HomeMy WebLinkAboutCVWD $2,400City of La Quinta CHECK NO: 200973
VENDOR: 00267 COACHELLA VALLEY WATER DISTRICT 02/14/2020
DATE ID PO# DESCRIPTION GLACCT# AMOUNT
2/4/2020 020420A 02/04/20 - DUNE PALMS BRIDGE ENCROACH PERMIT 401-0000-60185 2,400.00
e/� City of La Quinta BANK OF THE WEST
•r 78-495 Calle Tampico 90-78/1211
La Quinta, CA 92253
4. ❑F�
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CHECK TOTAL 2,400.00
CHECK
NO: 200973
02/14/2020
.' $2,400.00
PAY ---Two Thousand Four Hundred Dollars and 00/100 C t$
TO THE COACHELLA VALLEY WATER DISTRICT
ORDER THIS CHECK EXPIRES AND IS VOID 180 DAYS FROM ISSUE DATE
OF
P O BOX 1058�-�-
COACHELLA, CA 92236
II'20097Ps 1:12L1007821: 11105973L85LII'
2018-05-09 Rev.I
4 44� Quurcu
DEMAND/ CHECK REQUEST
CEM ti
of
Return check to requestor
L J Mail check
CITI• OF :J{
FINAMCF
Name / Title of person requesting check
Julie Mignogna, Management Analyst —I
Department individual is associated with0 3 1�ZQ 1�
I ,
Public Works Department "L A
EPT. Alp
Check payable to: j
Coachella Valley"'Water District X-) Amount: $ 2,
Name) (Vendor No.) I
PO Box �_ _0 - fl0 � -[os$ Account Number:
401-0000-60185
(Address) --_ - - -
Coachella, CA 92236 11 1205D
�_ Project Number:
Check description and invoice number:
Dune Palms Road Bridge Project (201 1-05) - CVWD Construction Encroachment Permit and
Permanent Errc10aL;1 rrt-Permit Fee and new storm drain- ocrt+et-fee $(100 for the -
encroachment permit application and $2,400 for the new storm drain outlet fees)
Signatu e:
VV/
(Oe i ment ea - — --- -
ti' � �?,(7Lo
(Date
APPROVED FOR PAYMENT
( na a Department "Oft /)
BY:
BY:
ACCOUNT NO.
DESCRIPTION
City of Le Quinta CHECK NO: 200893
VENDOR: 00267 COACHELLA VALLEY WATER DISTRICT 02/07/2020
DATE ID PO# DESCRIPTION GLACCT# AMOUNT
2/4/2020 020420 02/04/20 - DUNE PALMS BRIDGE ENCROACH PERMIT 401-0000-60185 2,500.00
��Irr� w+M�Ep � Igo
CHECK TOTAL 2,500.00
M
City of La Quinta BANK OF THE WEST CHECK NO: 200893
r� 78-495 Calle Tampico 90-78/1211
La Quinta, CA 92253
02/07/z020 $2,500.00
PAY ---Two Thousand Five Hundred Dollars and 00/100 Cents ---
TO THE COACHELLA VALLEY WATER DISTRICT
ORDER P 0 BOX 1058
OF COACHELLA, CA 92236
AUTHOWEO SIGNATURE
AWHORREO SIGNATURE
II' 20 08 9 3110 1: 1 2 1 100 78 21: Il'0 59 7 3 L8 5 Lill
Bernice Choo
From: Julie Mignogna
Sent: Tuesday, February 11, 2020 1:48_ PM
To: Bernice Choo
' Cc: Carley Escarrega
Subject: CVWD Dune Palms connection fee and encroachment permit fee check - fee change
Good afternoon, Bernice!
The $100 permanent encroachment permit fee as part of the recent CVWD check request we
submitted (for Dune Palms Bridge Project 2011-05) hasbeen waived. They requested that we
reduce the check amount from $2,500 to $2,400 to reflect this change. The $2,400 fee is a
connection fee and will remain. Please let me .know if you need a new check request or if we can
revise the original request.
Much appreciation,
Julie
t(V Ott I &(V
CAUFORNIA
J
3ulie Mignogna J Management Analyst
Public Works Department
City of La Qu i nta
78495 Calle Tampico I La Quinta, CA 92253
Ph. 760.777,7041
www.laquintaca.gov
www.playinla-quinta.com
1
City of La Quinta
VENDOR: 00267 COACHELLA VALLEY WATER DISTRICT
DATE ID PO # DESCRIPTION
2/4/2020 020420 02/04/20 - DUNE PALMS BRIDGE ENCROACH PERMIT
y =City of La Quinta
78-495.CaIle Tampico -
�� La Quinta, CA 92253
PAY Two Thousand Five Hundred Dollars and
THE..• +
PVT 'COACHELLA VALLEY WAT
y ,ORDER
x� P 0-BOX 1058
•COACHELLA, CA 92236
CHECK NO: 200893
02/07/2020
GL ACCT # AMOUNT
401-0000-60185 2,500.00
CHECKTOTAL 2,500.00
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BANK OF THE WEST CHECK �NO: 00
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$2,860.00.'
THIS CHECK EXPIRES AND 15 VOID 180 DAYS FROM ISSUE DATE
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20089 311' 1: h 2 L L00 M 21: 1100 59 7 3_L8-$ ill'
Manual Issue Entry - Confirmation
Cutoff time for the current window is at 18:30 PST. The last cutoff of the day is 18:30 PT.
Issues Entered to be Submitted
Account Cheek Payee/Additional
Number Number Amount Date Data Action Status
059731851. CITY
OF LA QUINTA 200893 $2,500.00 02/07/2020 Coachella Valley Void Approved
OPERATING Water District
ACCOUNT
o Issue Amount total:
i Void Amount total:
$0.00
$2,500.00
2/11/2020
WebDirect
Check inquiry - Selection
Stop Payment inquiry information
Account
059731851.CITY OF LA
O QUINTA OPERATING
ACCOUNT
Continue Cancel
Check Status
Number
200893 Outstanding
Amount Paid Action
Place Stop •
https://cib.bankofthewest.com/Ki/corp/landingpage 1/1
Julie Mignogna
From: Nick Nickerson <nnickerson@naiconsulting.com>
Sent: Wednesday, January 29, 2020 8:59 AM
To: Julie Mignogna
Cc: Bryan McKinney; Brad Donais
Subject: FW: Dune Palms Bridge - CVWD Initial Submittal
Attachments: ENG-EP-002-ConstEncPermit-DPRd Bridge.pdf; ENG-EP-001-PermEncPermit-DPRd
Bridge.pdf; MS4 Certification —Dune Palms Rd Bridge.docx, DPRd Bridge_CVWD Initial
Sheets.pdf
EXTERNAL: This message originated outside of the City of La Quinta. Please use,proper judgement and caution when opening
attachments, clicking links or responding to requests fbr information.
Good Morning Julie,
Attached for your review and Bryan's signature is the CVWD Encroachment Permit Documents for the Dune Palms Road
Bridge.
Please have Bryan Sign both the Encroachment Permit Applications and the MS4 Letter (needs your formatting
attention).
The City will need to issue a check to for a total of $2,500 ($100 for the application and $2,400 for the new storm drain
outlet). See the permanent encroachment permit for backup of the fees. The Encroachment Permit Submittal also
requires the City's Insurance Certification to be attached with the coverages, etc. described in the Permit Attachments.
Considering Brad is out of town and has no quick way of picking up the check, I assume we will need to submit the
applications to CVWD. I will get the CVWD contact's name from Brad when we talk later today or tomorrow.
Let me know if you have questions or require additional information.
Nick Nickerson, President
NAl Consulting, Inc.
68-955 Adelina Road
Cathedral City, CA 92234
e. nnickerson@naiconsulting.com
p. (760) 323-5344
m. (760) 861-6401
From: Brad Donais <bdonais@hept7.com>
Sent: Tuesday, January 28, 2020 4:56 PM
To: Nick Nickerson <nnickerson@naiconsulting.com>
Subject: Dune Palms Bridge - CVWD Initial Submittal
Nick:
I called and left a message for David Wilson to see if they would accept an initial submittal of the plans sheets for slope
protection and the storm drain outlets. As soon as I hear back from him I will let you know. In the meantime, review the
attached and let me know if you have any questions. If not please, forward the letter and applications to Julie and Bryan
for processing (Bryan's signature). For payment, CVWD will need a check for $2,500, $100 for the application and
000ACHELLA VALLEY WATER DISTRICT
INSTRUCTIONS TO APPLICANT
PERMANENT ENCROACHMENT PERMIT
1. Applicant shall provide one (1) set of approved CVWD Drawings.
2. Applicant shall submit a completed Permanent Encroachment Permit application and obtain an
executed Permanent Encroachment Permit prior to construction.
3. Applicant shall have insurance carrier provide an Acord certificate including required
endorsements as stated in the Coachella Valley Water District Insurance Requirements.
4. If permit is for a storm drain discharging into a CVWD facility, applicant shall pay a storm
drain inlet fee of $100 per diameter inch of pipe.
A. MS4 letter is required from the City.
5. Applicant shall pay a $100 permit processing fee at the time of submitting the application.
6. Processing can take up to thirty (30) days from the receipt of all required documents
(application, approved CVWD Drawings, insurance forms and endorsements, and all
applicable fees).
NOTE: The contractor performing the work will be required to obtain a separate Construction
Encroachment Permit prior to the start of construction.
CVWD WILL NOT PROCESS THE PERMIT UNLESS
THE PACKAGE SUBMITTED IS COMPLETE.
ENG EP-001
(Rev. 2/6/14
APPLICATION FOR PERMANENT ENCROACHMENT PERMIT
(Use separate application for each project)
Permission is requested to encroach on CVWD right-of-way as indicated below. Complete all items; insert N/A if not
applicable. Application will be returned if all required attachments are not included.
Location: Address Dune Palms Road @ CVSC City La Quinta
CVWD Facility CVSC
Date
APN 600-010-009
Nearest Cross Streets Corporate Centre Drive (South) & Highway 111 (South)
{NE} W) (SW) (SE) Quarter(s) of Section 29 , Township 5 South, Range 7 East
(circle one)
Work to be performed by:
Own forces X Contractor, Name
To be determined
Both
FULLY DESCRIBE WORK AND PERMANENT IMPROVEMENTS WITHIN CVWDIUSBR RIGHT-OF-WAY.
Attach approved CVWD drawings (one I I" x 17" set), specifications, calculations, maps, etc., if applicable.
Project will remove the existing low water crossing and replace it with a bridge. Project to also include construction
of a temporary bypass road for construction staging, roadway approach work, relocation of CVWD water and sewer
facilities, installation of channel slope protection, new storm drain outlets at two existing drain outlets and installation
of one new outlet (24"), misc. dry utility relocations, and installation of retaining walls.
Estimated Dates: Start January 2021 Complete
September 2022
Application shall be submitted a minimum of 30 days before construction is scheduled to start.
There shall be a $100.00 processing fee paid at the time this application is submitted.
PERFORMANCE WARRANTY: Bond may be required of the Permittee whenever in the judgment of CVWD it
becomes necessary or advisable to guarantee performance.
INSURANCE REQUIREMENTS: Must be met at the time this application is submitted.
THE UNDERSIGNED AGREES THAT THE WORK WILL BE DONE IN ACCORDANCE WITH CVWD
ENCROACHMENT PERMIT AND SUBJECT TO INSPECTION AND APPROVAL.
City of La Quinta
Applicant/ Company Name
Phone( 760 ) 777-7045
78-495 Calle Tampico
(mailing address)
La Quinta, CA 92253
(city and zip code)
Bryan McKinney
Authorized Name and Title (print)
Authorized Signature
bmckinney@laquintaca.gov
Email Address
ENG EP-001
(Rev. V6/19
If you have any questions in regard to the preparation of this application or if you need any information, please contact the
Right -of -Way Division at (760) 398-2651.
COACHELLA VALLEY WATER DISTRICT
INSURANCE REQUIREMENTS
MINIMUM SCOPE AND LIMIT OF COVERAGE. Prior to and at all times after executing
the Permit, Permittee shall procure and maintain, at its sole cost, for the duration of Permittee's
obligations hereunder, not less .than the following coverage and limits of insurance, with insurers and
under policy forms satisfactory to CVWD.
(a) Commercial General Liability Insurance written on an occurrence basis of at least
$1,000,000 per occurrence/$2,000,000 aggregate including ongoing operations, products and completed
operations, property damage, bodily injury, personal and advertising injury, and premises/operations
liability.
(i) Coverage for Commercial General Liability insurance shall be at least as broad as
Insurance Services Office Commercial General Liability coverage form (Occurrence Form CG 00 01) or
exact equivalent.
(ii) The policy shall contain no endorsements or provisions limiting coverage for (1)
contractual liability; (2) cross Iiability exclusion for claims or suits by one insured against another; (3)
products and completed operations liability; or (4) contain any other exclusion contrary to the Permit.
(iii) The policy shall be endorsed to name Coachella Valley Water District, its
employees, directors,_ officers, agents, and volunteers as additional insureds using ISO endorsement forms
CG 20 10 10 01 and 20 37 10 01, or endorsements providing the exact same coverage.
(b) Commercial Automobile Liability Insurance written on a per occurrence basis of at least
$1,000,000 per occurrence for bodily injury and property damage.
(i) Coverage for automobile liability insurance shall be at least as broad as Insurance
Services Office Form Number CA 00 01 covering automobile liability (Coverage Symbol 1, any auto)
(ii) The policy shall be endorsed to name Coachella Valley Water District, its
employees, directors, officers, agents, and volunteers as additional insureds.
(c) Workers' Compensation Insurance/Employers Liability as required by the State of
California with statutory Iimits or be legally self -insured pursuant to Labor Code section 3700 et seq.
along with Employer's Liability limits of no less than 51,000,000 per occurrence for bodily injury or
disease. The workers compensation insurer shall agree, using form WC 00 03 13 or the exact equivalent
to waive all rights of subrogation against Coachella Valley Water District, its employees, directors,
officers, and agents.
OTHER INSURANCE PROVISIONS. All of Permittee's policies shall meet the following
requirements and contain all specified provisions/endorsements noted hereunder.
(a) Insurers shall provide CVWD at least thirty (30) days prior written notice of cancellation, of
any policy required by this Permit, except that insurers shall provide at least ten (10) days prior written
notice of cancellation of any such policy due to non-payment of premium. In the event any insurer issuing
coverage hereunder does not agree to provide notice of cancellation to CVWD, Permittee shall assume
ENG EP-001
(Rev. 2/6119
such obligation and provide written notice of cancellation in accordance with the above. If any of the
required coverage is cancelled or expires during the term of this Permit, Permittee shall deliver renewal
certificate(s) including endorsements to CVWD at least ten (10) days prior to the effective date of
cancellation or expiration.
(b) The Commercial General Liability Policy and Automobile Policy shall each contain a
provision stating that Permittee's policy is primary insurance and that any insurance, self-insurance or
other coverage maintained by CVWD or any additional insureds shall not be called upon to contribute to
any loss.
(c) All required insurance coverages shall contain a provision, or be endorsed, to waive
subrogation in favor of the Coachella Valley Water District, its employees, directors, officers, and agents
or shall specifically allow Permittee to waive its right of recovery prior to a loss. Permittee hereby waives
its own right of recovery against Coachella Valley Water District, its employees, directors, officers, and
agents.
(d) If at any time during the life of the Permit, any policy of insurance required under this
Permit does not comply with these specifications or is canceled and not replaced, CVWD has the right but
not the duty to obtain the insurance it deems necessary and any premium paid by CVWD will be promptly
reimbursed by Permittee. In the alternative, CVWD may cancel this Permit.
(e) CVWD may require Permittee to provide complete copies of all insurance policies and
endorsements in effect for the duration of the Permit.
(f) The general liability and automobile liability programs may utilize either deductibles or
provide coverage excess of a self -insured retention, subject to written approval by CVWD, and provided
that such deductibles shall not apply to CVWD as an additional insured.
(g) Claims made policies are not acceptable
(h) Permittee shall not allow any of its contractors, consultants, subcontractors or
subconsultants to commence work under this Permit until Permittee has required and verified that
contractors, subcontractors, consultants, or subconsultants have secured all insurance required under this
Section, including waivers of subrogation and other endorsements. Policies of commercial general
liability insurance provided by such contractors, consultants, subcontractors or subconsultants shall be
endorsed to name Coachella Valley Water District, its employees, directors, officers, and agents as
additional insureds using ISO form CG 20 38 04 13 and CG 20 10 11 85, or an endorsement providing the
exact same coverage. If requested by Permittee, CVWD may approve different scopes or minimum limits
of insurance for particular contractors, consultants, subcontractors or subconsultants.
VERIFICATION OF COVERAGE. Prior to execution of the Permit, Permittee shall file with
CVWD evidence of insurance from an insurer or insurers certifying to the coverage of all insurance
required herein. Such evidence shall include original copies of the Certificate of Insurance (Acord Form
25-5 or equivalent), together with required endorsements. All evidence of insurance shall be signed by a
properly authorized officer, agent, or qualified representative -of -the -insurer -and -shall -certify the names of
the insured, any additional insureds, where appropriate, the type and amount of the insurance, the Iocation
and operations to which the insurance applies, and the expiration date of such insurance. All policies
required shall be issued by acceptable insurance companies, as determined by CVWD. Each such policy
shall be from a company or companies with a current A.M. Best's rating of no less than A:VII and
admitted to transact in the business of insurance in the State of California, or otherwise allowed to place
insurance through surplus Iine brokers under applicable provisions of the California Insurance Code or
any federal law.
ENG EP-001
(Rev. 2/6119
• LIABILITY NOT LIMITED. Defense costs shall be payable in addition to the limits set forth
herein. Requirements of specific coverage or limits contained herein are not intended as a limitation on
coverage, limits, or other requirement, or a waiver of any coverage normally provided by any insurance.
The limits set forth herein shall apply separately to each insured against whom claims are made or suits
are brought, except with respect to the limits of liability. Further the limits set forth herein shall not be
construed to relieve Permittee from liability in excess of such coverage, nor shall it limit Permittee's
indemnification obligations to CVWD and shall not preclude CVWD from taking such other actions
available to CVWD under other provisions of the Permit or law.
AVAILABLE LIMITS. Notwithstanding the minimum limits set forth above, any available
insurance proceeds in excess of the specified minimum limits of coverage shall be available to the parties
required to be named as additional insureds.
RESERVATION OF RIGHTS. CVWD reserves the right to modify these requirements, including
limits, based on the nature of the risk, prior experience, insurer, coverage, or other special circumstances.
ENG EP-001
(Rev. 2/6119
INSURANCE SUBMISSION*
It is IMPORTANT to know that CVWD requires that ENDORSEMENT FORMS be attached
behind the Certificate of Insurance. A statement on an insurance certificate will not be
accepted in lieu of the actual endorsement forms.
INSURANCE BROKERS should contact their insurance company UNDERWRITERS if they,
have questions. Every underwriter, regardless of the insurance company, has great
knowledge of what endorsement forms are and can provide the forms to the broker. The
endorsement forms are necessary and required.
Please use the CHECKLIST below to verify that you have obtained and attached each of the
proper items. Please submit the insurance as one (1) packet.
❑ General Liability Insurance Certificate in the amount of $1,000,000
❑ Additional Insured Endorsement Form
❑ Waiver of Subrogation Endorsement Form
❑ Automobile Liability Insurance Certificate in the amount of $1,000,000
❑ Additional Insured Endorsement Form
❑ Waiver of Subrogation Endorsement Form
❑ Workers' Compensation statutory limits, Employers liability $1,000,000
❑ Waiver of Subrogation Endorsement Form
Additional insured: Coachella Valley Water District, its employees, directors, officers,
and agents.
*This document is a short synopsis of CVWD's insurance requirements and is not intended to
limit CVWD's liability in any way.
ENG EP-001
(Rev. 216119
COACHELLA VALLEY WATER DISTRICT
INSTRUCTIONS TO APPLICANT
CONSTRUCTION ENCROACHMENT PERMIT
1. Applicant shall provide one (1) set of approved CVWD Drawings.
2. Applicant shall submit a completed Construction Encroachment Permit application and
obtain an executed Construction Encroachment Permit prior to construction.
Applicant shall have insurance carrier provide an Acord certificate including required
endorsements as stated in the Coachella Valley Water District Insurance Requirements.
4. Applicant shall pay a $100 permit processing fee at -the time of submitting the
application.
5. Processing can take up to thirty (30) days from the receipt of all required documents
(application, approved CVWD drawings, processing fee, and insurance forms and
endorsements).
NOTE: If permanent improvements are being installed within CVWD or United States
Bureau of Reclamation (USBR) right-of-way, the responsible party will be required to obtain
a separate authorization (Permanent Encroachment Permit, Noninterference Review Letter,
USBR Right -of -Use, etc.) prior to the start of construction.
*An estimated inspection deposit will be collected at the preconstruction meeting.
CVWD WILL NOT PROCESS THE PERMIT UNLESS
THE PACKAGE SUBMITTED IS COMPLETE.
ENG EP-002
(Rev; 3/27118)
APPLICATION FOR CONSTRUCTION ENCROACHMENT PERMIT
(Use separate application for each project)
Permission is requested to encroach on CVWD/USER right-of-way as indicated below. Complete all items; insert
NIA if not applicable. Application will be returned if all required attachments are not included.
Location: City La Quinta
CVWD/USBR Facility CVSC
County Riverside
Date
Nearest Cross Streets Corporate Centre Drive (South) & Highway 111 (South)
(NE) W) (SW) (SE) Quarter(s) of Section 29 , Township 5 South, Range 7 East
circle one)
FULLY DESCRIBE WORK WITHIN CVWD/USER RIGHT-OF-WAY. Attach approved CVWD
drawings (one 11" x 17" set), specifications, calculations, maps, etc., if applicable.
Project will remove the existing low water crossing and replace it with a bridge. _Project to also include construction
of a temporary bypass road for construction staging, roadway approach work, relocation of CVWD water and sewer
facilities, installation of channel slope protection, new storm drain outlets at two existing drain outlets and installation
of one new outlet (24"), misc. dry utility relocations, and installation of retaining walls.
Estimated Dates: Start January 2021 Complete September 2022
Application shall be submitted a minimum of 30 days before construction is scheduled to start.
There shall be a $100.00 processing fee,paid at the time this application is submitted.
PERFORMANCE WARRANTY: Bond maybe required of the Permittee whenever in the judgment
of CVWD it becomes necessary or advisable to guarantee performance.
INSURANCE REQUIREMENTS: Must be met at the time this application is submitted.
THE UNDERSIGNED AGREES THAT THE WORK WILL BE DONE IN ACCORDANCE WITH
CVWD ENCROACHMENT PERMIT AND SUBJECT TO INSPECTION AND APPROVAL.
City of La Quinta Bryan McKinney
Applicant/ Company Name Authorized Name and Title (print)
Phone (760 ) 777-7045
78-495 Caile Tampico
(mailing address)
La Quinta, CA 92253 _
(city and zip code)
Authorized Signature
bmckinney@laquintaca.gov
Email Address
If you have any questions in regard to the preparation of this application or if you need any information, please
contact the Right -of -Way Division at (760) 398-2651.
ENG EP-002
(Rev. M7118)
COACHELLA VALLEY WATER DISTRICT
INSURANCE REQUIREMENTS
MINIMUM SCOPE AND LIMIT OF COVERAGE. Prior to and at all times after
executing the Permit, Permittee shall procure and maintain, at its sole cost, for the duration of
Permittee's obligations hereunder, not less than the following coverage and limits of insurance,
with insurers and under policy forms satisfactory to CVWD.
(a) Commercial General Liability Insurance written on an occurrence basis of at
least $1,000,000 per occurrence/$2,000,000 aggregate including ongoing operations, products
and completed operations, property damage, bodily injury, personal and advertising injury, and
premises/operations liability.
(i) Coverage for Commercial General Liability insurance shall be at least as
broad as Insurance Services Office Commercial General Liability coverage form (Occurrence
Form CG 00 01) or exact equivalent.
(ii) The policy shall contain no endorsements or provisions limiting coverage
for (1) contractual liability; (2) cross liability exclusion for claims or suits by one insured against
another; (3) products and completed operations liability; or (4) contain any other exclusion
contrary to the Permit.
(iii) The policy shall be endorsed to name Coachella Valley Water District, its
employees, directors, officers, agents, and volunteers as additional insureds using ISO
endorsement forms CG 20 10 10 01 and 20 37 10 01, or endorsements providing the exact same
coverage.
(b) Commercial Automobile Liability Insurance written on a per occurrence basis
of at least $1,000,000 per occurrence for bodily injury and property damage.
(i) Coverage for automobile liability insurance shall be at least as broad as
Insurance Services Office Form Number CA 00 01 covering automobile liability (Coverage
Symbol 1, any auto)
(ii) The policy shall be endorsed to name Coachella Valley Water District, its
employees, directors, officers, agents, and volunteers as additional insureds.
(c) Workers' Compensation Insurance/Employers Liability as required by the
State of California with statutory limits or be legally self -insured pursuant to Labor Code section
3700 et seq. along with Employer's Liability limits of no Iess than $1,000,000 per occurrence for
bodily injury or disease. The workers compensation insurer shall agree, using form WC 00 03
13 or the exact equivalent to waive all rights of subrogation against Coachella Valley Water
District, its employees, directors, officers, and agents.
OTHER INSURANCE PROVISIONS. All of Permittee's policies shall meet the
following requirements and contain all specified provisions/endorsements noted hereunder.
(a) Insurers shall provide CVWD at least thirty (30) days prior written notice of
cancellation of any policy required by this Permit, except that insurers shall provide at Ieast ten
(i 0) days prior written notice of cancellation of any such policy due to non-payment of premium.
ENG EP-002
(Rev. 3/27/1 S)
In the event any insurer issuing coverage hereunder does not agree to provide notice of
cancellation to CVWD, Permittee shall assume such obligation and provide written notice .of
cancellation in accordance with the above. If any of the required coverage is cancelled or
expires during the term of this Permit, Permittee shall deliver renewal certificate(s) including
endorsements to CVWD at least ten (10) days prior to the effective date of cancellation or
expiration.
(b) The Commercial General Liability Policy and Automobile Policy shall each
contain a provision stating that Permittee's policy is primary insurance and that any insurance,
self-insurance or other coverage maintained by CVWD or any additional insureds shall not be
called upon to contribute to any loss.
(c) All required insurance coverages shall contain a provision, or be endorsed, to
waive subrogation in favor of the Coachella Valley Water District, its employees, directors,
officers, and agents or shall specifically allow Permittee to waive its right of recovery prior to a
loss. Permittee hereby waives its own right of recovery against Coachella Valley Water District,
its employees, directors, officers, and agents.
(d) If at any time during the life of the Permit, any policy of insurance required under
this Permit does not comply with these specifications or is canceled and not replaced, CVWD
has the right but not the duty to obtain the insurance it deems necessary and any premium paid
by CVWD will be promptly reimbursed by Permittee. In the alternative, CVWD may cancel this
Permit.
(e) CVWD may require Permittee to provide complete copies of all insurance
policies and endorsements in effect for the duration of the Permit.
(f) The general liability and automobile liability programs may utilize either
deductibles or provide coverage excess of a self -insured retention, subject to written approval by
CVWD, and provided that such deductibles shall not apply to CVWD as an additional insured.
(g) Claims made policies are not acceptable
(h) Permittee shall not allow any of its contractors, consultants, subcontractors or
subconsultants to commence work under this Permit until Permittee has required and verified
that contractors, subcontractors, consultants, or subconsultants have secured all insurance
required under this Section, including waivers of subrogation and other endorsements. Policies
of commercial general liability insurance provided by such contractors, consultants,
subcontractors or subconsultants shall be endorsed to name Coachella Valley Water District, its
employees, directors, officers, and agents as additional insureds using ISO form CG 20 38 04 13
and CG 20 10 11 85, or an endorsement providing the exact same coverage. If requested by
Permittee, CVWD may approve different scopes or minimum limits of insurance for particular
contractors, consultants, subcontractors or subconsultants.
VERIFICATION OF COVERAGE. Prior to execution of the Permit, Permittee shall
file with CVWD evidence of insurance from an insurer or insurers certifying to the coverage of
all insurance required herein. Such evidence shall include original copies of the Certificate of
Insurance (Acord Form 25-S or equivalent), together with required endorsements. All evidence
of insurance shall be signed by a properly authorized officer, agent, or qualified representative of
the insurer and shall certify the names of the insured, any additional insureds, where appropriate,
ENG EP-002
(Rev. 327/1 &)
the type and amount of the insurance, the location and operations to which the insurance applies,
and the expiration date of such insurance. All policies required shall be issued by acceptable
insurance companies, as determined by CVWD. Each such policy shall be from a company or
companies with a current A.M. Best's rating of no less than A:VII and admitted to transact in the
business of insurance in the State of California, or otherwise allowed to place insurance through
surplus line brokers under applicable provisions of the California Insurance Code or any federal
law.
LIABILITY NOT LIMITED. Defense costs shall be payable in addition to the limits
set forth herein. Requirements of specific coverage or limits contained herein are not intended as
a limitation on coverage, limits, or other requirement, or a waiver of any coverage normally
provided by any insurance. The limits set forth herein shall apply separately to each insured
against whom claims are made or suits are brought, except with respect to the Iimits of liability.
Further the limits set forth herein shall not be construed to relieve Permittee from liability in
excess of such coverage, nor shall it limit Permittee's indemnification obligations to CVWD and
shall not preclude CVWD from taking such other actions available to CVWD under other
provisions of the Permit or law.
AVAILABLE LIMITS. Notwithstanding the minimum limits set forth above, any
available insurance proceeds in excess of the specified minimum Iimits of coverage shall be
available to the parties required to be named as additional insureds.
RESERVATION OF RIGHTS. CVWD reserves the right to modify these
requirements, including limits, based on the nature of the risk, prior experience, insurer,
coverage, or other special circumstances.
ENO EP-002
(Rev. 3/27118)
INSURANCE SUBMISSION*
It is IMPORTANT to know that CVWD requires that ENDORSEMENT FORMS be
attached behind the Certificate of Insurance_ A statement on an insurance certificate
will not be accepted in lieu of the actual endorsement forms.
INSURANCE BROKERS should contact their insurance company
UNDERWRITERS if they have questions. Every underwriter, regardless of the
insurance company, has great knowledge of what endorsement forms are and can
provide the forms to the broker. The endorsement forms are necessary and required.
Please use the CHECKLIST below to verify that you have obtained and attached each
of the proper items. Please submit the insurance as one (1) packet.
❑ General Liability Insurance Certificate in the amount of $1,000,000
❑ Additional Insured Endorsement Form
❑ Waiver of Subrogation Endorsement Form
❑ Automobile Liability Insurance Certificate in the amount of $1,000,000
❑ Additional Insured Endorsement Form
❑ Waiver of Subrogation Endorsement Form
❑ Workers' Compensation statutory limits, Employers liability $1,000,000
❑ Waiver of Subrogation Endorsement Form
Additional insured: Coachella Valley Water District, its employees, directors,
officers, and agents.
*This document is a short synopsis of CVWD's insurance requirements and is not
intended to limit CVWD's liability in any way.
ENG EP-002
(Rev. Y27/18)
tev Q . ra City of La QUinta
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Canceled Payables
Vendor Set: 01- Vendor Set 01
Bank: APBNKBOW - APBNK- BOW
Vendor Number
Vendor Name
00267
COACHELLA VALLEY WATER DISTRICT
Payment Type
Payment Number
Check
200893
Payment Reversal Register
APPKT02283 - BC 02/11/202G
r
Total Vendor Amount
-2,500.00
Original Payment Date Reversal Date Cancel Date Payment Amount
02/07/2020 02/11/2020 02/11/2020-2,500.00
Payable Number: Description Payable Date Due Date Payable Amount
020420 02/04/20 - DUNE PALMS BRIDGE ENCROACH PERMIT 02/04/2020 02/07/2020 2,500.00
2/11/2020 6:01,17 PM Page 1 of 2