Insurance Certificates 2017/18 NAI Consulting, IncNAICONS-01 MRUIZ
CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
06/04/2018
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER License # OF09643 CONTACT Tona Delgado
Desert Empire Ins Services, Inc. PHONE FAX
77564 Country Club Drive (A/C. No. Ext): (760) 360-4700 (AIC. No):(760) 360-4799
E-
Suite 401 MAIL
LAODn�gs:
Palm Desert, CA 92211
INSURER(S) AFFORDING COVERAGE NAIC lI
INSURER A: Valley Forge Insurance Company
20508
INSURED
INSURER B :Ohio Security Insurance Company
24082
NAI Consulting, Inc.
INSURER C : Preferred Employers Insurance Co
10900
68955 Adelina Road
INSURER D! Hanover Insurance Company
22292
Cathedral City, CA 92234
INSURER E
INSURER F :
COVERAGES CERTIFICATE NUMBER:
REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE
POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLIC ES DESCRIBED HEREIN IS SUBJECT TO ALL
THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH 'OLIr.IES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY 'AID CLAIMS.
INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER
L R INSD MrVD
POLICY EFF POLICY EXP
IJNM/DD/YYYYI /MM/DFINV
LIMITS
A X COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
DAMMAGE TO RENTED
$ 2,000 001�
CLAIMS -MADE EX OCCUR X X IB 4017307305
02/28/2018 02/28/2019 ooatrrence]
PR tSES MR$
300:000
MED EXP (Any one Derson)
s 10,000
PERSONAL &ADV INJURY
S 2,000,000
GEWL AGGRECATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 4,000,0001
POLICY X PEPT LOC
PRODUCTS - COMP/OP AGG
$ 4,000,000
OTC.
BLKT ADDL INSUR
$ Included
B AUTOMOBILE LIABILITY
COMBINEDISINGLE LIMIT
$ 1,000,000
X ANY AUTO IBAS57443277
11/20/2017 11/20/2018
BODILY INJURY(Per Derson)
s
OWNED
SCHEDULED
AUTOSONLYAUUpTNNOppSyyyy
BODILY INJUppRY((Peraccident)
S
X AUTOS
X
EEpp
AUTOSONNLY
IPer2rddet)ANIAGE
$
ONLY
S
UMBRELLA LIAB H
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS -MADE
++
1 AGGREGATE
S
I I
DED RETENTION $
$
C WORKERS COMPENSATION
PER OTTH-
rR
AND EMPLOYERS' LIABILITY
Y/ N WKN 133867-12
06/01/2018 06101/2019
UTE
1,000,000
ANY CCPROPRIETOR/PARTNER/EXECUTIVE ❑
�NandER/MatoryEn BE EXCLUDED? N / A
E.L EACH ACCIDENT
$
1,000,000
If yes, describe under
ESCRIPJIONO eP RATIONS below
E.L. DISEASE - EA EMPLOYEE
E_L_DISEASE-POLICY LIMIT
S
$ 1,000,000
D rofesslona Lia ILH3890054608
11/01/2017 11101►2019 Each Claim
2,000,000
D Professional Liab ILH3890054608
11/01/2017 11/01/2019 Aggregate
4,000,000
DESCRIPTION OF OPERATIONS/ LOCATIONS I VEHICLES (ACORD 10%Additional Remarks Schedule, may bn attached if more space is required)
The City of La Quinta, City employees, officers, City Engineer, its consultants, elected officials, agents and sub -consultants are named as additional insured
per attached form. The general liability is primary and non contributory per attached form.
Project: Fiscal Year 2018/2019 Project Management and Contract Administrative Support Services
CERTIFICATE HOLDER
City of La Quinta
Public Works Deparment
78495 Calle Tampico
La Quinta, CA 92253
ACORD 25 (2016/03)
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
TAW
�-
@ 1988-20ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
SB-146932-E
(Ed. 06/11)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED - LIABILITY EXTENSION
This endorsement modifies insurance provided under the following:
BUSINESSOWNERS LIABILITY COVERAGE FORM
Coverage afforded under this extension of coverage endorsement does not apply to any person or organization covered
as an additional insured on any other endorsement now or hereafter attached to this Policy.
1. ADDITIONAL INSURED — BLANKET VENDORS
WHO IS AN INSURED is amended to include as an
additional insured any person or organization (referred
Lo below as vendor) with whom you agreed, because
of a written contract or agreement to provide
insurance, but only with respect to "bodily injury' or
"property damage" arising out of "your products" which
are distributed or sold in the regular course of the
vendor's business, subject to the following additional
exclusions:
1. The insurance afforded the vendor does not apply
to:
a. "Bodily injury' or "property damage" for which
the vendor is obligated to pay damages by
reason of the assumption of liability in a
contract or agreement. This exclusion does
not apply to liability for damages that the
vendor would have in the absence of the
contract or agreement;
b. Any express warranty unauthorized by you;
c. Any physical or chemical change in the
product made intentionally by the vendor;
d. Repackaging, except when unpacked solely
for the purpose of inspection, demonstration,
testing, or the substitution of parts under
instructions from the manufacturer, and then
repackaged in the original container;
e. Any failure to make such inspections,
adjustments, tests or servicing as the vendor
has agreed to make or normally undertakes to
make in the usual course of business, in
connection with the distribution or sale of the
products;
f. Demonstration, installation, servicing or repair
operations, except such operations performed
at the vendor's premises in connection with
the sale of the product;
g. Products which, after distribution or sale by
you, have been labeled or relabeled or used
as a container, part or ingredient of any other
thing or substance by or for the vendor; or
h. "Bodily injury" or "property damage" arising
out of the sole negligence of the vendor for its
own acts or omission or those of its
employees or anyone else acting on its
behalf. However, this exclusion does not
apply to:
(1) The exceptions contained in
Subparagraphs d. or f.; or
(2) Such inspections, adjustments, tests or
servicing as the vendor has agreed to
make or normally undertakes to make in
the usual course of business, in
connection with the distribution or sale of
the products.
2. This insurance does not apply to any insured
person or organization, from whom you have
acquired such products, or any ingredient, part or
container, entering into, accompanying or
containing such products.
3. This provision 2. does not apply to any vendor
included as an insured by an endorsement issued
by us and made a part of this Policy.
4. This provision 2. does not apply if "bodily injury" or
"property damage" included within the "products -
completed operations hazard" is excluded either
by the provisions of the Policy or by endorsement.
2. MISCELLANEOUS ADDITIONAL INSUREDS
WHO IS AN INSURED is amended to include as an
insured any person or organization (called additional
insured) described in paragraphs 2.a. through 2.h.
below whom you are required to add as an additional
insured on this policy under a written contract or
agreement but the written contract or agreement must
be:
1. Currently in effect or becoming effective during the
term of this policy, and
2. Executed prior to the "bodily injury," "property
damage" or "personal and advertising injury," but
Only the following persons or organizations are
additional insureds under this endorsement and
coverage provided to such additional insureds is
limited as provided herein:
a. Additional Insured —Your Work
That person or organization for whom you do
work is an additional insured solely for liability
SB-146932-E Page 1 of 5
(Ed. 06/11)
C/VA s (Ed. 06 1 )
due to your negligence specifically resulting
This insurance does not apply to "bodily
from your work for the additional insured
injury," "property damage" or "personal and
which is the subject of the written contract or
advertising injury" arising out of operations
written agreement. No coverage applies to
performed for the state or municipality.
liability resulting from the sole negligence of
c. Controlling Interest
the additional insured.
The insurance provided to the additional
Any persons or organizations with a
insured is limited as follows:
controlling interest in you but only with respect
to their liability arising out of:
(1) The Limits of Insurance applicable to the
additional insured are those specified in
(1) Their financial control of you; or
the written contract or written agreement
(2) Premises they own, maintain or control
or in the Declarations of this policy,
while you lease or occupy these
whichever is less. These Limits of
premises.
Insurance are inclusive of, and not in
addition to, the Limits of Insurance shown
This insurance does not apply to structural
in the Declarations.
alterations, new construction and demolition
operations performed by or for such additional
(2) The coverage provided to the additional
insured.
insured by this endorsement and
paragraph F.9. of the definition of "insured
d. Managers or Lessors of Premises
contract" under Liability and Medical
A manager or lessor of premises but only with
Expenses Definitions do not apply to
respect to liability arising out of the ownership,
bodily injuryor property damage
maintenance or use of that specific part of the
arising out of the "products -completed
premises leased to you and subject to the
operations hazard" unless required by the
following additional exclusions:
written contract or written agreement.
This insurance does not apply to:
(3) The insurance provided to the additional
insured does not apply to "bodily injury,"
(1) Any "occurrence" which takes place after
"property damage," or "personal and
you cease to be a tenant in that premises;
advertising injury" arising out of the
or
rendering or failure to render any
(2) Structural alterations, new construction or
professional services.
demolition operations performed by or on
b. State or Political Subdivisions
behalf of such additional insured.
A state or political subdivision subject to the
e. Mortgagee, Assignee or Receiver
following provisions:
�
A mortgagee, assignee or receiver but only
a 99 9 Y
(1) This insurance applies only with respect
with respect to their liability as mortgagee,
to the following hazards for which the
assignee, or receiver and arising out of the
sstate or political subdivision has issued a
ownership, maintenance, or use of a premises
permit in connection with premises you
by you.
own, rent, or control and to which this
This insurance does not apply to structural
insurance applies:
alterations, new construction or demolition
(a) The existence, maintenance, repair,
operations performed by or for such additional
construction, erection, or removal of
insured.
advertising signs, awnings, canopies,
f. Owners/Other Interests — Land is Leased
cellar entrances, coal holes,
^�^ driveways, manholes, marquees,
An owner or other interest from whom land
hoistaway openings, sidewalk vaults,
has been leased by you but only with respect
street banners, or decorations and
to liability arising out of the ownership,
similar exposures; or
maintenance or use of that specific part of the
(b) The construction, erection, or
land leased to you and subject to the following
removal of elevators; or
additional exclusions:
(2) This insurance applies only with respect
This insurance does not apply to:
to operations performed by you or on your
(1) Any "occurrence" which takes place
behalf for which the state or political
after you cease to lease that land; or
subdivision has issued a permit.
SB-146932-E Page 2 of 5
(Ed. 06/11)
CNA s (Ed. 06/1 )
(2) Structural alterations, new
Damage To Property, is replaced by the
construction or demolition operations
following:
performed by or on behalf of such
k. Damage To Property
additional insured.
g. Co-owner of Insured Premises
"Property damage" to:
A co-owner of a premises co -owned by you
1. Property you own, rent or occupy,
and covered under this insurance but only
including any costs or expenses
with respect to the co -owners liability as co-
incurred by you, or any other person,
owner of such premises.
organization or entity, for repair,
replacement, enhancement,
h. Lessor of Equipment
restoration or maintenance of such
Any person or organization from whom you
property for any reason, including
prevention of injury to a person or
lease equipment. Such person or organization
damage to another s property;
are insureds only with respect to their liability
arising out of the maintenance, operation or
2. Premises you sell, give away or
use by you of equipment leased to you by
abandon, if the "property damage"
such person or organization. A person's or
arises out of any part of those
organization's status as an insured under this
premises;
endorsement ends when their written contract
3. Property loaned to you;
or agreement with you for such leased
equipment ends.
4. Personal property in the care,
With respect to the insurance afforded these
custody or control of the insured;
additional insureds, the following additional
5. That particular part of any real
exclusions apply:
property on which you or any
This insurance does not apply:
contractors or subcontractors working
directly or indirectly in your behalf are
(1) To any "occurrence" which takes place
performing operations, if the "property
after the equipment lease expires; or
damage" arises out of those
(2) To "bodily injury," "property damage" or
operations; or
"personal and advertising injury" arising
B. That particular part of any property
out of the sole negligence of such
that must be restored, repaired or
additional insured.
replaced because "your work" was
Any insurance provided to an additional insured
incorrectly performed on it.
designated under paragraphs b. through h. above
Paragraph 2 of this exclusion does not
does not apply to "bodily injury" or "property
apply if the premises are "your work" and
damage" included within the "products -completed
were never occupied, rented or held for
operations hazard."
rental by you.
3. The following is added to Paragraph H. of the
Paragraphs 1, 3, and 4, of this exclusion
BUSINESSOWNERS COMMON POLICY
do not apply to "property damage" (other
CONDITIONS:
than damage by fire or explosion) to
H. Other Insurance
premises:
(1) rented to you:
4. This insurance is excess over any other
insurance naming the additional insured
(2) temporarily occupied by you with the
as an insured whether primary, excess,
permission of the owner, or
contingent or on any other basis unless a
(3) to the contents of premises rented to
written contract or written agreement
you for a period of 7 or fewer
specifically requires that this insurance be
consecutive days.
either primary or primary and
noncontributing.
A separate limit of insurance applies to
Damage To Premises Rented To You as
4. LEGAL LIABILITY — DAMAGE TO PREMISES
described in Section D — Liability and
Medical Expenses Limits of Insurance.
A. Under B. Exclusions, 1. Applicable to
Business Liability Coverage, Exclusion k.
SB-146932-E Page 3 of 5
(Ed. 06/11)
Paragraphs 3, 4, 5, and 6 of this
exclusion do not apply to liability
assumed under a sidetrack agreement.
Paragraph 6 of this exclusion does not
apply to "property damage" included in
the "products -completed operations
hazard."
B. Under B. Exclusions, 1. Applicable to
Business Liability Coverage, the last
paragraph of 2. Exclusions is deleted and
replaced by the following:
Exclusions c, d, e, f, g, h, 1, k, I, m, n, and o,
do not apply to damage by fire to premises
while rented to you or temporarily occupied by
you with permission of the owner or to the
contents of premises rented to you for a
period of 7 or fewer consecutive days. A
separate limit of insurance applies to this
coverage as described in Section D. Liability
And Medical Expenses Limits Of
Insurance.
C. The first Paragraph under item 5. Damage To
Premises Rented To You Limit of Section
D. Liability And Medical Expenses Limits
Of Insurance is replaced by the following:
The most we will pay under Business Liability
for damages because of "property damage"
to any one premises, while rented to you, or
temporarily occupied by you, with the
permission of the owner, including contents of
such premises rented to you for a period of 7
or fewer consecutive days, is the Damage to
Premises Rented to You limit shown in the
Declaration.
g 5. Blanket Waiver of Subrogation
We waive any right of recovery we may have
g
against:
a
a. Any person or organization with whom you
p have a written contract that requires such a
waiver.
6. Broad Knowledge of Occurrence
The following items are added to E.
Businessowners General Liability Conditions
in the Businessowners Liability Coverage
Form:
G. Paragraphs a. and b. apply to you or to any
additional insured only when such
® "occurrence," offense, claim or "suit" is known
® to:
E� (1) You or any additional insured that is an
individual;
SB-146932-E
(Ed. 06/11)
SB-146932-E
(Ed. 06/11)
(2) Any partner, if you or an additional
insured is a partnership;
(3) Any manager, if you or an additional
insured is a limited liability company;
(4) Any "executive officer" or insurance
manager, if you or an additional insured is
a corporation;
(5) Any trustee, if you or an additional
insured is a trust; or
(6) Any elected or appointed official, if you or
an additional insured is a political
subdivision or public entity,
This paragraph e. applies separately to you
and any additional insured.
7. Bodily Injury
Section F. Liability and Medical Expenses
Definitions, item 3. "Bodily Injury" is deleted and
replaced with the following:
"Bodily injury" means bodily injury, sickness or
disease sustained by a person, including death,
humiliation, shock, mental anguish or mental
injury by that person at any time which results as
a consequence of the bodily injury, sickness or
disease.
8. Expanded Personal and Advertising Injury
Definition
a. The following is added to Section F. Liability
and Medical Expenses Definitions, item 14.
Personal and Advertising Injury, in the
Businessowners General Liability
Coverage Form:
h. Discrimination or humiliation that results in
injury to the feelings or reputation of a natural
person, but only if such discrimination or
humiliation is:
Not done intentionally by or at the
direction of:
a. The insured; or
b. Any "executive officer," director,
stockholder, partner, member or
manager (if you are a limited liability
company) of the insured; and
2. Not directly or indirectly related to the
employment, prospective employment,
past employment or termination of
employment of any person or person by
any insured.
b. The following is added to Exclusions, Section
B.:
Page 4 of 5
CNA
(15) Discrimination Relating to Room,
Dwelling or Premises
Caused by discrimination directly or
indirectly related to the sale, rental, lease
or sub -lease or prospective sale, rental,
lease or sub -lease of any room, dwelling
or premises by or at the direction of any
insured.
(16) Fines or Penalties
Fines or penalties levied or imposed by a
governmental entity because of
discrimination.
c. This provision (Expanded Personal and
Advertising Injury) does not apply if
SB-146932-E
(Ed. 06/11)
SB-146932-E
(Ed. 06/11)
Personal and Advertising Injury Liability is
excluded either by the provisions of the Policy
or by endorsement.
9. Personal and Advertising Injury Redefined
Section F. Liability and Medical Expenses
Definitions, item 14, Personal Advertising Injury,
Paragraph c. is replaced by the following:
c. The wrongful eviction from, wrongful entry
into, or invasion of the right of private
occupancy of a room dwelling or premises
that a person or organization occupies
committed by or on behalf of it's owner,
landlord or lessor.
Page 5 of 5