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2019-20 Medeiros, Joy (Instructor) - Tai Chi Chuan ClassestaQwkra - — GEM ofthe DESERT — MEMORANDUM TO: Christina Calderon, Community Resources Manager FROM: Caroline Doran, Community Resources Specialist DATE: March 3, 2020 RE: Joy Medeiros, Fitness, #AGR422601-19, Instructor Attached for your signature is an agreement with independent contracted instructor Joy Medeiros for (Tai Chi Chuan) classes. Please sign the attached agreement(s) and return to the City Clerk for processing and distribution. Reauesting department shall check and attach the items below as appropriate; X Contract payments will be charged to account number: 101-0000-42214 X Amount of Agreement, Amendment, Change Order, etc.: 70`Y of fees are paid to instructor N/A A Conflict of Interest Form 700 Statement of Economic Interests from Consultant(s) is attached with no reportable interests in LQ or _ reportable interests N/A A Conflict of Interest Form 700 Statement of Economic Interests is not required because this Consultant does not meet the definition in FPPC regulation 18701(2). Authority to execute this agreement is based upon: X Approved by the City Council on April 18, 2017 N/A Community Resource Manager's signature for expenditures of $5,000 or less. This expenditure is $ 2721.60. N/A Initial to certify that 3 written informal bids or proposals were received and considered in selection The following required documents are attached to the agreement: X Insurance certificates as required by the agreement (approved by Risk Manager an3 2. 2 a2C)dW N/A Performance bonds as required b the agreement(originals) / q Y g X City of La Quinta Business License number LIC #763761 EXP. 3/31/2020 N/A A requisition for a Purchase Order has been prepared (amounts over $5,000) Revised May 2017 ta&a City La Qof uinta - --GEMoftheDESERT— Community Services Department Contract # 422601-19 INSTRUCTOR AGREEMENT This INSTRUCTOR AGREEMENT is hereby formed on JULY 1, 2019 through JUNE 30, 2020 between the CITY OF LA QUINTA, COMMUNITY RESOURCES DEPARTMENT ("CITY") and JOY MEDEIROS a person or business engaged in offering services (`CONTRACTOR") for Contractor's Provision of Services to the City. CITY AND CONTRACTOR MUTUALLY AGREE AS FOLLOWS: 1. SCOPE OF WORK. The scope of work is described as: FITNESS (TAI CHI CHUAN) classes held at a City of La Quinta facility. The scope of work includes all goods and actions necessary to complete the task CONTRACTOR has been hired to perform, whether specifically included in the scope of work or not. Specific dates and times for contracted work will be requ ted by letter to CONTRACTOR from CITY on a bi-annual basis. Work proposals, o proved by CITY will be attached as exhibits to this INSTRUCTOR AGREEMENT. r (initials) 2. COMPENSATION. CONT ACTOR shall be paid for services performed under this INSTRUCTOR AGREEMENT as follows: CONTRACTOR shall recommend fees to be charged by CITY. Such fees shall be paid directly to CITY. CITY shall maintain written records of gross receipts and shall submit such records to CONTRACTOR upon request. CONTRACTOR shall be compensated based on the following: STANDARD SESSIONS. CITY shall pay 70% of gross receipts collected to CONTRACTOR as compensation based upon the records and shall retain the remaining 30% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out-of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in Section 1, SCOPE OF WORK and will follow the approved annual payroll calendar. DROP -IN SESSIONS. CITY shall pay 70% of gross fees to CONTRACTOR as compensation based upon the records and shall retain the remaining 30% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out- of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in the SCOPE OF SERVICES and will follow the approve3d annual payroll calendar. 3. INDEPENDENT CONTRACTOR. This INSTRUCTOR AGREEMENT calls for the performance of the services of CONTRACTOR as an independent contractor and not as an employee of CITY. Neither CITY nor any of its employees shall have any control over the manner, mode, or means by which CONTRACTOR or its agents, perform the services required herein, except as otherwise set forth herein. CONTRACTOR shall perform all services required herein as an independent contractor of CITY and shall remain at all times as to CITY a wholly independent. contractor with only such Rev May 2015 1 obligations as are consistent with that role. CONTRACTOR shall have no power to incur any debt, obligation, or liability on behalf of CITY. CONTRACTOR shall not at any time or in any manner represent that it or any of its agents or employees are agents or employees of CITY. CONTRACTOR and any of its agents providing services under this INSTRUCTOR AGREEMENT shall not qualify for or become entitled to any compensation, benefit, or any incident of employment by CITY, including but not limited to eligibility to enroll in the California Public Employees Retirement System ("PERS") as an employee of CITY and entitlement to any contribution to be paid by CITY for employer contributions and/or employee contributions for PERS benefits. CONTRACTOR agrees to pay all required taxes on amounts paid to CONTRACTOR under this INSTRUCTOR AGREEMENT, and to indemnify and hold CITY harmless from any and all taxes, assessments, penalties, and interest asserted against CITY by reason of the independent contractor relationship created by this INSTRUCTOR AGREEMENT. CITY shall have the right to offset against the amount of any compensation due to CONTRACTOR under this INSTRUCTOR AGREEMENT any amount due to CITY from CONTRACTOR as a result of CONTRACTOR's failure to promptly pay to CITY any reimbursement or indemnification arising under this paragraph. 4. INDEMNIFICATION. To the fullest extent permitted by law, CONTRACTOR shall indemnify, protect, defend (with counsel selected by City) and hold harmless CITY and any and all of its officials, employees and agents ("Indemnified Parties") from and against any and all liability, claims, suits, actions arbitration proceedings, administrative proceedings, regulatory proceedings, losses, liabilities of every kind, nature, and description, damages, injury (including, without limitation, injury to or death of CONTRACTOR) costs and expenses of any kind, whether actual, alleged or threatened, including, without limitation, incidental and consequential damages, actual attorneys' fees incurred by CITY, court costs, interest, defense costs including fees of expert contractors or expert witnesses incurred in connection therewith and any other costs or expenses of any kind whatsoever incurred in relation to, as a consequence of, or arising out of or in any way attributable in whole or in part to the performance of this INSTRUCTOR AGREEMENT by CONTRACTOR or by any individual or entity for which CONTRACTOR is legally liable, including but not limited to agents of CONTRACTOR. All obligations under this provision are to be paid by CONTRACTOR as CITY incurs them. Without affecting the rights of CITY under any provision of this INSTRUCTOR AGREEMENT, CONTRACTOR shall not be required to indemnify and hold harmless CITY for liability attributable to the active negligence of CITY, provided such active negligence is determined by contract between the parties or by the findings of a court of competent jurisdiction. In instances where CITY is shown to have been actively negligent and where CITY's active negligence accounts for only a percentage of the liability involved, the obligation of CONTRACTOR will be for that entire portion or percentage of liability not attributable to the active negligence of CITY. PROMPT NOTICE. CONTRACTOR agrees to provide immediate notice to CITY of any claim or loss against CONTRACTOR arising out of the work performed under this INSTRUCTOR AGREEMENT. CITY assumes no obligation or liability by such notice, but has the right (but not the duty) to monitor the handling of any such claim or claims if they are likely to involve CITY. S. CANCELLATIONS/CHANGES. CITY RESPONSIBILITY. CITY will contact CONTRACTOR and all program participants if CITY cancels or changes a program from original approved schedule based on zero enrollments, minimum student Rev May 2015 2 requirement not met, or if use of facility becomes unavailable. CITY reserves the right to change original approved schedule of program if the facility becomes unavailable. CITY will attempt to re -locate said program to another suitable facility if available. If there are no available facilities, CITY will cancel said am and coordinate with CONTRACTOR to schedule a make-up date. (initials) CONTRACTOR RESPONSIBILITY. CONTRACTOR will contact CITY as defined in the NOTICE section in advance to notify of any cancellations or changes from original approved schedule if said program is cancelled or changed by CONTRACTOR. CONTRACTOR will be solely responsible to contact any and all Wipis of the program. Programs that are cancelled or changed bCTOR must be made up in a timely manner as approved by CITY. (initials) 6. INSURANCE.It is to be understood that CONTRACTOR is working under a contractual obligation as specified in this INSTRUCTOR AGREEMENT and is responsible as a self-employed person to remit any Federal or State Income Taxes, and to provide for his/her own Worker's Compensation, Disability Insurance, Unemployment Insurance coverage, Social Security, Liability Insurance and other such coverage, as applicable, in the amounts and under the conditions as set forth below. A. Commercial General Liability Insurance using Insurance Services Office "Commercial General Liability" policy form CG 00 01, with an edition date prior to 2004, or the exact equivalent. Coverage for an additional insured shall not be limited to its vicarious liability. The insurance policy shall contain a severability of interest clause providing that the coverage shall be primary for losses arising out of Contracting Party's performance hereunder and neither City nor its insurers shall be required to contribute to any such loss. Defense costs must be paid in addition to limits. Limits shall be no less than $1,000,000 per occurrence for all covered losses and no less than $2,000,000 general aggregate. Instructor shall obtain policy endorsement on Commercial General Liability Insurance that name Additional Insureds as follows: The City of La Quinta, its officers, officials, employees and agents. 6.1 CONTRACTOR agrees to provide evidence of the insurance required herein, satisfactory to CITY, consisting of: (a) certificate(s) of insurance evidencing all of the coverages required and, (b) an additional insured endorsement to CONTRACTOR's Commercial general liability policy using ISO Form CG 20 10 with an edition date prior to 1988, which form shall include coverage for completed operations and, The additional insured endorsement shall expressly name CITY, its officers, and employees as additional insureds on the policy (ies) as to commercial general liability coverages, and completed operations coverages, with respect to liabilities arising out of CONTRACTOR's performance of the services under this INSTRUCTOR AGREEMENT. 6.2 CONTRACTOR shall provide written notice to CITY within ten (10) working days if: (1) any of the required insurance policies is terminated; (2) the limits of any of the required polices are reduced; or (3) the deductible or self -insured retention is increased. In the event any of said policies of insurance are cancelled, CONTRACTOR shall, prior to the cancellation date, submit new evidence of insurance in conformance with this Section 6 to CITY. The procuring of such insurance or the delivery of policies or certificates evidencing the same shall not be construed as a limitation of CONTRACTOR's obligation to indemnify CITY, its officers, employees, contractors, or agents. Rev May 2015 7. BUSINESS LICENSE. CONTRACTOR will be required to obtain a City of La Quinta Business License within thirty (30) calendar days of this signed INSTRUCTOR AGREEMENT. A copy of the current La Quinta Business License must be provided to the Community Services Department within five (5) business days of receipt. S. COMPLIANCE WITH LAW.AII services rendered hereunder shall be provided in accordance with all ordinances, resolutions, statutes, rules, regulations, and laws of CITY and any Federal, State, or local government agency of competent jurisdiction. 9. COVENANT AGAINST DISCRIMINATION. CONTRACTOR covenants that, by and for itself, its heirs, executors, assigns, and all persons claiming under or through them, that there shall be no discrimination against or segregation of, any person or group of persons on account of race, color, creed, religion, sex, marital status, national origin, disability, or ancestry in the performance of this INSTRUCTOR AGREEMENT. 10. NO ASSIGNMENT. CONTRACTOR shall not, under any circumstances, assign this INSTRUCTOR AGREEMENT or its rights or duties without prior wri authorization from CITY. Should such authorization be granted, CONTRACTOR a o inform any assignee of all the stipulations of this INSTRUCTOR AGREEMENT. (initials) 11. TERMINATION. It is understood that CONTRACTOR will perform all services set forth herein in a good and workable manner. CITY reserves the right to terminate services for any reason, including, but not limited to, insufficient number of participants or unavailability of facilities. In such circumstances, CITY shall not be liable for compensation or damages to CONTRACTOR for remainder of this INSTRUCTOR AGREEMENT. 12. NOTICE. Notice shall be deemed given when CONTRACTOR contacts CITY COMMUNITY RESOURSES COORDINATOR or COMMUNITY SERVICES SUPERVISOR in person, via telephone call, email, faxed with a fax return, or seventy-two (72) hours after deposit in the United States mail postage prepaid, return receipt requested, addressed as follows: CITY: CONTRACTOR: City of La Quinta Joy Medeiros Community Resources Department 60240 Desert Shadows Drive 78495 Calle Tampico La Quinta, CA, 92253 La Quinta, CA 92253 (initials) 13. DOCUMENTS. Any documents an marketing materials created by CONTRACTOR under this INSTRUCTOR AGREEMENT shall be submitted to CITY for approval prior to distribution. 14. MISCELLANEOUS. This INSTRUCTOR AGREEMENT is the only agreement between CONTRACTOR and CITY and may be amended in writing and agreed upon by both parties. No waiver of any term or condition of this INSTRUCTOR AGREEMENT shall be a continuing waiver thereof. Rev May 2015 IN WITNESS WHEREOF, the parties hereto have caused this INSTRUCTOR AGREEMENT to be executed the day and year as first stated above. CITY OF LA QUINTA, JOY MEDEIROS COMMUNITY RESOURCES DEPARTMENT ("CONTRACTOR") ("CITY") APPROVED: By'. 1 ISTINA CALDERON Community Resources Manager 60240 Desert Shadows Drive La Quinta, CA, 92253 (760) 771-5187 Required for over $5,000: By: CHRIS ESCOBEDO Community Resources Director Rev May 2015 A4C"Rd PRODUCER Maguire Insurance Agency, Inc, FWI 1 Bala Plz Ste 100 Oala .Ynwyd, PA 190C4--1401 610.617.7900 INSURED Jay Medeim, 60240 Desert Shadows Cr La Quint., CA 92253- COVERAGES CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 12/09/2019 THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURER A: PhlladelDhia Indemnity Insurance Company 1B05B NSURER B: INSURER E: 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 CERIFICATION MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADO'L POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD TYPE.OFINISURANCE POLICY NUMBER DATE WM/DD/VYYY) DATE M OD YYY LIMITS A X GENERAL LIABILITY % COMMERCIAL GENERAL LIABILITY CLAIMS MADE n% OCCUR X PROFESSIONAL LIABILITY XGENT AGGREGATE LIMI C APPLIES PFR• POLICY PROJECT LOC PI IPK1761395- 001 01/06/2020 01/06/2021 EACH OCCURENCC S2,000,000 - bRFM1SS �a ueeu�• $500,000 S2,500 MED EXP (Any one person) PERSONAL & AUV INJURY 52.000.000 GENERAL AGGREGATE S4.000.000 PRODUCES—COMP/OP AGG 54,000,00n0 AUTOR6D&LE LIABILITY ANY AU TO ALL OWNED AUT05 SCHEDULED AUTOS HIRED AUTOS NON-OWNFDAUTOS COMBINED SINGLE LIMIT (EA acadent) BODILY INJURY (Per person) BODILY INJURY (Per accideo l) PROPERTY DAMAGE (Per a.. den t) GARAGE LIABILITY ANY AUl O AU10 ONLY — EA ACCIDENT OTHCR THAN FA ACC AUTO ONLY: AGG EXCESS / UMBRELLA LIABILITY OCCUR ❑ CLAIMS MADE DEDUCTIBLE RETENTION EACH OCCURENCE AGGREGATE WORKERS COMPENSATION AN13 EMPLOYERS' LIA91UTY Y N ANY FNIOPRIEiOIt�pIL4TNEfl/EXECUTIVE [ill ICE1I/MCtrIBfR F r.CLU DED! (Mandatory In NH) IlwL dnsetrlar under SPECIAL PROVISIONS below TORY LIMITS ER E.L. EACH ACCIDENT E.L DISEASE—EAAMPLOYEE GL DISEASE —POLICY LIMIT OTHER DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS It Is understood and agreed that the fallowing entity is added as an additional insured but only with rospect(s) to the operations of the named insured except that liability resulting from the additional insured's sale negli;ence CERTIFICATE HOLDER CANCELLATION City of La Quint, 78495 Calle Tampico La Quinla„ CA 92253- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR REPRESENTATIVES- AUTHORIiED REPRESENTATIVE ACORD 25 (2009/01) © 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: PHPK1761395-002 COMMERCIAL GENERAL LIABILITY CG 20 26 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART Name Of Additional Insured City of La Quinta 78495 Calle Tampico La Quinta, CA 92253- Information required to comD11 SCHEDULE Or Organization(s): this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for 'bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 26 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 PI-GL-005 (07/12) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED PRIMARY AND NON-CONTRIBUTORY INSURANCE This endorsement modifies insurance provided under the following. COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization (Additional Insured): City of La Quinta Effective Date: 01106/2020 SECTION II — WHO IS AN INSURED is amended to include as an additional insured the person(s) or organization(s) shown in the endorsement Schedule, but only with respect to liability for "bodily injury," "property damage" or "personal and advertising injury" arising out of or relating to your negligence in the performance of "your work" for such person(s) or organization(s) that occurs on or after the effective date shown in the endorsement Schedule. This insurance is primary to and non-contributory with any other insurance maintained by the person or organization (Additional Insured), except for loss resulting from the sole negligence of that person or organization. This condition applies even if other valid and collectible insurance is available to the Additional Insured for a loss or "occurrence" we cover for this Additional Insured. The Additional Insured's limits of insurance do not increase our limits of insurance, as described in SECTION III — LIMITS OF INSURANCE. All other terms, conditions, and exclusions under the policy are applicable to this endorsement and remain unchanged. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission. DATE(MM/DD/VYYY) A� CERTIFICATE OF LIABILITY INSURANCE 08/07/2019 PRODUCER Maguire Insurance Agency, Inc. FWI 1 Bala Piz Ste 100 Bala Cynwyd, PA 19004--1401 610.617 7900 INSURED Joy Medeiros 60240 Desert Shadows Dr La Quinta, CA 92253- COVERAGES THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE I NAIL # INSURER A: Philadelphia Indemnity Insurance Company 18058 INSURER B: INSURER C: INSURER D: INSURER E: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERIFICATION MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE IMM/DD/YYYY) DATE(MM/DD/YYYYJ LIMITS A X GENERAL LIABILITY PHPK1761395- 01/06/2019 01/06/2020 EACH OCCURENCE $2,000,000 X COMMERCIAL GENERAL LIABILITY 001 DAMA1� E TO RENTED PREMISES Ea or:<urrence $100,000 CLAIMS MADE F_X I OCCUR IVIED EXP (Anyone person) $2,500 PERSONAL & ADV INJURY $2,000,000 X PROFESSIONAL LIABILITY GENERAL AGGREGATE $4,000,000 PRODUCTS—COMP/OP AGG $4,000,000 GENT AGGREGATE LIMIT APPLIES PER: X POLICY PROJECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (EA accident) BODILY INJURY ALL OWNED AUTOS SCHEDULED AUTOS (Per person) BODILY INJURY HIRED AUTOS NON -OWNED AUTOS ( Per accident) PROPERTY DAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY — EA ACCIDENT ' OTHERTHAN EA ACC ANYAUTO AUTO ONLY: AGG EXCESS / UMBRELLA LIABILITY EACH OCCURENCE OCCUR ❑ CLAIMS MADE AGGREGATE DEDUCTIBLE RETENTION EMPLOYERS' LIABILITY YIN TORY LIMITS ER ANY PRO PSI I ETCR/PARTNER/EXECUTIVE � 1 OFFICER/MEMBER EXCLUDED? E.L EACH ACCIDENT E.L. DISEASE — EA AMPLOYEE (Mandatory in NH) If 7r�s, duTlbe unSIOder SPECIALePROVINS below E.L. DISEASE — POLICY LIMIT OTHER DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS It is understood and agreed that the following entity is added as an additional insured but only with respect(s) to the operations of the named insured except that liability resulting from the additional insured's sole negligence CERTIFICATE HOLDER CANCELLATION City of La Quinta 78495 Calle Tampico La Quinta„ CA 92253- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25 (2009/01) © 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2009/01) POLICY NUMBER: PHPK1761395-001 COMMERCIAL GENERAL LIABILITY CG 20 26 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Name Of Additional Insured Person(s) Or Oi City of La Quinta 78495 Calle Tampico La Quinta, CA 92253- Information required to complete this Schedule SCHEDULE if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 26 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 PI-GL-005 (07/12) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED PRIMARY AND NON-CONTRIBUTORY INSURANCE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization (Additional Insured): City of La Quinta Effective Date: 01/06/2019 SECTION II — WHO IS AN INSURED is amended to include as an additional insured the person(s) or organization(s) shown in the endorsement Schedule, but only with respect to liability for "bodily injury," "property damage" or "personal and advertising injury" arising out of or relating to your negligence in the performance of "your work" for such person(s) or organization(s) that occurs on or after the effective date shown in the endorsement Schedule. This insurance is primary to and non-contributory with any other insurance maintained by the person or organization (Additional Insured), except for loss resulting from the sole negligence of that person or organization. This condition applies even if other valid and collectible insurance is available to the Additional Insured for a loss or "occurrence" we cover for this Additional Insured. The Additional Insured's limits of insurance do not increase our limits of insurance, as described in SECTION III — LIMITS OF INSURANCE. All other terms, conditions, and exclusions under the policy are applicable to this endorsement and remain unchanged. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission