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ENC2022-00444 Qwkra — Gr.M ofibe DE';Fxr — ENCROACHMENT PERMIT PUBLIC WORKS CONSTRUCTION See below for Finance Revenue Codes For the construction of public or private curbs, driveways, pavements, sidewalks, parking lots, sewers, water mains and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS. DATE: 5/9/2022 LOCATION OF CONSTRUCTION (Street address or Description): HWY 111, WASHINGTON, AND JEFFERSON; SEE EXHIBIT PURPOSE OF CONSTRUCTION: CHANGEABLE MESSAGE SIGNS FOR EVENT - SEE ATTACHED EXHIBIT FOR LOCATIONS DESCRIPTION OF CONSTRUCTION: E-BIKE TOUR ON MAY 10TH; CMS SIGNS DIMENSION OF INSTALLATION OR REMOVAL: APPROXIMATE TIME WHEN WORK WILL BEGIN: 5/10/2022 TIME OF COMPLETION: 5/10/2022 ESTIMATED CONSTRUCTION COST: $5,000.00 (Including removal of all obstruction, materials, and debris, backfilling, compaction and placing permanent resurfacing and/or replacing improvements) Pto] MA 1AA 1: 1►1161 In consideration of the granting of this permit, the applicant hereby agrees to: Indemnify, defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and all penalties, liabilities or loss resulting from claims or court action and arising out of any accident, loss or damage to persons or property happening or occurring as a proximate result of any work undertaken under the permit granted pursuant to this application. Notify the Administrative Authority at least twenty-four (24) hours in advance of the time when work will be started at (760) 777-7097. To submit an inspection request, leave a message on the Inspection Request Hotline at (760) 777-7097 prior to 1:30 P.M. at least twenty-four (24) hours prior to the anticipated inspection. Comply with all applicable City Ordinances, the terms and conditions of the permit and all applicable rules and regulations of the City of La Quinta and to pay for any additional replacement necessary as the result of this work. EVENTIS PALM SPRINGS LLC -BRAD SMITH Name of Applicant (please print) TOPS N BARRICADES INC 40004 COOK ST STE 1 PALM DESERT, CA 92211 Business Address 44631 Jackson Street Indio, CA 92201 Name of Contractor and Job Foreman Business Address 787664 Contractor's License No. NEW YORK MARINE & GENERAL INSURANCE Applicant's Insurance Company Finance Revenue Code PERMIT INSPECTION TRAFFIC CONTROL $337.00 TECHNOLOGY ENHANCEMENT FEE $5.00 TOTAL: $0.00 103875 City Business License No. PK202200004224 Policy Number PERMIT NO: ENC2022-0044 DATE ISSUED: 5/9/2022 EXPIRATION DATE: 5/9/2023 BY: AMY YU WORK INSPECTED BY*: PERMIT COMPLETION DATE*: APPLIED ON ETRAKIT Signature of Applicant or Agent (805)451-2550 Telephone No. (760)347-2111 Telephone No. *If the work is covered by a Subdivision Improvement Agreement, Subdivider shall request final acceptance of improvements from the City Council. u II. u.,_.".­ uY w POP U l� ,7 r w }s Burge Bbx F + , M •, � ,,. .. .cy� - � _ r ly. "err ter.. a Breezest{emcivis _ :ice rr+d _ -�- • •acy Jrtwj� W. 4rinlg Dr rWarrn9 Or Paen JO r Rr"ale , p; - n irra l7esert+RtfeaL - + T sx nbianV�cllGoli Club �, F lfr�3te5[yp}f Re�. r�t v f Ly n(m � �n Weil - E , ,� � f lementaey ... ,�. r : A _'.,r CHANGEABLE l� 44&0tv La � tayr .. #' im Wells, 0 Idi�n Weill tedl5 at L15fiegh MESSAGE AI1e - wImfm — Ate k1�Ic�s ., SIGN Indio - <, f . o r . Middae ... .p r to C ffha.rse ICHANGEABLE; h . L� � � o - MESSAGE S�in�ug5 � ,q '` CHANGEABLE.,e - �re� r E Prz ,> y MESSAGE- - r.SIGN t �: . �.. • ,. .1"• SIGN "''•"� , . f� � Dr - estward Ho [7r � 'Atire+�ue ib I,�' •''' nr� CHANGEABLE ' ; s Ae is OulAt � '� ° l°" 4 Indio VSt�[lrla+ H '. g MESSAGE (acr,t (.,jr �ir� on s ' # _ ,y SIGN ac I+,_ ✓ - - F+1u�tim of - Sd :I • i &ddcp — 5 [ _ F _ ` .'_ : r� F§C,m e h � Gah�l;� ICI �'�, .. � .� '�iAat"hiS F,reLhars t�D01 Intl untry` ' ^" 4l r 4 '° ' �+ .. ! P, r1 :i the fimw, Depot r . r ,. rr rs�rne`. 'r #urrl�ture Indio y .�... _ t,•, , _ e rt r i �" j leg rear v Iarirs7l(jplf! PiAnrtl 4 LrRidI host Pius l�'Vcx1d#w4alrkek �- r,�.o; C.olvalez CHANGEABLE i�i it MESSAGE firawelctd�e We Ir�fecr: •" r �, rt rtcr CHANGEABLE I�t wrial r irzio SIGN - r da WE-! ftw �, n MESSAGE��I� �'� r� SIGN - `.. K _ - - iiYc'n- €t, ky2 kd .ti+r wi;—ii�; 1-1jorrtth St �f 4 _ ' r r • x e _+ .. . •. r ° .e•` _ . < 'r 'a..a� s7tC+road��h , Eiseealwtr [1� „+++ r 7, •' ,�,,r�-'+. I Ftl�'�`_k �f:;(ar. can tfUrr+es Rancho Lt r ' CHANGEABLE ' CHANGEABLE ,�. .,+'" CHANGEABLE , -' . MESSAGE MESSAGE r Lgrr,tYrt ;,'., MESSAGE SIGN SIGN A" " 4% SIGN a d 3- t mmmmm I. t�l � -he�WLLntd ¢ t +. Lrasrng i??~ ... t3emetttary Sd1D .. r k,+.ealty m-xi l4rerx,c 5+D'+�,+w1za+�tain iVj4lt k� `I r a ! $i �� SVri m T �/7,�� yy�+,*.+ ,F lh. I 7 - - M,CFiW1uY yr . M lei � 4L[�N � 'c�ti 'ry.. "I �.'� " ���� altra y i.,s `� - ,� twCMJntT�P, '•+5' 4993rO Lundberg Ln. 41 .A I Qulnta a n � �_! a k" R�rCffO P � s CA 92201, 3nrk,ed 5 Embassy' S+aites tr, �+r La Qwft Rteuxt K: ton la( _ ,� Cl��b CHANGEABLE Goff Come �A west c t of l�r't MESSAGE , Tack Roc ` n+ta�nv�r SIGNcountry� � � IJXIl1RY;LEASING,4NC , v Club _L'_�_. ES# rdt Maria of I w, ' J lt71xd5 tl liriand •E'3iP&O PIM C& r i„ La' MuSeurn PERMIT NO. ENC2022-0044 E-Bike Tour /Changeable Message Boards for Event /Hwy 111, Washington St, and Jefferson St; See Attached Exhibit (No asphalt or earthwork permitted) The following permit conditions shall apply: 1. Pursuant to Section 14.16.320 of the La Quinta Municipal Code (Ordinance 10 § 1 (part), 1982), all work shall be performed in accordance with the latest edition of the Standard Specifications for Public Works Construction (SSPWC) and as directed by and to the satisfaction of the City Engineer. 2. This permit or copy of it shall be on the work site (usually the job trailer) for inspection during the actual work performed. 3. The permittee shall remove all signs immediately after the completion of the event. Sign removal should be accomplished by the end of 6PM on May 10, 2022. 4. The permittee must maintain proper stopping and sight distances for the vehicular traffic users using the public right of way. 5. The permittee is responsible for obtaining a valid separate permit from other cities and agencies if any of the work or traffic control devices extend into other cities and agencies' right of way. 6. The City of La Quinta reserves the right to require modifications of the work be made at permittee's sole cost for proper sight distance requirements per guidelines in the AASHTO "A Policy on Geometric Design of Highways and Streets, 51h Edition" or latest, in the installation of all appurtenances abutting and within the public street right-of-way. 7. Streets shall be kept clean. They shall be completely cleaned at the end of each working day and more frequently, if required. 8. The Applicant or Contractor shall furnish the City satisfactory evidence of insurance in the amounts provided in the Engineering Bulletin #97-04 for Indemnification & Insurance Requirements. This insurance shall be kept in full force and effect at all times by Applicant or Contractor during the prosecution of the permitted work and updated Certificate of Liability Insurance and endorsements shall be submitted to the City. Each policy shall name the City as an additional insured. 9. Pursuant to Section 14.16.250 of the La Quinta Municipal Code (Ordinance 10 § 1 (part), 1982), at residential streets, advance warning signs and traffic control shall be installed and maintained in accordance the latest edition of the California Manual of Uniform Traffic Control Devices (CA MUTCD) or the latest edition of the Work Area Traffic Control Handbook (WATCH). On Collectors to Arterial Streets, the permittee must submit a traffic control plan which shall be from or prepared under the guidance of the latest edition of the California Manual of Uniform Traffic Control Devices (CA MUTCD) or the latest edition of the Work Area Traffic Control Handbook (WATCH). Traffic Control plans not from the CA MUTCD or the WATCH shall be signed and stamped by a civil or traffic engineer registered in the State of California. It shall be the Permittee's responsibility to appropriately detour and barricade all construction sites. PERMIT NO. ENC2022-0044 E-Bike Tour /Changeable Message Boards for Event /Hwy 111, Washington St, and Jefferson St; See Attached Exhibit (No asphalt or earthwork permitted) 10. If public traffic lanes are required to be closed, this permit is not valid until the permittee submits, to the Public Works Department, a traffic control plan for review and approval prior to start of construction or parking on the paved R/W. 11. Pursuant to Section 14.16.110 of the La Quinta Municipal Code (Ordinance 10 § 1 (part), 1982), Permittee shall assume responsibility for repair of any pavement damage to any public or private street and for any damage to other City streets or facilities as a result of work performed under this permit. 12. Prior to excavating, if required, the Permittee shall contact Underground Service Alert at 1- 800-422-4133. It shall be the Permittee's responsibility to notify the Public Works Department of anticipated excavation which impact City facilities, including but not limited to traffic signal conduits and loops, irrigation lines, electrical conduits, and storm drain facilities. 13. Should additional work, materials, or modifications of the work be required in order to meet City standards, safety requirements, signage requirements, or to fit actual field conditions, the work shall be performed by the Permittee as directed by and to the satisfaction of the City Engineer at no cost to the City of La Quinta. 14. The permittee shall not encroach upon private property without prior written approval (submit to the Design and Development Department, attention to the Associate Engineer) of the private land owner whom is being encroached upon. 15. All landscaping, irrigation, decorative rock, decorative concrete, sidewalk, lighting, etc., shall be replaced to its original condition. 16. Access and egress to all local properties shall be maintained at all times. 17. Permittee shall permanently stabilize any and all soil that was disturbed as a result of work performed under this permit with an approved dust control treatment. Soil stabilization shall be done immediately after completing the operation. 18. Pursuant to Chapter 12.56 of the La Quinta Municipal Code (Ordinance 10 § 1 (part), 1982) the City has designated certain city streets as Truck Routes. The weight limit for restricted streets (i.e., streets not part of the Truck Route network) is three (3) tons; trucks exceeding the weight limit may use a restricted street if making a delivery or pickup on the subject street, or if this permit specifically grants permission to use the street to deliver street construction materials and/or equipment. 19. The City of La Quinta reserves the right to revoke, suspend or void this permit at any time. 20. The permittee shall indemnify, hold harmless and assume the defense of the City from all damages, delay costs, costs or expenses in law or equity that may arise out of work under this permit. ACCEPAL-01 MGRABOWSKI , 0 CERTIFICATE OF LIABILITY INSURANCE 111. �� DATE (M 4/28/202 YYY) 2022 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 # 0757776 CONTACT Mona -Rena Grabowski NAME: PHONE FAX (A/C, No, Ext): (818) 257-7407 (A/C, No): HUB International Insurance Services Inc. PO Box 20005 Encino, CA 91436 ADDRESS: Mona.Grabowski@hubinternational.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: New York Marine & General Insurance 16608 INSURED INSURER B : INSURER C Eventis Palm Springs, LLC dba Eventis Destination Services 40004 Cook St, Suite 1 INSURER D : INSURER E : Palm Desert, CA 92211 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 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 INSD SUBR WVD POLICY NUMBER POLICY EFF MM DD YYY POLICY EXP MM DD YYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR X PK202200004224 4/21/2022 4/21/2023 DAMAGE TO RENTED PREMISES Ea occurrence 100,000 $ MED EXP (Any oneperson) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY El JECT PRO ❑ LOC PRODUCTS - COMP/OP AGG $ 1,000,000 X $ OTHER: Per Event Aggregate A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 $ BODILY INJURY Perperson) $ ANY AUTO PK202200004224 4/21/2022 4/21/2023 OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ X PROPERTY DAMAGE Per accident $ HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 EXCESS LIAB CLAIMS -MADE UM202200001678 4/21/2022 4/21/2023 DED X RETENTION $ 10,000 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PER OTH- STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) N / A E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: May 10th, 2022 -E-Bike Tour The Certificate Holder is included as Additional Insured, but only as respects to claims arising out of the negligence of the Named Insured, only if required by written and signed contract. Primary and Non -Contributory wording is applicable with respect to General Liability, as required by written and signed contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of La Quinta Y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 78-495 Calle Tampico La Quinta, CA 92253 REPRESENTATIVE AUTHORIZED ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CERTIFICATE OF LIABILITY INSURANCE DATE 04/28/2022YYY) 04/28/2022 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 CONTACT NAME: AIC%, Ext : 877 362-6785 FAX No): 877 677-0447 PAYCHEX INSURANCE AGENCY INC 225 KENNETH DR ROCHESTER, NY 14623 E-MAIL ADDRESS: paychex@travelers.com INSURER(S) AFFORDING COVERAGE NAIC # (877) 362-6785 INSURER A: TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA INSURED EVENTIS PALM SPRINGS, LLC INSURER B : INSURER C : 40004 COOK ST INSURER D : STE 1 PALM DESERT, CA 92211 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 284985512581811 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 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP (Any oneperson) $ PERSONAL & ADV INJURY $ AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ GEN'L POLICY PRO- JECT LOC PRODUCTS - COMP/OP AGG $ $ OTHER: AUTOMOBILE LIABILITY (Ea acccident) INGLE LIMIT $ BODILY INJURY (Per person) $ ANY AUTO OWNED AUTOS AUTOS ONLY BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE (Per accident) $ $ OCCUR EACH OCCURRENCE $ �UMBRESLLAB CLAIMS -MADE $AGGREGATENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE N/A X UB-6N339531-21 10/01/2021 10/01/2022 X I STATUTE EORH EACH ACCIDENT $ 1 ,000,000 OFFICER/MEMBER EXCLUDED? ElE.L. (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 1 ,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AS RESPECTS TO WORKERS COMPENSATION COVERAGE, WC 04 03 06 (01) AND WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA HAS BEEN ATTACHED TO THE POLICY IN REGARD TO THE CITY OF LA QUINTA. VGFC I Irlk A 1 G MULUG11 THE 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, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE d ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: PK202200004224 COMMERCIAL GENERAL LIABILITY CG 20 26 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Additional Insured Person(s) Or Organization(s) City of La Quinta 78-495 Calle Tampico La Quinta, CA 92253 The City is included as Additional Insured, but only as respects to claims arising out of the negligence of the Named Insured, only if required by written and signed contract. Primary and Non -Contributory wording is applicable with respect to General Liability, as required by written and signed contract. Event Date: May 10, 2022 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II -Who Is An Insured is amended to include as 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 of omissions or the acts or omissions of those acting on your behalf: A. In the performance of your ongoing operations; B. In connection with your premises owned by or rented to you. CG 20 26 07 04 Page 1 of 1