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Insurance Certificates 2024/25 McGrath MetalNOTICE OF CANCELLATION POLICY NO.: NN1718523 EFFECTIVE DATE OF CANCELLATION: KIND OF POLICY: Commercial DATE: 11/21/2024 TIME: 12:01 AM (HOUR Package Policy STANDARD TIME) INSURANCE COMPANY: Nautilus DATE OF MAILING: 11/6/2024 Insurance Company INSURED NAME & ADDRESS McGrath Metal Manufacturing PIIAN Systems LLC 45090 Golf Center Pkwy Indio, CA 92201-7342 ISSUED THROUGH AGENCY OFFICE: AGENT Kelley Jiggins & OR Associates BROKER PO Box 60310 Pasadena, CA 91116 Reason for Cancellation: Nonpayment of Premium XPT Partners - WSS Dept604O Woburn , MA 01888-4110 (If notice of cancellation is mailed to the Insured, Lienholder or Mortgagee, complete the following.) hereby certify that I personally mailed in the U.S. Post Office, at the place and time stamped hereon, a notice of cancellation to the Insured, Lienholder or Mortgagee an exact carbon copy of which appears above, and at said time received from the U.S. Postal Service the receipt made a part hereof or attached hereto. Additional Insured: Coastal Real Estate Investment Inc & California Property Management Connections Inc c/o CPMC Realty 44-835 Portola Ave Palm Desert, CA 92260 David Stoner 338 SE Spokane St Portland, OR 97202 Channell Partners Capital LLC ISAOA PO Box 202131 Florence, SC 29502 The City of La Quinta, its officers, officials, employees and agents 78495 Calle Tampico La Quinta, CA 92253 INSURANCE REVIEW c4a 0"&a CALIFORNTA RE: Short Form Services Agreement with McGrath Metal for Metal fabrication services for $30,000. 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 9/3/2024 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: F-1$1,000,000 per occurrence/loss Other: List other insurance types such as - molestation, harassment, etc. Approved by: Date: L PIIASYS-01 KDINWIDDIE ACORO CERTIFICATE OF LIABILITY INSURANCE DATE9/3/2 D/YYYY) /3/2024 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 Keith Dinwiddie NAME: PHONE FAX (A/C, No, Et): (626) 396-1035 (A/C, No):(626) 396-1045 Kelley, Jiggins & Associates 455 N. El Mollno Ave. Pasadena, CA 91101 AD AILkeith@kjains.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: Nautilus Insurance Company 17370 INSURED INSURER B : INSURER C : PIIAN Systems, LLC INSURERD: 45090 Golf Center Pkwy Indio, CA 92201-7342 INSURER E 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 POLICY EXP MM DD LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR X NN1718523 7/8/2024 7/8/2025 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence 100,000 $ MED EXP (Any oneperson) $ 5,000 PERSONAL & ADV INJURY $ Excluded GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO- JECT LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ Excluded AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY Perperson) $ BODILY INJURY Per accident $ PerOaccidenDAMAGE $ UMBRELLA LIAB EXCESS LIAB OCCUR EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE $ DED I RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECU I VE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A PER OTH- ISTATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of La Quinta, its officers, officials, employees and agents are additional insureds for general liability per attached form CG2010 0704. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE The Cityof La Quinta, its officers, officials, employees and THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. agents 78495 Calle Tampico La Quinta, CA 92253 AUT�HO�RIZEED� REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: NN1718523 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organ izations : Locations Of Covered Operations The City of La Quinta, its officers, officials, employees and 45090 Golf Center Pkwy, Indio, CA 92201 agents 78495 Calle Tampico La Quinta, CA 92253 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an 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: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) desig- nated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equip- ment 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) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. CG 20 10 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 ❑ ENDORSEMENT NO. 2 EFFECTIVE DATE: 8/19/2024 12:01 AM Named Insured: PIIAN Systems LLC Insurer: Nautilus Insurance Company Policy No.: NN1718523 IT IS UNDERSTOOD AND AGREED THAT IN CONSIDERATION OF NO ADDITIONAL OR RETURN PREMIUM. THE ABOVE CAPTIONED POLICY IS AMENDED AS FOLLOWS: Form CG 20 01 04 13 - PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION has been added to the policy. ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED Date of Issue September 29, 2024 / support3 COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 VDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance, and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. CG 20 01 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 Kemper Auto Commercial 'rCEMPER Auto 11700 Great Oaks Way, Suite 450 COMMERCIAL Alpharetta, GA 30022 Underwritten by: Infinity Select Insurance Company Customer Service: (800) 722-3391 Claims Service: (800) 334-1661 COMMERCIAL AUTO DECLARATION PIIAN SYSTEMS LLC 45090 Golf Center Pkwy, Ste A Indio, CA 92201 POLICY NUMBER 50000913201 POLICY PERIOD 12/20/2023 To: 12/20/2024 This policy is effective no earlier than the date and time on which the application is accepted by the Company and shall expire at 12:01 a.m on the last day of the policy period shown on the Declarations Page. If the policy is cancelled for nonpayment, it may be continued with or without a lapse in coverage, contingent upon valid payment and in accordance with our underwriting rules. The following coverages and limits apply to each described vehicle as shown below. Coverages are defined in the policy and are subject to the terms and conditions contained in the policy, including amendments and endorsements. No changes will be effective prior to the time changes are requested, Deductible # Year Make / Model VIN Number COL / COM / FTC 1 2019 CHEVROLET- SILVERADC MEDIUM DUTY 1HTKHPVK7KH210526 10001 10001 NiA COVERAGES - LIMITS OF LIABILITY PREMIUMS FOR VEHICLES THE COVERAGE IS APPLICABLE ONLY IF A PREMIUM IS INDICATED VEH ' IIPD Liability $1,000,000 CSL 4932 Uninsured Motorist - BI $50,000 each person $100.000 each accident 82 Comprehensive ill Any Auto Bodily Injury 711 Any Auto Property Damage 325 Collision Deductible Waiver $1000 Deductible 865 PREMIUM BY VEHICLE: 7,026 TOTAL VEHICLE PREMIUM(S): $7,026,00 FEES: $85.00 'see reverse for fee schedule ENDORSEMENTS MADE A PART OF THIS POLICY: TOTAL POLICY PREMIUM: $7,111.00 50461AAEU1, bU461AIE01, 5U461AEZ01, 50461CDW01, 50461ADE02. 50461LPE01, 50461POL02, 50000CDD01 This Policy provides reduced liability coverage limits when an insured auto is being operated by a regular permissive driver who was not disclosed on the policy application or otherwise as a driver to be covered by this policy, or was not disclosed within (30) days after becoming a driver subsequent to the date of application. Liability limits drop to the minimum California Statutory Liability Limits which are $15,000 for Bodily Injury per person, $30,000 for Bodily Injury per accident, and $5,000 for Property Damage per accident, See PART A -LIABILITY, ADDITIONAL DEFINITIONS USED IN PART A ONLY, Paragraph 1.13 and PART A -LIABILITY EXCLUSION 27. SEE REVERSE FOR ADDITIONAL INFORMATION 50400DCPG02 Page 1 of 2 AMEND DATE: 04/03/2024 ENDORSEMENT. 2-7 Additional Information: Agency Information: Dean Mofidi Insurance Services LLC 4633 E RAMON RD PALM SPRINGS, CA 92264-1525 Please mail all inquiries to: Kemper Commercial Auto 11700 Great Oaks Way, Suite 450 Alpharetta, GA 30022 Please fax all inquiries to: (877)722-3391 DRIVER INFORMATION: # DRIVER NAME EXCL SR22 1 GREGORY MCGRATH No No 2 RILEY JEAN MCGRATH Yes No 3 DEBBIE LENA MCGRATH Yes No 4 JACK D MCGRATH No No 5 MARTIN MONTEZ No No VEHICLE LOSS PAYEE/ADDITIONAL INTEREST INFORMATION. VEH# NAME TYPE ADDRESS CITY STATE ZIP 1 ALLY FINANCIAL Loss Payee PO BOX 8128 COCKEYSVILLE MD 21030 RATING CRITERIA: VEH# DRV# DRV VEH PERSONAL VEH GARAGING STATED VALUE VEH VEH PNTS GVW USE USE ZIP (INCL: ADDL. EQUIP STATED VALUE) RADIUS BODY 1 4 0 19500 NO H 92201 $70,000.00 500 230 POLICY LEVEL INFORMATION: PAID -IN -FULL: Ej YES Q NO PHYSICAL DAMAGE ONLY: YES 0 NO CDL DISCOUNT: YES 0 NO PRIOR COVERAGE. YES Q NO BUSINESS EXPERIENCE: YES 0 NO STATE FILING: AYES NO FEDERAL FILING: YES 0 NO CGL OR BOP DISCOUNT. Q YES NO RATED OCCUPATION. Wholesale Delivery & Pickup ADDITIONAL DRIVER: EYES NO OCCUPATION CODE: G18 For Personal Use coverage, refer to "Rating Criteria" for each vehicle listed above. PAY PLAN OPTION: Monthly Pay - 8 33% Down Pay - 11 Installments SCHEDULE OF APPLICABLE FEES: DESCRIPTION AMOUNT DESCRIPTION AMOUNT Vehicle Fee - Distributed $60.00 Dept Of Transportation Fee $25.00 50400DCPG02 Page 2 of 2 AMEND DATE: 04/0312024 ENDORSEMENT: 2-7 PIIASYS-01 NGARCIA ,4coR0 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 10/9/2024 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 Noemi Garcia NAME: PHONE FAX -5083 (A/C, No, Ext): (626) 773-8488 No):(951) 737 Orion Business Insurance and Risk Management Services, Inc. 1250 Corona Pointe Court, Suite 302 Corona, CA 92879 ADDRESS: ngarcia@orionins.com INSURERS AFFORDING COVERAGE NAIC # INSURER A:Employers Preferred Insurance Company 10346 INSURED INSURER B : INSURER C : Piian Systems, LLC INSURER D : 45090 Golf Center Parkway, Suite A Indio, CA 92201 INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 1 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 COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑ OCCUR EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP (Any oneperson) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY El PECOT- LOC OTHER: GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $ AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED L NON -OWNED AUTOS ONLY AUTOS ONLY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY Perperson) $ BODILY INJURY Per accident $ PROPERTY DAMAGE Per accident $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ A WORKERS COMPENSATION ANDEMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A X EIG5472798-00 2/21/2024 2/21/2025 X PER OTH- STATUTE ER E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000,000 $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Project: City of La Quinta's City's Community Awards Acknowledgement Monument and Veterans Acknowledgement Monuments Waiver of subrogation is included as respects Workers' Compensation per the attached policy form. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE The City of La Quinta Y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 78495 Calle Tampico La Quinta, CA 92253 AUTHORIZED REPRESENTATIVE � � ■ VlY'lA W qW lA.ila ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA 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. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) 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 0 % of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization THE CITY OF LA QUINTA 78-495 CALLE TAMPICO LA QUINTA CA 92253 The charge for this endorsement is $ 250 Job Description 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.) This endorsement, effective 02/21/2024 Policy No. EIG 5472798 00 Issued to PIIAN SYSTEMS, LLC Premium $4,524 Countersigned at at 12:01 AM standard time, forms a part of Of the EMPLOYERS PREFERRED INS. CO. Carrier Code 00920 Endorsement No. on Y Authorized Representative WC 04 03 06 (Ed. 4-84) © 1998 by the Workers' Compensation Insurance Rating Bureau of California. All rights reserved.