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Insurance Certificates 2025/26 Desert Aids Project (DAP)/ A� " CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 1/28/2025 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 Irvine CA 92614 CONTACT NAME: Heffernan Insurance Brokers PHONE FAX AIC No Ext : 925-934-8500 A/C No): 925-934-8278 ADDRESS: HIB24-7@heffins.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Philadelphia Indemnity Insurance Company 18058 License#: 0564249 INSURED DESEAID-03 INSURER B : Safety National Casualty Corporation 15105 DAP Health 1695 N Sunrise Way INSURER C: The Hanover Atlantic Insurance Company, Ltd. INSURERD: Nonprofits United Workers Compensation Group, Inc. Palm Springs CA 92262 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 193511232 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 C X COMMERCIAL GENERAL LIABILITY Y Y L3Q-J851080-00 10/5/2024 10/5/2025 EACH OCCURRENCE $1,000,000 CLAIMS -MADE � OCCUR TED PREMISES (Ea oDAMAGE TO ccurrence) $ 250,000 MED EXP (Any one person) $ PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000 POLICY ❑ PRO- JECT ❑ LOC X PRODUCTS - COMP/OP AGG $ 3,000,000 $ OTHER: A AUTOMOBILE LIABILITY PHPK2609780-001 10/5/2024 10/5/2025 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY C UMBRELLA LAB X OCCUR L3Q-J851081-00 10/5/2024 10/5/2025 EACH OCCURRENCE $ 4,000,000 X AGGREGATE $ 4,000,000 EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N NPU-WCG001-2025 1/1/2025 1/1/2026 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 C Prof. Liability - Claims Made L3Q-J851080-00 10/5/2024 10/5/2025 $1,000,000 Per Claim $3,000,000 Aggr B XSWC XSWC-SP4067530 1/1/2025 1/1/2026 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) Automobile Policy #PHPK2609780-001: Collision Deductible: Private Passenger/Light Truck/Trailer $1,000; Medium & Heavy Truck/Trailer $2,000 Comprehensive Deductible: $1,000 Re: Events on February 10th, March 10th and April 14th, 2025, at La Quinta Wellness Center, 78450 Avenida La Fonda, La Quinta, CA. 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. CERTIFICATE HOLDER CANCELLATION 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 LaQuinta 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 Policy #L3Q-J851080-00 ENDORSEMENT NO. ADDITIONAL INSURED ENDORSEMENT (GENERAL LIABILITY) (INCLUDES WAIVER OF SUBROGATION) This endorsement modifies insurance under the following: MISCELLANEOUS HEALTHCARE FACILITIES GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Additional Insured: Blanket as required by contract The following is added to Section II. WHO IS AN INSURED of the MISCELLANEOUS HEALTHCARE FACILITIES GENERAL LIABILITY COVERAGE PART: The person or organization shovan in the Schedule above is included as an additional Insured if you are obligated by virtue of a written contract to provide insurance to such person or organization of the type afforded by this Policy, but only with respect to liability arising out of operations conducted by you or on your behalf. Notwithstanding any provision in the written contract between you and the person or organization shown in the Schedule above to the contrary, the person or organization shown in the Schedule above shall not be construed as a person or organization acting on your behalf and there shall be no coverage with respect to liability for injury or damages arising out of any act or omission of such person or organization. In the event that the Limits of Insurance provided by this Policy exceed the Limits of Insurance required by the written contract, the insurance provided by this endorsement shall be limited to the Limits of Insurance (inclusive of any applicable deductible or self insured retention) required by the written contract. The Limits of Insurance (inclusive of any applicable deductible or self insured retention) provided by this Policy shall not 141662 (07/21) Page 1 of 2. HC1168 be increased for any reason, including any failure, refusal or inability of any self insuranceAnsured to pay any amounts due thereunder. This endorsement shall not increase the Limits of Insurance shown in the Declarations pertaining to the coverage provided herein. Any coverage provided by this endorsement to an additional Insured shown in the Schedule above shall be excess over any other valid and collectible insurance or self insured retention available to the additional Insured whether primary, excess, contingent or on any other basis, unless the written contract with the additional Insured specifically requires that this insurance be primary and non-contributory with any other insurance carried by the additional Insured. In such case, this insurance shall be primary and non-contributory with any other insurance carried by the additional Insured. In the event of payment under the Policy, we waive our right of subrogation against any person or organization shown in the Schedule above where the Named Insured has waived liability of such person or organization as part of a written contractual agreement between the Named Insured and such person or organization, which was executed prior to the effective date of this endorsement and prior to the occurrence or offense. In accordance with the terms and conditions of the Policy, as soon as practicable, each additional Insured must give us prompt notice of any occurrence or offense which may result in a claim, forward all legal papers to us, cooperate in the defense of any actions, and otherwise comply with all of the Policy's terms and conditions. Failure to comply with this provision may, at cur option, result in the claim or suit being denied. All other terms and conditions of the policy remain the same. Authorized Representative 141662 (0721) Page 2 of 2 HC1168 �0 WORKERS' COMP GROUP 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 001-2025 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, 2025 Expiration Date: January 1, 2026 Member DAP Health Inc. Endorsement No: NPUWCG-DAID- Date Issued: Jan 1, 2025 NPU-WCG Authorized Representative for NPU-WCG Page 1 MOC: Policy #L3Q-J851080-00 ENDORSEMENT NO. ADDITIONAL INSURED ENDORSEMENT (GENERAL LIABILITY) (INCLUDES WAIVER OF SUBROGATION) This endorsement modifies insurance under the following: MISCELLANEOUS HEALTHCARE FACILITIES GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Additional Insured: Blanket as required by contract The following is added to Section II. WHO IS AN INSURED of the MISCELLANEOUS HEALTHCARE FACILITIES GENERAL LIABILITY COVERAGE PART: The person or organization shovan in the Schedule above is included as an additional Insured if you are obligated by virtue of a written contract to provide insurance to such person or organization of the type afforded by this Policy, but only with respect to liability arising out of operations conducted by you or on your behalf. Notwithstanding any provision in the written contract between you and the person or organization shown in the Schedule above to the contrary, the person or organization shown in the Schedule above shall not be construed as a person or organization acting on your behalf and there shall be no coverage with respect to liability for injury or damages arising out of any act or omission of such person or organization. In the event that the Limits of Insurance provided by this Policy exceed the Limits of Insurance required by the written contract, the insurance provided by this endorsement shall be limited to the Limits of Insurance (inclusive of any applicable deductible or self insured retention) required by the written contract. The Limits of Insurance (inclusive of any applicable deductible or self insured retention) provided by this Policy shall not 141662 (07/21) Page 1 of 2. HC1168 be increased for any reason, including any failure, refusal or inability of any self insuranceAnsured to pay any amounts due thereunder. This endorsement shall not increase the Limits of Insurance shown in the Declarations pertaining to the coverage provided herein. Any coverage provided by this endorsement to an additional Insured shown in the Schedule above shall be excess over any other valid and collectible insurance or self insured retention available to the additional Insured whether primary, excess, contingent or on any other basis, unless the written contract with the additional Insured specifically requires that this insurance be primary and non-contributory with any other insurance carried by the additional Insured. In such case, this insurance shall be primary and non-contributory with any other insurance carried by the additional Insured. In the event of payment under the Policy, we waive our right of subrogation against any person or organization shown in the Schedule above where the Named Insured has waived liability of such person or organization as part of a written contractual agreement between the Named Insured and such person or organization, which was executed prior to the effective date of this endorsement and prior to the occurrence or offense. In accordance with the terms and conditions of the Policy, as soon as practicable, each additional Insured must give us prompt notice of any occurrence or offense which may result in a claim, forward all legal papers to us, cooperate in the defense of any actions, and otherwise comply with all of the Policy's terms and conditions. Failure to comply with this provision may, at cur option, result in the claim or suit being denied. All other terms and conditions of the policy remain the same. Authorized Representative 141662 (0721) Page 2 of 2 HC1168