The URL can be used to link to this page

Insurance Certificates 2018/19 EcoHero Show LLCDATE (MMIDDrMY) ACC>R1:>® CERTIFICATE OF LIABILITY INSURANCE 12/2012018 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 ICONTACT Mikhail Sarkhosh Sarkhosh Insurance Agency 2491 W. Shaw Suite #124 Fresno, CA 93711 License #: OE83633 INSURED NAME. faH _Nu r.n• 559.243.9000 rem. fuel. 559.449.8466 I INSURER(S) AFFORDING COVERAGE I NAIC #f I INSURER A : INSURER B : The EcoHero Show LLC msuaeaR _QQMpensztj'QA r nee gn_ 2012 W Alluvial Ave INSURERD: United States Liabilily Insurance Cnrgpanv Fresno, CA 93711-0449 INSURERE: INSURER F COVERAGES CERTIFICATE NUMBER: 00000000-596847 REVISION NUMBER: 55 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 AODL rdimi POLICY EFF POLICY EXP TYPE OF INSURANCE D7YYYY LIMITS LTR INSD WVD POLICY NUMBER M..... YYY MMI0 A x COMMERCIAL GENERAL LIABILITY Y Y USA-4229254 10101/2018 10101/2019 EACH OCCURRENCE S 2,000,000 � OCCUR DAMAGE-TCLAIMS-MADE PREM SESOEa orOen� S 100,000 MED EXP (Any one person) $ 5,000 PERSONAL B. ADV INJURY S .2,Op0,0O.0^ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 4000,000 X POLICY F� PFC LOC PRODUCTS - COMPIOP AGG S 4,000,000 Abuse $ Molestation S 11000,000 I OTHER: B AUTOMOBILE LIABILITY Y Y BA040000040533 01/25/2018 01/25/2019 Ea a=I ®ISINGLE LIMIT S 1,000,000 BODILY INJURY (Per person) S ANY AUTO OWNED SCHEDULED AUTOS ONLY x AUTOS BODILY INJURY (Per accident) S PROPERTY DAMAGE Pe : aru $ HIRED NON -OWNED AUTOS ONLY X AUTOS ONLY Uninsured Motor s 1000000 UMBRELLA LIAB OCCUR EACH OCCURRENCE S AGGREGATE S EXCESS LIAB CLAIMS -MADE DED RETENTIONS I S `+ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE YIN NIA OFFICERIMEMBER EXCLUDED? (Mandatory in NH) 9223254-18 12122/2018 1212212019 X PER OTH- TU - ER E L EACH ACCIDENT E.L DISEASE- EA EMPLOYE S 1 000,000 S 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below EL DISEASE- POLICY LIMIT S 1,000,000 D PROFESSIONAL LIABILI SP1567570 01/20/2018 01/20/2019 2,000,000 A Sexual Misconduct USA-4229254 10/01/2018 10/01/2019 11000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of La Quinta, its directors, officials, officers, employees, agents and volunteers are named as additionally insured in respects to General Liability policies per attached endorsement(s). This insurance is deemed primary and certificate holders insurance shall be non-contributory per attached Endorsement Workers Comp: Brett Edwards CERTIFICATE HOLDER CANCELLATION City of La Quinta 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. REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Printed by MMS on December 20. 2018 at 07:28PM ENDORSEMENT AGREEMENT WAIVER OF SUBROGATION BLANXET BASIS 9223254-18 RENEWAL NE HOME OFFICE SAN FRANCISCO EFFECTIVE DECEMBER 22, 2018 AT 12.01 A.M. PAGE 1 OF 1 AND EXPIRING DECEMBER 22, 2019 AT 12.01 A.M. ALL EFFECTIVE DATES ARE AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME THE ECOHERO SHOW LLC 2012 W ALLUVIAL AVE FRESNO, CA 93711 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 2.00% OF THE TOTAL POLICY PREMIUM. SCHEDULE PERSON OR ORGANIZATION ANY PERSON OR ORGANIZATION FOR WHOM THE NAMED INSURED HAS AGREED BY WRITTEN CONTRACT TO FURNISH THIS WAIVER JOB DESCRIPTION BLANKET WAIVER OF SUBROGATION NOTHING IN THIS ENDORSEMENT SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS ABOVE STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS IN THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED ATTSSAN FRANCISCO: At1T!-IQRIiED REPRESENT IVE SCIF FORM 13217 IREV.4.2018) DECEMBER 6, /20/18 PRESIDENT AND CEO 2572 OLD DP 217 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, BLANKET ADDITIONAL INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. The following is added to the Section 11— Liability Coverage, Paragraph A.I. Who Is An Insured Provision: Any person or organization that you are required to Include as additional insured an the Coverage Form in a written contract or agreement that is signed and executed by yeu before the "bodily injury" or "property damage" occurs and that is in effect during the policy period is an "insured" for Liability Coverage, but only for damages to which this insurance appiles and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Section II. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET WAIVER OF SUBROGATION This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. SECTION IV — BUSINESSS AUTO CONDITIONS, A. Loss Conditions, 5. Transfer of Rights Of Recovery Against Others To Us, the following is added: We waive any right of recovery we may have against any person or organization to the extent required of you by a written contract executed prior to any "accident" or "loss", provided that the "accident' or "loss" arises out of the operations contemplated by such contract. The waiver applies only to the person or organization designated in such contract. Policy # USA-4229254 CGL 2010 0318 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 FORM SCHEDULE Name of Additional Insured Person(s) or Organization(s) Location(s) Of Covered Operations Any person or organization as required by written Various locations as required under a written contract or contract to be named as additional insured. agreement where the named insured is performing work for an additional insured under this Coverage Part 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; and 3. A person(s or organization's status as an additional insured under this endorsement ends, with respect to any particular project when your operations on that project are completed. B. With respect to the insurance afforded to these additional insured's, 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 CGL 2010 0318 Page 1 of 2 Includes copyrighted material of Insurance Services Office, Inc., used with its permission. 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 operation for a principal as part of the same project. 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. All other terms and conditions of this policy remain unchanged. CGL 2010 0318 Page 2 of 2 Includes copyrighted material of Insurance Services Office, Inc., used with its permission. Policy # USA-4229254 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: CONM ERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE ame of Person or Organization, ny person or organization for whom you are required to waive your right of recovery on this Coverage Part u written contract or agreement. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV - Conditions: 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 operations 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. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page I of I Policy # USA-4229254 CGL 1816 0216 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION, PRIMARY AND NON-CONTRIBUTORY This endorsement modifies insurance provided under the following: CONTRACTORS LIMITED CLAIMS MADE GENERAL LIABILITY COVERAGE FORM CONTRACTORS LIMITED CLAIMS MADE AND REPORTED GENERAL LIABILITY COVERAGE FORM COMMERCIAL GENERAL LIABILITY COVERAGE FORM SCHEDULE Name of Additional Insured Person(s) or Organization Location(s) of Covered Operations Any Person or Organization as Required by written Contract to be named as Additional Insured, Various Locations as per contract with the named insured 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. CGL 1816 0216 Includes copyrighted material of Insurance Services Office, Inc., used with its permission. Page 1 of 2 CGL 1816 0216 C. The insurance provided for the benefit of the above scheduled additional insured(s) shall be primary and non- contributory, 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 in the Schedule above- D. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits of Insurance and Deductible: 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 All other terms and conditions of this policy remain unchanged. CGL 1816 0216 Includes copyrighted material of Insurance Services Office, Inc., used with its permission. Page 1 of 2