SHALL PAY A CLAIMS CHARGE TO BERNARDS IN THE AMOUNT OF $5,000 FOR EACH OCCURRENCE. A CHANGE ORDER WILL BE WRITTEN TO RECOVER THIS CLAIMS CHARGE.



Excess Liability

Limits of Liability Shared by All Insureds for All Projects

Each Occurrence Limit $ 48,000,000 Annual General Aggregate Limit $48,000,000

• Underwritten by: Allied World Ins. Co. pol#0309-3782 $8M XS Primary Starr Surplus Lines Ins. Co. pol#SLSLGCE51010212 $10M XS $12M Swiss Re International SE pol#MH973331 $10M XS $22M Lex-London pol#62785479 $20M XS $32M

• Follow Form Excess Policy

NOTE: Contractors and Subcontractors are advised to arrange their own insurance for Contractor or Subcontractor owned or leased equipment and materials not intended for inclusion in the project. The CCIP will not cover Contractor or Subcontractor property. The descriptions on these pages provide a summary of coverages ONLY. Contractors and Subcontractors should refer to the policies for actual terms and conditions. Copies of policies will be provided upon request.

3.2 CCIP Termination or Modification

Bernards reserves the right to terminate or modify the CCIP or any portion thereof. If Bernards exercises this right, Subcontractors will be provided notice as required by the terms of their individual contracts. At its option, Bernards may procure alternate coverage or may require the Contractors and Subcontractors to procure and maintain alternate insurance coverage.

SUBCONTRACTOR REQUIRED COVERAGE


4.0 SUBCONTRACTOR REQUIRED COVERAGE

Subcontractors are required to maintain insurance coverage that protects Bernards from liability for claims for damages. These liabilities may arise from the Subcontractor’s operations performed away from the Project site, from activities not insured by the CCIP, or from operations performed by Excluded Parties.

There are two types of subcontractors: Eligible Subcontractors and Excluded Subcontractors.

Eligible Subcontractors are to provide evidence of Workers’ Compensation insurance for all activities including both “on-site” and “off-site” (away from the Bernards project site) activities, and General Liability for “off-site” activities as per the insurance specifications in the contract. See Section 3 for the definition of an Eligible Subcontractor.

Excluded Subcontractors must provide evidence of General Liability and Workers’ Compensation insurance for all activities including both “on-site” and “off-site” activities as per the insurance specifications in the contract. See Section 3 for the definition of Excluded Parties.

All Subcontractors must submit verification of insurance in the form of a Certificate of Insurance on a standard ACORD form 25-S. The Certificate must evidence that each carrier has provided a Waiver of Subrogation in favor of Bernards as referenced by the General Conditions of the Contract for Construction. Please note the requirements for thirty (30) day notice of cancellation, modification or material change. All General Liability Policies shall name: (Project Name); The members of (Project Owner), and its officers, agents, employees and volunteers; ARCHITECT; Bernards Bros. Inc., their officers, employees and agents and any wholly owned subsidiaries or parent organizations, as additional insured by use of Standard Insurance Service Office Form CG20100704 and CG20370704 or their equivalent. (See Contract for specific language.)

Subcontractor(s) is responsible for monitoring their Enrolled lower tier Subcontractors and Excluded Parties’ Certificates of Insurance. Bernards reserves the right to disapprove the use of Subcontractors unable to meet the insurance requirements. Certificates evidencing compliance are to be available to Bernards, or the CCIP Administrator upon request.

SECTION

4


4.1 Subcontractor Maintained Coverage The limits of liability shown for the insurance required of the Contractors and Subcontractors are minimum limits only and are not intended to restrict the liability imposed on the Contractors and Subcontractors for work performed under their Contract.

Workers’ Compensation and Employer’s Liability Part One: Workers’ Compensation Statutory Limit

Part Two: Employer’s Liability Annual Limits Per Insured Bodily Injury by Accident, each accident $1,000,000 Bodily Injury by Disease, each employee $1,000,000 Bodily Injury by Disease, policy limit $1,000,000 Eligible Subcontractors shall provide evidence of workers’ compensation applicable to “on- site” and “off-site” activities. Waiver of Subrogation endorsement required. Excluded Subcontractors shall provide evidence of workers’ compensation applicable to “on-site” and “off-site” activities. The CCIP does not provide coverage for workers’ compensation.

Coverage is required to be on an Occurrence form and shall apply to bodily injury and property damage for operations (including explosion, collapse and underground coverage), independent contractors, products and completed operations. Limits can be provided by a combination of a primary Commercial General Liability policy and Excess or Umbrella Liability policy.

Please refer to your Subcontract Agreement for any clarification.

CERTIFICATE OF INSURANCE: Prior to mobilization and within three (3) days of renewal, change or replacement of coverage, Subcontractors will submit to Alliant a Certificate of Insurance evidencing the coverage and limits as specified in this section. A 30-day notice of cancellation provision and waiver of subrogation is required on all Certificates.

General Liability and/or Excess Liability Enrolled Parties Excluded Parties General Aggregate $ 4,000,000 $ 4,000,000 Products/ Completed Operations Aggregate $ 4,000,000 $ 4,000,000 Personal/ Advertising Injury $ 3,000,000 $ 3,000,000 Each Occurrence Limit $ 3,000,000 $ 3,000,000 Eligible Subcontractors shall provide evidence of general liability insurance for “off-site” activities. Additional Insured Endorsement Form CG20100704 and CG20370704 or their equivalent), Waiver of subrogation and Primary and Non-Contributory endorsements required. Physical Copies of Endorsement Required. Excluded Subcontractors shall provide evidence of general liability insurance applicable to “on-site” and “off-site” activities.

.


Automobile Liability Commercial Business Auto Policy covering all owned, hired and non-owned automobiles, trucks and trailers is required, with coverage limits not less than

1. $1,000,000 Combined Single Limit each accident for Bodily Injury and Property Damage. Coverage will apply both on and away from the Project Site. All lower tier Subcontractors shall also be required to maintain limits of not less than $1,000,000 Combined Single Limit. All Subcontractors shall provide evidence of automobile liability. The CCIP does not cover automobile liability. Any Subcontractor that is responsible for the transport of any hazardous materials must provide the following: a. Endorsement CA 99 48 10 13 (Pollution Liability – Broadened Coverage for Covered

Autos) b. Endorsement MCS-90 (Endorsement for Motor Carrier Policies of Insurance for Public

Liability under Sections 29 and 30 of the Motor Carrier Act of 1980)

Property Insurance Subcontractors are advised to arrange their own insurance for owned and leased equipment and materials, whether such equipment is located at a Project Site or “in transit”. Subcontractors are solely responsible for any loss or damage to their personal property including, without limitation, property or materials created or provided under the Contract until installed at the Project Site, contractor tools and equipment, scaffolding and temporary structures, whether owned, used, leased or rented by contractor. T h e Bernards CCIP does not cover subcontractor’s property.

Watercraft and Aircraft Liability The operator of any watercraft or aircraft of any kind must maintain liability naming the P r o j e c t Owner, Bernards and the respective Contractor and/or Subcontractor as an additional insured with primary and non-contributory wording. In addition, the limit of liability must be satisfactory to Bernards. Such insurance requirements will be determined as the need arises.

Professional Liability

All professional service firms must provide professional liability insurance appropriate for their profession. Architect and engineering firms must provide insurance covering liability arising out of design errors and omissions with a limit as specified in the Contract. The Bernards CCIP does not provide professional liability insurance.


Pollution Liability

Hazard remediation and demolition Contractors and Subcontractors whose Work involves removal or treatment of hazardous materials are required to provide and maintain Contractors Pollution Liability insurance that will be primary and non- contributory to any pollution coverage provided under the Bernards CCIP. Such coverage will specifically schedule the type of work defined in the Contract. Bernards will determine limits based on the nature of the contract and the risk involved.

NOTE: Waivers Required. Contractor Workers’ Compensation, General Liability, Umbrella or Excess Liability and Property insurers shall provide Waivers of Subrogation in favor of Bernards and other designated parties.


SUBCONTRACTOR RESPONSIBILITIES

5.0 SUBCONTRACTOR RESPONSIBILITIES

The Subcontractor is required to cooperate with Bernards and its CCIP Administrator in all aspects of CCIP operation and administration.

Responsibilities of Subcontractors of all tiers include the following:

• Enrollment in the CCIP, if eligible • Complying with Insurance Credit procedures designed to remove the cost of

CCIP provided Insurance from its price for work to Bernards • Providing each lower tier Subcontractor with a copy of the Insurance Manual and

Project Safety Standards • Reviewing and understanding coverages, exclusions, and limitations of CCIP

policies • Including CCIP provisions in all subcontracts as appropriate • Providing timely evidence of insurance to the CCIP Administrator (Alliant) • Notifying the CCIP Administrator (Alliant) of all subcontracts awarded • Cooperating with the CCIP Administrator’s requests for information • Complying with insurance, claim and safety procedures • Notifying the CCIP Administrator (Alliant) immediately of any insurance renewal,

cancellation, or non-renewal (Contractor-required insurance) • Promptly Paying General Liability or Builders Risk Obligations • Assisting with lower tier Subcontractor compliance with all CCIP requirements • Monitoring its lower tier Subcontractor's Certificates of Insurance

5.1 Subcontractor Bids Subcontractor bids shall include costs for insurance that Bernards will provide to all eligible and Enrolled Subcontractors under the CCIP for Work performed at the Project Site, as outlined in Section 3 of this Insurance Manual. The paragraphs below, “Adjustments for Insurance Costs” describes the procedures for identifying "on-site" ((Project Name) site) project insurance costs, and how you must account for these insurance costs. The CCIP Administrator can also help with your estimate, as well as provide assistance to your own insurance representative to ensure your insurance carriers do not charge for coverage provided under the Bernards CCIP.

SECTION

5



5.2 Calculation of Insurance Credits Overview

Adjustments for Subcontractor insurance cost avoidance (“Insurance Credits”), shall reflect the Subcontractor’s and Sub-subcontractors’ total cost of risk for insurance of the types provided by the CCIP. “Cost of Risk” includes, without limitation, Subcontractor’s actual insurance company premium rates and claim costs rates (including, without limitation, loss adjustment costs) within deductibles or self-insured retentions.

1. The Insurance Credit will be in the form of a fixed amount that Subcontractor

shall deduct from its invoices to Bernards. a) In the event of a claim covered by the Program involving

Subcontractor and/or any entity for which Subcontractor is responsible, Subcontractor shall pay Bernards a deductible based on amount agreed to in the subcontract.

Procedures

At the time the subcontract bid is submitted and before the start of work at the Bernards Jobsite, Subcontractor shall provide the CCIP Administrator with, along with enrollment data, an estimate of Subcontractor’s and its Sub-subcontractors’ costs of insurance for like kinds of coverages to be provided by the CCIP, by completing and submitting, and having its Sub-subcontractors complete and submit, the Enrollment form.

In order to verify the Insurance Credit and/or Insurance Credit rate and any subsequent Insurance Credit(s), Subcontractor and each of its Sub-subcontractors shall submit all documentation reasonably requested by Bernards and/or CCIP Administrator in connection therewith, including, without limitation:

1. Copies of insurance policies declaration and rate schedule pages,

2. Deductible or retention pages,

3. If applicable, information on self-insured retention programs and documentation

of the Total Cost of Risk in any self-insured program, including five (5) year actuarial studies and prior loss histories.

The CCIP Administrator will review the insurance credit information and other data submitted by subcontractor for accuracy and make corrections if necessary.



Subcontractor is solely responsible for the recovery from its Sub-subcontractors of any and all Insurance Credits attributable to such Sub-subcontractors’ participation in the CCIP. Subcontractor hereby represents and covenants that all insurance cost information submitted to Bernards or to the CCIP Administrator to calculate any Insurance Credit is or shall be accurate and complete. Subcontractor further agrees that Bernards is entitled to and may collect, from time to time, additional Insurance Credits resulting from any scope changes, additional work, and inaccurate assumptions in the initial Credit, or from information discovered during any audits which justify the taking of additional Insurance Credits. The procedures for collecting additional Credits and the development of a composite rate formula are addressed in the CCIP Insurance Manual and shall apply to each enrolled Subcontractor and Sub-subcontractor.

5.3 Enrollment Each Subcontractor shall provide details about its lower tier Subcontractors as necessary to enroll them in the CCIP. Bernards will need all of the information requested in the Enrollment Application. This information must be completed and submitted to the CCIP Administrator prior to mobilization.

A separate Enrollment Application is required for each Eligible Subcontractor of any tier which performs Work at the Project Site.

Each Enrolled Subcontractor will receive a Confirmation Letter via email. A Confirmation Letter is a letter issued by the CCIP Administrator that confirms acceptance of the applicant into the Bernards CCIP.

5.4 Safety Guidelines

Each Subcontractor is required to establish a written safety program and to provide a designated safety representative who is on site when any work is in progress. Minimum standards for subcontractor safety programs are outlined in The Bernards Project Safety Standards.

NOTE: ENROLLMENT IS AUTOMATIC Enrollment into the Wrap-up is automatic at the time a subcontractagreement is signed; however, all Eligible Subcontractors of every tierMUST complete the enrollment forms and participate in the enrollment



5.5 Assignment of Return Premiums

The cost of the CCIP insurance coverage is pre-paid by Bernards. Bernards will be the sole recipient of any return CCIP premiums or dividends. All Enrolled Subcontractors will assign, to Bernards, all adjustments, refunds, premium discounts, dividends, credits or any other monies due from the CCIP insurer(s). Subcontractors will assure that each Enrolled lower tier Subcontractor has executed such an assignment. The Online Enrollment Application will be used for this purpose.

5.6 Change Order Procedures

Subcontractors shall include the cost of the Program Coverage for all change order proposals submitted by Subcontractor or by any of its sub-subcontractors. Bernards shall advance the cost of the CCIP insurance coverage and be entitled to an offset to amounts due to Subcontractor for the amount of the CCIP Credit for change orders which is determined by the steps indicated in Section 5.2. 5.7 Close-Out and Audit Procedures

The Notice of Work Termination should be submitted when a Subcontractor or an associated lower tier Subcontractor has completed its Work at the Project site and no longer has on-site workers, and does not expect future work from Bernards. The Close- Out and Audit process with Bernards are expected to take no longer than thirty (30) days.

Final payment will not be released by Bernards until all necessary forms have been submitted to the CCIP Administrator. Any penalties, for which the Subcontractor of any tier is responsible, will be considered at the time of close-out. Penalties will not be considered if previously reimbursed.


CLAIMS PROCEDURES

6.0 CLAIMS PROCEDURES

6.1 Liability Claims Accidents at or around the job site resulting in damage to property of others (other than your own work product), or personal injury or death to a member of the public, must be reported immediately to the CCIP Administrator. Complete and deliver the General Liability Loss Notice (Acord Form 3) to the CCIP Administrator within 24 hours of the incident.

Do not voluntarily admit liability. Cooperate with Bernards or the CCIP insurer representatives in the accident investigation.

In the event Bernards or a trade enrolled in the CCIP program receive a lawsuit involving construction defect or related allegations that relates to the construction project with which they are enrolled the original document along with any service of suit documents should be sent to:

Alliant Insurance Services 333 South Hope Suite 3750 Los Angeles, CA 90071 Attn: Bob Dixon

In the event of a claim involving a Subcontractor and/or any entity for which this Subcontractor is responsible, Subcontractor shall pay Bernards a deductible amount of $5,000 per claim.

Contractors and Subcontractors shall be solely responsible for obtaining reimbursement for the cost of the deductible of each occurrence including court costs, attorney fees and costs of defense for bodily injury or property damage to the extent losses payable are attributable to a Subcontractor’s acts or omissions from the Subcontractor.

Bernards reserves the right to increase Contractor and Subcontractor deductible based on Contractor and/or Subcontractor claim activity during the CCIP term.

SECTION

6


CLAIMS PROCEDURES

6.2 Property and Builder’s Risk Claims No coverage is provided for Subcontractor’s property, including materials until installed under the CCIP. It is the sole responsibility of each Subcontractor and lower tier Subcontractor to insure and report accidents/claims involving their property to their own insurers.

HOWEVER, all accidents occurring in or around the job site must be reported to the CCIP Administrator, and your property insurer.

6.3 Automobile Claims No coverage is provided for automobile accidents under the CCIP. It is the sole responsibility of each Subcontractor to report accidents/claims involving their automobiles to their own insurers.

HOWEVER, all accidents occurring in or around the job site must be reported to the CCIP Administrator. Accident investigations will occur and focus on liability arising out of the project construction activities that could result in future claims (i.e. due to the conditions of the roads, etc.). Each Subcontractor shall cooperate in the investigation of all automobile accidents.

6.4 Pollution Claims Contractors and Subcontractors performing environmental remediation work are required to carry Contractor’s Pollution Liability insurance that is primary and non- contributory to any coverage under the Bernards CCIP. All parties should report claims by immediately notifying the CCIP Administrator of any known or suspected pollution incidents.

PROJECT FORMS

7.0 PROJECT FORMS

• Contractor Enrollment Form

• Notice of Subcontract Award

• Sample Certificate of Insurance

• Notice of Work Termination – Notify CCIP Administrator

For assistance in getting access to the online system or with completing these forms, please contact:

AUSTIN COHEN ALLIANT INSURANCE SERVICES

Phone: 213-443-2445 Fax: 866-867-5811 E-Mail: [email protected]

SECTION

7


Bernards Bros., Inc. - (PROJECT NAME)CONTRACTOR ENROLLMENT FORM

Section I

Company Name: Address:

Main Phone#: Main Fax#:

Federal ID#: Company Entity Type (Circle): Corporation Partnership Sole Proprietor Limited Partnership JV LLC LLP other________

Primary Contact Name: Primary Contact Phone#: Primary Contact Email:

Insurance Contact Name: Insurance Contact Phone#: Insurance Contact Email:

Work Description: Project Name/Number:

Estimated Start Date: Estimated Completion Date:

Awarding Contractor: Contract Value:

Are you subcontracting out any work? □Yes* * % Subcontracted:

Section II Current GL Carrier: Eff Date: Exp Date:

GL Deductible:

GL Classification GL Code GL Rate Rating Basis Premium

$100 /$1000 PR / CV

$100 /$1000 PR / CV

$100 /$1000 PR / CV

$100 /$1000 PR / CV

Totals

Insurance Agent/Broker Information: Agency Name: Phone:

Contact: Fax:

Email:

NO CERTIFICATES OF INSURANCE OR POLICIES WILL BE PROVIDED UNDER THE WRAP-UP UNTIL THIS FORM IS RECEIVED.

Please attach a copy of your GL declaration page and schedule rate sheet.

Signature: ___________________________ Date: __________________________ Name: ______________________________ Title: __________________________

Please return by Email, Fax or Mail to:

Email: [email protected]: (866) 867-5811 Phone: (213) 443-2463

Austin CohenAlliant Insurance Services 333 S Hope St. Suite 3750 Los Angeles, CA 90071

acohen

Highlight

PROJECT FORMS Bernards Bros., Inc. - (PROJECT NAME)

NOTICE OF SUBCONTRACT AWARD

SUBCONTRACTOR MAKING AWARD: Alliant Assigned Contract #

BY: TITLE:

PHONE: FAX:

EMAIL ADDRESS: DATE:

WE HAVE AWARDED A SUBCONTRACT AS FOLLOWS:

SUBCONTRACTOR NAME:

ESTIMATED PROJECT START DATE: ESTIMATED COMPLETION DATE:

SUBCONTRACTOR ADDRESS:

CONTACT NAME: EMAIL ADDRESS:

PHONE: FAX:

Please Note: It is the responsibility of the Contractor awarding Subcontract to ensure that their tier sub(s) fill out, maintain, and file all necessary Wrap-up Enrollment forms and Insurance documentation with the Wrap-up Administrator. No hired tier sub maycommence work until they are properly enrolled into the Wrap-up program, as evidenced by a Certificate of Insurance provided by the Wrap-up Administrator

Please return by Email, Fax or Mail to:

Email: [email protected] Fax: (866) 867-5811 Phone: (213) 443-2463

Austin CohenAlliant Insurance Services 333 S Hope St., Suite 3750 Los Angeles, CA 90071

SCOPE OF WORK

CONTRACT VALUE:

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