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Insurance Certificates 2018/19 Caha, Becky' h Aco�o' CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 06/20/2019 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 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: Hiscox Inc. d/b/a/ Hiscox Insurance Agency in CA PHONE {888} 202-3007 PAx [XC. iyo, ExU;--- (A/C, Rat: 520 Madison Avenue E-MAIL 32nd Floor ADDRESS__ contact@hiscox.com New York, NY 10022 INSURER $ AFFORDING COVERAGE INSURERA: Hiscox Insurance Company Inc 10200 INSURED REBECCA CAHA 9812 Continental HUNTINGTON BEACH, CA 92646 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NLIMRFR- RFVISION N[IMRFR- 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. 1NSR TYPE OF INSURANCE iADDL POLICYEFF POLICY EXP LTR POLICY NUMBER (MMiDo= IMMID I LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S CLAIMS -MADE _OCCUR PREMISES Eaoccurre - PREMISES f REccurre S S MED EXP (Any one person) S PERSONAL BADVINJURY GEN'L AGGREGATE LIMIT APPLIES PER: S GENERAL AGGREGATE POLICY � CT LOC PRODUCTS - COMP/OP AGG S 5 OTHER: AUTOMOBILE LIABILITY O10MBINED SINGLE L1141T _�qa accldeni S BODILY INJURY (Per person) S ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) S NON -OWNED HIREDAUTOS AUTOS PERTY DAMAGE Par accident S S f UMBRELLA LIAB OCCUR EACH OCCURRENCE S AGGREGATE S EXCESS LIAB CLAIMS -MADE DED RETENTION S S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN PER OTH- STATUT ER E L EACH ACCIDENT S ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N / A ` E-L DISEASE - EA EMPLOYE S (Mandatory in NH) ! If yes, describe under DESCRIPTION OF OPERATIONS below E-L DISEASE -POLICY LIMIT I S A Professional Liability N UDC-1314750-EO-18 12/10/2018 12/10/2019 Each Claim: $ 1,000,000 Aggregate: $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) %,=K I II-IL,A I t 1`1 ULLJ=M 1L ANL.tLLA I IUN La Quinta Housing Authority F7 4495 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 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD Aco>�>o CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 06/20/2019 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 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 _ Hiscox Inc. d/b/a/ Hiscox Insurance Agency in CA PHONE (888) 202-3007 FAX 520 Madison Avenue -MAI - IAIC, Nol: 32nd Floor ADPRE55, contact@hiscox.com New York, NY 10022 INSURERIS)AFFORDING COVERAGE NAIC9 iusrraFrsn. Hiscox Insurance Comoanv Inc 10200 INSURED REBECCA CAHA 9812 Continental HUNTINGTON BEACH, CA 92646 INSURER D : INSURER E : COVERAGES CERTIFICATE NUMRER- RFVISION N1IMRFR- 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 L'SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE WSD I WVD I POLICY NUMBER DD/YYYY) IMMODrfYYYI LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 CLAIMS -MADE X OCCUR _ DAMAGE TO RENTED ,.PREMISES (Ea occurrence) S 100,000 MED EXP (Any one person) s 5,000 X Primary & Noncontributory A N Y UDC-1314750-CGL-18 12/10/2018 12/10/2019 PERSONAL & ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s 2,000,000 X POLICY IPETf FLOC PRODUCTS - COMP/OP AGG s S/T Gen. Agg OTHER: S . AUTOMOBILE LIABILITY COMBINED STNGLF LIMTT EaagggWil S BODILY INJURY (Per person) S ANY AUTO _ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) S NON -OWNED HIREDAUTOS AUTOS PRE PPE TY DAMAGE S s UMBRELLA LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE S AGGREGATE EXCESS LIAR S DED RETENTIONS S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN PER DTH- STATUTE ER E.L EACH ACCIDENT OFFIC RMEMBEREXCLUDEED7ECUTIVE ❑ NIA s E L. DISEASE - EA EMPLOYE S (Mandatory In NH) If yes, describe under DESCRIPTION OF CIPERAT IONS below EL DISEASE - POLICY LIMIT I S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION La Quinta Housing Authority 78495 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 @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD f$0 HISCOX Policy Number: UDC-1 314750-CGL-1 8 Named Insured: REBECCA CAHA Endorsement Number: 20 Endorsement Effective: June 1, 2019 Hiscox Insurance Company Inc. 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 Persons Or Organization(s) La Quinta Housing Authority, a public body corporate and politic 78495 Calle Tampico La Quinta,CA 92253 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II — Who Is An Insured is amended to in- clude as an additional insured the person(s) or organi- zation(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 omis- sions of those acting on your behalf: A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. CG 20 26 07 04 0 ISO Properties, Inc., 2004 Page 1 of 1 40 HISCOX Policy Number: UDC-1314750-CGL-18 Named Insured: REBECCA CAHA Endorsement Number: 19 Endorsement Effective: June 1, 2019 Hiscox Insurance Company Inc. 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 Persons Or Organization(s) City of La Quinta/La Quinta Housing Authority, a public body corporate and politic 78495 Calle Tampico La Quinta,CA 92253 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II — Who Is An Insured is amended to in- clude as an additional insured the person(s) or organi- zation(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 omis- sions of those acting on your behalf: A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. CG 20 26 07 04 0 ISO Properties, Inc., 2004 Page 1 of 1 AM H I SCOX Policy Number: Named Insured: Endorsement Number: Endorsement Effective UDC-1314750-CGL-18 REBECCA CAHA 18 June 1, 2019 Hiscox Insurance Company Inc. 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 Oraanization(s) The City of La Quinta, a public body corporate and politic 78-495 Calle Tampico La Quinta,CA 92247 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II — Who Is An Insured is amended to in- clude as an additional insured the person(s) or organi- zation(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 omis- sions of those acting on your behalf: A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. CG 20 26 07 04 0 ISO Properties, Inc., 2004 Page 1 of 1 40 HISCOX Policy Number: Named Insured: Endorsement Number: Endorsement Effective UDC-1314750-CGL-18 REBECCA CAHA 17 June 1, 2019 Hiscox Insurance Company Inc. 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 A. 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, pro- vided: 1. you have agreed in a written contract or agreement to add such additional insured to a policy providing the type of coverage af- forded by this policy; and 2. you have agreed in a written contract or agreement with such additional insured that this insurance would be primary and would not seek contribution from any other insur- ance available to the additional insured. CGL E5581 CW (03/16) Includes copyrighted material of Page 1 of 1 Insurance Services Office, Inc., with its permission