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Insurance Certificates 2020/21 HR Green Pacific IncSHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME: CONTACT (A/C, No): FAX E-MAIL ADDRESS: PRODUCER (A/C, No, Ext): PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT ER OTH- STATUTE PER LIMITS(MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) POLICY EFF POLICY NUMBERTYPE OF INSURANCELTR INSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY X Attn: Maria Casillas 1,000,000 mgruis@holmesmurphy.com 2,000,000 X conditions. 866-231-7822 Subrogation in favor of the City of La Quinta as required by written contract with the insured, per policy terms and DPR9952889 written contract with the insured, per policy terms and conditions. The General Liability includes a Waiver of The City of La Quinta, its officials, employees and agents are Additional Insured on General Liability as required by Re: On-Call Engineering Plan Check Services for the City of La Quinta USA ZUP14N8656620 N A 1-800-300-0325 Corona, CA 92879-5013 05/22/2020 GLO373096710 01/01/21 1,000,000 mgruiscr 01/01/2101/01/20 1,000,000 HR Green Pacific, Inc. C 1,000,000 XL SPECIALTY INS CO Travelers Property Casualty Company of Zurich American Insurance Company A 1,000,000 01/01/20 Suite 305 1260 Corona Point Court X X 78-495 Calle Tampico 319-896-7715 300,000 57927167 57927167 X 201 First Street SE, Suite 700 Cedar Rapids, IA 52401 15,000,00001/01/20 6,000,000 5,000,000 BAP373096810 2,000,000 X 01/01/21 X 01/01/21 X 01/01/20 La Quinta, CA 92253 10,000 10,000 (Claims Made Coverage) Professional Liability X WC373096610 City of La Quinta B 15,000,000 A 01/01/21 01/01/20 X 37885 Aggregate 25674 Per Claim 16535 2,000,000 Michelle Gruis X Holmes Murphy & Assoc - CR P5260028(N11AC. YY CERTIFICATE OF LIABILITY INSURANCE FDATE(MMIDDIYYYY) /09/2019 THIS L ;ATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFh. DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. IS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. v IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED O provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. N A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 7-800-300-0325 CONTACT Holmes NAME.- Michelle Gruis Murphy a ASSOC - CA PHONE 319-896-7715 FAX - EIRnIL _ pue No : 866-231-7822 201 First Street BE, Suite 700 gpDR>-gs: 0gr_Lriasholmeamrphy-cpm > INSIIRE�S AFFORDINGCOVr_.RAGE Cedar Rapids, TA 52401 NAN:t W - ---- — --.. _ INSURER A: Zurich American insurance company 16535 INSURED INSURERS: Travelers Property Casualty Company Of 25674 HR Green Pacific, Inc. INSURER C: XL SPECIALTY INS CO 37885 1260 Corona Point Court INSURER D- Suite 305 INSURER E- Corona, CA 92879-5013 - — — _ INSURER F:. COVERAGES CERTIFICATE NUMBER: 57927126 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. NSR Ati$LSUBR LTR TYPE OF INSURANCENSO WVO POLICYNUMBER POLICY FFF POLK:1' E7IP -- --� - MMfDD YN AIYS'I UNITS A X COMMERCIAL GENERAL LIABILITY OL0373096710 01/01/20 O1/Ol/21 EACHOCCURRENCE y 11000,000 CLAIMS -MADE Fi� OCCUR VA -A rA TO P_ RCMISES�� S 300, 000 MED EXP {Any ona parrrri) i 10, 000 PERSONALSADVINJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: POLICY � PRO- X LOC GENERAL AGGREGATE S 2,000,000 JECT PRODUCTS - COMPIOPAGG f 2,000,000 OTHER; A AUTOMOBILELIABILm BAP373096810 i 61/01/20 01/01/21 COMBINED SINGLE UMfT X ANYAUTO as n! $ 2,000,000 OWNED SCHEDULED BODILY INJURY (Per person) S JI AUTOS ONLY - AUTOS X HIRED NON -OWNED __ BODILY INJURY (Per accident) E X AUTOS ONLY — AUTOS ONLY ; iFROaELMAGE B X UMBRELLALIAB X OCCUR ZUP14NB656620 $ 01/ 12020 01/01/21 EXCESS LUIB EACH OCCURRENCE i 15,000,000 CLAlMS••MApE AGGREGATE = 15,000,000 X 10, 000 DET3 RETE-wnQN $ WORKERS COMPENSATION A $ AND EMPLOYERS'LIABILITY YIN WC373096610 01/01/20 01/01/21 X P gTUIE OTH- ANYPROPRIETORIPARTNERIEXECUTIYE " OFFICERIMEMBEREXCLUDED7 � NIA E-LEACH ACCIDENT f 11000,000 (Mandatory In NH) Ifyyss.descdbe-I- E.L-01SEASE-EAEMpLOY S 1,000,000 0 SCRIPTlpN OF OPERATIONS Wknv El. DISEASE -POLICY LIMIT j 1,000,000 C Professional Liability DPR9952889 Ol/Ol/20 Ol/Ol/21 Per Claim 5,000,000 (Claims Made Coverage) � Aggregate 61000,000 DESCRIPTION OF OPERATIONS? LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached N more space Is required) Project: 171838 On -Call Building Plan Review and Inspection The City of La Quints. is an additional insured on the General Liability on a primary and non-contributory basis as required by written contract with the insured, per policy terms and conditions. The Workers Compensation includes a waiver of subrogation in favor of the additional insureds as required by written contract with the insured, per policy terms and conditions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of La Quints THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Actin: Maria Caeillas ACCORDANCE WITH THE POLICY PROVISIONS. 78-495 Calle Tampico AUTHORIZED REPRESENTATIVE La Quints, CA 92253 / USA ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD mgruiscr 57927126 P5260028002 At ?v CERTIFICATE OF LIABILITY INSURANCE I DATE(MMIDDIYYYY) 12/09/2019 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 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 1-800-300-0325 NAY � Michelle Gruie Holmes Murphy E Assoc - CR PHONE .319-896-7715 FIUt .866-231-7822 AIL 201 First Street SE, Suite 700 ADDRESS: mgruingholmesmurphy.com Cedar Rapids, TA 52401 INSURED HR Green Pacific, Inc. 1260 Corona Point Court Suite 305 Corona, CA 92879-5013 INSURERS AFFORDING COVERAGE NAIC if INSURER A: Zurich American Insurance Company 16535 INSURERB:Travelers Property Casualty Company Of 25674 INSURERC:XL SPECIALTY INS CO 37885 INSURERD: INSURER E: INSURERF: r.nVFROf;FA rFRTIFI('ATF NIIFARFR• 57927167 klliaaoco• 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 ADDL WOW POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD Wvo POLICYNUMBER IMWOD M LIMITS A X COMMERCIAL GENERAL LIABILITY GL0373096710 01/01/20 01/01/21 EACH OCCURRENCE $ 1,000,000 ACLAIMS -MADE OCCUR p T Ee nnce $ 300,000 MED EXP LAmy one person) $ 10,000 PERSONAL BADVINJURY E 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER, POLICY JEST [X ] LOC PRODUCTS - COMP/OP AGG E 2,000,000 $ OTHER A AUTOMOBILE LIABILITY HAP373096810 01/01/20 01/01/21 COMBINED SNGLE UMrr aaccident) $ 2,000,000 BODILY INJURY (Per person) $ X ANY AUTO OWNED SCHEDULED AUTOS ONLY - AUTOS P BODILY INJURY eraceldent ( ) E X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY PROPEg7YpAMAGE (Per den E _ _ $ B X UMBRELLALIAB X OCCUR ZUP14NB656620 01/01/20 01/01/21 EACHOCCURRENCE $ 15,000,000 AGGREGATE $ 15,000,000 EXCESS LUIB CLAIMS -MADE DED X RETENTIONS 10,000 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY rrYI N ANYPROPRIETORRARTNER/EXECUTIVE - OFFICER/MEMBEREXCLUE NIA WC373096610 01/01/20 01/01/21 X S7ATUT OTH E.L EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 C Professional Liability DPR9952889 01/01/20 01/01/21 Per Claim 5,000,000 ,(Claims Made Coveraje) Aggregate 6,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more apace la required) Re: On -Call Engineering Plan Check Services for the City of La Quints. The City of La Quints, its officials, employees and agents are Additional Insured on General Liability as required by written contract with the insured, per policy terms and conditions. The General Liability includes a Waiver of Subrogation in favor of the City of La Quints. as required by written contract with the insured, per policy terms and conditions. City of La Quinta Attn: Maria Casillas 78-495 Calls Tampico I,La Quints, CA 92253 ACORD 25 (2016103) mgruiscr 57927167 (:ANI:tLLA I IUN 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 USA /r%[�i ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD z w P52("129M' AC � 12/09/201201CERTIFICATE OF LIABILITY INSURANCEDATE YYY) 2/09 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 1-800-300-0325 CONTACT NAME Michelle Gruia Holmes Murphy & Assoc - CR PHONEFAXcti,• 319-896-7715 diii, m— 866-231-7822 201 First Street BE, Suite 700 Cedar Rapids, IA 52401 INSURED HE Green Pacific, Inc. ADDRESS: mgrn3-g4II011fle8aurn ny, COM INSURERS) AFFORDING COVERAGE_ _ NAICR INSURERA: Zurich American Insurance Company 16535 INSURERS: Travelers Property Casualty Company Of 25674 INSURERC:XL SPECIALTY INS CO 37885 1260 Corona Point Court INSURERO: Suite 305 INSURER E: - Corona, CA 92879-5013 INSURERF: f.0VFRACFS r1=RTIFIf ATF NIIMRFR• 57927583 RFVlglnu IJIIMaFR• 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 AQQL SUER POLICY EFF POLICY EXP' LTR TYPE OF INSURANCE POLICY NUMBER MM!DOIYYYY MWDD LIMITS A X COMMERCIAL GENERAL LIABILITY GL0373096710 01/01/20 01/01/21 EACHOCCURRENCE $ 1,000,000 CLAIMS -MADE l — ` PREMISES REM�S` REMI5£5 Ea Eaomamnce ; 300,000 MED EXP (Any one person) $ 10,000 PERSONAL &ADV INJURY $ 1,000,000 GENI AGGREGATE LIMIT APPLIES PER: POLICY JEST IxLOC GENERAL AGGREGATE $ 2,000,000 _ PRODUCTS - COMP/OP AGG_ $ 2,000,000 $ OTHER. A AUTOMOBILE LIABILITY BAP373096810 01/01/20 01/01/21 COMBINED SINGLE LIMIT $ 2,000,000 BODILY INJURY (Per person) $ X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS _ BODILY INJURY (Per accident) ; HIRED NON -OWNED X AUTOS ONLY X AUTOS ONLY PROPERTYDAMAGE f Per 2Rgden(} $ ; H X UMBRELLA LIAB X OCCUR ZUP14N8656620 01/01/20 01/01/21 EACH OCCURRENCE $ 15,000,000 AGGREGATE $ 15, 000, 000 EXCESS LIAB CLAIMS -MADE OED I X I RETENTIONS 10,000 $ A WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN ANYPROPRIETORIPARTNERIEXECUTIVE OFFICERIM EMBER EXCLUE NIA WC373096610 01/01/20 01/01/21 X STATUTE ER . E.L. EACH ACCIDENT $ 1,000,000 EL. DISEASE- EA EMPLOYEE $ 1,000,000 (Mandatory In NH) If yes, doscntb under DESCRIPTION OF OPERATIONS below $ 1,000,000 EL. DISEASE - POLICY LIMIT C Professional Liability DPR9952889 01/01/20 01/01/21 Per Claim 5,000,000 (Claims Made Coverage) Aggregate 6,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) City of La Quinta, CA is included as an Additional Insured on the General Liability on a primary and non-contributory basis as required by written contract with the insured, per policy terms and conditions. The Workers Compensation includes a Waiver of Subrogation in favor of the City of La Quints. when required by written contract with the insured, per policy terms and conditions. L,Crc 1 irll,04It C IlULLPCK City of La Quinta, CA 78-495 Calls Tampico La Quints, CA 92253 ACORD 25 (2016103) mgruiscr 57927583 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 USA ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD M- , 00 z W P526002 M2 �m CERTIFICATE OF LIABILITY INSURANCE 1Z1o9�Za"9"' 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 endorsements . PRODUCER 1-800-300-0325 CONTACT Michelle Gruie NA_ME:. Holmes Murphy ati Assoc - CR PHONE FAX 1Nr._Ny.E Ik: 319-896-7715 (A/C.NN_ 866-231-7822 201 First Street BE, Suite 700 A DARESS: mgru"Gholma amlfspttiy . com INSURERS AFFORDING COVERAGE NAIC N Cedar Rapids, IA 52401 INSURERA:Zurich American Insurance Company 16535 INSURED INSURERB: Travelers Property Casualty Company Of 25674 HR Green Pacific, inc. INSURERC; XL SPECIALTY INS CO 37885 1260 Corona Point Court INSURERD: Suite 305 INSURERE: _ Corona, CA 92879-5013 INSURERF: C.C)VFRACI:.q r:FRTIFlr.ATF IJIFMRFR• 57927608 RFVICIn1d KUHUIRFR• 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 I TYPE OF INSURANCE ADOL SOBR POLICY NUMBER POLICY EFF POLICY EXP L MMD MMt0 LIMITS A x COMMERCIAL GENERAL LIABILITY GL0373096710 01/01/20 01/01/21 EACH OCCURRENCE $ 1,000,000 7 CLAIMS -MADE u OCCUR PREMISES(Eao7 PREMISES Eaoccaarence S 300,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY S 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JEST LOC PRODUCTS- COMP/OP AGG $ 2,000,000 $ OTHER. A AUTOMOBILE LIABILITY BAP373096810 01/01/20 01/01/21 COMSkNEDSINGLELIMIi Ea ac6ldenl $ 2,000,000 BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS 1X BODILY INJURY (Per accldenl) $ x HIRED x NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTYOAMAGE Para _ $ _ $ B x UMBRELLALIAB x OCCUR ZUP14N8656620 01/01/20 01/01/21 EACH OCCURRENCE $ 15,000,000 AGGREGATE $ 15, 000, 000 EXCESS LIAB CLAIMS -MADE DIED I x RETENTION $ 10,000 $ A WORKERS COMPENSATION AND EMPLOYERS' LWBILFTY YIN ANYPROPRIETORIPARTNERIEXECUTIVE N -i OFFICERIMEMBEREXCLUDED7 NIA WC373096610 01/01/20 01/01/21 x I STATUTE �H E.L.EACH ACCIDENT $ 1,000,000 $ 1,000,000 (Mandatory In NH) EL DISEASE - EAEMPLOYEE If yes, describe under DESCRIPTION OF OPERATIONS belay $ 1,000,000 EL DISEASE -POLICY LIMIT C Professional Liability DPR9952889 01/01/20 01/01/21 Per Claim 5,000,000 (Claims Made Coverage) Aggregate 6,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more apace Is required) The City and its officers and employees are included as Additional Insureds on the General Liability on a primary and non-contributory basis as required by written contract with the insured, per policy terms and conditions. The Workers Compensation includes a a Waiver of Subrogation in favor of the City as required by written contract with the insured, per policy terms and conditions. CERTIFICATE HOLDER CANCELLATION City of La Quinta, CA 78-495 Calle Tampico La Quints, CA 92253 ACORD 25 (2016/03) mgruiscr 57927608 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 USA ��iiC�i{ ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD oo W Additional Insti red —Automatic — Owners, Lessees Or Contractors ZURICH Policy No. I Eff. Date of Pol Exp. Date of Pol. Eff. Date of End. Producer No. AddT Prem Return Prem. L 7 7-10 0 01 /20 01 /0112021 01 /01 /2020 37-17 -00 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Named Insured: HR GREEN, INC. Address (including ZIP Code): 8710 Earhart Lane SW Cedar Rapids, IA 52404 This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part A. Section II — Who Is An Insured is amended to include as an additional insured any person or organization whom you are required to add as an additional insured on this policy under a written contract or written agreement. Such person or organization is an additional insured 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 or "your work" as included in the "products -completed operations hazard", which is the subject of the written contract or written agreement. However, the insurance afforded to such additional insured: 1. Only applies to the extent permitted by law; and 2. Will not be broader than that which you are required by the written contract or written agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to: "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or failure to render, any professional architectural, engineering or surveying services including: a. The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or b. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the 'occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any professional architectural, engineering or surveying services. U-GL-1175-F CW (04/13) Page 1 of 2 Includes copyrighted material of Insurance Services Office, Inc., with its permission. C. The following is added to Paragraph 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit of Section IV — Commercial General Liability Conditions: The additional insured must see to it that: 1. We are notified as soon as practicable of an 'occurrence" or offense that may result in a claim; 2. We receive written notice of a claim or "suit' as soon as practicable; and 3. A request for defense and indemnity of the claim or "suit' will promptly be brought against any policy issued by another insurer under which the additional insured may be an insured in any capacity. This provision does not apply to insurance on which the additional insured is a Named Insured if the written contract or written agreement requires that this coverage be primary and non-contributory. D. For the purposes of the coverage provided by this endorsement: 1. The following is added to the Other Insurance Condition of Section IV — Commercial General Liability Conditions: Primary and Noncontributory insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured provided that: a. The additional insured is a Named Insured under such other insurance; and b. You are required by written contract or written agreement that this insurance be primary and not seek contribution from any other insurance available to the additional insured. 2. The following paragraph is added to Paragraph 4.b. of the Other Insurance Condition of Section IV —Commercial General Liability Conditions: This insurance is excess over: Any of the other insurance, whether primary, excess, contingent or on any other basis, available to an additional insured, in which the additional insured on our policy is also covered as an additional insured on another policy providing coverage for the same 'occurrence", offense, claim or "suit'. This provision does not apply to any policy in which the additional insured is a Named Insured on such other policy and where our policy is required by a written contract or written agreement to provide coverage to the additional insured on a primary and non- contributory basis. E. This endorsement does not apply to an additional insured which has been added to this policy by an endorsement showing the additional insured in a Schedule of additional insureds, and which endorsement applies specifically to that identified additional insured. F. With respect to the insurance afforded to the additional insureds under this endorsement, the following is added to Section III — Limits Of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the written contract or written agreement referenced in Paragraph A. of this endorsement; 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. U-GL-1175-F CW (04/13) Page 2 of 2 Includes copyrighted material of Insurance Services Office, Inc., with its permission. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 0313 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT 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.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule ANY PERSON OR ORGANIZATION FOR WHOM YOU ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT TO OBTAIN THIS WAIVER OF RIGHTS FROM US. 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 01 / 01 / 2 0 2 0 Policy No. WC 3 7 3 0 9 6 6-10 Endorsement No. Insured HR GREEN, INC. Premium $ Insurance Company ZURICH AMERICAN INSURANCE CO. Countersigned 13y1'f%---- -- '*A - WC 00 03 13 (Ed. 4-84) Copyright 1983 National Council on Compensation Insurance