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Insurance Certificates 2022/23 Urban Habitat___"N URBAHAB-01 CHT A'CQRf> CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) `� 1 7126/2022 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(les) 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 License # OC32169 co CT Rancho Mesa Insurance Services, Inc. n/cco l o 619 937-0164 ac No : 619 937-0168 250 Riverview Parkway Santee, CA 92071 INSURER/SI AFFORDING COVERAGE NAIC # INSURED Urban Habitat P.O. Box 1177 La Quinta, CA 92247 nce INSURER F f OVERAGES CERTIFICATE NUMBER: 2 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 - A A TYPE OF INSURANCE POLICY NUMBER r i LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 1 CLAIMS -MADE OCCUR X �A0116293004 7/1/2022 7/1/2023 DAMAGE70RENTED GEWL AGGREGATE LIMIT APPLIES PER: ENE POLICY LOC PR D OTHER: _ COME AUTOMOBILE LIABILITY X ANY AUTO A0116293001 711 /2022 7/1/2023 BODIL B LL OWNED SCHEDULED AUTOS ONLY AUTO�SVy PBrOa X HIFFI ppOS ONLY X AU�OS 110 UMBRELLA LIAB X OCCUR EACH X EXCESS LIAB CLAIMS -MADE A0116293005 7/1/2022 711/2023 ArrR DED I A RETENTION $ V B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N [ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ X ,A0116293006 711/2022 711/2023 {Mandatory in NHS EXCLUDED? N I A If ves. describe under 1 5, 1,000, I 1_ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHiCI.ES (ACORD 101. Additional Remaiks Schedule, ma be attached if more space is required) RE: PROJECT#2016.03G, X-PARR LANDSCAPING AND IRRIGATION IMPROVEMENTS. CITY OF LA QUINTA AND ITS OFFICERS, EMPLOYEES AND AGENTS ARE INCLUDED AS ADDITIONAL INSURED WITH REGARDS TO THE GENERAL LIABILITY PER ATATCHED PER ATTACHED FORMS. PRIMARY AND NON-CONTRIBUTORY WORDING APPLIES WITH REGARDS TO THE GENERAL LIABILITY PER ATTACHED FORMS. WAIVER OF SUBROGATION APPLIES WITH REGARDS TO THE WORKERS COMPENSATION PER ATTACHED FORMS. (p) CITY OF LA QUINTA 78-495 CALLE TAMPICO LA QUINTA, CA 92253 ACORD 25 (2016/03) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE I THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: A0116293004 COMMERCIAL GENERAL LIABILITY CG20100413 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 Organization(s) Any person or organization you are required to add as an additional insured under a written contract or agreement in effect prior to any accident, injury, loss or damage Location(s) Of Covered Operations Codes per the General Liability Declaration Page Description- Jobsites as described in contracts Description: Jobsites as described in contracts 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) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: 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) 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 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. CG20100413 A0116293 Middlesex Insurance Company 1 00001 0000000000 19164 0 N ©insurance Services Office, Inc., 2012 bf9faa9b-b73f-49ao-a5ef-2561 o494646d Page 1 of 2 06/23/2021 C. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Rage 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 0413 A01 16293 06/23/2021 Middlesex Insurance Company POLICY NUMBER: A0116293004 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations Any person or organization you are required to add as Jobsites as described in contracts. Codes per the an additional insured under a written contract or General Liability Declaration Page agreement in effect prior to any accident, injury, loss or damage 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" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 37 04 13 A0116293 Middlesex Insurance Company 1 00001 0000000000 19164 0 N © Insurance Services Office, Inc., 2012 107b155e-a6df-0e3-a 120498e0be306cd Page 1 of 1 06/23/2021 Policy Number: A0116293004 COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT 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 0413 A0116293 Middlesex Insurance Company 1 00001 0000000000 19164 0 N © Insurance Services Office, Inc., 2012 542effe6-903e-41 80-bW-40681 8e6301 Page 1 of 1 06/23/2021 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 4-84) 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. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Name: Any person or organization from whom you are required to waiver your right to recover under a written contract or agreement in effect prior to any loss or damage. Address: 37505 Goodman Rod, Indio, CA Description of Waiver: Any person or organization for whom the Named Insured has agreed by written contract executed prior to loss. JobID: 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 7/1/2022 Insured Urban Habitat Insurance Company Sentry Insurance Company WC000313 (Ed. 4-84) ©1983 National Council on Compensation Insurance. Policy No. A0116293006 Countersigned Endorsement No. Premium Page 1 of 1 A0116293006 06/30/2022 Sentry 1 00001 0000000000 21127 0 N aaebaeea-0782-4bb0-85fe-85473909c262