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Insurance Certificates 2016/17 HdL Coren & ConeHDLCO-1 OP ID: ALA AC' OR ii.....---- CERTIFICATE OF LIABILITY INSURANCE DATE IMM/DDNYYY) 10/23/2017 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 Partee Insurance Assoc.,Inc. License #0786033 584 S. Grand Avenue Covina, CA 91724-3409 Wayne M. Partee CIC, CWCA CONTACT NAME: PHONEFAX (AIC No, Ezt1- I (NC, Noy E-MAIL ADDRESS[ INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Ohio Security Insurance Co INSURED HdL Coren and Cone 1340 Valley Vista Dr # 120 Diamond Bar, CA 91765 INSURER B :American Fire and Casualty Co 11/15!2017 INSURER C : Twin City Fire Insurance Co. $ 2,000,000 INSURER D i INSURER E : CLAIMS -MADE INSURER F : OCCUR X 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 /IOU SUER Vi/VD VD POLICY NUMBER POLICY EFF (MMIDDIYYYY) POLICY EXP (MMIDD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY 1 BZS56380327 11/1512016 11/15!2017 EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE X OCCUR X DAMAGE 70 RENTED PREMISES (Ea incurrence} 2 000 000 $ , , MED EXP (Any one person) $ 15,000 PERSONAL & ADV INJURY $ Included GEN'L X AGGREGATE POLICY OTHER' LIMIT APPLIES PER: LOC GENERAL AGGREGATE $ 4,000,000 PRODUCTS - COMP/OP AGG $ 4,000,000 $ A AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X SCHEDULED AUTOS NON -OWNED AUTOS BAS56380327 11/15/2016 11/15/2017 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000' BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per arridanl) $ $ B X UMBRELLA LIAB EXCESS !JAB X OCCUR CLAIMS -MADE USA56380327 11/15/2016 11/15/2017 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 DED X RETENTION$ 10,000 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y A ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If describe under !DESCRIPTION OF OPERATIONS below / N N / A X XWS56380327 11/15/2016 11/15/2017 X PER STATUTE OTH- ER E.L. EACH ACCIDENT $ 1,000,000 EL. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 C Professional CLAIMS MADE FORM 72PG0260349 RETRO DATE 2/15/2003 11/15/2016 11/15/2017 LIMIT 2,000,000 DED 25,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) *30 day notice of cancellation, 10 days for nonpayment. The City of La Quinta is named as additional insured, primary/non- contributory as respects the General Liability. Waiver of Subrogation applies as respects to the Workers Compensation. CERTIFICATE HOLDER CANCELLATION CITYLAQ City of La Quinta 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 ACORD 25 (2014/01) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: BZS56380327 BUSINESSOWNERS BP 04 48 07 13 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 Additional Insured Person(s) Or Organization(s): City of La Quinta 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 - Liability is amended as follows: A. The following is added to Paragraph C. Who Is An Insured: 3. Any person(s) or organization(s) shown in the Schedule is also an additional insured, but only with respect to liabil- ity for "bodily injury", "property dam- age" or "personal and advertising in- jury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your be- half 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 ad- ditional insured only applies to the extent permitted by law; and b. If coverage provided to the addi- tional insured is required by a con- tract 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 addi- tional insured. BP 04 48 07 13 B. Wth respect to the insurance afforded to these additional insureds, the following is added to Paragraph D. Liability And Medical Expenses Limits Of Insurance: If coverage provided to the additional in- sured is required by a contract or agree- ment, the most we will pay on behalf of the additional insured is the amount of insur- ance: 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 ap- plicable Limits Of Insurance shown in the Declarations. ©Insurance Services Office, Inc., 2012 Page 1 of 1 Policy Number: BZS56380327 BUSINESSOWNERS BP 14 88 07 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM The following is added to Paragraph H. Other In- surance of Section III - Common Policy Condi- tions and supersedes any provision to the con- trary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance avail- able to an additional insured under your poli- cy provided that: 1. The additional insured is a Named In- sured under such other insurance; and BP 14 88 07 13 2. You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribu- tion from any other insurance available to the additional insured. © Insurance Services Office, Inc., 2012 Page 1 of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 79 (Ed. 01-13) 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 en- gaged in the work described in the Schedule. The additional premium for this endorsement is $ Schedule Person or Organization City of La Quinta 78495 Calle Tampico La Quinta, CA 92253 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 11/15/2016 Endorsement No. 0009 Policy Effective 11/15/2016 Premium $250.00 State California Policy No. XWS56380327 Insured HdL Coren and Cone Insurance Company Ohio Security Insurance Company WC 99 06 79 (Ed. 01-13) 19291 Countersigned by 2013Liberty Mutual Insurance Includes copyrighted material of WCIR9.with its permission.