Insurance Certificates 2023/24 CDBG - LQ Evidence of CoverageEVIDENCE OF COVERAGE June 28, 2023 11:45 AM
COVERAGE PROVIDER
MEMBER
California Joint Powers Insurance Authority
La Quinta
8081 Moody Street
78-495 Calle Tampico
La Palma CA 90623
www.cipia.org
La Quinta, CA 92253-2839
760-777-7123
Contact Name: Jim Thyden, Insurance Programs Manager
Phone: (562) 467-8784
Laurie McGinley
]mcginley@laquintaca.gov
EOC Number 20151123162344001059
760-777-7123
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
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 INSURANCE 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
OCCURRENCE
07/01/22-06/30/24
AGGREGATE
$1,000,000
PRODUCTS-COMP/OP AGG
$ N/A
PERSONAL INJURY
M O C L P
PERSONAL & ADV INJURY
$1,000,000
ERROR & OMISSIONS
EACH OCCURRENCE
$1,000,000
EMPLOYMENT PRACTICES
FIRE DAMAGE (Any one fire)
$ N/A
SEXUAL ASSAULT AND
MOLESTATION
MED EXP (Any one person)
$ N/A
AUTOMOBILE
LIABILITY
ANY AUTOS
ALL OWNED AUTOS
COMBINED SINGLE LIMIT
$1,000,000
BODILY INJURY
$ N/A
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
07/01/22-06/30/24
er erson
BODILY INJURY
(Per accident)
$ N/A
PROPERTY DAMAGE
$ N/A
WORKER'S COMPENSATION AND
WC STATUTORY LIMITS
$ N/A
EMPLOYER'S LIABILITY
07/01/22-06/30/24
EMPLOYER'S LIABILITY
$1,000,000
ADDITIONAL REMARKS
EVIDENCE HOLDER
CANCELLATION
The California JPIA will endeavor to provide at least thirty (30) days notice of any
Riverside County HWS, Community Svcs Division
cancellation of coverage or reduction in coverage limits to the Evidence Holder.
44199 Monroe Street, Suite B
78495 Calle Tampico
La Quinta, CA 92253
Blanca Higuera
B1Higuera@Rivco.org
AUTHORIZED REPRESENTATIVE, Jim Thyden
760-863-2650
California Joint Powers Insurance Authority is ajoint powers authority pursuant to Article 1 (commencing with Section 6500) Chapter 5 of Division 7 of Title 1 of the California Govemment Code.
EVIDENCE OF COVERAGE June 28, 2023 11:45 AM
ADDITIONAL COVERAGE NOTES
CDBG Block Grant 2023-24 CDBG Block Grant 2023-24
CC LIST