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Insurance Certificates 2024/25 Desert Aids Project (DAP)INSURANCE REVIEWCu �Cu CALIFORNIA RE: DAP Health - Volunteer Organization Agreement FY 2024-25 Please list the Contracting Party/ Vendor Name, type of agreement to be executed, including any change orders or amendments, and the type of services to be provided. Make sure to list any related Project No. and Project Name. Insurance certificates required per the Agreement: ACCORD Certificate dated 10 -days prior or less 6/24/2024 enter ACCORD issue date Commercial General Liability Insurance: ❑✓ $1,000,000 per occurrence/$2,000,000 aggregate OR ❑ $2,000,000 per occurrence/$4,000,000 aggregate ❑✓ Additional Insured Endorsement naming City of La Quinta ❑✓ Primary and Non -Contributory Endorsement Automobile Liability: $1,000,000 combined single limit for bodily injury and property damage. Workers' Compensation: ❑✓ Statutory Limits / Employer's Liability $1,000,000 per accident or disease ❑✓ Workers' Compensation Endorsement with Waiver of Subrogation ❑ Sole Proprietor Professional Liability (Errors and Omissions): ❑ Errors and Omissions Liability insurance with a limit of not less than $1,000,000 per claim Cyber Liability/Technology Errors and Omissions Liability Insurance: $1,000,000 per occurrence/loss Other: Approved by: Date: List other insurance types such as - molestation, harassment, etc. Oscar Mojica 7/24/2024 / A� " CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 6/24/2024 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 (OC) Heffernan Insurance Brokers 18004 Sky Park Circle, Suite 210 CA 92614 CONTACT NAME: Heffernan Insurance Brokers PHONE FAX AIC No Ext): 925-934-8500 AIC No): 925-934-8278 E-MIrvine ADDRESS: HIB24-7@heffins.com INSURER(S) AFFORDING COVERAGE NAIC # Y INSURERA: National Fire & Marine Insurance Company 20079 License#: 0564249 INSURED DESEAID-03 INSURERB: Philadelphia Indemnity Insurance Company 18058 Desert Aids Project Inc 1695 N Sunrise Way INSURERC: Nonprofits United Workers Compensation Group, Inc. INSURER D: Safety National Casualty Corporation 15105 Palm Springs CA 92262 INSURER E, PREMISES (Ea oDAMAGE TO ccurrence) INSURER F: MED EXP (Any one person) COVERAGES CERTIFICATE NUMBER: 815731348 REVISION NUMBER: 1 Added Professi 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/DDIYYYY POLICY EXP MM/DDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y HN017770 10/5/2023 10/5/2024 EACH OCCURRENCE $1,000,000 CLAIMS -MADE � OCCUR PREMISES (Ea oDAMAGE TO ccurrence) $ 250,000 MED EXP (Any one person) $ PERSONAL & ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000 GEN'L X POLICY ❑ PRO- JECT [:]LOC PRODUCTS - COMP/OP AGG $ 3,000,000 $ OTHER: B AUTOMOBILE LIABILITY PHPK2609780 10/5/2023 10/5/2024 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ X HIRED�( NON -OWNED AUTOS ONLY AUTOS ONLY A UMBRELLA LAB X OCCUR EN017770 10/5/2023 10/5/2024 EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 X EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N NPU-WCG002-2024 1/1/2024 1/1/2025 X PER OTH- STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 750,000 OFFICER/MEMBER EXCLUDED? ❑ N/A E.L. DISEASE - EA EMPLOYEE $ 750,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 750,000 A Prof. Liability - Claims Made HN017770 10/5/2023 10/5/2024 $1,000,000 Per Claim $3,000,000 Aggr D XSWC SP4067530 1/1/2024 1/1/2025 XSof$750,000 XS of $750,000 2,000,000 (EL) Statutory (WC) DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: Events in La Quinta on July 10th, August 14th and September 11th, 2024. City of La Quinta is included as an additional insured (primary and non-contributory) on General Liability policy per the attached endorsements, if required. Waiver of Subrogation is included on General Liability policy per the attached endorsement, if required. This Certificate Replaces and Supersedes all previously issued Certificates. CERTIFICATE HOLDER CANCELLATION ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of La Quinta 78495 Calle Tampico La Quinta, CA 92253 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD MedPro Group 1 _ a BAFhim Flalha y campy Issuing Company: National Fire & Marine Insurance Company Omaha, Nebraska THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULL Y, Endorsement No.: Forming Part of Policy No.: Issued to: 7 HN017770 Desert AIDS Project Inc. Effective Date of Endorsement: 10/05/2023 at 12:01 a.m. at the address of the First Named Insured stated herein. BLANKET ADDITIONAL INSURED ENDORSEMENT (GENERAL LIABILITY) Only with respect to coverage provided under this endorsement and under the General Liability Coverage Part, and in consideration of the payment of the additional premium due, if any, and in reliance upon the representations of all insureds, the company and the insureds agree to amend the policy as follows: The definition of additional insured in the Definitions section of the Common Policy Provisions and Conditions is deleted and replaced with the following: Additional insured means any person or organization with which the insured has entered into a written contract or agreement prior to the event or offense agreeing: 1. to add the person or organization as an additional insured; or 2. to hold harmless or indemnify such person or organization. However, such person or organization is not an additional insured with respect to events or offenses arising from, or in connection with, any acts or omissions alleged to have been committed by that additional insured. The following subparagraph is added to all Insuring Clauses of the General Liability Coverage Part: The company's duty to defend and pay losses or claims expense on behalf of any insured shall extend to any additional insured meeting the terms and conditions of this policy, but only with respect to any loss or claims expense payable as the result of the additional insured's vicarious liability for the acts or omissions of an insured otherwise covered under this Coverage Part. However, the coverage provided to an additional insured shall not be broader than that which an insured is required by written contract or agreement to provide to that additional insured and is subject to all other conditions, definitions, exclusions and terms applicable to the insured. Additionally, coverage shall not apply to structural alterations, new construction or demolition operations performed by or on behalf of an additional insured. The following provision is added to the Limits of Liability section of the General Liability Coverage Part: ADDITIONAL INSUREDS Additional insureds share the Limits of Liability of the insured for which the additional insured is alleged to be vicariously liable for the acts or omissions of the insured otherwise covered under this Coverage Part. All other terms and conditions of the policy remain unchanged. 1506-PGX-00-0121 Page 1 of 1 © 2021 MedPro Group. All rights reserved. MedProGroup 1 _ a B»kshin= Halha o y company Issuing Company: National Fire & Marine Insurance Company Omaha, Nebraska THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULL Y, Endorsement No.: Forming Part of Policy No.: Issued to: HN017770 Desert AIDS Project Inc. Effective Date of Endorsement: 10/05/2023 at 12:01 a.m. at the address of the First Named Insured stated herein. BLANKET ADDITIONAL INSURED — PRIMARY AND NON-CONTRIBUTORY ENDORSEMENT (GENERAL LIABILITY) Only with respect to coverage provided under this endorsement and under the General Liability Coverage Part, and in consideration of the payment of the additional premium due, if any, and in reliance upon the representations of all insureds, the company and the insureds agree to amend the policy as follows: The definition of additional insured in the Definitions section of the Common Policy Provisions and Conditions is deleted and replaced with the following: Additional insured means any person or organization with which the insured has entered into a written contract or agreement prior to the event or offense agreeing: 1. to add the person or organization as an additional insured; or 2. to hold harmless or indemnify such person or organization. However, such person or organization is not an additional insured with respect to events or offenses arising from, or in connection with, any acts or omissions alleged to have been committed by that additional insured. The following subparagraph is added to the Other Insurance condition of the Conditions section of the Common Policy Provisions and Conditions: Only if required by written contract or agreement with the insured, coverage for any additional insured shall be primary and non-contributory as respects any other insurance policy issued to such additional insured. The following subparagraph is added to all Insuring Clauses of the General Liability Coverage Part policy: The company's duty to defend and pay losses or claims expense on behalf of any insured shall extend to any additional insured meeting the terms and conditions of this policy, but only with respect to any loss or claims expense payable as the result of the additional insured's vicarious liability for the acts or omissions of an insured otherwise covered under this Coverage Part. However, the coverage provided to an additional insured shall not be broader than that which an insured is required by written contract or agreement to provide to that additional insured and is subject to all other conditions, definitions, exclusions and terms applicable to the insured. Additionally, coverage shall not apply to structural alterations, new construction or demolition operations performed by or on behalf of an additional insured. 1507-PGX-00-0121 Page 1 of 2 © 2021 MedPro Group. All rights reserved. The following provision is added to the Limits of Liability section of the General Liability Coverage Part: ADDITIONAL INSUREDS Additional insureds share the Limits of Liability of the insured for which the additional insured is alleged to be vicariously liable for the acts or omissions of the insured otherwise covered under this Coverage Part. All other terms and conditions of the policy remain unchanged. 1507-PGX-00-0121 Page 2 of 2 © 2021 MedPro Group. All rights reserved. MedProGroup 1 _ a B»kshin= Halha o y company Issuing Company: National Fire & Marine Insurance Company Omaha, Nebraska THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULL Y, Endorsement No.: Forming Part of Policy No.: Issued to: 0 HN017770 Desert AIDS Project Inc. Effective Date of Endorsement: 10/05/2023 at 12:01 a.m. at the address of the First Named Insured stated herein. BLANKET WAIVER OF SUBROGATION ENDORSEMENT (GENERAL LIABILITY) In consideration of the payment of the additional premium due, if any, and in reliance upon the representations of all insureds, the company and the insureds agree to amend the policy as follows: Only with respect to coverage provided under the General Liability Coverage Part, the following condition is added to the Conditions section of the Common Policy Provisions and Conditions: WAIVER OF SUBROGATION The company shall waive any right of recovery the company may have against a person or organization to the extent that the insured has agreed in writing prior to the date of loss to waive the insured's rights of recovery against that person or organization. All other terms and conditions of the policy remain unchanged. 1512-PGX-00-1215 Page 1 of 1 © 2015 MedPro Group. All rights reserved. / A� " CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 6/21/2024 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: Bree Wallace NonProfits' United Workers' Compensation Group AIc"N Ext: (916) 868-6226 AIX No: E-MAIL ADDRESS: Bree@nonprofitsunited.com 610 Fulton Avenue, Suite 200 Sacramento, CA 95825 INSURER(S) AFFORDING COVERAGE NAIC# INSURERA: NonProfits' United Workers' Compensation Group COMMERCIAL GENERAL LIABILITY INSURED INSURER B: Safety National Casualty Corporation 15105 INSURER C: EACH OCCURRENCE $ Desert AIDS Project 1695 N Sunrise Way INSURER D: Palm Springs, CA92262 INSURER E: DAMAGE TO RENTED INSURER F: COVERAGES CERTIFICATE NUMBER: DAID-2508 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 ACCORDANCE WITH THE POLICY PROVISIONS. ADDL SUBR AUTHORIZED REPRESENTATIVE POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDD/YYYY MMIDD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS -MADE El OCCUR PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ AGGREGATE LIMIT APPLIES PER: GEN'L GENERAL AGGREGATE $ PRO ❑ POLICY- LOC JECT PRODUCTS - COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINEDSINGLE 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 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DED RETENTION $ $ A WORKERS COMPENSATION NPU-WCG 002-2024 1/1/2024 1/1/2025 X PER STATUTE OERH AND EMPLOYERS' LIABILITY Y I N ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 750,000 OFFICER/MEMBER EXCLUDED? ❑ NIA Y (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 750,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 750,000 B XSWC SP4067530 1/1/2024 1/1/2025 of 750000 ,000 (E ) $750,000 XXS S of Sta$2,0u0t ry DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: Events in La Quinta on July 10th, August 14th and September 11th, 2024. Waiver of Subrogation in favor of City of La Quinta CERTIFICATE HOLDER CANCELLATION ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD THIS CERTIFICATE SUPERSEDES PREVIOUSLY ISSUED CERTIFICATE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of La Quinta THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 78495 Calle Tampico ACCORDANCE WITH THE POLICY PROVISIONS. La Quinta, CA 92253 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD THIS CERTIFICATE SUPERSEDES PREVIOUSLY ISSUED CERTIFICATE <11 NONPROFITS UNITED) THIS ENDORSEMENT CHANGES THE MEMORANDUM OF COVERAGE PLEASE READ IT CAREFULLY WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US NonProfits' United Workers' Compensation Group Memorandum of Coverage: NPU-WCG 002-2024 This endorsement modifies the coverage provided under the following: Momorandum of Coverage: PART ONE: WORKERS' COMPENSATION COVERAGE Paragraph H. RECOVERY FROM OTHERS is amended with respect to the following: Name and Address of Person or Organization: City of La Quinta 78495 Calle Tampico La Quinta, CA 92253 DESCRIPTION OF OPERATIONS/LOCATIONS ADDED BY ENDORSEMENT: City of La Quinta NPU-WCG waives any right of recovery it may have against the person or organization shown above because of payments made by NPU-WCG for injury or damage arising out of the Members' operations done under a contract with that person or organization shown above and included in the coverage provided by the Memorandum of Coverage. This waiver applies only to the person or organization shown on the Schedule Above. This endorsement is part of the Memorandum of Coverage and is effective on the date shown below. All other terms and conditions remain unchanged. Effective Date January 1, 2024 Expiration Date: January 1, 2025 Member Desert AIDS Project Endorsement No: NPUWCG-DAID-2 Date Issued: Jun 21. 2024 NPU-WCG Authorized Representative for NPU-WCG Page 1 MOC: