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Insurance Certificates 2024/25 Southwest AquaticsACOR 7 0 CERTIFICATE OF LIABILITY INSURANCE Y) DATE(MM/024 10/03/2024 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 Albert Zamora NAME: RISI dba Pan American Insurance Services PHONE Ext : (760) 772-1700 FAX No): (760) 772-1775 79-440 Corporate Center Drive E-MAIL abert.zamora@relationinsurance.com ADDRESS: Suite 114 INSURER(S) AFFORDING COVERAGE NAIC# La Quinta CA 92253 INSURERA : Certain Underwriters at Lloyds INSURED INSURER B : Infinity Select Insurance Company 20260 Desert Limnologists, Inc., DBA: Southwest Aquatics INSURERC: Zenith Insurance Company 13269 PO Box 13212 INSURER D : Platte River Ins Co 18619 INSURER E : Palm Desert CA 92255 INSURER F : COVERAGES CERTIFICATE NUMBER: 2024-25All Lines 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. IPOLICY LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DDYIYYYY EXP MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 OCCUR RENTED— DA AGE ToCLAIMS-MADE PREMISES Ea occurrence $ 50,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 A Y EC0055617ORB 09/01/2024 09/01/2025 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JECT PRO LOC PRODUCTS - COMP/OPAGG $ 2,000,000 Pollution Liability $ 1,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ ANYAUTO B OWNED SCHEDULED AUTOS ONLY AUTOS 50014189001 09/01/2024 09/01/2025 BODILYINJURY(Peraccident) $ HIRED NON -OWNED ONLY AUTOS ONLY M PROPERTYDAMAGEAUTOS Per accident $ Uninsured motorist $ 1,000,000 UMBRELLA LIAB OCCUR ��"Z6" "4Ny "", " EACH OCCURRENCE $ PEXCESS AGGREGATE $ LIAB CLAIMS -MADE Y DED RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N/A Z133313209 04/01/2024 04/01/2025 %< STATUTE ERH- E.L. EACH ACCIDENT $ 1, 000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1,0001000 $ CSLB Bond D 41047527 02/12/2023 02/12/2025 Limit $15,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) DIVISION: Public Works - Parks Project 2019-11 City of La Quinta is recognized as an Additional Insured and coverage is Primary & Non -Contributory, per form BW-EILPACK-0005A, as related to General Liability. Waiver of Subrogation applies to City of La Quinta per form WC-04-03-06B as respects to workers' compensation. I IUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of La Quinta ACCORDANCE WITH THE POLICY PROVISIONS. 78495 Calle Tampico AUTHORIZED REPRESENTATIVE La Quinta CA 92253 19RR_201A ACARn Cf)RP0RATInN_ All rinhtc racarvarl ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY ThhW WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy.We will not enforce our right against the person or organization named in the Schedule. You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 5.00% of the California workers compensation premium otherwise due on such remuneration. Minimum Premium: $0.00 Schedule Person or Organization CITY OF LA QUINTA 78495 CALLE TAMPICO LA QUINTA, CA 92253 RE: CA OPERATIONS This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 04/01/2024 ZENITH INSURANCE COMPANY - 13145 Insured SOUTHWEST AQUATICS Policy No. Z133313209 Policy Period 04/01/2024 To 04/01/2025 Issued On 03/28/2024'r_ At Fresno, CA CHIEF EXECUTIVE OFFICER WC-04-03-06B (Ed. 10-07) Endorsement No. 19 0 W do I aa" 0J iman liTJ [a i"M ki I RM k, L01 k, Iff.01ou THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDERTHE FOLLOWING: COMMERCIAL GENERAL LIABILITY COVERAGE Name of Person or Organisation An - y person or organization that is an owner of real property or personal property on which you are performing operations, or a contractor on whose behalf you are performing operations, andonly at the specific written request of such person or organization to you, wherein such request is made prior to commencement of operations. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. For the purposes of this endorsement, Section 11. WHO IS AN ENSURED NSVRED is amended to include as an insured the person or organization shown in the SCHEDULE above, but only with respect to liability arising out of your ongoing operations performed for that insured. B. With respect to the insurance -afforded to theseadditional insu red b, the following paragraph is added to Section I COVERAGES Paragraph 2. EXCLUSIONS, This insurance does not apply to bodily injury or property damage occurring after: (1) All work, including materials, parts or equipment furnished. in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) atthe site of the covered operations has been completed; or (2) That portion of yourworkout of which the injury or damage arises has been put to, its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project G. The coverage provided hereunder shall be primary and non-contributing with any other insuraInce available to those designated above Under any other third party liability policy All other terms and conditions remain the same. 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