Insurance Certificates 2021/22 LQ Hospitality Group, LLC�_iIR9I N :J:ZsylTi I
14911:1-jolI
144CCWRL)l` CERTIFICATE OF LIABILITY INSURANCE
EDA�TE(MM/DDffYYY)
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(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
Southwest Risk Management, LLC
4801 E McKellips
Mesa, AZ 85215
CANT ACT
PA/CO,NNo, Ext: 480 924-1200 FAx
( ) (Alc, No):(480) 924-1211
E-p%RI , service@southwestrisk.com
INSU S AFFORAING COVERAGE
NAIC #
INSURER A.- Auto -Owners -Insurance Company
.18988
INSURED
INSURER B: ACE Property and Casualty Insurance Company
20699
INSURER C :
LQ Hospitality Group, LLC
INSURER D :
79675 Highway 111
La Quinta, CA 92253
INSURER E ;
INSURER F ;
COVERAGES CFRTIFIrATF Nl]MRF-R- REVISInN 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 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
TYPE OF INSURANCE
ADDL
SUBR
POLICY NUMBER
POLICY EFF
POLICY EXPLTR
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE C OCCUR
X
.45234003
9/23/2021
9/23/2022
EACH OCCURRENCE
$ 1,000,000
DAMMGE.TISES0 RENTED ocruivencel$
300,000
MED EXP (Any oneperson)
$ 10,000
PERSONAL B ADV INJURY
$ 1,000,000
GEN'LAGGREGATE LIMIT APPLIES PER:
X Poucy jEeT LOC
OTHER;
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - COMP/OP AGG
$ 2,000,000
A
AUTOMOBILE
X
LIABILITY
ANY AUTO _
OWNED j SCHEDULED
AUTOS ONLY AUTOS
AUTOS ONLY AUOTO ON
49-438557-01
9/2312021
9/23/2022
COMBINED SINGLE LIMIT
tEa a cident)
1,000,000
BODILY INJURY Per erson
$
BODILY INJURY Per accident
$
eOecEotlTent AMAGE
$
B
X
UMBRELLA LIAB
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
IHL121-A-G73650860
9/23/2021
9/23/2022
EACH OCCURRENCE
$ 25,000,000
AGGREGATE
$ 25,000,000
DIED I X I RETENTION $ 0
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE ❑
FFIC ER/MEMBER EXCLUDED?
9.55toryInNH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N / A
P7A7 E ORH
EL EACH ACCIDENT
$
F1,DISEASE -EAEMPLOYEE
$
F L DISFASE - POLICY LIMIT
$
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required)
The City of La Quinta, CA
78-495 Calle Tampico
La Quinta, CA 92253
RfLl►L4la11111R-11 III Lai ►I
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
`7
ACORD 25 (2016103) @ 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD