Preview
FILED: NEW YORK COUNTY CLERK 12/09/2022 08:41 PM INDEX NO. 652321/2020
NYSCEF DOC. NO. 115 RECEIVED NYSCEF: 12/09/2022
Exhibit F
FILED: NEW YORK COUNTY CLERK 12/09/2022 08:41 PM INDEX NO. 652321/2020
NYSCEF DOC. NO. 115 RECEIVED NYSCEF: 12/09/2022
STA: SPECIALTY LINES
Douglas A Leto 399 Park Avenue, 9" 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 7 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, 13 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 thisCompany, 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
STARRUW01150
CONFIDENTIAL INFORMATION
FILED: NEW YORK COUNTY CLERK 12/09/2022 08:41 PM INDEX NO. 652321/2020
NYSCEF DOC. NO. 115 RECEIVED NYSCEF: 12/09/2022
|
PROJECT NAME: |
Region 8 Bridge Replacements
PROJECT This project involves the replacement of three bridges. One on East 3° 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 3" 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 $5,000,000 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 coverproperty 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:
When the owner or buyer accepts the property;
When the interest of the Named Insured ceases;
Beyond sixty (60) days after completion of the project;
When the Named Insured abandons the construction with no intention to complete it; or
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
STARRUW01151
CONFIDENTIAL INFORMATION STARRUWO01151
FILED: NEW YORK COUNTY CLERK 12/09/2022 08:41 PM INDEX NO. 652321/2020
NYSCEF DOC. NO. 115 RECEIVED NYSCEF: 12/09/2022
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 In -Loss of Gross Earnings (subject to scheduled sub-limits &
| Delay Completion
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 tospecific 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)
& Landscaping Materials (maximum $5,000 per item)
$ 100,000 | Trees, Shrubs, Plantings
$ 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
STARRUW01152
CONFIDENTIAL INFORMATION STARRUWO01152
FILED: NEW YORK COUNTY CLERK 12/09/2022 08:41 PM INDEX NO. 652321/2020
NYSCEF DOC. NO. 115 RECEIVED NYSCEF: 12/09/2022
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 mimimum
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;
3 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 deductibleshall 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
SN/A / $100 Delay In Completion
SN/A / $100 Physical Damage Existing Property
SN/A / $100 Hot Testing G0 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
Certified and Non Certified Terrorism Premium (optional & in addition to above)
S 3,047 to Disclosure Notice
(refer attached)
$ 104,618 | Total Term Policy Premium including Terrorism
Starr Specialty 100% SHARE | $ 101,571 | Total Policy Premium (subject to |
25 |
% minimum & earned premium)
Certified and Non Certified Terrorism Premium (optional & in addition to above)
3,047 to Disclosure Notice
(refer 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
STARRUW01153
CONFIDENTIAL INFORMATION STARRUWO01153
FILED: NEW YORK COUNTY CLERK 12/09/2022 08:41 PM INDEX NO. 652321/2020
NYSCEF DOC. NO. 115 RECEIVED NYSCEF: 12/09/2022
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
BRORER RESPORSIBLE FOR SURPLUS LEISES PILTAGS
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 & Contamimation; 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,
show, 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 1evoids, 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., allwhen 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
STARRUW01154
CONFIDENTIAL INFORMATION STARRUWO01154
FILED: NEW YORK COUNTY CLERK 12/09/2022 08:41 PM INDEX NO. 652321/2020
NYSCEF DOC. NO. 115 RECEIVED NYSCEF: 12/09/2022
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. Ifnot so replaced,
loss shall besettled 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 suchmaterials 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 besettled atActual Cash Value (thecost 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
if any
Property In Transit — The invoice cost plus accrued shipping charges less shipper's liability,
Delay In Completion Coverage — Actual Loss Sustained
Page 6 of 21
STARRUW01155
CONFIDENTIAL INFORMATION STARRUW01155
FILED: NEW YORK COUNTY CLERK 12/09/2022 08:41 PM INDEX NO. 652321/2020
NYSCEF DOC. NO. 115 RECEIVED NYSCEF: 12/09/2022
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, certified by 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
Cixi
No premium adjustment shall take place if the difference is 3% or less
Page 7 of 21
STARRUW01156
CONFIDENTIAL INFORMATION STARRUW01156
FILED: NEW YORK COUNTY CLERK 12/09/2022 08:41 PM INDEX NO. 652321/2020
NYSCEF DOC. NO. 115 RECEIVED NYSCEF: 12/09/2022
POLICY FORMS & ENDORSEMENTS APPLICABLE:
Starr Specialty Builders Risk Form
Starr Specialty Completed Value Construction/Erection All Risk Form Delay In Opening Endorsement
DS
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
IES
Dewatermg Endorsement
Ingress or Egress and Civil Authority
Service Interruption Extension
Ios
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
iad
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
STARRUW01157
CONFIDENTIAL INFORMATION STARRUW01157
FILED: NEW YORK COUNTY CLERK 12/09/2022 08:41 PM INDEX NO. 652321/2020
NYSCEF DOC. NO. 115 RECEIVED NYSCEF: 12/09/2022
ADDITIONAL UNDERWRITING INFORMATION REQUIRED AS A CONDITION OF BINDING COVERAGE
Lf anitem 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
La Owner or third party supplied material to be installed and not included above
(a 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
La 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
XI
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
Cl
For all other projects the type of foundation to be utilized (e.g. pad, raft, piled)
Oth r 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
STARRUW01158
CONFIDENTIAL INFORMATION STARRUWO01158
FILED: NEW YORK COUNTY CLERK 12/09/2022 08:41 PM INDEX NO. 652321/2020
NYSCEF DOC. NO. 115 RECEIVED NYSCEF: 12/09/2022
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
STARRUW01159
CONFIDENTIAL INFORMATION STARRUW01159
FILED: NEW YORK COUNTY CLERK 12/09/2022 08:41 PM INDEX NO. 652321/2020
NYSCEF DOC. NO. 115 RECEIVED NYSCEF: 12/09/2022
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 poducing broker, it is your responsibility to arrange for the payment of thestate 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 Gif 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
STARRUW01160
CONFIDENTIAL INFORMATION STARRUW01160
FILED: NEW YORK COUNTY CLERK 12/09/2022 08:41 PM INDEX NO. 652321/2020
NYSCEF DOC. NO. 115 RECEIVED NYSCEF: 12/09/2022
STARR SPECIALTY LINES
POLICY HOLDER 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 retmbursed 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 lossescovered by this law exceeding a statutorily established deductiblethat 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 $85,230,000.
Please indicate your selection below.
Thereby elect to purchase coverage in accordance with the Act.
Thereby reject coverage and accept the exclusion in accordance with the Act.
Signature of Insured Date
Print Name/Title
1/2015
Page 12 of 21
STARRUW01161
CONFIDENTIAL INFORMATION STARRUWO01 161
FILED: NEW YORK COUNTY CLERK 12/09/2022 08:41 PM INDEX NO. 652321/2020
NYSCEF DOC. NO. 115 RECEIVED NYSCEF: 12/09/2022
TERRORISM
As respects Acts of Terrorism as defined by the Terrorism
Preview
FILED: NEW YORK COUNTY CLERK 12/09/2022 08:41 PM INDEX NO. 652321/2020 NYSCEF DOC. NO. 115 RECEIVED NYSCEF: 12/09/2022 Exhibit F FILED: NEW YORK COUNTY CLERK 12/09/2022 08:41 PM INDEX NO. 652321/2020 NYSCEF DOC. NO. 115 RECEIVED NYSCEF: 12/09/2022 STA: SPECIALTY LINES Douglas A Leto 399 Park Avenue, 9" 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 7 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, 13 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 thisCompany, 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 STARRUW01150 CONFIDENTIAL INFORMATION FILED: NEW YORK COUNTY CLERK 12/09/2022 08:41 PM INDEX NO. 652321/2020 NYSCEF DOC. NO. 115 RECEIVED NYSCEF: 12/09/2022 | PROJECT NAME: | Region 8 Bridge Replacements PROJECT This project involves the replacement of three bridges. One on East 3° 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 3" 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 $5,000,000 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 coverproperty 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: When the owner or buyer accepts the property; When the interest of the Named Insured ceases; Beyond sixty (60) days after completion of the project; When the Named Insured abandons the construction with no intention to complete it; or 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 STARRUW01151 CONFIDENTIAL INFORMATION STARRUWO01151 FILED: NEW YORK COUNTY CLERK 12/09/2022 08:41 PM INDEX NO. 652321/2020 NYSCEF DOC. NO. 115 RECEIVED NYSCEF: 12/09/2022 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 In -Loss of Gross Earnings (subject to scheduled sub-limits & | Delay Completion 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 tospecific 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) & Landscaping Materials (maximum $5,000 per item) $ 100,000 | Trees, Shrubs, Plantings $ 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 STARRUW01152 CONFIDENTIAL INFORMATION STARRUWO01152 FILED: NEW YORK COUNTY CLERK 12/09/2022 08:41 PM INDEX NO. 652321/2020 NYSCEF DOC. NO. 115 RECEIVED NYSCEF: 12/09/2022 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 mimimum 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; 3 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 deductibleshall 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 SN/A / $100 Delay In Completion SN/A / $100 Physical Damage Existing Property SN/A / $100 Hot Testing G0 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 Certified and Non Certified Terrorism Premium (optional & in addition to above) S 3,047 to Disclosure Notice (refer attached) $ 104,618 | Total Term Policy Premium including Terrorism Starr Specialty 100% SHARE | $ 101,571 | Total Policy Premium (subject to | 25 | % minimum & earned premium) Certified and Non Certified Terrorism Premium (optional & in addition to above) 3,047 to Disclosure Notice (refer 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 STARRUW01153 CONFIDENTIAL INFORMATION STARRUWO01153 FILED: NEW YORK COUNTY CLERK 12/09/2022 08:41 PM INDEX NO. 652321/2020 NYSCEF DOC. NO. 115 RECEIVED NYSCEF: 12/09/2022 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 BRORER RESPORSIBLE FOR SURPLUS LEISES PILTAGS 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 & Contamimation; 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, show, 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 1evoids, 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., allwhen 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 STARRUW01154 CONFIDENTIAL INFORMATION STARRUWO01154 FILED: NEW YORK COUNTY CLERK 12/09/2022 08:41 PM INDEX NO. 652321/2020 NYSCEF DOC. NO. 115 RECEIVED NYSCEF: 12/09/2022 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. Ifnot so replaced, loss shall besettled 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 suchmaterials 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 besettled atActual Cash Value (thecost 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 if any Property In Transit — The invoice cost plus accrued shipping charges less shipper's liability, Delay In Completion Coverage — Actual Loss Sustained Page 6 of 21 STARRUW01155 CONFIDENTIAL INFORMATION STARRUW01155 FILED: NEW YORK COUNTY CLERK 12/09/2022 08:41 PM INDEX NO. 652321/2020 NYSCEF DOC. NO. 115 RECEIVED NYSCEF: 12/09/2022 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, certified by 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 Cixi No premium adjustment shall take place if the difference is 3% or less Page 7 of 21 STARRUW01156 CONFIDENTIAL INFORMATION STARRUW01156 FILED: NEW YORK COUNTY CLERK 12/09/2022 08:41 PM INDEX NO. 652321/2020 NYSCEF DOC. NO. 115 RECEIVED NYSCEF: 12/09/2022 POLICY FORMS & ENDORSEMENTS APPLICABLE: Starr Specialty Builders Risk Form Starr Specialty Completed Value Construction/Erection All Risk Form Delay In Opening Endorsement DS 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 IES Dewatermg Endorsement Ingress or Egress and Civil Authority Service Interruption Extension Ios 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 iad 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 STARRUW01157 CONFIDENTIAL INFORMATION STARRUW01157 FILED: NEW YORK COUNTY CLERK 12/09/2022 08:41 PM INDEX NO. 652321/2020 NYSCEF DOC. NO. 115 RECEIVED NYSCEF: 12/09/2022 ADDITIONAL UNDERWRITING INFORMATION REQUIRED AS A CONDITION OF BINDING COVERAGE Lf anitem 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 La Owner or third party supplied material to be installed and not included above (a 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 La 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 XI 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 Cl For all other projects the type of foundation to be utilized (e.g. pad, raft, piled) Oth r 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 STARRUW01158 CONFIDENTIAL INFORMATION STARRUWO01158 FILED: NEW YORK COUNTY CLERK 12/09/2022 08:41 PM INDEX NO. 652321/2020 NYSCEF DOC. NO. 115 RECEIVED NYSCEF: 12/09/2022 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 STARRUW01159 CONFIDENTIAL INFORMATION STARRUW01159 FILED: NEW YORK COUNTY CLERK 12/09/2022 08:41 PM INDEX NO. 652321/2020 NYSCEF DOC. NO. 115 RECEIVED NYSCEF: 12/09/2022 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 poducing broker, it is your responsibility to arrange for the payment of thestate 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 Gif 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 STARRUW01160 CONFIDENTIAL INFORMATION STARRUW01160 FILED: NEW YORK COUNTY CLERK 12/09/2022 08:41 PM INDEX NO. 652321/2020 NYSCEF DOC. NO. 115 RECEIVED NYSCEF: 12/09/2022 STARR SPECIALTY LINES POLICY HOLDER 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 retmbursed 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 lossescovered by this law exceeding a statutorily established deductiblethat 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 $85,230,000. Please indicate your selection below. Thereby elect to purchase coverage in accordance with the Act. Thereby reject coverage and accept the exclusion in accordance with the Act. Signature of Insured Date Print Name/Title 1/2015 Page 12 of 21 STARRUW01161 CONFIDENTIAL INFORMATION STARRUWO01 161 FILED: NEW YORK COUNTY CLERK 12/09/2022 08:41 PM INDEX NO. 652321/2020 NYSCEF DOC. NO. 115 RECEIVED NYSCEF: 12/09/2022 TERRORISM As respects Acts of Terrorism as defined by the Terrorism