Loading...
Insurance Certificates 2017/18 Landmark Golf ManagementAC rya I DATE (MM/DDrY YY) CERTIFICATE OF LIABILITY INSURANCE 1 04/30/2018 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 I CONTACT Cynthia Cadenhead NAME: Temecula Insurance Services I PHONE (951) 694-5200 FAX (951) 302-0470 +AIC. Na. Exlf: LAIC, Nv}: 41923 Second Street I k-MAIL cynthia@temeculainsuranceservices.com ADDRESS: Suite 201 I INSURER(S) AFFORDING COVERAGE NAIC # Temecula CA 92590 INSURERA: Granite State Insurance Company 23809 I INSURED INSURER B : Markel American Insurance Company 28932 Landmark Golf Management, LLC, DBA: SilverRock Resort i INSURER C : Guard 20044 79-179 Ahmanson Lane INSURER D : INSURER E ; La Quinta CA 92253 INSURER F : COVERAGES CERTIFICATE NUMBER: CL184601987 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 CONTRACTOR 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 'AUUL'SGHK POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSD WVD POLICYNUMBER (MM/DD/VYYY) (MM/DD/YYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE ❑X OCCUR DAMAGES 1! cN ` I PRFTAISES (Ea orLu rental $ 31)(),()I)I) I MED EXP (Any onepelson) $ 15,000 A Y 02LX0661425146 11/05/2017 11/05/2018 I PERSONAL BADVINJURY S 11000,000 I GENERAL AGGREGATE $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 'R? POLICY J_l;T LOC I PRODUCTS - COMP/OP AGG 3,000,000 $ OTHER: I $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT !Ea aocidmn $ 1.,000 00D _ ANYAUTO I BODILY INJURY (Per person) $ A OWNED SCHEDULED 02LX0661425146 11/05/2017 11/05/2018 I BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS HIRED NON -OWNED H PROP ERI V DAMAGE I $ 25 AUTOS ONLY AUTOS ONLY fear acddentl $ X UMBRELLA LIAR X OCCUR EACH OCCURRENCE S 10,000,000 B EXCESS LIAB H CLAIMS -MADE MKLMlEUL100114 11/05/2017 11/05/2018 AGGREGATE s 10,000,000 DED I I RETENTION $ $ 'WORKERS OMPENSATION VI PER I 1OTH- X STATUTE ER AND EMPLOYERS' LIABILITY Y / N ANY PROPRIMB R/PARTNER/EXECUTIVE I E.L. EACH ACCIDENT s 1,000,000 C EXCLUDED? ❑ NIA LAWC842520 12/23I2017 12123/2018 OFFICER/MEMBER (Mandatory in NH) I EL. DJSEASE-EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E,L DISEASE - POLICY LIMIT S 1,000,000 Limit $2,020,226 Inland Marine - Replacement Cost A Business Income 02LX0661425146 11/05/2017 11/05/2018 Limit $500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate holder is hereby named as Loss Payee and Additional Insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of La Quinta ACCORDANCE WITH THE POLICY PROVISIONS. 78495 Calle Tampico AUTHORIZED REPRESENTATIVE 7 La Quinta CA 92253 (f LlG(wf I / ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 02-LX-066142514-6 COMMERCIAL GENERAL LIABILITY CG 20 26 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED 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): City of La Quinta 78495 Calle Tampico La Quinta, CA 92253 As respects to as their interest may appear 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 your acts or omissions or the acts or omissions of those acting on your behalf. 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. 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 26 0413 ©insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: 02-LX-066142514-6 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON CONTRIBUTORY ENDORSEMENT This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS Name Of Additional Insured Person(s) Or Organization(s): City of La Quinta 78495 Calle Tampico La Quinta, CA 92253 If no entry appears above, this endorsement applies to all Additional Insureds covered under this policy. Any coverage provided to an Additional Insured under this policy shall be excess over any other valid and collectible insurance available to such Additional Insured whether primary, excess, contingent or on any other basis unless a written contract or written agreement specifically requires that this insurance apply on a primary and noncontributory basis. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP5031 US O4-10 Page 1 of 1 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 1.02 % of the California workers' compensation premium otherwise due on such remuneration. Person or Organization Schedule Job Description Blanket Waiver - Any person or organization for whom the All CA Operations Named Insured has agreed by written contract to furnish this waiver. 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 Policy No. LAWC842520 Endorsement No. Insured Insurance Company Countersigned By ©1998 by the Workers' Compensation Insurance Rating Bureau of California. All rights reserved. POLICY NUMBER: 02-LX-066142514-6 COMMERCIAL GENERAL LIABILITY CG 24 07 0196 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRODUCTS/COMPLETED OPERATIONS HAZARD REDEFINED This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Description of Premises and Operations: GOLF/TENNIS/CITY CLUBS/RESTAURANT (If no entry appears above, information required to complete this endorsement will be shown in the Dec- Iaraiions as applicable to this endorsement.) With respect to "bodily injury" or "property dam- age" arising out of "your products" manufactured, sold, handled or distributed: 1. On, from or in connection with the use of any premises described in the Schedule, or 2. In connection with the conduct of any opera- tion described in the Schedule, when conduct- ed by you or on your behalf, Paragraph a. of the definition of "Products - completed operations hazard" in the DEFIM- TIONS Section. is replaced by the following: "Products -completed operations hazard": a. Includes all "bodily injury" and "property damage" that arises out of "your products" if the "bodily injury" or ",property damage" occurs after you have relinquished posses- sion of those products. CG 24 07 0196 Copyright, Insurance Services Office, Inc., 1994 Page 1 of 1 0