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Insurance Certificates 2021/22 JNS Media Specialists dba JNS Next08/09/2021 Ascend Insurance Agency 36917 Cook St. Ste 101 Palm Desert, CA 92211 License #: 0F44130 Ana Santos (760)341-3477 (760)341-3476 ana@ascendins.com 00004059-175478 6 JNS Media Specialists Inc. PO Box 420 La Quinta, CA 92247-0420 Sentinel Insurance Company, Limited 11000 A Y 57 SBA BK7571 07/08/2021 07/08/2022X X 1,000,000 1,000,000 10,000 1,000,000 2,000,000 2,000,000 California Automobile Insurance Company 38342 B BA040000060196 07/20/2021 07/20/2022 X X X 1,000,000 Employers Preferred Ins. Co.10346 C Y EIG4567237-01 07/08/2021 07/08/2022 Y X 1,000,000 1,000,000 1,000,000 Capitol Indemnity Corporation 10472 D ME2019112903 07/08/2021 07/08/2022Profesional Liab Liability Occ/Agg 1,000,000 Sentinel Insurance Company, Limited 11000 A 57 SBA BK7571 07/08/2021 07/08/2022Business Property BPP Limit 57,200 Certificate Holder, The City of La Quinta, its directors, officials, officers, employees, agents and volunteers, are named as an additional insured as per attached endorsement on the commercial general liability, and is primary and non-contributory as per attached endorsement. The City of La Quinta City Manager's Office 78495 Calle Tampico La Quinta, CA 92253 (ACS) Printed by ACS on August 09, 2021 at 09:33AM ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? INSR ADDL SUBR LTR INSD WVD DATE (MM/DD/YYYY) PRODUCER CONTACTNAME: FAXPHONE(A/C, No):(A/C, No, Ext): E-MAILADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY) (MM/DD/YYYY) AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATION AND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE EACH OCCURRENCE $ DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence) MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $ PRO-POLICY LOC PRODUCTS - COMP/OP AGG $JECT OTHER:$ COMBINED SINGLE LIMIT $(Ea accident) ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY (Per accident) $AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $AUTOS ONLY AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE $ CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ PER OTH-STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMIT $DESCRIPTION OF OPERATIONS below INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A (Mandatory in NH) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 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 POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 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). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORDACORD 25 (2016/03) CERTIFICATE OF LIABILITY INSURANCE MERCURY Policy Number: BA040000060196 / INSURANCE Effective Date: 07/20/2021 Renewal Declarations BUSINESS AUTO DECLARATIONS For resolving issues or other information you can contact your agent or Mercury using the below phone numbers: Issued By: Agent: California Automobile Insurance Company ASCEND INSURANCE P.O. Box 10730 36917 COOK ST STE 101 Santa Ana, CA 92711-0730 PALM DESERT, CA 92211 Billing: (888) 637-2176 Agent Number: 04C426 Claims: (800) 503-3724 Agent Phone: (760) 341-3477 ITEM ONE GENERAL INFORMATION Named Insured: JNS MEDIA SPECIALISTS INC. Mailing Address: PO Box 420, La Quinta, CA 92247-0420 Policy Period: From 07/20/2021 to 07/20/2022 at 12:01 AM Standard Time at your mailing address Business Type: Advertising Agency Business Category: Services Form of Business: Corporation Total Policy Premium: $2,264.76 This policy may be subject to final audit. In return for the payment of the premium, and subject to all the terms of this policy, we agree with you to provide the insurance as stated in this policy. ENDORSEMENTS ATTACHED TO THIS POLICY IL 00 17 1198 - Common Policy Conditions MCANONFAC0516 - Permanently Attached Non -Factory IL 00 2109 08 - Nuclear Energy Liability Exclusion MCA 2154 04 19 - California Uninsured Motorists - Bodily IL 00 03 09 08 - Calculation of Premium CA 04 24 10 13 - California Auto Medical Payments Coverage CA 00 0110 13 - Business Auto Coverage Form CA 99 23 10 13 - Rental Reimbursement Coverage CA 01 21 10 13 - Limited Mexico Coverage MCA86100617 - Roadside Assistance Coverage CA 0143 05 17 - California Changes MCA AM END 04 19 - Amendatory Endorsement MIL 02 70 04 19 - California Changes - Cancellation and MCH VEHSHARE 0619 - Vehicle Sharing Exclusion CA 23 94 10 13 - Silica or Silica Related Dust Exclusion IL N 119 10 15 - California Auto Body Repair Consumer Bill of MCA85100817-CA - Mercury Broadening Endorsement CA 20 0110 13 - Lessor- Additional Insured and Loss Payee MCA 23 45 06 19 - Public or Livery Passenger Conveyance MDS030817-CA Page 1 of 4 07/20/2021 12:01 AM PT Policy Number: BA040000060196 Effective Date: 07/20/2021 MERCURY INSURANCE ITEM TWO SCHEDULE OF COVERAGES AND COVERED AUTOS This policy provides only those coverages where a charge is shown in the premium column below. Each of these coverages will apply only to those "autos" shown as covered "autos". "Autos" are shown as covered "autos" for a particular coverage by the entry of one or more of the symbols from the Covered Autos Section of the Business Auto Coverage Form next to the name of the coverage. Coverages Coverage Limit Premium Symbol The Most We Will Pay For Any One Accident Or Loss Liability 7 $1,000,000 CSL $1,160 Medical Payments 7 $5,000 per person $55 Uninsured Motorists Bodily 7 $500,000 CSL $128 Injury Uninsured Motorists Rejected Property Damage Actual Cash Value Or Cost Of Repair, Whichever Is Less, Minus Deductible Shown in ITEM THREE For Each Covered Comprehensive 7 Auto, But No Deductible Applies To Loss Caused By Fire $231 Or Lightning. See ITEM FOUR For Hired Or Borrowed Autos. Actual Cash Value Or Cost Of Repair, Whichever Is Less, Specified Causes of Loss Minus Deductible Shown in ITEM THREE For Each Covered Auto For Loss Caused By Mischief Or Vandalism. See ITEM FOUR For Hired Or Borrowed Autos. Actual Cash Value Or Cost Of Repair, Whichever Is Less, Collision 7 Minus Deductible Shown in ITEM THREE For Each Covered $456 Auto. See ITEM FOUR For Hired Or Borrowed Autos. Premium For ITEM FOUR (Hired Auto Coverage) Premium For ITEM FIVE (Non -Ownership Liability) Premium For Endorsements $233.00 Miscellaneous Fees and Expense California Consumer Services and Fraud Program Fees $1.76 Total Policy Premium $2,264.76 MDS030817-CA Page 2 of 4 Policy Number: BA040000060196 Effective Date: 07/20/2021 MERCURY INSURANCE ITEM THREE SCHEDULE OF COVERED AUTOS YOU OWN Covered Auto No. Description Body Type VIN Garaging City ST Zip Code 1 2021 LEXUS RX 350 Sport Utility Vehicle 2T2HZMAA5MC202735 Indio CA 92201 Covered Auto No. Radius (In Miles) Vehicle Use Business Use *Stated Amount Non -Factory Equipment Limit Loss Payee 1 Up to 100 Miles Personal & Business Service $0 Toyota Lease Trust * Stated Amount coverage lists your vehicle's actual cash value, including the actual cash value of any Non -Factory Equipment permanently attached to the vehicle that you disclose to us, and is the most we will pay for a loss. Non -Factory Equipment coverage is subject to a sub -limit shown on the Declarations. Be sure to check the Stated Amount and Non -Factory Equipment sub -limit at every renewal in order to receive the best value from your Mercury Business Auto policy. COVERAGES, PREMIUMS, LIMITS, AND DEDUCTIBLES (Absence of a deductible or limit entry in any column below means that the limit or deductible entry in the corresponding ITEM TWO column applies instead.) Covered Auto No. Liability Premium Auto Medical Payments Premium UM Bodily Injury Premium UM Property Damage Premium Comprehensive Deductible Premium 1 $1,160 $55 $128 $500 $231 Covered Auto No. Specified Causes Of Loss Collision CDW Premium Roadside Assistance Deductible Premium Deductible Premium Limit Per Occurrence Premium 1 $500 $456 $100 per $20 Covered Auto No. Rental Reimbursement Auto Loan/Lease Gap Premium Audio, Visual, & Data Equipment Total Vehicle Premium Maximum Payment Each Covered Auto Premium Limit Premium 1 $40 per day/30 days $38 $2,088.00 MDS030817-CA Page 3 of 4 Policy Number: BA040000060196 Effective Date: 07/20/2021 MERCURY INSURANCE TOTAL PREMIUMS Liability $1,160 Medical Payments $55 Uninsured Motorists Bodily Injury $128 Uninsured Motorists Property Damage Collision Deductible Waiver Comprehensive $231 Specified Causes of Loss Collision $456 Roadside Assistance $20 Rental Reimbursement $38 Loan/Lease Gap Audio, Visual and Data Electronic Equipment ITEM FOUR SCHEDULE OF HIRED OR BORROWED COVERED AUTO COVERAGE AND PREMIUMS Cost of hire means the total amount you incur for the hire of "autos" you don't own (not including "autos" you borrow or rent from your partners or "employees" or their family members). Cost of hire does not include charges for services performed by motor carriers of property or passengers. Estimated Annual Cost Of Hire Liability Coverage Physical Damage Coverage Total ITEM FOUR Premium Premium Limit Of Insurance Premium Actual Cash Value Or Cost Of Repair, Whichever Is Less, Minus $500 Deductible For Each Covered Auto. ITEM FIVE SCHEDULE FOR NON -OWNERSHIP LIABILITY Number Of Employees (Including Volunteers) Total ITEM FIVE Premium ADDITIONAL INFORMATION Discounts • Pay in Full • Multi -Line Driver Information Listed Drivers Excluded Drivers JUDY SAGE GARRY SAGE Other Endorsements I Premium Broadening Endorsement $175 MDS030817-CA Page 4 of 4 ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE(MMro01YYY1f) 07/08/2021 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(les) 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 endorsements . PRODUCER Ascend Insurance Agency 36917 Cook St. Ste 101 Desert, CA 92211 CONTACT NAME: Ana Santos ONE FAx 760 341-3477 MC No): 760 341-3476 E-MAIPalm ADDRESS: ana@ascondins.com INSURERS AFFORDING COVERAGE NAIC p License #: OF44130 INSURER A: Sentinel Insurance Col1�pal1y, Limited 11000 _ INSURED INSURER B : California Automobile Insurance Company 38342 JNS Media Specialists Inc. INSURERC: Empoyers Preferred Ins. Co. 10346 PO Box 420 La Quinta, CA 92247-0420 INSURER D : CpftUndemnity Corporation 10472 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 00004059-175478 REVISION NUMBER: 5 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 POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP M DD LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR Y 57 SBA BK7671 07/08/2021 07/0812022 EACH OCCURRENCE $ 1000,000 DAMAGE TO RENTED PREMISES Ea occurrence)$ 1,000000 f-' GEN'L X MED EXP (Any one person) $ 10,000 PERSONAL 8 ADV INJURY $ 11000,000 AGGREGATE LIMIT APPLIES PER: POLICY JEC LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS AUTOS ONLY Ix X AUTOS ONLY AUTOS ONLD BA040000060196 07/20/2020 07/20/2021 COMid SI D NGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) S BODILY INJURY (Per accident) S Peer a�den DAMAGE _ $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE I I EACH OCCURRENCE Is AGGREGATE Is DED I RETENTION S I S C WORKERS COMPENSATION AND EMPLOYERS* LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? a (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A Y EIG4567237-01 07/08/2021 07/08/2022 X STAOT STATUTE ER E.L. EACH ACCIDENT $ 1,000 000 E.L. DISEASE - EA EMPLOYE $ 1 1000P000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 D A Profesional Liab Business Property ME2019112903 57 SBA BK7671 07/08/2021 07/08/2021 07108/2022 07/0812022 Liability Occ/Agg BPP Limit 190000000 67,200 DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more apace Is required) Certificate Holder, The City of La Quinta, its directors, officials, officers, employees, agents and volunteers, are named as an additional insured as per attached endorsement on the commercial general liability, and is primary and non-contributory as per attached endorsement. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE The City of La Quinta THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City Manager's Office ACCORDANCE WITH THE POU Y PROVISIONS. 78495 Calle Tampico AUTHORIZED REPRESENTATIVE , La Quinta, CA 92263 ACS 01988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Printed by ACS on .July 08, 2021 at 03:59PM Policy: 57 SBA BK7571 Insured: JNS MEDIA SPECIALISTS, INC. BUSINESS LIABILITY COVERAGE FORM BLANKET ENDORSEMENTS Additional Insureds When Required by Written Contract, Written Agreement or Permit The person(s) or organization(s) identified in Paragraphs a. through f. below are additional insureds when you have agreed, in a written contract, written agreement or because of a permit issued by a state or political subdivision, that such a person or organization be added as an additional insured on your policy, provided the damage occurs subsequent to the execution of the contract or agreement, or the issuance of the permit. A person or organization is an additional insured under this provision only for that period of time require by the contract, agreement or permit. a) Vendors b) Any express warranty unauthorized by you; c) Lessors Of Land or Premises d) Architects, Engineers or Surveyors e) Permits Issued By State or Political Subdivisions f) Any Other Party not insured in A through E above Primary And Non -Contributory To Other Insurance When Required By Contract If you have agreed in a written contract, written agreement or permit that this insurance is primary and non-contributory with the additional insured's own insurance, this insurance is primary and will not seek contribution from that other insurance. Waiver Of Rights Of Recovery (Waiver Of Subrogation) If the insured has waived any rights of recovery against any person or organization for all or part of any payment, including Supplementary Payments, we have made under this Coverage Part, we also waive that right, provided the insured waived their rights of recovery against such person or organization in a contract, agreement or permit that was executed prior to the injury or damage. FORM SS 00 08 04 05 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 0313 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. SCHEDULE Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. Policy Effective 0 7/ 0 8/ 2 019 Policy Expiration 0 7/ 0 8/ 2 0 2 0 Carrier Code 22985 Endorsement Effective 0 7 / 0 a / 2 019 Policy Number QWC1086287 Insured JNS Media Specialists Inc.