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CHAMBERS GROUP, INC. (4)
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CHAMBERS GROUP, INC. (4)
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Last modified
7/19/2021 4:16:52 PM
Creation date
7/19/2021 3:58:14 PM
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Contracts
Company Name
CHAMBERS GROUP, INC.
Contract #
A-2021-110-02
Agency
Community Development
Council Approval Date
7/6/2021
Expiration Date
7/31/2022
Insurance Exp Date
5/12/2022
Destruction Year
2028
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SCHEDULE OF FORMS AND ENDORSEMENTS <br />Policy Number: ECP2026303-13 <br />Named Insured: Chambers Group, Inc. <br />FORMS ATTACHED TO AND'MADE A PART OF THIS POLICY: <br />FORM NUMBER FORM TITLE <br />E001 J 07 20 <br />Nautilus Policy Jacket <br />ENV DI CLAIMS 01 <br />20 Policyholder Notice - Claim Reporting Information <br />ENV DEC 08 12 <br />Common Policy Declarations <br />ECP SUPP DEC 01 <br />21 Environmental Combined Policy Supplemental Declarations <br />ENV FORMS 09 10 <br />Schedule of Forms and Endorsements <br />ECP 1200 02 21 <br />Environmental Combined Policy Insuring Agreement <br />D-2 FORM 01 20 <br />California Surplus Lines Notice <br />E906CA (06-07) <br />Service of Suit - California <br />ECP 120501 21 <br />Contractual Liability - Railroads <br />ECP 120701 21 <br />Employee Benefits Liability <br />ECP 1210 01 21 <br />Limited Cyber Coverage <br />ECP 1232 01 21 <br />Earned Premium and Composite Rate - Not Subject to Premium Audit <br />ECP 1233 01 21 <br />Named Insured Schedule <br />ECP 123401 21 <br />Notice of Cancellation to Designated Person or Organization <br />ECP 1234 01 21 <br />Notice of Cancellation to Designated Person or Organization <br />ECP 1234 01 21 <br />Notice of Cancellation to Designated Person or Organization <br />ECP 1234 01 21 <br />Notice of Cancellation to Designated Person or Organization <br />ECP 1234 01 21 <br />Notice of Cancellation to Designated Person or Organization <br />ECP 1246 01 21 <br />Additional Insured - Owners, Lessees or Contractors - Automatic Status - Ongoing <br />Operations - Coverage A, B, D.1 and DA <br />ECP 1247 01 21 <br />Additional Insured - Owners, Lessees or Contractors - Scheduled Person or <br />Organization - Ongoing Operations - Coverage A, B, D,1 & DA <br />ECP 1247 01 21 <br />Additional Insured - Owners, Lessees or Contractors - Scheduled Person or <br />Organization - Ongoing Operations - Coverage A, B, D.1 & DA <br />ECP 1248 01 21 <br />Additional Insured - Owners, Lessees or Contractors - Automatic Status - Completed <br />Operations - Coverage A, D.1 & DA <br />ECP 1249 01 21 <br />Additional Insured - Owners, Lessees or Contractors - Scheduled Person or <br />Organization - Completed Operations - Coverage A, DA & DA <br />ECP 124901 21 <br />Additional Insured - Owners, Lessees or Contractors - Scheduled Person or <br />Organization - Completed Operations - Coverage A, DA & DA <br />ECP 1260 01 21 <br />Waiver of Subrogation - Automatic Status —Coverage A, B & D <br />ECP 126201 21 <br />Waiver of Subrogation - Designated Person(s) or Organization(s) - Coverage A, B & D <br />ECP 127201 21 <br />Exclusion - Financial Services <br />ECP 127501 21 <br />Exclusion of Certified Acts of Terrorism <br />ECP 128501 21 <br />First Party Transportation Pollution Liability Coverage for Designated Vehicle(s) <br />ECP 1291 01 21 <br />Microbial Substance Contractors Pollution Liability - Claims Made and Reported <br />ECP 1294 01 21 <br />Designated Construction Project(s) General Aggregate Limit - Coverage A - Automatic <br />Status <br />IL 12 02 01 16 <br />Office of Foreign Asset Control (OFAC) Exclusion Endorsement <br />ENV FORMS 09 10 Pagel of 1 <br />
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