Preview
FILED: NEW YORK COUNTY CLERK 09/04/2020 11:56 AM INDEX NO. 652321/2020
NYSCEF DOC. NO. 5 RECEIVED NYSCEF: 09/04/2020
EXHIBIT A
FILED: NEW YORK COUNTY CLERK 09/04/2020 11:56 AM INDEX NO. 652321/2020
NYSCEF DOC. NO. 5 RECEIVED NYSCEF: 09/04/2020
Douglas A Leto 399 Park Avenue, 9th Floor
Eastern Regional Construction Manager New York, NY 10022
Phone: (212) 884-0529 douglas.leto@starrcompanies.com
NON-BINDING INDICATION QUOTATION BINDER
POLICY NUMBER: TBA
Date: March 20, 2017 Proposal No.: 01 Replaces Proposal Dated: N/A
Broker Name, Company & Address Ms. Kristin Wisner, Account Manager
McGriff, Seibels & Williams, Inc.
2211 7th Avenue South
Birmingham, AL 35233
Telephone No. (205) 581-9428
Email Address KWisner@McGriff.com
Starr Surplus Lines Insurance Company, with an A.M. Best Financial Strength Rating of A (Excellent), and a Financial Size
Category of XV (non-admitted) is pleased to offer the following, subject to additional information as outlined at the conclusion of this
document.
NAMED INSURED: E.E. Cruz & Company, Inc.
MAILING ADDRESS: 32 Avenue of the Americas, 13th Floor
New York, NY 10013
ADDITIONAL INSURED:
Architects, engineers, manufacturers, suppliers, contractors and subcontractors of every tier, as respects their work at the project site
To the extent required by any contract or subcontract for an INSURED PROJECT*, and then only as their respective interests may
appear, all owners, all contractors and subcontractors of every tier, tenants of the INSURED PROJECT* and any other individual or
entity specified, in such contract or subcontract are recognized as Additional Insured’s hereunder.
Additional Insured’s as provided above, shall be as shown on ACORD Certificates of Insurance issued by the Broker copies of which will
be forwarded to this Company and kept on file.
The first Named Insured shall be deemed the sole and irrevocable agent of each and every Insured hereunder for the purpose of
giving and receiving notices to and/or from this Company, giving instruction to or agreeing with this Company as respects Policy
alteration and for making or receiving payments of premium or adjustments to premium.
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FILED: NEW YORK COUNTY CLERK 09/04/2020 11:56 AM INDEX NO. 652321/2020
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PROJECT NAME: Region 8 Bridge Replacements
PROJECT This project involves the replacement of three bridges.One on East 3rd Street over Route 907W and
DESCRIPTION: the Hutchinson River in Pelham, NY, 190 feet long and the other two on Route 987D over the Saw
Mill River in Greenburgh, NY, 190 feet and 150feet long. Construction is steel girder and concrete.
PROJECT LOCATIONS: E 3rd Street and Hutchinson River Parkway, Pelham, NY
Latitude 40.906252
Longitude -73.813790
Route 987D over Saw Mill River, Greenburgh, NY
Latitude 41.044008
Longitude -73.834975
ESTIMATED TOTAL $ 85,000,000 Physical Damage (hard costs + owner supplied material + non-time element soft cost)
CONTRACT VALUE: $ 250,000 Existing Property
$ Not Covered Delay In Completion – Soft Costs (time element exposure)
$ Not Covered Delay In Completion – Loss of Rental Income
$ Not Covered Delay In Completion – Loss of Gross Earnings
$ 85,250,000 Estimated TOTAL CONTRACT VALUE
POLICY TERRITORY: This Policy covers within the fifty (50) States comprising the United States of America,
including the District of Columbia, except that we will not cover property in transit by water or air
traveling to or from Alaska or Hawaii regardless of origin of shipments.
POLICY TERM: Effective: June 1, 2017 To: April 1, 2019 (669 days or 22 months or 1.833 years).
Including Not Covered consecutive days of Hot Testing
As respects Delay in Completion Coverage, the Period of Indemnity shall be Not Covered Consecutive Calendar
Days.
Coverage provided hereunder shall attach as of the date shown on the declarations page and shall continue in
full force and effect until:
A. When the owner or buyer accepts the property;
B. When the interest of the Named Insured ceases;
C. Beyond sixty (60) days after completion of the project;
D. When the Named Insured abandons the construction with no intention to complete it; or
E. When this Policy expires or is cancelled;
Whichever first occurs.
In the event that an owner places insurance on any portion of the work which has been declared and accepted as
Substantially Complete or any portion of the work is occupied or placed into commercial service for its intended
purpose, coverage as respects such portion of the work shall cease as of the Substantial Completion Date as stated
in the Certificate of Substantial Completion, the date of occupancy or the date of commercial service, whichever
first occurs
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SECURITY: Starr Surplus Lines Insurance Company
POLICY FORM: Starr Specialty Completed Value Construction All Risk Policy
COVERAGE: All-Risk of direct physical loss or damage, including Land Movement and Flood and Named Windstorm and Delay In
Completion
STARR SPECIALTY LINES PARTICIPATION: 100% being $85,250,000 part of $85,250,000
100% POLICY LIMIT OF LIABILITY:
The Company will not be liable for more than its proportion of $85,250,000 in any one occurrence and further subject to its proportion
of the following limits, sublimits and aggregate limits:
POLICY SUBLIMITS & $ 85,000,000 Physical Damage to the INSURED PROJECT*
AGGREGATE LIMITS $ 250,000 Physical Damage to Existing Property Legal Liability All Risk
$ Not Covered Delay In Completion - Loss of Rental Income (subject to scheduled sub-limits & policy
term aggregate) – not exceeding $____ Maximum Monthly Indemnity
$ Not Covered Delay In Completion - Loss of Gross Earnings (subject to scheduled sub-limits &
Application of all sub-limits policy term aggregate) - not exceeding $____ Maximum Monthly Indemnity
is per occurrence unless $ Not Covered Delay In Completion – Soft Costs (time element exposures only) including expense
noted otherwise to avoid or reduce a Delay in opening, not exceeding $____ Maximum Monthly
Indemnity subject to specific sub-limits & policy term aggregate as follows:
Coverage is excluded when $ 85,250,000 LAND MOVEMENT* Physical Damage and Delay Combined (annual aggregate)
a sublimit is blank $ Not Covered FLOOD* Physical Damage and Delay Combined (annual aggregate)
$ 85,250,000 NAMED WINDSTORM* Physical Damage and Delay Combined (annual
Sub-limits are part of policy aggregate)
limit, not in addition thereto $ 85,250,000 All Other WINDSTORM* Physical Damage and Delay Combined (annual
aggregate)
$ 1,000,000 Physical Damage to property in Inland Transit (per conveyance)
$ 5,000,000 Physical Damage to property in Offsite Temporary Storage (per location)
$ 5,000,000 or 25% of the amount of physical loss or damage to insured property, whichever
is less – Debris Removal (180 days reporting)
$ 5,000,000 Ordinance & Law / Demolition & Increased Cost of Construction
$ Not Covered Interior Water Intrusion Damage
$ 250,000 Architects and/or Engineers and Professional Fees (in restoration following an
insured loss)
$ 500,000 or 20% of the amount of physical loss or damage to insured property, whichever
is less – Expediting Expense
$ 100,000 Emergency Property Protection Expense (applies for up to thirty (30) consecutive days)
$ 100,000 Trees, Shrubs, Plantings & Landscaping Materials (maximum $5,000 per item)
$ 100,000 Plans & Blueprints & Other Contract Documents
$ 100,000 Fire Brigade Service Charges & Extinguishing Expenses
$ 100,000 Pollution & Contamination Cleanup & Decontamination (Policy Term Aggregate)
$ 50,000 Claim Preparation Costs (exclude Public Adjuster costs)
$ Not Covered Mold & Fungus Remediation (Policy Term Aggregate)
$ Not Covered Civil Authority / Ingress Egress (30 days / within 10 statute miles)
$ Not Covered Service Interruption Extension (14 days)
$ Not Covered Green Building Coverage
10% Escalation – Physical Damage to the Insured Project
90 Days Extension of Policy Term (at pro-rata additional premium)
Included Cold Testing
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DEDUCTIBLES: From the amount of each claim for insured loss or damage arising out of any one occurrence, there shall
be deducted the applicable amount shown below, and then the liability of this Company shall be only for
the amount of such insured loss or damage in excess thereof, subject to the limit of liability, sublimits of
liability or annual aggregate limits of liability set forth above:
When a percentage (%) is $ 100,000 as respects all other perils Physical Damage, except
entered absent a $ N/A as respects WATER DAMAGE* other than FLOOD*;
corresponding minimum 0 % of the total insured values at risk at the time and place of loss subject to a minimum
dollar amount, the deduction of $N/A as respects the peril of FLOOD* except
percentage shall be applied 0 % of the total insured values at risk at the time and place of loss subject to a minimum
without minimum. When a deduction of $100,000 as respects the peril of LAND MOVEMENT*
dollar amount is entered 0 % of the total insured values at risk at the time and place of loss subject to a minimum
absent a corresponding deduction of $100,000 as respects the peril of NAMED WINDSTORM*;
percentage (%), the word 0 % of the total insured values at risk at the time and place of loss subject to a minimum
minimum is deleted deduction of $100,000 as respects the peril of Windstorm;
$ N/A to property insured while undergoing HOT TESTING*;
N/A days Per Occurrence deductible period – Delay In Completion/ Soft Costs
In the event that more than one physical damage deductible is shown herein, or specified in any
endorsement issued hereunder applies to insured physical loss or damage in any one OCCURRENCE*,,
only the largest deductible shall be applied. Where an extension of coverage applies the base property
damage deductible shall apply unless otherwise stated. As respects Delay In Completion coverage, the
deductible period stated in the
Delay In Completion Endorsement attached to the policy and also shown above, will always be applied
in addition to any dollar deductible or percentage (%) deductible stated for physical damage.
ANNUAL RATES: $0.06500 / $100 Physical Damage
$N/A / $100 Delay In Completion
$N/A / $100 Physical Damage Existing Property
$N/A / $100 Hot Testing (30 consecutive Days)
Rates are applied against declared estimated total contract values and estimated project term
TERM PREMIUM – 100% $ 101,571 Physical Damage
$ N/A Delay In Completion
$ N/A Hot Testing (30 consecutive Days)
$ 101,571 Total Term Policy Premium
$ 3,047 Certified and Non Certified Terrorism Premium (optional & in addition to above)
(refer to Disclosure Notice attached)
$ 104,618 Total Term Policy Premium including Terrorism
Starr Specialty 100% SHARE $ 101,571 Total Policy Premium (subject to 25 % minimum & earned premium)
$ 3,047 Certified and Non Certified Terrorism Premium (optional & in addition to above)
(refer to Disclosure Notice attached)
$ 104,618 Total Starr Specialty Premium including Terrorism
ADDITIONAL $ 54,848 $5,000,000 Loss Limit – Term Premium Plus $1,645 Terrorism; $100,000
COVERAGE OPTIONS: Deductible
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ADDITIONAL Deductible $ N/A
OPTIONS: $ N/A
PREMIUM 1 100% Payable within 30 days of policy inception
PAYMENT 2 0% Payable by N/A
SCHEDULE: 3 0% Payable by N/A
4 0% Payable by N/A
All premiums are adjustable upon project completion based on final total contract value and actual project term at the rates stated
above
Applicable Surplus Lines taxes and fees are in addition to the premiums stated above.
BROKER RESPONSIBLE FOR SURPLUS LINES FILINGS
COMMISSION: 15%
CANCELLATION: N/A days except 10 days for nonpayment of premium
PERILS INSURED:
Subject to the terms, exclusions, limitations and conditions contained in or endorsed to the Policy, coverage is provided against all risks
of direct physical loss of or damage to property insured while at the location of the INSURED PROJECT*, while in offsite storage or
while in transit, during Cold Testing, all within the Policy territory and occurring during the Period of Insurance of this Policy.
PERILS EXCLUDED:
Loss, damage or expense caused by, resulting from, contributed to or made worse by any of the following excluded perils, all whether
direct or indirect, proximate or remote or in whole or in part caused by, contributed to or aggravated by any physical loss or damage
insured by this Policy, except as specifically allowed in the Policy:
Consequential loss, damage or expense; Cost of making good fault, defect, error, deficiency or omission in workmanship, supplies,
materials, designs, plans or specifications (resultant damage is covered); War; Nuclear; Inventory Shortage; Infidelity & Dishonesty;
Fungus; Pollution & Contamination; Asbestos; Loss or damage covered by manufacturer / supplier guarantee or warranty; Normal
subsidence, settling, cracking, expansion, contraction or shrinkage; Cessation of work; Infestation, disease, freeze, drought, hail, ice,
snow, vermin, rodent and animal damage to trees, plants shrubs and landscaping; Erosion of finish or rough grades from runoff;
Electrical / mechanical injury or error / omission in creating processing or copying electronic records; Millennium exclusion; Cyber
risk-data recognition; Nuclear, chemical or biological terrorism; Water damage to property in the open or from water entering a
building through unprotected openings and other perils per standard Starr Companies policy form
PROPERTY INSURED:
Permanent Works - All materials, supplies, equipment, machinery, and other property of a similar nature, being property of the Insured
or of others for which the Insured may be contractually responsible, the value of which has been included in the estimated value of the
INSURED PROJECT* in Section I-9.,all when used or to be used in or incidental to the demolition of existing structures,site
preparation, fabrication or assembly, installationor erection or the construction of or alteration,renovation, rehabilitation of the
INSURED PROJECT*;
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Temporary works - All scaffolding, form work, fences, shoring, hoarding, falsework and temporary buildings all incidental to the project
and the value of which has been included in the estimated value of the INSURED PROJECT*.
PROPERTY EXCLUDED:
Land & land value; Water; Ocean Cargo, Vehicles, Existing Property; Testing of prototypical equipment; Testing of used equipment;
Property located at other than project site except while in transit or temporary storage or offsite fabrication; Contractor’s tools and
equipment and other property per the policy form.
VALUATION: Property Under Construction – The cost to repair or replace the lost or damaged property, valued as of the
time and place of loss, with material of like kind and quality, less betterment, including contractor’s reasonable
profit and overhead in the same proportion as that included in the original contract documents. If not so replaced,
loss shall be settled on an Actual Cash Value basis with proper deduction for depreciation and exclusive of
overhead and profit
Temporary Works – The actual cash value of the lost or damaged property valued as of the time and place of
loss
Property Of Others (including items supplied by the owner or for which the Insured is legally
responsible) - The cost to repair or replace the property lost or damaged with material of like kind and quality
including contractor's charges incurred prior to loss and related to such property, if any, less betterment, or the
property owner's cost, whichever is less
Existing Property - The cost to repair or replace the lost or damaged property with material of like kind and
quality valued as of the time and place of loss. In the event that repair or replacement with materials of like kind
and quality cannot be effected due to obsolescence or non-availability of such materials or the means and
methods of fabricating, manufacturing, or installing such materials, repair or replacement shall be effected with
materials, means and / or methods that are functionally equivalent to the lost or damaged property but excluding
betterment. If not so replaced, loss shall be settled at Actual Cash Value (the cost to repair or replace as
determined above, less depreciation)
Plans, Blueprints, Drawings, Renderings, Specifications Or Other Contract Documents And Models –
The cost to reproduce with property of like kind and quality including the cost of gathering or assembling
information from back up data if replaced. If not replaced - the value of blank material
Trees, Shrubs, Plantings And Landscaping - The cost to replace with property of like kind, quality and size
plus the proper proportion of labor expended if such damage occurs after installation
Property In Transit – The invoice cost plus accrued shipping charges less shipper's liability, if any
Delay In Completion Coverage – Actual Loss Sustained
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OTHER TERMS APPLYING:
OTHER TERMS Permission to Occupy Unlimited Continuous weeks of coverage. The Insured shall
APPLYING: immediately report any increase in hazard beyond that
provided for in the Policy. All fire protection, security and
other protective devices and systems shall be installed,
tested, activated and, where required, certifiedby local
authorities.
Protective Safeguards Fenced Jobsite Perimeter
Applicable Watchman / Security Service – non-working hours
Fire Hydrants Within 500’ – Tested & Operational
Exterior Lighting
Brush / Vegetation Control
Cameras
Other (define)
Favorable Inspection & compliance with recommendations, if any
Coverages and/or Extensions of Coverage not specifically shown above are not included.
No Coinsurance.
Coverage shall be primary and non-contributory
Automatic reinstatement of loss applies except as respects any coverage subject to an annual or policy
term aggregate
Knowledge of Occurrence – knowledge by Risk Management department only
No premium adjustment shall take place if the difference is 3% or less
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POLICY FORMS & ENDORSEMENTS APPLICABLE:
Starr Specialty Builders Risk Form
Starr Specialty Completed Value Construction/Erection All Risk Form Delay In Opening Endorsement
Starr Terrorism Endorsements
Service of Suit Clause (samples attached)
Starr Electronic Data/Media, Asbestos and Political Risk endorsements (samples attached)
OFAC (samples attached)
Piling, Sheetpiling & Caisson Endorsement
Dewatering Endorsement
Ingress or Egress and Civil Authority
Service Interruption Extension
Damage to Existing Property
Damage to Existing Property – Boiler & Machinery
Earthquake Limitation - California Code #7105
Modified Asbestos Exclusion
Green Building Coverage
LEG 3/06
Contingent Delay in Completion Extension
Protective Safeguard Endorsement
Concealed Damage
Marine Cargo 50-50 Clause
Dredging Exclusion
Break & Review Claus
Wet Works
Dam, Cofferdam & Tunnel Endorsement
Open Trench during laying of Pipeline
Serial Loss
Horizontal Directional Drilling Endorsement
Historic Valuation Endorsement
Pipeline Leak Search
THE COMPANY MAY WITHDRAW THIS QUOTATION AT ANY TIME PRIOR TO ACCEPTANCE AND IN NO EVENT
WILL IT REMAIN OPEN FOR ACCEPTANCE BEYOND 30 DAYS FROM THE DATE OF THIS DOCUMENT. COVERAGE
MAY NOT BE BOUND WITHOUT PRIOR WRITTEN AUTHORIZATION FROM THE COMPANY.
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ADDITIONAL UNDERWRITING INFORMATION REQUIRED AS A CONDITION OF BINDING COVERAGE
If an item is checked (x) below it is a required part of the basis for the terms and conditions set forth herein. Any item(s)
outstanding at the time a binder is requested may be cause for withdrawal or amendment of these terms and conditions
Breakdown Of Estimated Total Contract Values
Breakdown of construction contract value by bridge
Owner or third party supplied material to be installed and not included above
Value of existing property to be insured and forming a part of the project
Detailed itemized breakdown of Soft Cost line items to be insured by Phase
Pro forma income statement for Loss of Rental Income coverage
Pro forma income statement for Loss of Profit
Construction Schedule
Critical Path or Bar Chart / Time Line / Gantt Chart
Project Plans
Site or Plot Plan
Elevation Plan
Typical Floor Plan
Structural Framing Plan and Cross Sections (for large span open spaces within a structure)
Cross Sections (for dams and tunnels)
Profiles (for tunnels and underground / underwater utilities whether bored, drilled or trenched)
Geotechnical
Summary Geotechnical Report for all projects (1) requiring deep foundations, (2) in an ISO Earthquake Zone 1 or 2, (3) in
close proximity to quarries or underground / aboveground mines (active or abandoned) or areas of past sinkhole activity,
all (4) bridges, dams, tunnels and all other underground construction and (5) all coastal exposures
For all other projects the type of foundation to be utilized (e.g. pad, raft, piled)
Other Items As Listed Below
Equipment Nameplate Data
Federal Emergency Management Agency Standard Flood Hazard Determination (FEMA Form 81-93)
Statement of contractor experience with similar projects
Contractor's construction method statement and risk assessment
Heavy lifts and number of mobile and fixed cranes
Comprehensive dilapidation survey on the existing buildings
Details of the demolition and construction procedures
Fit out specifications
Flood history at the site and precautions
Modifications to foundations
Existing and serviceable sprinkler systems which will be fully in place during the entire construction period and details of
the fire protection and fire precautions to be utilized
Brokers Manuscript Policy Form
Prior to binding we will need a completed and signed copy of the attached Terrorism Disclosure and Surplus Lines Filing Agreement.
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Please call with any questions you may have or if you need further clarification of any information presented in this document.
Regards,
_______________________________
Doug Leto
Eastern Regional Construction Manager
Starr Specialty Lines Insurance Agency, LLC
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BROKER RESPONSIBLE FOR SURPLUS LINES FILINGS
TO: RETURN TO:
Producer Name : ________________________ Insured: __________________________
Address 1: _____________________________ Policy # __________________________
City: ___________ State: _______ Zip: Effective Date: _____________________
___________
This policy is written on a surplus lines basis by (please check the appropriate box):
X Starr Surplus Lines Insurance Company
in the state(s) of:___________________________________________________
As the producing broker, it is your responsibility to arrange for the payment of the state tax and/or stamping fee
on 100% of the premium for this policy.
Please return a copy of this letter within 10 business days of receipt with your acknowledgment that you have arranged for the filing
and payment of the surplus lines tax and/or stamping fee in accordance with the state regulation.
PLEASE ATTACH A COPY OF YOUR CURRENT SURPLUS LINES LICENSE IF ONE IS NOT CURRENTLY ON FILE.
*Please list licensed resident surplus lines broker:
Individuals Name: ______________________ Firm Name: ___________________________
Firm Address:__________________________ Surplus Lines License#: _________________
(for state where the risk is located)
New Jersey SLA # (Transaction Number) assigned for this policy (if a NJ risk):____________________
Tax and/or fee paid:
STATE: ___________________ AMOUNT OF PREMIUM ALLOCATED $ __________________
FEE: $ ________________________ TAX: $ _________________________
By: __________________________ _____________________________ _____________
Producing Broker signature Producing broker (Print Name) Date
*The producing broker agrees that, upon request by the company or any insurance regulator, the broker will provide a copy of all
surplus lines licenses referenced above as well as any documentation supporting the payment of surplus lines taxes.
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STARR SPECIALTY LINES
POLICYHOLDER DISCLOSURE STATEMENT
UNDER
TERRORISM RISK INSURANCE ACT, AS AMENDED
You are hereby notified that under the federal Terrorism Risk Insurance Act of 2002, as amended (the “Act”),
you now have a right to purchase insurance coverage for losses arising out of an Act of Terrorism, which is
defined in the Act as an act certified by the Secretary of the Treasury in consultation with the Secretary of
Homeland Security and the Attorney General of the United States (i) to be an act of terrorism, (ii) to be a violent
act or an act that is dangerous to (A) human life; (B) property or (C) infrastructure, (iii) to have resulted in
damage within the United States, or outside of the United States in case of an air carrier or vessel or the
premises of a U.S. mission and (iv) to have been committed by an individual or individuals as part of an effort
to coerce the civilian population of the United States or to influence the policy or affect the conduct of the
United States Government by coercion. You should read the Act for the definition of an “Act of Terrorism” and
other terms of the Act. The Secretary’s decision to certify or not to certify an event as an Act of Terrorism and
thus encompassed by this law is final and not subject to review. Coverage is subject to all policy exclusions
(including nuclear hazard and war exclusions) and other policy provisions.
YOU SHOULD ALSO KNOW THAT THE TERRORISM RISK INSURANCE ACT, AS AMENDED, CONTAINS A $100
BILLION CAP THAT LIMITS U.S. GOVERNMENT REIMBURSEMENT AS WELL AS INSURERS’ LIABIITY FOR
LOSSES RESULTING FROM CERTIFIED ACTS OF TERRORISM WHEN THE AMOUNT OF SUCH LOSSES IN ANY
ONE CALENDAR YEAR EXCEEDS $100 BILLION. IF THE AGGREGATE INSURED LOSSES FOR ALL INSURERS
EXCEED $100 BILLION, COVERAGE MAY BE REDUCED.
For your information, coverage provided by this policy for losses caused by an Act of Terrorism may be partially reimbursed by the
United States under a formula established by the Act. Under this formula, the United States pays a share, as per the schedule shown
below, of terrorism losses covered by this law exceeding a statutorily established deductible that must be met by the insurer. This
deductible is based on a percentage of the insurer’s direct earned premiums for the year preceding the Act of Terrorism.
Schedule – Federal Share of Terrorism Losses:
85% Year 2015
84% Year 2016
83% Year 2017
82% Year 2018
81% Year 2019
80% Year 2020
Unless you reject coverage under the Act by so indicating below and returning this Policyholder Disclosure statement to us, you will
have accepted Terrorism coverage under the Act at a premium of $3,047 for a limit of $85,250,000 part of $85,250,000.
Please indicate your selection below.
______ I hereby elect to purchase coverage in accordance with the Act.
______ I hereby reject coverage and accept the exclusion in accordance with the Act.
_________________________
Signature of Insured Date
Print Name/Title
1/2015
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TERRORISM
As respects Acts of Terrorism as defined by the Terrorism Risk Insurance Act of 2002, as amended, the Insured has the option to
exclude this coverage. To exclude coverage the Insured must affirmatively opt out of the coverage by signing the attached
Policyholder Disclosure Statement prior to binding. If the Insured elects to exclude coverage, then the attached Terrorism Exclusion
(Form #61330 – 01/15) shall be endorsed on to the Policy.
Coverage option for Acts of Terrorism not Certified under the Terrorism Risk Insurance Act, as amended, is included in this offer.
In all cases, Terrorism coverage outside of the United States is excluded. (Endorsement NMA 2918)
The table below can be used to determine the endorsements and documentation that are needed to effect coverage desired by the
Insured.
Certified Terrorism Applicable Terrorism
Coverage (TRIA) Exclusion
purchased 61333
rejected 61330 and 61331
(1/15)
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THIS ENDORSEMENT CHANGES YOUR POLICY. PLEASE READ IT CAREFULLY.
TERRORISM EXCLUSION
(FOR CERTIFIED ACTS OF TERRORISM UNDER THE TERRORISM RISK INSURANCE ACT, AS
AMENDED)
This Policy excludes loss, damage, cost or expense, arising directly or indirectly as a result of a “certified act of
terrorism” as defined by the Terrorism Risk Insurance Act of 2002, as amended (“the Act”), and any revisions
or amendments thereto, regardless of any other cause or event contributing concurrently or in any other
sequence to the loss.
For purposes of this endorsement and in compliance with the Act, “certified act of terrorism” shall mean an act
that is certified by the Secretary of the Treasury in consultation with the Secretary of Homeland Security and
the Attorney General of the United States, to be an act of terrorism pursuant to the Act. The criteria contained in
that Act for a "certified act of terrorism" include the following:
1. The act resulted in aggregate losses in excess of $5 million; and
2. The act is a violent act or an act that is dangerous to human life, property or
infrastructure and is committed by an individual or individuals as part of an effort to coerce the civilian
population of the United States or to influence the policy or affect the conduct of the United States Government
by coercion.
However, if an act of terrorism results in a fire and the direct physical loss or damage to property insured
hereunder located in any State of the United States, the District of Columbia, the Commonwealth of Puerto
Rico, the Commonwealth of the Northern Mariana Islands, American Samoa, Guam, each of the United States
Virgin Islands and any territory or possession of the United States, that, either pursuant to the Standard Fire
Policy or otherwise, prohibits exclusions for acts of terrorism that result in fire, this Company will pay for the
loss or damage caused by that fire. Such coverage for fire applies only to direct loss or damage to property
insured hereunder and may be limited, in accordance with the Standard Fire Policy to the lesser of the actual
cash value of the property at the time of the loss, or the amount which it would cost to repair or replace the
property, without allowance for any increased cost of repair or replacement by reason of any ordinance or law,
and without any compensation for business interruption, extra expense to continue business activities, or any
other coverage for loss or damage other than direct physical loss or damage to the property insured hereunder.
With respect to fire resulting from any one or more acts of terrorism, this Company will not pay any amounts
for which this Company is not responsible under the terms of the Act (including subsequent Congressional
action pursuant to the Act) due to the application of Section 103 of the Act or any clause that results in a cap on
our liability for payments for terrorism losses.
THE TERRORISM RISK INSURANCE ACT, AS AMENDED, CONTAINS A $100 BILLION CAP
THAT LIMITS U.S. GOVERNMENT REIMBURSEMENT AS WELL AS INSURERS’ LIABIITY FOR
LOSSES RESULTING FROM CERTIFIED ACTS OF TERRORISM WHEN THE AMOUNT OF
SUCH LOSSES IN ANY ONE CALENDAR YEAR EXCEEDS $100 BILLION. IF THE AGGREGATE
INSURED LOSSES FOR ALL
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FILED: NEW YORK COUNTY CLERK 09/04/2020 11:56 AM INDEX NO. 652321/2020 NYSCEF DOC. NO. 5 RECEIVED NYSCEF: 09/04/2020 EXHIBIT A FILED: NEW YORK COUNTY CLERK 09/04/2020 11:56 AM INDEX NO. 652321/2020 NYSCEF DOC. NO. 5 RECEIVED NYSCEF: 09/04/2020 Douglas A Leto 399 Park Avenue, 9th Floor Eastern Regional Construction Manager New York, NY 10022 Phone: (212) 884-0529 douglas.leto@starrcompanies.com NON-BINDING INDICATION QUOTATION BINDER POLICY NUMBER: TBA Date: March 20, 2017 Proposal No.: 01 Replaces Proposal Dated: N/A Broker Name, Company & Address Ms. Kristin Wisner, Account Manager McGriff, Seibels & Williams, Inc. 2211 7th Avenue South Birmingham, AL 35233 Telephone No. (205) 581-9428 Email Address KWisner@McGriff.com Starr Surplus Lines Insurance Company, with an A.M. Best Financial Strength Rating of A (Excellent), and a Financial Size Category of XV (non-admitted) is pleased to offer the following, subject to additional information as outlined at the conclusion of this document. NAMED INSURED: E.E. Cruz & Company, Inc. MAILING ADDRESS: 32 Avenue of the Americas, 13th Floor New York, NY 10013 ADDITIONAL INSURED: Architects, engineers, manufacturers, suppliers, contractors and subcontractors of every tier, as respects their work at the project site To the extent required by any contract or subcontract for an INSURED PROJECT*, and then only as their respective interests may appear, all owners, all contractors and subcontractors of every tier, tenants of the INSURED PROJECT* and any other individual or entity specified, in such contract or subcontract are recognized as Additional Insured’s hereunder. Additional Insured’s as provided above, shall be as shown on ACORD Certificates of Insurance issued by the Broker copies of which will be forwarded to this Company and kept on file. The first Named Insured shall be deemed the sole and irrevocable agent of each and every Insured hereunder for the purpose of giving and receiving notices to and/or from this Company, giving instruction to or agreeing with this Company as respects Policy alteration and for making or receiving payments of premium or adjustments to premium. Page 1 of 21 FILED: NEW YORK COUNTY CLERK 09/04/2020 11:56 AM INDEX NO. 652321/2020 NYSCEF DOC. NO. 5 RECEIVED NYSCEF: 09/04/2020 PROJECT NAME: Region 8 Bridge Replacements PROJECT This project involves the replacement of three bridges.One on East 3rd Street over Route 907W and DESCRIPTION: the Hutchinson River in Pelham, NY, 190 feet long and the other two on Route 987D over the Saw Mill River in Greenburgh, NY, 190 feet and 150feet long. Construction is steel girder and concrete. PROJECT LOCATIONS: E 3rd Street and Hutchinson River Parkway, Pelham, NY Latitude 40.906252 Longitude -73.813790 Route 987D over Saw Mill River, Greenburgh, NY Latitude 41.044008 Longitude -73.834975 ESTIMATED TOTAL $ 85,000,000 Physical Damage (hard costs + owner supplied material + non-time element soft cost) CONTRACT VALUE: $ 250,000 Existing Property $ Not Covered Delay In Completion – Soft Costs (time element exposure) $ Not Covered Delay In Completion – Loss of Rental Income $ Not Covered Delay In Completion – Loss of Gross Earnings $ 85,250,000 Estimated TOTAL CONTRACT VALUE POLICY TERRITORY: This Policy covers within the fifty (50) States comprising the United States of America, including the District of Columbia, except that we will not cover property in transit by water or air traveling to or from Alaska or Hawaii regardless of origin of shipments. POLICY TERM: Effective: June 1, 2017 To: April 1, 2019 (669 days or 22 months or 1.833 years). Including Not Covered consecutive days of Hot Testing As respects Delay in Completion Coverage, the Period of Indemnity shall be Not Covered Consecutive Calendar Days. Coverage provided hereunder shall attach as of the date shown on the declarations page and shall continue in full force and effect until: A. When the owner or buyer accepts the property; B. When the interest of the Named Insured ceases; C. Beyond sixty (60) days after completion of the project; D. When the Named Insured abandons the construction with no intention to complete it; or E. When this Policy expires or is cancelled; Whichever first occurs. In the event that an owner places insurance on any portion of the work which has been declared and accepted as Substantially Complete or any portion of the work is occupied or placed into commercial service for its intended purpose, coverage as respects such portion of the work shall cease as of the Substantial Completion Date as stated in the Certificate of Substantial Completion, the date of occupancy or the date of commercial service, whichever first occurs Page 2 of 21 FILED: NEW YORK COUNTY CLERK 09/04/2020 11:56 AM INDEX NO. 652321/2020 NYSCEF DOC. NO. 5 RECEIVED NYSCEF: 09/04/2020 SECURITY: Starr Surplus Lines Insurance Company POLICY FORM: Starr Specialty Completed Value Construction All Risk Policy COVERAGE: All-Risk of direct physical loss or damage, including Land Movement and Flood and Named Windstorm and Delay In Completion STARR SPECIALTY LINES PARTICIPATION: 100% being $85,250,000 part of $85,250,000 100% POLICY LIMIT OF LIABILITY: The Company will not be liable for more than its proportion of $85,250,000 in any one occurrence and further subject to its proportion of the following limits, sublimits and aggregate limits: POLICY SUBLIMITS & $ 85,000,000 Physical Damage to the INSURED PROJECT* AGGREGATE LIMITS $ 250,000 Physical Damage to Existing Property Legal Liability All Risk $ Not Covered Delay In Completion - Loss of Rental Income (subject to scheduled sub-limits & policy term aggregate) – not exceeding $____ Maximum Monthly Indemnity $ Not Covered Delay In Completion - Loss of Gross Earnings (subject to scheduled sub-limits & Application of all sub-limits policy term aggregate) - not exceeding $____ Maximum Monthly Indemnity is per occurrence unless $ Not Covered Delay In Completion – Soft Costs (time element exposures only) including expense noted otherwise to avoid or reduce a Delay in opening, not exceeding $____ Maximum Monthly Indemnity subject to specific sub-limits & policy term aggregate as follows: Coverage is excluded when $ 85,250,000 LAND MOVEMENT* Physical Damage and Delay Combined (annual aggregate) a sublimit is blank $ Not Covered FLOOD* Physical Damage and Delay Combined (annual aggregate) $ 85,250,000 NAMED WINDSTORM* Physical Damage and Delay Combined (annual Sub-limits are part of policy aggregate) limit, not in addition thereto $ 85,250,000 All Other WINDSTORM* Physical Damage and Delay Combined (annual aggregate) $ 1,000,000 Physical Damage to property in Inland Transit (per conveyance) $ 5,000,000 Physical Damage to property in Offsite Temporary Storage (per location) $ 5,000,000 or 25% of the amount of physical loss or damage to insured property, whichever is less – Debris Removal (180 days reporting) $ 5,000,000 Ordinance & Law / Demolition & Increased Cost of Construction $ Not Covered Interior Water Intrusion Damage $ 250,000 Architects and/or Engineers and Professional Fees (in restoration following an insured loss) $ 500,000 or 20% of the amount of physical loss or damage to insured property, whichever is less – Expediting Expense $ 100,000 Emergency Property Protection Expense (applies for up to thirty (30) consecutive days) $ 100,000 Trees, Shrubs, Plantings & Landscaping Materials (maximum $5,000 per item) $ 100,000 Plans & Blueprints & Other Contract Documents $ 100,000 Fire Brigade Service Charges & Extinguishing Expenses $ 100,000 Pollution & Contamination Cleanup & Decontamination (Policy Term Aggregate) $ 50,000 Claim Preparation Costs (exclude Public Adjuster costs) $ Not Covered Mold & Fungus Remediation (Policy Term Aggregate) $ Not Covered Civil Authority / Ingress Egress (30 days / within 10 statute miles) $ Not Covered Service Interruption Extension (14 days) $ Not Covered Green Building Coverage 10% Escalation – Physical Damage to the Insured Project 90 Days Extension of Policy Term (at pro-rata additional premium) Included Cold Testing Page 3 of 21 FILED: NEW YORK COUNTY CLERK 09/04/2020 11:56 AM INDEX NO. 652321/2020 NYSCEF DOC. NO. 5 RECEIVED NYSCEF: 09/04/2020 DEDUCTIBLES: From the amount of each claim for insured loss or damage arising out of any one occurrence, there shall be deducted the applicable amount shown below, and then the liability of this Company shall be only for the amount of such insured loss or damage in excess thereof, subject to the limit of liability, sublimits of liability or annual aggregate limits of liability set forth above: When a percentage (%) is $ 100,000 as respects all other perils Physical Damage, except entered absent a $ N/A as respects WATER DAMAGE* other than FLOOD*; corresponding minimum 0 % of the total insured values at risk at the time and place of loss subject to a minimum dollar amount, the deduction of $N/A as respects the peril of FLOOD* except percentage shall be applied 0 % of the total insured values at risk at the time and place of loss subject to a minimum without minimum. When a deduction of $100,000 as respects the peril of LAND MOVEMENT* dollar amount is entered 0 % of the total insured values at risk at the time and place of loss subject to a minimum absent a corresponding deduction of $100,000 as respects the peril of NAMED WINDSTORM*; percentage (%), the word 0 % of the total insured values at risk at the time and place of loss subject to a minimum minimum is deleted deduction of $100,000 as respects the peril of Windstorm; $ N/A to property insured while undergoing HOT TESTING*; N/A days Per Occurrence deductible period – Delay In Completion/ Soft Costs In the event that more than one physical damage deductible is shown herein, or specified in any endorsement issued hereunder applies to insured physical loss or damage in any one OCCURRENCE*,, only the largest deductible shall be applied. Where an extension of coverage applies the base property damage deductible shall apply unless otherwise stated. As respects Delay In Completion coverage, the deductible period stated in the Delay In Completion Endorsement attached to the policy and also shown above, will always be applied in addition to any dollar deductible or percentage (%) deductible stated for physical damage. ANNUAL RATES: $0.06500 / $100 Physical Damage $N/A / $100 Delay In Completion $N/A / $100 Physical Damage Existing Property $N/A / $100 Hot Testing (30 consecutive Days) Rates are applied against declared estimated total contract values and estimated project term TERM PREMIUM – 100% $ 101,571 Physical Damage $ N/A Delay In Completion $ N/A Hot Testing (30 consecutive Days) $ 101,571 Total Term Policy Premium $ 3,047 Certified and Non Certified Terrorism Premium (optional & in addition to above) (refer to Disclosure Notice attached) $ 104,618 Total Term Policy Premium including Terrorism Starr Specialty 100% SHARE $ 101,571 Total Policy Premium (subject to 25 % minimum & earned premium) $ 3,047 Certified and Non Certified Terrorism Premium (optional & in addition to above) (refer to Disclosure Notice attached) $ 104,618 Total Starr Specialty Premium including Terrorism ADDITIONAL $ 54,848 $5,000,000 Loss Limit – Term Premium Plus $1,645 Terrorism; $100,000 COVERAGE OPTIONS: Deductible Page 4 of 21 FILED: NEW YORK COUNTY CLERK 09/04/2020 11:56 AM INDEX NO. 652321/2020 NYSCEF DOC. NO. 5 RECEIVED NYSCEF: 09/04/2020 ADDITIONAL Deductible $ N/A OPTIONS: $ N/A PREMIUM 1 100% Payable within 30 days of policy inception PAYMENT 2 0% Payable by N/A SCHEDULE: 3 0% Payable by N/A 4 0% Payable by N/A All premiums are adjustable upon project completion based on final total contract value and actual project term at the rates stated above Applicable Surplus Lines taxes and fees are in addition to the premiums stated above. BROKER RESPONSIBLE FOR SURPLUS LINES FILINGS COMMISSION: 15% CANCELLATION: N/A days except 10 days for nonpayment of premium PERILS INSURED: Subject to the terms, exclusions, limitations and conditions contained in or endorsed to the Policy, coverage is provided against all risks of direct physical loss of or damage to property insured while at the location of the INSURED PROJECT*, while in offsite storage or while in transit, during Cold Testing, all within the Policy territory and occurring during the Period of Insurance of this Policy. PERILS EXCLUDED: Loss, damage or expense caused by, resulting from, contributed to or made worse by any of the following excluded perils, all whether direct or indirect, proximate or remote or in whole or in part caused by, contributed to or aggravated by any physical loss or damage insured by this Policy, except as specifically allowed in the Policy: Consequential loss, damage or expense; Cost of making good fault, defect, error, deficiency or omission in workmanship, supplies, materials, designs, plans or specifications (resultant damage is covered); War; Nuclear; Inventory Shortage; Infidelity & Dishonesty; Fungus; Pollution & Contamination; Asbestos; Loss or damage covered by manufacturer / supplier guarantee or warranty; Normal subsidence, settling, cracking, expansion, contraction or shrinkage; Cessation of work; Infestation, disease, freeze, drought, hail, ice, snow, vermin, rodent and animal damage to trees, plants shrubs and landscaping; Erosion of finish or rough grades from runoff; Electrical / mechanical injury or error / omission in creating processing or copying electronic records; Millennium exclusion; Cyber risk-data recognition; Nuclear, chemical or biological terrorism; Water damage to property in the open or from water entering a building through unprotected openings and other perils per standard Starr Companies policy form PROPERTY INSURED: Permanent Works - All materials, supplies, equipment, machinery, and other property of a similar nature, being property of the Insured or of others for which the Insured may be contractually responsible, the value of which has been included in the estimated value of the INSURED PROJECT* in Section I-9.,all when used or to be used in or incidental to the demolition of existing structures,site preparation, fabrication or assembly, installationor erection or the construction of or alteration,renovation, rehabilitation of the INSURED PROJECT*; Page 5 of 21 FILED: NEW YORK COUNTY CLERK 09/04/2020 11:56 AM INDEX NO. 652321/2020 NYSCEF DOC. NO. 5 RECEIVED NYSCEF: 09/04/2020 Temporary works - All scaffolding, form work, fences, shoring, hoarding, falsework and temporary buildings all incidental to the project and the value of which has been included in the estimated value of the INSURED PROJECT*. PROPERTY EXCLUDED: Land & land value; Water; Ocean Cargo, Vehicles, Existing Property; Testing of prototypical equipment; Testing of used equipment; Property located at other than project site except while in transit or temporary storage or offsite fabrication; Contractor’s tools and equipment and other property per the policy form. VALUATION: Property Under Construction – The cost to repair or replace the lost or damaged property, valued as of the time and place of loss, with material of like kind and quality, less betterment, including contractor’s reasonable profit and overhead in the same proportion as that included in the original contract documents. If not so replaced, loss shall be settled on an Actual Cash Value basis with proper deduction for depreciation and exclusive of overhead and profit Temporary Works – The actual cash value of the lost or damaged property valued as of the time and place of loss Property Of Others (including items supplied by the owner or for which the Insured is legally responsible) - The cost to repair or replace the property lost or damaged with material of like kind and quality including contractor's charges incurred prior to loss and related to such property, if any, less betterment, or the property owner's cost, whichever is less Existing Property - The cost to repair or replace the lost or damaged property with material of like kind and quality valued as of the time and place of loss. In the event that repair or replacement with materials of like kind and quality cannot be effected due to obsolescence or non-availability of such materials or the means and methods of fabricating, manufacturing, or installing such materials, repair or replacement shall be effected with materials, means and / or methods that are functionally equivalent to the lost or damaged property but excluding betterment. If not so replaced, loss shall be settled at Actual Cash Value (the cost to repair or replace as determined above, less depreciation) Plans, Blueprints, Drawings, Renderings, Specifications Or Other Contract Documents And Models – The cost to reproduce with property of like kind and quality including the cost of gathering or assembling information from back up data if replaced. If not replaced - the value of blank material Trees, Shrubs, Plantings And Landscaping - The cost to replace with property of like kind, quality and size plus the proper proportion of labor expended if such damage occurs after installation Property In Transit – The invoice cost plus accrued shipping charges less shipper's liability, if any Delay In Completion Coverage – Actual Loss Sustained Page 6 of 21 FILED: NEW YORK COUNTY CLERK 09/04/2020 11:56 AM INDEX NO. 652321/2020 NYSCEF DOC. NO. 5 RECEIVED NYSCEF: 09/04/2020 OTHER TERMS APPLYING: OTHER TERMS Permission to Occupy Unlimited Continuous weeks of coverage. The Insured shall APPLYING: immediately report any increase in hazard beyond that provided for in the Policy. All fire protection, security and other protective devices and systems shall be installed, tested, activated and, where required, certifiedby local authorities. Protective Safeguards Fenced Jobsite Perimeter Applicable Watchman / Security Service – non-working hours Fire Hydrants Within 500’ – Tested & Operational Exterior Lighting Brush / Vegetation Control Cameras Other (define) Favorable Inspection & compliance with recommendations, if any Coverages and/or Extensions of Coverage not specifically shown above are not included. No Coinsurance. Coverage shall be primary and non-contributory Automatic reinstatement of loss applies except as respects any coverage subject to an annual or policy term aggregate Knowledge of Occurrence – knowledge by Risk Management department only No premium adjustment shall take place if the difference is 3% or less Page 7 of 21 FILED: NEW YORK COUNTY CLERK 09/04/2020 11:56 AM INDEX NO. 652321/2020 NYSCEF DOC. NO. 5 RECEIVED NYSCEF: 09/04/2020 POLICY FORMS & ENDORSEMENTS APPLICABLE: Starr Specialty Builders Risk Form Starr Specialty Completed Value Construction/Erection All Risk Form Delay In Opening Endorsement Starr Terrorism Endorsements Service of Suit Clause (samples attached) Starr Electronic Data/Media, Asbestos and Political Risk endorsements (samples attached) OFAC (samples attached) Piling, Sheetpiling & Caisson Endorsement Dewatering Endorsement Ingress or Egress and Civil Authority Service Interruption Extension Damage to Existing Property Damage to Existing Property – Boiler & Machinery Earthquake Limitation - California Code #7105 Modified Asbestos Exclusion Green Building Coverage LEG 3/06 Contingent Delay in Completion Extension Protective Safeguard Endorsement Concealed Damage Marine Cargo 50-50 Clause Dredging Exclusion Break & Review Claus Wet Works Dam, Cofferdam & Tunnel Endorsement Open Trench during laying of Pipeline Serial Loss Horizontal Directional Drilling Endorsement Historic Valuation Endorsement Pipeline Leak Search THE COMPANY MAY WITHDRAW THIS QUOTATION AT ANY TIME PRIOR TO ACCEPTANCE AND IN NO EVENT WILL IT REMAIN OPEN FOR ACCEPTANCE BEYOND 30 DAYS FROM THE DATE OF THIS DOCUMENT. COVERAGE MAY NOT BE BOUND WITHOUT PRIOR WRITTEN AUTHORIZATION FROM THE COMPANY. Page 8 of 21 FILED: NEW YORK COUNTY CLERK 09/04/2020 11:56 AM INDEX NO. 652321/2020 NYSCEF DOC. NO. 5 RECEIVED NYSCEF: 09/04/2020 ADDITIONAL UNDERWRITING INFORMATION REQUIRED AS A CONDITION OF BINDING COVERAGE If an item is checked (x) below it is a required part of the basis for the terms and conditions set forth herein. Any item(s) outstanding at the time a binder is requested may be cause for withdrawal or amendment of these terms and conditions Breakdown Of Estimated Total Contract Values Breakdown of construction contract value by bridge Owner or third party supplied material to be installed and not included above Value of existing property to be insured and forming a part of the project Detailed itemized breakdown of Soft Cost line items to be insured by Phase Pro forma income statement for Loss of Rental Income coverage Pro forma income statement for Loss of Profit Construction Schedule Critical Path or Bar Chart / Time Line / Gantt Chart Project Plans Site or Plot Plan Elevation Plan Typical Floor Plan Structural Framing Plan and Cross Sections (for large span open spaces within a structure) Cross Sections (for dams and tunnels) Profiles (for tunnels and underground / underwater utilities whether bored, drilled or trenched) Geotechnical Summary Geotechnical Report for all projects (1) requiring deep foundations, (2) in an ISO Earthquake Zone 1 or 2, (3) in close proximity to quarries or underground / aboveground mines (active or abandoned) or areas of past sinkhole activity, all (4) bridges, dams, tunnels and all other underground construction and (5) all coastal exposures For all other projects the type of foundation to be utilized (e.g. pad, raft, piled) Other Items As Listed Below Equipment Nameplate Data Federal Emergency Management Agency Standard Flood Hazard Determination (FEMA Form 81-93) Statement of contractor experience with similar projects Contractor's construction method statement and risk assessment Heavy lifts and number of mobile and fixed cranes Comprehensive dilapidation survey on the existing buildings Details of the demolition and construction procedures Fit out specifications Flood history at the site and precautions Modifications to foundations Existing and serviceable sprinkler systems which will be fully in place during the entire construction period and details of the fire protection and fire precautions to be utilized Brokers Manuscript Policy Form Prior to binding we will need a completed and signed copy of the attached Terrorism Disclosure and Surplus Lines Filing Agreement. Page 9 of 21 FILED: NEW YORK COUNTY CLERK 09/04/2020 11:56 AM INDEX NO. 652321/2020 NYSCEF DOC. NO. 5 RECEIVED NYSCEF: 09/04/2020 Please call with any questions you may have or if you need further clarification of any information presented in this document. Regards, _______________________________ Doug Leto Eastern Regional Construction Manager Starr Specialty Lines Insurance Agency, LLC Page 10 of 21 FILED: NEW YORK COUNTY CLERK 09/04/2020 11:56 AM INDEX NO. 652321/2020 NYSCEF DOC. NO. 5 RECEIVED NYSCEF: 09/04/2020 BROKER RESPONSIBLE FOR SURPLUS LINES FILINGS TO: RETURN TO: Producer Name : ________________________ Insured: __________________________ Address 1: _____________________________ Policy # __________________________ City: ___________ State: _______ Zip: Effective Date: _____________________ ___________ This policy is written on a surplus lines basis by (please check the appropriate box): X Starr Surplus Lines Insurance Company in the state(s) of:___________________________________________________ As the producing broker, it is your responsibility to arrange for the payment of the state tax and/or stamping fee on 100% of the premium for this policy. Please return a copy of this letter within 10 business days of receipt with your acknowledgment that you have arranged for the filing and payment of the surplus lines tax and/or stamping fee in accordance with the state regulation. PLEASE ATTACH A COPY OF YOUR CURRENT SURPLUS LINES LICENSE IF ONE IS NOT CURRENTLY ON FILE. *Please list licensed resident surplus lines broker: Individuals Name: ______________________ Firm Name: ___________________________ Firm Address:__________________________ Surplus Lines License#: _________________ (for state where the risk is located) New Jersey SLA # (Transaction Number) assigned for this policy (if a NJ risk):____________________ Tax and/or fee paid: STATE: ___________________ AMOUNT OF PREMIUM ALLOCATED $ __________________ FEE: $ ________________________ TAX: $ _________________________ By: __________________________ _____________________________ _____________ Producing Broker signature Producing broker (Print Name) Date *The producing broker agrees that, upon request by the company or any insurance regulator, the broker will provide a copy of all surplus lines licenses referenced above as well as any documentation supporting the payment of surplus lines taxes. Page 11 of 21 FILED: NEW YORK COUNTY CLERK 09/04/2020 11:56 AM INDEX NO. 652321/2020 NYSCEF DOC. NO. 5 RECEIVED NYSCEF: 09/04/2020 STARR SPECIALTY LINES POLICYHOLDER DISCLOSURE STATEMENT UNDER TERRORISM RISK INSURANCE ACT, AS AMENDED You are hereby notified that under the federal Terrorism Risk Insurance Act of 2002, as amended (the “Act”), you now have a right to purchase insurance coverage for losses arising out of an Act of Terrorism, which is defined in the Act as an act certified by the Secretary of the Treasury in consultation with the Secretary of Homeland Security and the Attorney General of the United States (i) to be an act of terrorism, (ii) to be a violent act or an act that is dangerous to (A) human life; (B) property or (C) infrastructure, (iii) to have resulted in damage within the United States, or outside of the United States in case of an air carrier or vessel or the premises of a U.S. mission and (iv) to have been committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. You should read the Act for the definition of an “Act of Terrorism” and other terms of the Act. The Secretary’s decision to certify or not to certify an event as an Act of Terrorism and thus encompassed by this law is final and not subject to review. Coverage is subject to all policy exclusions (including nuclear hazard and war exclusions) and other policy provisions. YOU SHOULD ALSO KNOW THAT THE TERRORISM RISK INSURANCE ACT, AS AMENDED, CONTAINS A $100 BILLION CAP THAT LIMITS U.S. GOVERNMENT REIMBURSEMENT AS WELL AS INSURERS’ LIABIITY FOR LOSSES RESULTING FROM CERTIFIED ACTS OF TERRORISM WHEN THE AMOUNT OF SUCH LOSSES IN ANY ONE CALENDAR YEAR EXCEEDS $100 BILLION. IF THE AGGREGATE INSURED LOSSES FOR ALL INSURERS EXCEED $100 BILLION, COVERAGE MAY BE REDUCED. For your information, coverage provided by this policy for losses caused by an Act of Terrorism may be partially reimbursed by the United States under a formula established by the Act. Under this formula, the United States pays a share, as per the schedule shown below, of terrorism losses covered by this law exceeding a statutorily established deductible that must be met by the insurer. This deductible is based on a percentage of the insurer’s direct earned premiums for the year preceding the Act of Terrorism. Schedule – Federal Share of Terrorism Losses: 85% Year 2015 84% Year 2016 83% Year 2017 82% Year 2018 81% Year 2019 80% Year 2020 Unless you reject coverage under the Act by so indicating below and returning this Policyholder Disclosure statement to us, you will have accepted Terrorism coverage under the Act at a premium of $3,047 for a limit of $85,250,000 part of $85,250,000. Please indicate your selection below. ______ I hereby elect to purchase coverage in accordance with the Act. ______ I hereby reject coverage and accept the exclusion in accordance with the Act. _________________________ Signature of Insured Date Print Name/Title 1/2015 Page 12 of 21 FILED: NEW YORK COUNTY CLERK 09/04/2020 11:56 AM INDEX NO. 652321/2020 NYSCEF DOC. NO. 5 RECEIVED NYSCEF: 09/04/2020 TERRORISM As respects Acts of Terrorism as defined by the Terrorism Risk Insurance Act of 2002, as amended, the Insured has the option to exclude this coverage. To exclude coverage the Insured must affirmatively opt out of the coverage by signing the attached Policyholder Disclosure Statement prior to binding. If the Insured elects to exclude coverage, then the attached Terrorism Exclusion (Form #61330 – 01/15) shall be endorsed on to the Policy. Coverage option for Acts of Terrorism not Certified under the Terrorism Risk Insurance Act, as amended, is included in this offer. In all cases, Terrorism coverage outside of the United States is excluded. (Endorsement NMA 2918) The table below can be used to determine the endorsements and documentation that are needed to effect coverage desired by the Insured. Certified Terrorism Applicable Terrorism Coverage (TRIA) Exclusion purchased 61333 rejected 61330 and 61331 (1/15) Page 13 of 21 FILED: NEW YORK COUNTY CLERK 09/04/2020 11:56 AM INDEX NO. 652321/2020 NYSCEF DOC. NO. 5 RECEIVED NYSCEF: 09/04/2020 THIS ENDORSEMENT CHANGES YOUR POLICY. PLEASE READ IT CAREFULLY. TERRORISM EXCLUSION (FOR CERTIFIED ACTS OF TERRORISM UNDER THE TERRORISM RISK INSURANCE ACT, AS AMENDED) This Policy excludes loss, damage, cost or expense, arising directly or indirectly as a result of a “certified act of terrorism” as defined by the Terrorism Risk Insurance Act of 2002, as amended (“the Act”), and any revisions or amendments thereto, regardless of any other cause or event contributing concurrently or in any other sequence to the loss. For purposes of this endorsement and in compliance with the Act, “certified act of terrorism” shall mean an act that is certified by the Secretary of the Treasury in consultation with the Secretary of Homeland Security and the Attorney General of the United States, to be an act of terrorism pursuant to the Act. The criteria contained in that Act for a "certified act of terrorism" include the following: 1. The act resulted in aggregate losses in excess of $5 million; and 2. The act is a violent act or an act that is dangerous to human life, property or infrastructure and is committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. However, if an act of terrorism results in a fire and the direct physical loss or damage to property insured hereunder located in any State of the United States, the District of Columbia, the Commonwealth of Puerto Rico, the Commonwealth of the Northern Mariana Islands, American Samoa, Guam, each of the United States Virgin Islands and any territory or possession of the United States, that, either pursuant to the Standard Fire Policy or otherwise, prohibits exclusions for acts of terrorism that result in fire, this Company will pay for the loss or damage caused by that fire. Such coverage for fire applies only to direct loss or damage to property insured hereunder and may be limited, in accordance with the Standard Fire Policy to the lesser of the actual cash value of the property at the time of the loss, or the amount which it would cost to repair or replace the property, without allowance for any increased cost of repair or replacement by reason of any ordinance or law, and without any compensation for business interruption, extra expense to continue business activities, or any other coverage for loss or damage other than direct physical loss or damage to the property insured hereunder. With respect to fire resulting from any one or more acts of terrorism, this Company will not pay any amounts for which this Company is not responsible under the terms of the Act (including subsequent Congressional action pursuant to the Act) due to the application of Section 103 of the Act or any clause that results in a cap on our liability for payments for terrorism losses. THE TERRORISM RISK INSURANCE ACT, AS AMENDED, CONTAINS A $100 BILLION CAP THAT LIMITS U.S. GOVERNMENT REIMBURSEMENT AS WELL AS INSURERS’ LIABIITY FOR LOSSES RESULTING FROM CERTIFIED ACTS OF TERRORISM WHEN THE AMOUNT OF SUCH LOSSES IN ANY ONE CALENDAR YEAR EXCEEDS $100 BILLION. IF THE AGGREGATE INSURED LOSSES FOR ALL