Insurance Certificates 2023/24 CVWD SilverRock - LQ EOCEVIDENCE OF COVERAGE and ADDITIONAL PROTECTED PARTY June 28, 2023 3:31 PM
COVERAGE PROVIDER
MEMBER
California Joint Powers Insurance Authority
La Quinta
8081 Moody Street
78-495 Calle Tampico
La Palma CA 90623
www.cjpia.ora
La Quinta, CA 92253-2839
7607777123
Contact Name: Jim Thyden, Insurance Programs Manager
Phone: (562) 467-8700
Laurie McGinley
EOC Number 20190822174855008609
lmcginley@laquintaca.gov
7607777123
THIS IS TO CERTIFY THAT THE MEMBER LISTED ABOVE PARTICIPATES IN THE CALIFORNIA JOINT POWERS INSURANCE AUTHORITY'S SELF-
INSURANCE AND COMMERCIAL INSURANCE PROGRAM WITH THE COVERAGES AND LIMITS LISTED BELOW, SUBJECT TO ALL THE TERMS,
DEFINITIONS, EXCLUSIONS, CONDITIONS, AND RESPONSIBILITIES OF THE MEMORANDA OF COVERAGE FOR EACH LINE OF COVERAGE.
COVERAGES 16
THE COVERAGES LISTED BELOW HAVE BEEN ISSUED TO THE MEMBER NAMED ABOVE FOR THE COVERAGE PERIOD INDICATED,
NOTWITHSTANDING ANY REQUIREMENT, TERM, OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
EVIDENCE MAY BE ISSUED OR MAY PERTAIN, THE COVERAGE AFFORDED BY THE MEMORANDA DESCRIBED HERIN IS SUBJECT TO ALL THE
TERMS, EXCLUSIONS, AND CONDITIONS OF SUCH MEMORANDA. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
COVERAGE
TYPE OF COVERAGE
MEMORANDUM
EFFECTIVE DATE
LIMITS
(MM/DD/YY)
LIABILITY
AGGREGATE
$2,000,000
X OCCURRENCE
MOC LP
07/01/22-06/30/24
PRODUCTS-COMP/OP AGG
$ N/A
X
PERSONAL INJURY
PERSONAL & ADV INJURY
$2,000,000
X
ERRORS & OMISSIONS
EACH OCCURRENCE
$2,000,000
X
EMPLOYMENT PRACTICES
FIRE DAMAGE (Any one fire)
$ N/A
X
SEXUAL ABUSE AND
MED EXP (Any one person)
$ N/A
MOLESTATION
AUTOMOBILE
LIABILITY
ANY AUTOS
ALL OWNED AUTOS
SCHEDULED AUTOS
07/01/22-06/30/24
COMBINED SINGLE LIMIT
$2,000,000
X
BODILY INJURY (Per person)
$ N/A
BODILY INJURY (Per accident)
$ N/A
HIRED AUTOS
NON -OWNED AUTOS
PROPERTY DAMAGE
$ N/A
WORKER'S COMPENSATION
X
WC STATUTORY
$ N/A
AND EMPLOYER'S LIABILITY
MOC WC
07/01/22-06/30/24
LIMITS
X
I EMPLOYER'S LIABILITY
$1,000,000
ADDITIONAL REMARKS
When required by written agreement, the California Joint Powers Insurance Authority agrees to include the Evidence Holder as an Additional
Protected Party under the Memorandum of Coverage Liability Program, subject to the above -stated limits, but only for "Occurrences" caused by the
activity described in the written agreement between the Member and the Evidence Holder for the date(s) and time(s) specified in the written
agreement. If the written agreement requires, coverage shall be primary and non-contributory. If the written agreement requires, subrogation is
waived.
EVIDENCE HOLDER
CANCELLATION
Coachella Valley Water District
P.O. Box 1058
The California JPIA will endeavor to provide at least thirty (30) days notice
of any cancellation of coverage or reduction in coverage limits to the
Evidence Holder.
-
Coachella, CA92236
Tommy Fowlklkes
tfowlkes@cvwd.org,cvwd@ebix.com
760-398-2661
F
AUTHORIZED REPRESENTATIVE, Jim Thyden
California Joint Powers Insurance Authority is a joint powers authority pursuant to Article 1 (commencing with Section 6500) Chapter 5 of Division 7 of Title 1 of the California
Government Code.
EVIDENCE OF COVERAGE and ADDITIONAL PROTECTED PARTY June 28, 2023 3:31 PM
ADDITIONAL PROTECTED PARTY
Coachella Valley Water District, its employees, directors, officers and agents
ADDITIONAL COVERAGE NOTES
domestic water system, sanitation system and irrigation system modification installation at SilverRock.
domestic water system, sanitation system and irrigation system modification installation at SilverRock.
CC LIST