Insurance Certificates 2019/20 Hubstor, IncCS10 CERTIFICATE OF LIABILITY INSURANCE
This certificate is issued as a matter of information only and confers no rights upon the certificate holder and imposes no liability on the insurer.
This certificate does not amend, extend or alter the coverage afforded by the policies below.
CERTIFICATE HOLDER- NAME AND MAILING ADDRESS
INSURED'S FULL NAME AND MAILING ADDRESS
City of La Quinta
Hubstor, Inc.
784 Calle Tampico
515 Legget Drive, Suite 800
La Quinta, CA 92253 USA
POSTAL
CODE
Kanata ON
POODESTAL K2K
C 3G4
DESCRIPTION OF OPERATIONSILOCATIONS/AUTOMOSILES/SPECIAL ITEMS TO WHICH THIS CERTIFICATE APPLIES (but only with respect to the tpeeresons of Me Named Insured)
VERIFICATION OF INSURANCE COVERAGES
COVERAGES
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 requirements, terms
or conditions 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 terms, exclusions and Conditions of such policies.
LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
TYPE OF INSURANCE
INSURANCE COMPANY
EFFECTIVE
DATE
EXPIRY
DATE
LIMITS OF
Canadian dollars unless
LIABILITY
Indicated
otherwise
AND POLICY NUMBER
VYYY/MM/DD
YYYY/MM/DD
COVERAGE
DED.
AM
COMMERCIAL GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
NSUURANCE
Trisura Guarantee Insurance Co
2019/10/24
2020/10124
BODILY INJURY AND PROPERTY DAMAGE
LIABILITY
$1,000
$10,000.000
❑ CLAIMS MADE OR Q OCCURRENCE
- GENERAL AGGREGATE
$1,000
$10,000.000
El PRODUCTS AND OR COMPLETED OPERATIONS
TOP1002684
EACH OCCURRENCE
I] EMPLOYER'S LIABILITY
PRODUCTS AND COMPLETED OP057TION
I]CROSSLABILITY
AGGREGATE
$1.000
$10,000,000
PERSONAL INJURY LABILITY
OPERSONAL AND ADVERTISING INJURY
LABILITY
$1,000
$10,000.000
MEDICAL PAYMENTS
$5,000
El TENANTS LEGAL LIABILITY
TENANTS LEGAL LIABILITY
$1,000
$250.000
❑ POLLUTION LIABILITY EXTENSION
POLLUTION LABILITY EXTENSION
I71 NON-OWNEDAUTOMOBILES
risura Guarantee Insurance Co
NON OWNED AUTOMOBILE
ElHIREDAUTOMOBILES
TOP1002684
2019/10/24
2020/10/24
$1,000
$1,000,000
AUTOMOBILE LIABILITY
BODILY INJURY AND PROPERTY
❑ DESCRIBED AUTOMOBILES
DAMAGE COMBINED
❑ AL OWNED AUTOMOBILES
BODILYINJURY (PER PERSON)
❑ LEASED AUTOMOBILES-
BODILYINJURY (PERAOCIDENT)
-A AMOMOSILESLE EOIN"CEeeor
N DAYS WHERE THE INSURED 18 REWIRED
PROPERTYDAMAGE
To PROVIDE INSURANCE
EXCESS LIABILITY
EACH OCCURRENCE
❑ UMBREUAFORM
AGGREGATE
❑
OTHER LIABILITY (SPECIFY)
Trisura Guarantee Insurance Co
17 Enex.rid Omissions Liability
TPL1011706
2019/10/24
2020/1 W24
Emus and Omissions Liability
$5.000
$5,000,000
Network Security& Pmii.
❑ y
Trisura Guarantee Insurance Co
TPL 1U11706
2019/10/24
2020/10/24
Network Security &Privacy
$5,000
$5.0pt1.000
Employers Liability Extension
Trisura Guarantee Insurance Co
TOP1002684
2019/10/24
2020/10/24
Employers Botlily Injury
$t0,Op0.000
CANCELLATION
Should any of the alcove described policies be cancelled before the expiration date thereof, the issuing company will endeavor to mail 30 days written notice to the certificate
holder named above, but failure to mail such notice shall impose no obligation or liability of any kind upon the company, its agents or representatives.
BROKERAGE/AGENCY FULL NAME AND MAILING ADDRESS
ADDITIONAL INSURED NAME AND MAILING ADDRESS
(but only with respect M the operations of the Named Insured)
Smith Petrie Carr & Scott Insurance Brokers Ltd.
City of La Quinta
600-359 Kent Street
784 Calle Tampico
La Quints, CA 92253 USA
Ottawa ON
cone" K2 OR
"(Added as Additional Insured in Respect of Policy ( p y TOP1002684 Only)—
BROKER CLIENT to: HUBST-1
POSTAL
CODE
CERTIFICATE AUTHORIZATION
ISSUER Trisura Guaranis MPT2y+ — CONTACT NUMBERS)
PE BUS NO. (877)432-51 18 TYPEBUS NO. (613)237-2871
AUTHORIZED REPRESENTATIVII[hitebeall1l"bw 9PR O�p y. TYPE BUS NO. (613) 366-7251 TyTEFAX NO, (613) 237-1179
SIGNATURE OF
AUTHORIZED REPRESENTATIVE �� DATE 2019/10/18 EMAILADDRESS Michael.Nicholson@epee-ins.Gom
r Rln rneanvrr
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