Embed Size (px)
Citation preview
------------------
CERTIFICATE OF LIABILITY INSURANCE ACORD® DATE (MM/DD1YYYY)
\-..,...- 08/12/2013I PRODUCER THIS CERTIFICATE IS ISSUED AS A MAnER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATEDAVE CARPENTER INSURANCE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
22850 CRENSHAW AVE. SUITE 203 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. TORRANCE, CA 90505 tel , 31 0 325-6565 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A FARMERS INSURANCE GROUP
CHAMEAU INC, INSURER B: 339 N. FAIRFAX AVE. INSURER C: LOS ANGELES, CA 90036 INSURER D
I INSURER E
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
LTR INSRD TYPE OF INSURANCE POLICY NUMBER "'D'i>.'i'~(MMIDD/YY) "'~kW'(MMIDD/YY) LIMITS
GENERAL LIABILITYoCOMMERCIAL GENERAL LIABILITY o CLAIMS MADE [;Z] OCCUR
EACH OCCURRENCE
~~~f?,H9E~~~J~r~nce) MED EXP (Anyone person)
$ 2,000,000
$ 100,000
$ 5,000
A Y B 60138-47-09 05/14/2013 05/14/2014 PERSONAL & ADV INJURY
GENERAL AGGREGATE
$ 2,000,000
$ 4,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 4,000,000
IY1 POLICY n PROJECT n LOC Liquor Liability 1,000,000
AUTOMOBILE LIABILITY I-
ANY AUTO COMBINED SINGLE LIMIT (Ea aCCident)
$
i=
F== ALL OWNED AUTOS
SCHEDULED AUTOS BODILY INJURY (Per person) $
= ==
tJIRED AUTOS
NON-OWNED AUTOS BODILY INJURY (Per accidenl)
$
= = PROPERTY DAMAGE
(Per accident) $
GARAGE LIABILITY
tJ ANY AUTO
n AUTO ONLY - EAACCIDENT
OTHER THAN EAACC AUTO ONLY AGG
$
$
$
EXCESS/UMBRELLA LIABILITY
tJ OCCUR 0 CLAIMS MADE
EACH OCCURRENCE
AGGREGATE
$
$
$
RDEDUCTIBLE
RETENTION $
$
$
WORKERS COMPENSATION AND EMPLOYERS' LIABILITY l T'6~·Nr~Ws r l UER -
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED?
EL. DISEASE -EA EMPLOYEE $
~~~M~s~~~v~S~~S below El DISEASE - POLICY LIMIT $
OTHER
A BUSINESS PROPERTY 60138-47-09 05/14/2013 05/14/2014 $224,700, ALL RISK, $1,000 DID
if 'u -/5f'~GIAL
Remote Broadcasting Inc., its parent(sl, SUbsidiaries, successors, licensees, related and affiliated companies, their officers, directors, employees, agents,
representatives and assigns as Additional Insureds as their interests may appear and where applicable as loss payess as their interests may appear.
Coverage is primary and noncontributory.
Waiver of SUbrogation.
CERTIFICATE HOLDER CANCELLATION
Remote Broadcasting Inc. 10202 W. Washington Blvd. Culver City, CA 90232 Attn: Risk Management
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN -NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBL,lGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENJoIl'\1VES.
I
AUTHOR1D1jP!¥.ENrT1V?
--/1 II I ,'ACORD 25 (2001/08) ©ACORD CORPORATION 1988
POLICY NUMBER: 60138-47-09 BUSINESSOWNERS
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION
This endorsement modifies insurance provided under the following:
BUSINESSOWNERS POLICY
SCHEDULEO'
Name Of Person Or Organization: REMOTE BROADCASTING, INC. ATTN: RISK MANAGEMENT ITS PARENT(S), SUBSIDIARIES, SUCCESSORS, LICENSEES, RELATED & AFFILIATED COMPANIES, THEIR OFFICERS, DIRECTORS, EMPLOYEES, AGENTS, REPRESENTATIVES & ASSIGNS AS ADDITIONAL INSUREDS, NOT JUST REMOTE BROADCASTING, INC. COVERAGE IS PRIMARY & NON CONTRIBUTORY WITH WAIVER OF SUBROGATION
* Information required to complete this Schedule, if not shown on this endorsement, wiWbe shown in the Declarations.
The following is added to Paragraph C. Who Is An Insured in the Businessowners Liability Coverage Form:
4. Any person or organization shown in the Schedule is also an insured, but only with respect to liability arising out of your ongoing operations or premises owned by or rented to you.
IBP 04 48 01 97 Copyright, Insurance Services Qffice, Inc., 1997 Page 1 of 1
1
Allen, Louise
From: Allen, LouiseSent: Wednesday, August 14, 2013 1:31 PMTo: 'Sean Veder'; Zechowy, Linda; Barnes, Britianey; Luehrs, DawnCc: Sergio RodriguezSubject: RE: Community Certificate of Insurance-Chameau
OK … please give him the number below.
Louise Allen Risk Management T: (519) 273‐3678
From: Sean Veder [mailto:[email protected]] Sent: Wednesday, August 14, 2013 1:22 PM To: Allen, Louise; Zechowy, Linda; Barnes, Britianey; Luehrs, Dawn Cc: Sergio Rodriguez Subject: Re: Community Certificate of Insurance-Chameau Hi Louise - I'm having the broker contact you directly so we can end the back and forth. Not sure why it is still not right since I thought it was all spelled out in Exhibit A, but once you speak I'm sure we can close the book on this.Thanks, Sean
From: "Allen, Louise" <[email protected]> To: Sean Veder <[email protected]>; "Zechowy, Linda" <[email protected]>; "Barnes, Britianey" <[email protected]>; "Luehrs, Dawn" <[email protected]> Cc: Sergio Rodriguez <[email protected]> Sent: Wednesday, August 14, 2013 9:52 AM Subject: RE: Community Certificate of Insurance-Chameau Sean … here are the only remaining issues with the insurance paperwork: Need another $1M/occ general liability insurance … do they have an excess/umbrella liability policy? Unless we are payrolling the caterers, we require (a) waiver of subrogation wording added to the work comp cert and (b) a waiver of subrogation endorsement with the wording I supplied yesterday Thanks, Louise
From: Allen, Louise Sent: Wednesday, August 14, 2013 12:08 PM To: 'Sean Veder'; Zechowy, Linda; Barnes, Britianey; Luehrs, Dawn Cc: Sergio Rodriguez Subject: RE: Community Certificate of Insurance-Chameau
1
Allen, Louise
From: Sean Veder [[email protected]]Sent: Wednesday, August 14, 2013 1:08 PMTo: Allen, Louise; Zechowy, Linda; Barnes, Britianey; Luehrs, DawnCc: Sergio RodriguezSubject: Re: Community Certificate of Insurance-Chameau
No.
From: "Allen, Louise" <[email protected]> To: Sean Veder <[email protected]>; "Zechowy, Linda" <[email protected]>; "Barnes, Britianey" <[email protected]>; "Luehrs, Dawn" <[email protected]> Cc: Sergio Rodriguez <[email protected]> Sent: Wednesday, August 14, 2013 9:07 AM Subject: RE: Community Certificate of Insurance-Chameau Sean … are we payrolling their people?
From: Sean Veder [mailto:[email protected]] Sent: Tuesday, August 13, 2013 5:42 PM To: Allen, Louise; Zechowy, Linda; Barnes, Britianey; Luehrs, Dawn Cc: Sergio Rodriguez Subject: Community Certificate of Insurance-Chameau I hope this works! ----- Forwarded Message ----- From: Kelly Klemovich <[email protected]> To: Sean Veder <[email protected]> Sent: Tuesday, August 13, 2013 2:19 PM Subject: Fwd: Certificate of Insurance-Chameau please read below and see attached! Begin forwarded message:
From: glenn levine <[email protected]> Subject: Fw: Certificate of Insurance-Chameau Date: August 13, 2013 2:15:30 PM PDT To: "[email protected]" <[email protected]> Reply-To: glenn levine <[email protected]> Kelly, please see the attached, I believe it is complete except that the Liability limit is only $2M per Occurrence. Again, I went back to Sean's earlier e-mail and it seems pretty clear that he is requesting $3M. I leave that to you. Glenn
1
Allen, Louise
From: Allen, LouiseSent: Wednesday, August 14, 2013 12:52 PMTo: 'Sean Veder'; Zechowy, Linda; Barnes, Britianey; Luehrs, DawnCc: 'Sergio Rodriguez'Subject: RE: Community Certificate of Insurance-Chameau
Sean … here are the only remaining issues with the insurance paperwork:
Need another $1M/occ general liability insurance … do they have an excess/umbrella liability policy?
Unless we are payrolling the caterers, we require (a) waiver of subrogation wording added to the work comp cert and (b) a waiver of subrogation endorsement with the wording I supplied yesterday
Thanks, Louise
From: Allen, Louise Sent: Wednesday, August 14, 2013 12:08 PM To: 'Sean Veder'; Zechowy, Linda; Barnes, Britianey; Luehrs, Dawn Cc: Sergio Rodriguez Subject: RE: Community Certificate of Insurance-Chameau Sean … are we payrolling their people?
From: Sean Veder [mailto:[email protected]] Sent: Tuesday, August 13, 2013 5:42 PM To: Allen, Louise; Zechowy, Linda; Barnes, Britianey; Luehrs, Dawn Cc: Sergio Rodriguez Subject: Community Certificate of Insurance-Chameau I hope this works! ----- Forwarded Message ----- From: Kelly Klemovich <[email protected]> To: Sean Veder <[email protected]> Sent: Tuesday, August 13, 2013 2:19 PM Subject: Fwd: Certificate of Insurance-Chameau please read below and see attached! Begin forwarded message:
From: glenn levine <[email protected]> Subject: Fw: Certificate of Insurance-Chameau Date: August 13, 2013 2:15:30 PM PDT To: "[email protected]" <[email protected]> Reply-To: glenn levine <[email protected]>
2
Kelly, please see the attached, I believe it is complete except that the Liability limit is only $2M per Occurrence. Again, I went back to Sean's earlier e-mail and it seems pretty clear that he is requesting $3M. I leave that to you. Glenn ----- Forwarded Message ----- From: Staff of dcarpenter2 <[email protected]> To: glenn levine <[email protected]> Sent: Tuesday, August 13, 2013 2:08 PM Subject: Re: Certificate of Insurance-Chameau Glenn, Here is the corrected Certificate. Irene Rodriguez Office of David Carpenter Farmers Insurance 22850 Crenshaw Blvd Ste 203 Torrance, CA 90505 License Number: 0688275 310-325-6565 (Office) 310-325-7037 (Fax) [email protected] http://www.farmersagent.com/dcarpenter2
------ Original Message ------ Received: 12:11 PM PDT, 08/13/2013 From: glenn levine <[email protected]> To: Staff of dcarpenter2 <[email protected]> Subject: Re: Certificate of Insurance-Chameau
thanks Dave. could you possibly add the "Waiver" and "Non-Contributory" wording on the Endorsement? From: Staff of dcarpenter2 <[email protected]> To: [email protected] Sent: Tuesday, August 13, 2013 12:04 PM Subject: Certificate of Insurance Glen, Please see attached certificate. Thank you, Irene Rodriguez Office of David Carpenter Farmers Insurance 22850 Crenshaw Blvd Ste 203 Torrance, CA 90505 License Number: 0688275
1
Allen, Louise
From: Sean Veder [[email protected]]Sent: Tuesday, August 13, 2013 5:08 PMTo: Zechowy, Linda; Allen, Louise; Luehrs, Dawn; Barnes, BritianeySubject: Fw: Community - Chameau, Inc. CertificateAttachments: 81413mtginv.doc
Hopefully this will work. There was a hiccup about the $3M before we realized that was $2M + $1M. Thanks. ----- Forwarded Message ----- From: Kelly Klemovich <[email protected]> To: Sean Veder <[email protected]> Sent: Tuesday, August 13, 2013 2:04 PM Subject: Re: Community - Chameau, Inc. Certificate how does this look???? On Aug 13, 2013, at 10:01 AM, Sean Veder <[email protected]> wrote: Hi Kelly - Please see additional notes from Sony Risk Management below for the certificate of insurance. Please let me know if you have any questions. Thanks, Sean Here are the changes we still require … Umbrella and/or Excess Liability - additional $1,000,000 per occurrence (we require $3M and only $2M per occurrence is evidenced) We need the waiver of subrogation wording added to the work comp cert. “A Waiver of Subrogation is granted in favor of Remote Broadcasting, Inc., its parent(s), subsidiaries, successors, licensees, related & affiliated companies, their officers, directors, employees, agents, representatives & assigns.” The Additional insured endorsement must list Remote Broadcasting, Inc., its parent(s), subsidiaries, successors, licensees, related & affiliated companies, their officers, directors, employees, agents, representatives & assigns as additional insureds, not just Remote Broadcasting, Inc. We still need the
o Primary/non-contributory endorsement o Waiver of subrogation endorsement
Chameau Inc. 339 N. Fairfax Avenue Los Angeles, CA 90036 EIN #: 04-3636760
INVOICE NO: 9978 DATE: August 14, 2013
To: Community Ship To: Paramount Pictures 5555 Melrose Avenue Hollywood, CA 90038 ATTN: Accounting
SALESPERSON P.O. NUMBER DATE SHIPPED SHIPPED VIA F.O.B. POINT TERMS
QUANTITY DESCRIPTION UNIT PRICE AMOUNT
1/2 400 pan of kale salad $30.00 $30.00
1 small tray of apple, fig, goat cheese & spiced nut $30.00 $30.00
1 small tray of prosciutto and melon $35.00 $35.00
1/2 400 pan of goat cheese & apricot stuffed chicken breast $60.00 $60.00
1/2 400 pan of carrot mashed potatoes $35.00 $35.00
1/2 400 pan of quinoa with pesto and veggies $30.00 $30.00
1/2
1/2
1/2
400 pan of sautéed shrimp with fresh tomato, basil & garlic
400 pan of grilled cauliflower with sea salt and olive oil
400 pan of chocolate croissant bread pudding
$70.00
$35.00
$35.00
$70.00
$35.00
$35.00
SUBTOTAL $360.00
TAX ON HOT FOOD $23.85
DELIVERY $5.00
TOTAL DUE $388.85
Make all checks payable to: Chameau Inc. If you have any questions concerning this invoice, call: Kelly, 323.951.0039
THANK YOU FOR YOUR BUSINESS!
1
Allen, Louise
From: Allen, LouiseSent: Tuesday, August 13, 2013 12:29 PMTo: 'Sean Veder'; Luehrs, Dawn; Zechowy, Linda; Barnes, BritianeyCc: Sergio RodriguezSubject: RE: Community - Chameau, Inc. Certificate
Here are the changes we still require …
Umbrella and/or Excess Liability - additional $1,000,000 per occurrence (we require $3M and only $2M per occurrence is evidenced) We need the waiver of subrogation wording added to the work comp cert. “A Waiver of Subrogation is granted in favor of Remote Broadcasting, Inc., its parent(s), subsidiaries, successors, licensees, related & affiliated companies, their officers, directors, employees, agents, representatives & assigns.” The Additional insured endorsement must list Remote Broadcasting, Inc., its parent(s), subsidiaries, successors, licensees, related & affiliated companies, their officers, directors, employees, agents, representatives & assigns as additional insureds, not just Remote Broadcasting, Inc. We still need the
o Primary/non-contributory endorsement o Waiver of subrogation endorsement
Thanks, Louise
From: Sean Veder [mailto:[email protected]] Sent: Monday, August 12, 2013 5:01 PM To: Luehrs, Dawn; Zechowy, Linda; Allen, Louise; Barnes, Britianey Cc: Sergio Rodriguez Subject: Community - Chameau, Inc. Certificate Here is the revised Chameau cert for your approval. I have the signed catering agreement, just have not had a chance to scan. Thanks. ----- Forwarded Message ----- From: glenn levine <[email protected]> To: Kelly Klemovich <[email protected]>; "[email protected]" <[email protected]> Cc: "[email protected]" <[email protected]> Sent: Monday, August 12, 2013 1:58 PM Subject: Re: Fwd: Community - Chameau, Inc. Certificate Hi, please see the revised Certificate of Insurance, Liability limits have been increased, Evidence of Property Coverage provided. Additionally, the Waiver of Subrogation working has been included and a copy of the Policy Endorsement attached. Please don't hesitate to contact me with any questions. Best regards,
-.,,...q\ CERTIFICATE OF LIABILITY INSURANCEacoxi:*
L v -
E DATE (MM/DD/YYYY)
0811212013
PRODUCER
DAVE CARPENTER INSURANCE22850 CRENSHAWAVE. SUITE 203TORRANCE, CA 90505t e l . 3 1 0 3 2 5 - 6 5 6 5
TTIIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
onlv axo coNFERs No RtcHTs uPoN THE cERTIFIcATEHOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND ORnirEn rne covERAGE AFFoRDED BY MlellelEs EEley[
INSURERS AFFORDING COVERAGE NAIC #
I N S U R E D
CHAMEAU INC.339 N. FAIRFAXAVE.LOS ANGELES, CA 90036
INSURER A FARMERS INSURANCE GROUP
INSURER B
INSURER C
INSURER D
INSURER E:
COVERAGES
T H E P o L | C I E S o F | N S U R A N C E L | S T E D B E L O W H A V E B E E N I S S U E D T o T H E I N S LANY REQUIREMENT, TERNiI OR CONDITION OF ANY CONTRACT OR OTHER DOCI.
PERTA |N 'THEINSURANCEAFFORDEDBYTHEPOL |C IESDESCRIBEDHERE|N ISpn| I ( ] I t rS AGGRFGATF I I I \ i I ITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLF
RED NAMEDABOVIJMENT WITH RESPISUBJECT TO ALL Tilv1s.
: FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING:CT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY
HE TERI\ ,4S. EXCLUSIONS AND CONDITIONS OF SUCH
N 5 KLTR N S R O T Y P E O F I N S U R A N C E POLICY NUMBER
Y
GENERAL LIABILITY
/ coutt unctn. cENERAL LlABtLlrY
|-l crnrr'as vnoe fl occun_--l
601 38-47-09 05114t2013 0511412014
EACH OCCURRENCED A M A G T I O H h N I b UPREIvIISES (Ea occurence)
MED EXP (Anv one Person)
g 1 00,000
5,000
PERSONAL & ADV INJURY g 2,000,000
_lGENERAL AGGREGATE $ 4.000,000
GEN'L AGGREGATE LII\,4IT APPLIES PER
7 por rcv f l pnorecr fl r-oc
PRODUCTS - COMP/OPAGG$ 4,000,000
L iquor L iab i l i tY 1 ,000 ,000
llllll
TOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
I I IRED AUTOS
NON-OWNED AUTOS
COMBINED SINGLE L I I \ ,4 IT(Ea accident)
$
BODILY INJURY(Per person)
$
BODILY INJURY(Per accident)
$
PROPERTY DAI,4AGE(Per accident)
$
GARAGE LIABILITY
] nr.rvnuro-t
AUTO ONLY _ EAACCIDENT $
OTHERTHAN EAACC
AUTO ONLY: AGG
$
$
EXCESS/UMBRELLA LIABILITY
] occun l-l crerr,,rs vrnoe
l__lDEDUCTIBLE
EACH OCCURRENCE
AGGREGATE
$
$
WORKERS COMPENSATION ANDEMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVEOFFICEFUME[4BER EXCLUDED?
lf ves, describe underSPECtAL PRov ls loNS be low
v v u ) l A l u I l w r lI TORY LII\,4ITS I I ER
E L EACHACCIDENT
E.L,DISEASE EAEMPTOYEE
E,L DISEASE' POLICY L IMI $
A
OTHER
BUSINESS PROPERTY 601 38-47-09 05t1412013 0511412014$224J00, ALL RISK, $1,000 Di D
Remote Broadcasting Inc., its parent(s), subsidiaries, successors, licensees, related and affiliated companies, their officers, directors' employees' agents'
reDresentatives and assigns as Additional Insureds as their interests may appear and where applicable as loss payess as their interests may appear
Coverage is primary and noncontributoryWaiver of Subrogation.
CANCELLATIONCERTIFICATE HOLLIEK
Remote Broadcasting Inc.10202 W. Washington Blvd.Culver City, CA 90232Attn: Risk Management
SHOULD ANY OF THE ABOVE DESCRIBEO POLICTES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREoF, THE rssutNc tNsuRER wlLL ENDEAVoR To untl 30 DAYS wRlrrEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBUGATION OR LIABILITY OF ANY KIND UPON THE INSURER' ITS AGENTS OR
988w
ACORD 2s (2001/08)OACORD CORPORATION
P o L I C Y N U M B E R : 6 0 L 3 8 - 4 7 - 0 9
THIS ENDORSEMENT CHANGES THE
BUSINESSOWNERS
POLICY. PLEASE READ IT CAREFULLY.
ADDITIONALINSURED - DESIGNATED PERSONOR ORGANIZATION
orovided under the fo l lowing:This endorsement modi f ies insurance
BUSINESSOWNERS POLICY
SCHEDULE-
Name Of Person Or Organization:REMOTE BROADCASTING, INC.
ATTN: RISK MANAGEMENT
* Informat ion requi red to complete th is Schedule, i f not shown on th is endorsement '
Decla rat ions.
The fo l lowing is added to Paragraph C. Who ls An
lnsured in the Businessowners L iabi l i ty CoverageForm:
4. Any person or organizat ion shown in the Sched-u le i s a l so an i nsu red , bu t on l y w i t h respec t t o
l iab i l i ty ar is ing out of your ongoing operat ionsor premises owned by or rented [o you.
Copyr ight , Insurance Serv ices Of f ice, Inc. , 1997
w i l l be shown i n t he
nBP 04 48 01 97 Page 1 o f 1
1
Allen, Louise
From: Allen, LouiseSent: Monday, August 12, 2013 2:16 PMTo: Barnes, Britianey; 'Sean Veder'Cc: Luehrs, Dawn; Zechowy, Linda; 'Sergio Rodriguez'Subject: RE: Community - Chameau, Inc. Certificate
Here are the changes we need to the insurance paperwork ….
Umbrella and/or Excess Liability - $2,000,000 per occurrence $2,000,000 aggregate
“All Risk” Property and/or Miscellaneous Equipment coverage on all property rented/leased or owned for replacement cost value
On the work comp cert, add the wording “A Waiver of Subrogation is granted in favor of Remote Broadcasting, Inc., its parent(s), subsidiaries, successors, licensees, related & affiliated companies, their officers, directors, employees, agents, representatives & assigns.”
Endorsements: We require the following endorsements (either a blanket endorsement already part of the policy or a customized endorsement with the same wording in the description of operations of the cert):
o Additional insured endorsement o Primary/non-contributory endorsement o Waiver of subrogation endorsement
Thanks, Louise
.-- CERTIFICATE OF LIABILITY INSURANCE
COVERAGES
Ar?.Rif\*-
DATE (MM/DD/YYYY}
08t0712013PRODUCER
DAVE CARPENTER I NSURANCE22850 CRENSHAW AVE. SUITE 203TORRANCE, CA 90505t e l . 3 1 0 3 2 5 - 6 5 6 5
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIONONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATEHOLDER. THIS CERTIFICATE DOES NOTAMEND. EXTEND ORALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE NAIC #
INSURED
CHAMEAU INC.339 N. FAIRFAXAVE.LOS ANGELES, CA 90036
INSURERA: FARMERS INSURANCE GROUP
INSURER B
INSURER C
INSURER D
INSURER E
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDINGANY REQUIREI\ , , IENT, TER[/ OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAYPERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERIVIS, EXCLUSIONS AND CONDITIONS OF SUCHPOLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
T R INSRO TYPE OF INSURANCE POLICY NUMBER DATE (MM/DD/YY)t s U L I I I E A T I K A I I U NDATE (MM/DD/YY} LIMITS
A X
GENERAL LIABILITY
/ comrr,rencrer- GENERAL LrABrLrry
l-l crervs r'rnoe M occun
l Y 601 38-47-09 05t1412013 05t14t2014
EACH OCCURRENCE $ 1 ,000 ,000
U A M A b t r I U K E N I E UPREMISES (Ea occurence) 9 100 ,000
lvlED EXP (Any one person) $ 5 ,000
PERSONAL & ADV INJURY s 1 ,000 ,000
l GENERAL AGGREGATE g 2,000,000
J E N ' L A G G R E G A T E L I N , 4 I T A P P L I E S P E R PRODUCTS - COMP/OP AGG $ 2,000,000
Z porrcv fl pnolecr fl roc L iquor L iab i l i t y 1 ,000 ,000
AUTOMOBILE LIABILITY
] nr.rvauro
] nrrownronuros
] scueouleonuros
] Hrnronuros
] ruoru owNEDAuros
l
COMBINED SINGLE L I I ,4 IT(Ea accident)
$
BODILY INJURY(Per person) $
BODILY INJURY(Per accident)
$
PROPERTY DAMAGE(Per accident)
$
li::^,- -
_l
AUTO ONLY - EAACCIDENT $
OTHER THANAUTO ONLY:
EAACC
AGG
$
$
EXCESS/UMBRELLA LIABILITY
] occun f-] cr-nrnrs veor
l_-l DEDUCTIBLE
RETENTION $
EACH OCCURRENCE
AGGREGATE $
$
$
$
WORKERS COMPENSATION ANDEM PLOYERS' LIABILITY
ANY PROPRIETOR]PARTNER/EXECUTIVEO FF lC E RIME N,IBE R EXCLUDED?lf ves. describe underSPECIAL PROVISIONS be low
I l v r r r _T O R Y L I M I T S I I E R
E.L . EACH ACCIDENT $
EL D]SEASE EAEI\, IPLOYEE $
E.L . DISEASE - POLICY L IMIT
OTHER
DESCRIP I ION OI- OPbRAI IONS / LOCAI IONS / VbHICLhS / hXCLUSIONS AUUEU BY tNUUKsEMtsN I / ) tstsUIAL TKUVI)IUN>
Remote Broadcasting lnc., its parent(s), subsidiaries, successors, licensees, related and afflliated companies, theirofficers, directors, employees, agents,representatives and assigns as Additional Insureds as their interests may appear and where applicable as loss payess as their interests may appear.Coverage is primary and noncontributory. .
CERTIFICATE HOLDER
ACORD 25 (2001/08)
CANCELLATION
@ ACORD CORPORATION 1 988
Remote Broadcast ing lnc.10202 W. Washington Blvd.Culver City, CA 90232Attn: Risk Manaqement
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING TNSURER WILL ENOEAVOR TO MAIL 30 OEVS WNITTEI|
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFI BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY K|ND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUrHoRlzEP/RE T.flU / .,t^,
1
Allen, Louise
From: Allen, LouiseSent: Monday, August 12, 2013 2:07 PMTo: Barnes, Britianey; Sean VederCc: Luehrs, Dawn; Zechowy, Linda; Sergio RodriguezSubject: RE: Community - Chameau, Inc. CertificateAttachments: Chameau Inc. Catering T&C - Community.doc
Sean … I looked back in my file from last year and Chameau just gave you an invoice and then we attached this amending agreement which Chameau signed. Here is the same agreement. You just have to insert the date in the first paragraph and sign. I’ll send you a separate email with the changes we need to the cert. Thanks, Louise
From: Barnes, Britianey Sent: Sunday, August 11, 2013 2:02 PM To: Sean Veder Cc: Luehrs, Dawn; Zechowy, Linda; Allen, Louise; Sergio Rodriguez Subject: RE: Community - Chameau, Inc. Certificate Hi Sean – Do you have the agreement? Offhand I can tell you the certificates will need to be revised but there isn’t much we can do without the agreement.
Britianey Barnes Sr. Analyst | P. 310.244.4241 | F. 310.244.6111 [email protected]
From: Sean Veder [mailto:[email protected]] Sent: Wednesday, August 07, 2013 4:37 PM To: Luehrs, Dawn; Barnes, Britianey; Zechowy, Linda; Allen, Louise Subject: Community - Chameau, Inc. Certificate Hi - Here is another from Chameau, Inc. Thanks, Sean ----- Forwarded Message ----- From: Kelly Klemovich <[email protected]> To: Sean Veder <[email protected]> Sent: Wednesday, August 7, 2013 4:34 PM Subject: Fwd: Remote Cert Begin forwarded message:
2
From: glenn levine <[email protected]> Subject: Re: Fwd: Remote Cert Date: August 7, 2013 4:32:22 PM PDT To: Kelly Klemovich <[email protected]> Cc: "[email protected]" <[email protected]> Reply-To: glenn levine <[email protected]> Kelly, please see the attached. best success, Glenn From: Kelly Klemovich <[email protected]> To: Yvette Tufi <[email protected]>; glenn levine <[email protected]> Sent: Wednesday, August 7, 2013 12:58 PM Subject: Fwd: Community can i please get a certificate for remote broadcasting - see attached document for address thanks kelly Begin forwarded message:
From: Sean Veder <[email protected]> Subject: Community Date: August 7, 2013 12:17:47 PM PDT To: Kelly Klemovich <[email protected]> Reply-To: Sean Veder <[email protected]> Here's that agreement with the certificate of insurance info. Thanks!
1
Allen, Louise
From: Sean Veder [[email protected]]Sent: Wednesday, August 07, 2013 7:35 PMTo: Luehrs, Dawn; Barnes, Britianey; Zechowy, Linda; Allen, LouiseCc: Sergio RodriguezSubject: Community - Chameau Inc. Attachments: Remote Broadcasting Cert C.pdf
Hi - Please review the attached certificate from Chameau, Inc., one of the caterers we will use for crafts service on the stage. The catering agreement is forthcoming. Thanks, Sean Begin forwarded message: From: "Lesley Mathews" <[email protected]> Subject: Remote Broadcasting COI Date: August 7, 2013 2:59:36 PM PDT To: <[email protected]> Re: Chameau Good afternoon, We are pleased to provide for your review and acceptance the attached Certificate of Insurance. We anticipate you will find everything in order, however if you notice any discrepancies or the attached doesn't satisfy the requirements needed, please let us know and we will amend the document and resend as instructed. Please let me know if I need to request the waiver of subrogation for the Work Comp policy. Regards, Lesley Mathews Commercial CSR Assistant
Snapp & Associates Insurance Services, Inc. 438 Camino del Rio S., Ste #112 San Diego, CA 92108 Phone #: 619‐908‐3100 x 152 Fax #: 619‐908‐3110 Email: [email protected] **Please Note: There is a 24-hour turn-around time for all certificates. We will process the certificates as they are received. Thank you for your patience. **CONFIDENTIALITY NOTICE: The information contained in this e‐mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review; use, disclosure or distribution is prohibited. If you are not the intended recipient, and have received this communication in error, please contact the sender by reply e‐mail and destroy all copies of the original message. Thank you.
2
Question: When is the last time you had your employee handbook reviewed for state and federal compliance? Did you know we offer FREE handbook reviews? Please let me know if we can review your handbook for free.
From: Kelly Klemovich [mailto:[email protected]] Sent: Wednesday, August 07, 2013 12:59 PM To: Yvette Tufi ; glenn levine Subject: Fwd: Community can i please get a certificate for remote broadcasting - see attached document for address thanks kelly Begin forwarded message:
From: Sean Veder <[email protected]> Subject: Community Date: August 7, 2013 12:17:47 PM PDT To: Kelly Klemovich <[email protected]> Reply-To: Sean Veder <[email protected]> Here's that agreement with the certificate of insurance info. Thanks!
Catering Terms and Conditions Amendment
This following amends that certain catering services agreement/bid dated as of _______________, 2013 (”Agreement”) between Chameau, Inc. (“Caterer”) and Remote Broadcasting, Inc. (“Company”) attached hereto in connection with Company’s use of Caterer’s services (“Services”) for the theatrical motion picture or television production currently entitled “Community” (“Picture”). For good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged by the parties, Caterer and Company hereby agree to the following: 1. Indemnification. Caterer shall indemnify, defend and hold harmless Company, its parent(s), subsidiaries, licensees, successors, related and affiliated parties and their officers, directors, employees, representatives, assigns and agents from any and all liabilities, judgments, losses, claims, demands, damages, penalties, interest, costs and expenses of any kind whatsoever (including without limitation, reasonable attorneys’ and accountants’ fees and disbursements suffered by any person or persons arising out of or related to Caterer’s acts or omissions, except to the extent caused by Company's negligence or willful misconduct or Company’s breach of its representations, warranties and obligations hereunder. 2. Insurance. Caterer shall maintain insurance in accordance with Exhibit A attached hereto and will provide a certificate of insurance and policy endorsements to Company prior to rendering Services to Company hereunder. 3.. Dispute Resolution. The parties agree that any and all disputes or controversies of any nature between them arising in connection with the Picture and/or this Agreement shall be determined by binding arbitration in accordance with the rules of JAMS (or, with the agreement of the parties, ADR Services) before a single neutral arbitrator ("Arbitrator") mutually agreed upon by the parties. If the parties are unable to agree on an Arbitrator, the Arbitrator shall be appointed by the arbitration service. The Arbitrator's decision shall be final and binding as to all matters of substance and procedure, and may be enforced by a petition to the Superior Court for confirmation and enforcement of the award. This Agreement shall be governed by and construed in accordance with the laws of the State of California. 4. Performance. Caterer shall provide Services in a professional manner in accordance with the customary practices of caterers in the entertainment industry and shall abide by all laws, statutes, rules and regulations of any applicable regulatory agencies governing the rendering of Services, (e.g.,, the local department of health or the equivalent thereof), in the location where the Services are provided. Company shall have the right to terminate this Agreement immediately for any reason, with or without cause. 5. Confidentiality. Caterer agrees on its behalf and on behalf of all of its employees and independent contractors assigned to provide Services hereunder (“Assigned Staff”) that it, and each member of the Assigned Staff, shall guard in the strictest confidence and not disclose to any third party and not use for any reason except to provide Services pursuant to this Agreement, any of Company’s confidential information disclosed to Caterer or to which Caterer or any of the Assigned Staff may otherwise gain access to (including by visual inspection or otherwise) by virtue of the provision of Services under this Agreement. Caterer acknowledges and agrees that Company’s confidential information includes without limitation all details regarding the Picture, the identities of the Picture cast and crew, the budget, the locations and dates, and any of the terms of this Agreement.
6. Authority to Enter Agreement. Any additional changes or amendments to the Agreement must be provided in writing and executed by authorized representatives of both parties. The person signing this Agreement on behalf of Caterer warrants that he or she is Caterer or Caterer’s authorized agent and, as such, has the right to enter into this Agreement and that no other authorization is necessary. 7. Compostable Materials. Caterer warrants that it will use compostable catering supplies for containers, cups, plates, flatware, etc. 8. Amending Agreement Governs. The parties acknowledge that to the extent that any provisions of this Amending Agreement are inconsistent with the Agreement, the provisions of this Amending Agreement shall govern. ACCEPTED AND AGREED TO:
COMPANY: By: Its:
CATERER: ___________________________ By: Its:
Exhibit A
Remote Broadcasting, Inc. STANDARD INSURANCE REQUIREMENTS
FOR CATERERS
A Certificate of Insurance is to be sent to the Risk Management Department of Remote Broadcasting, Inc. reflecting the following insurance coverage: Commercial General Liability - $1,000,000. per occurrence $1,000,000. aggregate Umbrella and/or Excess Liability - $2,000,000 per occurrence $2,000,000 aggregate Automobile Liability - $1,000,000. CSL Automobile Physical Damage
**Statutory Workers' Compensation **Employer's Liability - $1,000,000.
“All Risk” Property and/or Miscellaneous Equipment coverage on all property rented/leased or owned for replacement cost value For all of these coverages except Workers’ Compensation, provide an endorsement naming Remote Broadcasting, Inc., its parent(s), subsidiaries, successors, licensees, related & affiliated companies, their officers, directors, employees, agents, representatives & assigns as Additional Insureds as their interests may appear and where applicable as loss payees as their interests may appear
All endorsements required above must indicate that the Named Insured's insurance is primary and any insurance maintained by the Additional Insureds is non-contributing to any of the Named Insured’s insurance. **Worker’s Compensation coverage should include a Waiver of Subrogation endorsement in favor of Remote Broadcasting, Inc., its parent(s), subsidiaries, successors, licensees, related & affiliated companies, their officers, directors, employees, agents, representatives & assigns
A Thirty (30) Day written notice of cancellation, non-renewal or material reduction in coverage
The insurance carriers must be licensed in the state of California & have an A.M. Best Guide Rating of at least A:VII
CERTIFICATE HOLDER: Remote Broadcasting, Inc. 10202 W. Washington Blvd., Culver City, CA 90232 Attn: Risk Management ** Not required if Caterers payrolled by Remote Broadcasting, Inc.’s payroll services company
