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Insurance Certificates 2020/21 Urban Habitat - Project 2016-03EINSURANCE REVIEW �C� -- l Al IFORNIA - RE: Urban Habitat - La Quinta Landscape Renovation Improvement - Rancho Ocotillo Project No. 2016-03E 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 oer the Agreement: ACCORD Certificate dated 10-days prior or less 08/07/2020 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: V$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): 1-1 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—]$1,000,000 per occurrence/loss Other: Excess Liability $5,000,000 (per occurance/aggregate) List other insurance types such as - molestation, harassment, etc. Approved by: Nichole Romane Date: 8/17/2020 URBAHAB-01 CER171 .acoRo CERTIFICATE OF LIABILITY INSURANCE DATE IMMIDD/YYYI� C srr►2020 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 INSURERS), 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 License # OC32169 CONE CT Rancho Mesa Insurance Services, Inc. PHONE FAx 250 Riverview Parkway A►m,, Ho, E a! : (619) 937-0164 AM, Nuy:(619) 937-0168 Santee, CA 92071 Ai?IryIp11_ 5: INSURED Urban Habitat P.O. Box 1177 INsuRERC: INSURER D La Quinta, CA 92247 INSURER E INSURER F f n►►CRAC_CC C`C0 ri=lf ATC RII IRil RCD- 9 Ilesex Insurance Comjpany t23434 River Insurance Company 34630 OF►►ICIIIRr Rfl IR1101"10. 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 TYPE OF INSURANCE AODL 5UBR POLICY NUMBER POLICY EFF POLICY EXP LTD INSD WV!] M 1 / LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE EXI OCCUR X A0116293004 7/1/2020 1' 7/1/2021 EACH OCCURRENCE $ 1,000,000 DAMAGE TO�oNTE RENTED S 500,000 MED Face (Any one son $ 5,000 _ PERSONAL BADVI Y 11000,000 GEN'LAGGREGATELIMIT APPLIES PER: POLICY [X]jEo- LOC GENERAL AGGREGATE S 3,000,000 PRODUCTS-GOMPIpP AGG $ 2,000,000 $ OTHER! _ A AUTOMOBILE LIABILITY Grp 8e4HED SINGLE LIMIT S 1,000,000 ANY AUTO A0116293001 7/1/2020 7/1/2021 BODILY INJURY Per anon Ix OWNED SCHEDULED AUTOOS ONLY AU❑TµO�Sy�.��p BODILY INJURY Per acciden S AUTOS ONLY X Al1TO5 C]NLY PFar W�nIDANIAGE S $ I A UMBRELLA LIAB X OCCUR EACH OCCUR ENGE S 5,000,000 X ExcEssuAB CLAIMS -MADE A0116293005 7/1/2020 7/1/2021 A GRFGATE $ 5,000,000 DED RETENTION $ S B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY. PROPRIETORIPARTNERIEXECUTIVE YIN WaRCERIM EMBER EXCLUDED? {S1andRtary in NH) If yes, describe under DESCRIPTION F OPERATIONS below NIA X IURWC104739 7/1/2020 7/1/2021 X PER OTH- E EACH ACCIDENT S 1,000,000 EL DISEASE- EA EMPLOYEE S 1,000,000 E DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES ACORD tin Addiiianal Remarks Schedule, maybe allachod if mores ace is required) RE: PROJECT M16-03E, LA QUINTA LANDSCAPE REN6VATION IMPROVEMENT - RANCHO OCOTILLO CITY LA QUINTA AND ITS OFFICERS AND EMPLOYEES ARE INCLUDED AS ADDITIONAL INSURED PER FORMS CG 2010 04 13 AND CG 2037 0413 ATTACHED. PRIMARY AND NON-CONTRIBUTORY WORDING APPLIES. WAIVER OF SUBROGATION IN FAVOR OF CERTIFICATE HOLDER AND ADDITIONAL INSUREDS APPLIES TO WORKERS COMPENSATION POLICY. (p) CITY OF LA QUINTA 78495 CALLE TAMPICO LA QUINTA, CA 92253 ACORD 25 (2016/03) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED ©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) Location(s) Of Covered Operations Any person or organization you are required to add as Codes per the General Liability Declaration Page an additional insured under a written contract or Description- Jobsites as described in contracts agreement Description: in effect prior to any accident, injury, loss or damage Jobsites as described in contracts above, will be shown in the Declarations. Information required to complete this Schedule, if not shown 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. CG20100413 A0116293 Middlesex Insurance Company 1 00001 0000000000 19164 0 N 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. © Insurance Services Office, Inc., 2012 bf9faa9b-b73f-49ac-a5ef-2561 c494646d Page 1 of 2 06/24/2020 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. Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 2010 04 13 Ap 116293 06/24/2020 Middlesex Insurance Company POLICY NUMBER: A0116293004 COMMERCIAL GENERAL LIABILITY CG 20 37 0413 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) Location And Description Of Completed Or Organization(s) 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. CIS 20 37 0413 A0116293 Middlesex Insurance Company 1 00001 0000000000 19164 0 N 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. C Insurance Services Office, Inc., 2012 107b155e-a6df-4be3-a120-196eObe306cd Page 1 of 1 06/24/2020 Policy Number: A0116293004 COMMERCIAL GENERAL LIABILITY CG 20 01 0413 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 CG 20 01 0413 A0116293 Middlesex Insurance Company 1 00001 0000000000 19164 0 N (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. © Insurance Services Office, Inc., 2012 542efte6-903e-4180-b56f-4a36818e6301 Page 1 of 1 06/24/2020 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 0410 C (Ed. 01-19) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA BLANKET BASIS 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.) The additional premium for this endorsement shall be calculated by applying a factor of 2% to the total manual premium, with a minimum initial charge of $350, then applying all other pricing factors for the policy to this calculated charge to derive the final cost of this endorsement. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule Schedule Blanket Waiver Person/Organization Blanket Waiver — Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. Job Description Waiver Premium (prior to adjustments) All CA Operations 2357.00 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: 07/01/2020 PolicyNo.: URWC104739 Endorsement No. Insured: Urban Habitat Premium $ Insurance Company: Oak River Insurance Company Countersigned by WC990410C (Ed. 01-19)