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Insurance Certificates 2018/19 Bengal EngineeringAC Ro Q CERTIFICATE OF LIABILITY INSURANCE DATE 10/24/2018Y) �� • 10/24/2018 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 CONTACT NAME Tina Jackson Tina Jackson Insurance Services, Inc P°Nd 8059662500 a . 8055635328 E-MAI3834 Pemm PI ADDRESS: tine tine acksonins.com AODREBs: � J Santa Barbara, CA 93110 INSURE S AFFORDING COVERAGE NAIC# INSURERA: Hanover Insurance Company INSURED INSURER13: U.S. Specialty Insurance Company Bengal Engineering, Inc INSURERC: INSURER D : 250 Big Sur Drive INSURER E: Goleta CA 93117 INSURER F: CAVFRArFS CFRTIFICATF NUMBER- 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 POLI INSR TYPE OF INSURANCE AODL SUBRI FF POLICY NUMBER MM/DCDM'YY M4O/DD/YYYY LIMITS .A X COMMERCIAL GENERAL LIABILITY Y Y OB3-A316654-00 06/15/18 06/15/19 EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE OCCUR UA—MAG E TO RENTE p PREMISES Fa occurrence $ 300 000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 X PRO ❑ LOC POLICY ❑ dECT PRODUCTS - COMP/OPAGG $ 4,000,000 $ OTHER: A AUTOMOBILE LIABILITY AW3A50250500 12/12/17 12/1 Z/18 COMBINED SINGLE LIMIT amdant $ 1,000,OOO.i BODILY INJURY (Per person) $ ANY AUTO SCHEDULED OWNED [X:] AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Par acaldaM $ HIRED NON -OWNED X AUTOS ONLY AUTOS ONLY $ I , UMBRELLALIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ A WORKERS COMPENSATION Y WZ3 D557061 00 05/15/18 05/15119 X PER - STATUTE ER AND EMPLOYERS' LIABILITY Y❑ E. L, EACH ACCIDENT $ 1,000,000 ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N / A (Mandatory in NH) E,L, DISEASE - EA EMPLOYE $ 1,000,000 E L DISEASE - POLICY LIMIT If yes, describe under DESCRIPTION OF OPERATIONS below $ 1,000,000 B Professional Liability USS 18 29008 109/17/181D9/17/19 $1,000000 Per Occurrence $2,000:000 Aggregate DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of La Quinta, it's officer and employees are listed as additional insured in respects to general liability Coverage is primary and non- contributory. The Dune Palms Road Low Water Crossing Replacement at the Coachella Valley Storm Water Channel, City Project No. 2011-05, Federal Project No BRLKS-5433(014) **10 days notice of cancellation of non-payment of premium** CERTIFICATE HOLDER CANCELLATION City of La Quinta Attn: Frank Spevacek City Manager 78-495 Calle Tampico La Quinta, CA 92253 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 REPRESENTATIVE J ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM SCHEDULE Name of Person or Organization: CITY OF LA QUINTA, IT'S OFFICERS AND EMPLOYEES (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement) For the purpose, of coverage provided by this endorsement, the following changes are made to SECTION II - LIABILITY: A. The following is added to SECTION II - LIABILITY, C. Who is an Insured: Any person or organization shown in the Schedule above is also an additional insured, 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 in the performance of your ongoing operations or in connection with your premises owned by or rented to you. However: a. The insurance afforded to such additional insured only applies to the extent permitted by law; and b. 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. The following is added to SECTION II - LIABILITY, D. Liability and Medical Expenses 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: a. Required by the contract or agreement; or b. 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. ALL OTHER TERMS, CONDITIONS, AND EXCLUSIONS REMAIN UNCHANGED. 391-1941 08 16 Includes copyrighted material of Insurance Services Offices, Inc., with its permission Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: BLISINESSOWNERS COVERAGE FORM SCHEDULE* Name Of Person Or Organization: CITY OF LA QUINTA, IT'S OFFICERS AND EMPLOYEES I* Information required to complete this Schedule, if not shown on this endorsement, will be shown in the Declarations. Paragraph K. Transfer Of Rights Of Recovery Against Others To Us in Section III - Common Pol- icy Conditions is amended by the addition of the following: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing op- erations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. BP 04 97 07 02 Copyright, ISO Properties, Inc., 2001 Page 1 of 1 lHangver Insurance Group.. 0133 A316654 1001257 1. SECTION I - PROPERTY, if two or more of However, if you agree in a written this coverage part's coverages apply to contract, written agreement, or the same loss or damage, we will not pay written permit that the insurance more than the actual amount of the loss or provided to any person or damage. organization included as an 2. SECTION II - LIABILITY, it is our stated Additional Insured under this intent that the various Coverage Parts, Coverage Part is primary and non-contributory, we will not seek forms, endorsements or policies issued to contribution from any other the named insured by us, or any company insurance available to that Additional affiliated with us, do not provide any duplication or overlap of coverage for the Insured which covers the Additional same claim, "suit", "occurrence", offense, Insured as a Named Insured except: accident, "wrongful act" or loss. We will (1) For the sole negligence of the not pay more than the actual amount of Additional Insured; or the loss or damage. (2) When the Additional Insured is If this Coverage Part and any other an Additional Insured under Coverage Part, form, endorsement or another liability policy policy issued to the named insured by us, b. Excess Insurance or any company affiliated with us, apply to the same claim, "suit", occurrence, This insurance is excess over: offense, accident, "wrongful act" or loss, (1) Any of the other insurance, the maximum Limit of Insurance under all whether primary, excess, such Coverage Parts, forms, contingent or on any other basis: endorsements or policies combined shall (a) That is Fire, Extended not exceed the highest applicable Limit of Coverage, Builder's Risk, Insurance under any one Coverage Part, Installation Risk similar form, endorsement or policy. w coverage for your work"; This condition does not apply to any (b) That is Property Insurance for Excess or Umbrella Policy issued by us premises rented to you or specifically to apply as excess insurance temporarily occupied by you over this policy. with permission of the owner; G. Liberalization (c) That is insurance purchased If we adopt any revision that would broaden by you to cover your liability the coverage under this policy without as a tenant for "property additional premium within 45 days prior to or damage" to premises rented during the policy period, the broadened to you or temporarily coverage will immediately apply to this policy. occupied by you with H. Other Insurance permission of the owner; or 1. SECTION I - PROPERTY (d) If the loss arises out of the If there is other insurance covering the maintenance or use ofaircraft, "autos" or watercraft same loss or damage, we will pay only for to the extent not subject to the amount of covered loss or damage in SECTION II - LIABILITY, excess of the amount due from that other Exclusion g. Aircraft, Auto or insurance, whether you can. collect on it or Watercraft; and not. But, we will not pay more than the applicable Limit of Insurance of SECTION 1 (2) Any other primary insurance - PROPERTY. available to you covering liability 2. SECTION II - LIABILITY for damages arising out of the premises or operations, or the If other valid and collectible insurance is products and completed available to the insured for a loss we operations, for which you have cover under SECTION II - LIABILITY, our been added as an additional obligations are limited as follows: insured by attachment of an a. Primary Insurance endorsement. This insurance is primary except when When this insurance is excess, we will have no duty under SECTION II - paragraph b. below applies. If this LIABILITY to defend the insured insurance is primary, our obligations against any 'suit if any other are not affected unless any of the insurer has a duty to defend the other insurance is also primary. Then, �� insured against that suit". If no other we will share with all that other insurer defends, we will undertake to insurance by the method described in do so, but we will be entitled to the paragraph c. below. 391-1003 08 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 79 of 81 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM SCHEDULE Name of Person or Organization: CITY OF LA QUINTA, IT'S OFFICERS AND EMPLOYEES (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) For the purpose of coverage provided by this endorsement, the following changes are made to SECTION II - LIABILITY: A. The following is added to SECTION II - LIABILITY, C. Who is an Insured: Any person or organization shown in the Schedule above is also an additional insured, 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 in the performance of your ongoing operations or in connection with your premises owned by or rented to you. However: a. The insurance afforded to such additional insured only applies to the extent permitted by law; and b. 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. The following is added to SECTION II - LIABILITY, D. Liability and Medical Expenses 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: a. Required by the contract or agreement; or b. 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. ALL OTHER TERMS, CONDITIONS, AND EXCLUSIONS REMAIN UNCHANGED. 391-1941 08 16 Includes copyrighted material of Insurance Services Offices, Inc., with its permission Pagel of 1 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 2 due on such remuneration. Person or Organization AS REQUIRED BY CONTRACT % of the California workers' compensation premium otherwise Schedule Job Description 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 Insured Policy No. WZ3-D557061-00 Endorsement No. Insurance Company THE HANOVER AMERICAN INSURANCE COMPANY Countersigned By WC 04 03 06 (Ed 04-84)