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Insurance Certificates 2019/20 Acorn Technology ServicesACp1?b' CERTIFICATE OF LIABILITY INSURANCE DATE (M MIDDIYYYY) 7/3/2019 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 rUNTACT NAME, Julie Rybak Kellogg 6 Moreland Agency, Inc. DBA PHONE (909) 792-8950 FAX Alai:(a0a)7s2-2o00 julier@arroyoins.com Arroyo Insurance ServicesRE 1654 Plum Lane INSURER(S) AFFORDING COVERAGE NAIC 0 INSURER A: Federal Ins Co 20281 Redlands CA 92374-4532 INSURED INSURERS:Allmerica Financial Benefit Ins Co 41840 Mighty Oak Technology, DBA: Acorn Technology Services INSURERC: 1960 Chicago Ave NE9 INSURER D: INSURER E : INSURER F: Riverside CA 92507 COVERAGES CERTIFICATE 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. INSR LTR TYPE OF INSURANCE DOL >U POLICY NUMBER POLICY EFF MMfDWYWY) POLICY FXP IMMMDrYYYYj LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE g 1, 000, 000 A CLAIMS -MADE X OCCUR A A PREAtr5E5 Fa erzurvpnCp S 1,000,000 MED EXP (Any one person) S 10,000 X 3583-35-68 WCE 3/20/2019 3/20/2020 PERSONAL d ADV INJURY S 1,000,000 GEN't AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000, POLICY ❑ JEo- M LOC PRODUCTS - COMPIOP AGO $ 2,000,000 Errors S Omissions $ 2 , 000 , 00 0 OTHER: AUTOMOBILE LIABILITY comalFlt IN LE bw I (Ea accident) S 1,000,ODO BODILY INJURY (Per person) $ A ANY AUTO BODILY INJURY (Per acadent) $ ALL OWNED SCHEDULED AUTOS AUTOS s7352-68-66 3/20/2019 3/20/2020 X PROPERTY DAMAGE S NON -OWNED M HIRED AUTOS AUTOS IPer BGrJdenl S X UMBRELLA UAB X OCCUR EACH OCCURRENCE S 2,000,000 AGGREGATE $ 2,000,000 A EXCESS LIAB CLAIMS -MADE DED RETENTION $ S 7983-27-01 3/20/2019 3/20/2020 WORKERS COMPENSATION X PER vTH- STATUTE ER AND EMPLOYERS' LIABILITY YIN E L EACH ACCIDENT $ 1,000,000 AN)' PROPRi E7U"ARTNERIEXECUTIVE B OF FICERNAVVEER EXCLUDED? ❑ N I A (Mandatory In NN) y W23-D961238-00 7/1/2019 7/1/2020 EL DISEASE - EA EMPLOYEE $ 1 . 000 , 000 If yes, describe under DESCRIPTION OF OPERATIONS below EL DISEASE - POLICY LIMIT S 1,000,000 A Cyber Liability 3583-35-68 WCE 3/20/2019 3/20/2020 $n,000,000 Aggregate Limil .✓ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space Is required) "City of La Quinta is hereby recognized as additional insured including primary wording per attached form 080022367,, CERTIFICATE HOLDER CANCELLATION City of La Quinta 78495 Calle Tampico La Quints, 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 Julie Rybak/JULIE WL ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD INS025 (201401) C H U B B' Liability Insurance Endorsement Policy Period MARCH 20, 2019 TO MARCH 20.2020 Effective Date TUNE 25, 2019 Policy Number 3583-35-68 WCE Insured MIGHTY OAK TECHNOLOGY DBA ACORN TECHNOLOGY SERVICES Name of Company FEDERAL INSURANCE COMPANY Date Issued NNE 26, 2019 This Endorsement applies to the following forms: GENERAL LIABILITY 3�'S�ut 63`3fXrw.'W.+�'=.#:7rl.L;'>i::�:.'�.'h:ui�6%S2�<.Y:�A6"v.2dIli�icz"s2.i'�,.`�.i%c:3::.L£:aJ:::�r::::l�ti\%Y.'5::�:{s::i:;%:;:xc::F.k9.4kh::-::,^:Y:if.<:;:i�«ti;:y;::i:;:�:::�::i�.;,•:::::+:19S91Si Under Who Is An Insured, the following provision is added. Who Is An Insured Additional Insured - Persons or organizations shown in the Schedule are insureds; but they are insureds only if you are Scheduled Person ❑N,, p t� L a t:+zrat f.3r ��trf provide them with such insurance as is afforded by Or Organization Lfis policy. However, the person or organization is an insured only: • if and then only to the extent the person or organization is described in the Schedule; to the extent such contract or agreement requires the person or organization to be afforded status as an insured; • for activities that did not occur, in whole or in part, before the execution of the contract or agreement; and • with respect to damages, loss, cost or expense for injury or damage to which this insurance applies. No person or organization is an insured under this provision: • that is more specifically identified under any other provision of the Who Is An Insured sectiun (regardless of any limitation applicable thereto). • with respect to any assumption of liability (of another person or organization) by them in a contract or agreement. This limitation does not apply to the liability for damages, loss, cost or expense for injury or damage, to which this insurance applies, that the person or organization would have in the absence of such contract or agreement. » :&at wasea�wab�au.a: Liability Insurance Additional Insured - Scheduled Person Or Organization Furor 80-02-2367(Rev. 5-07) Endorsement M continued Page 1 CHUBS' Liability Endorsement (continued) Under Conditions, the following provision is added to. the condition titled Other Insurance. Conditions Other Insurance — If you are obligated, pursuant, to a contractor agreement, to provide the person or organization Primary, Noncontributory shown in the Schedule -with primary insurance such as is afforded by this policy, then in such case Insurance — Scheduled this insurance iobwry, aftwo" s,xk cu;itr;k,utinn from insi ra me available to such person Person Or Organization or organization. � a�>�x..aa xtc x�n rr:xua x affis-s .r-xftsx:s.::s�,•�xP. .:.,•�^'."�•uar.�iv:�.e:chaowr: �.; .meee�h n Schedule Liability Insurance Form 8( 02-iW (Rev. 5-07) CITY OF LA QUINTA 78495 CALLE TAMPICO LA QUINTA, CA 92253 All other terms and conditions remain unchanged. Authorized Representative - p, n�� Additional Insured - Scheduled Person Or Organization last page Endorsement Page 2 a,,,---,,HAnqver insurance Group_ W23 D961238 1001674 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 5 % of the California workers' compensation premium otherwise due on such remuneration. Person or Organization CITY OF LA QUINTA Schedule Job Description 78495 CALLS TAMPICO LAQUINTA, CA92253 This endorsement changes the policy to which It is attached and is effective on the date issued unless otherwise slated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy,) Endorsement Effective 0 7/ 01 / 2 019 Policy No. W 2 3- D 9 612 3 8- 0 0 Endorsement No. D 1 Insured MIGHTY OAK TECHNOLOGY Insurance CompanyALLMERICA FINANCIAL BENEFIT INSURANCE Countersigned By WC 04 03 06 (Ed 04-84)