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Insurance Certificates 2020/21 ClearSource FinancialCLEAR-1 0 ID: AR DATE(M 2/20 0 12/0/2020 CERTIFICATE OF LIABILITY INSURANCE CE 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 831-337-4661 Clarion Pacific Insurance 2035 N.. Pacific Ave. CONTACT Ariel Rittenhouse Williams NAM (A/C, PHONE No EXt): 831-337-0661 �AAic, No):831-612-1810 Santa Cruz, CA 95060 Ryan Deane TM---p-rm S INSURERS AFFORDING COVERAGE NAIC # INSURER A: Travelers Property Casualty Co 25674 SURED earsource Financial Consulting Terry Madsen 7960 SO uel Dr. ste: B363 Aptos, C� 95003 INSURERB:Nationwide Mutual Insurance Co 23787 Philadelphia INSURER C : Indemnity p `7 1$05$ INSURER D INSURER E : INSURER F : CCdVFRA(,F.R r FRTIFI('ATF MI IMRPR• Pr-VIRIr)M MI IMRF=P& 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 TypE OF INSURANCE DDNSOL UBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS B X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR X ACP 3029102473 12/09/2020 12/09/2021 EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED PR MI Ea occurr e S 300,000 MED EXP (Any one n $ 5,000 PERSONAL & ADV INJURY $ 2,000,600 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY jeaT El LOC OTHER: GENERAL AGGREGATE $ 4,000,000 PRODUCTS - COMP/OP AGG $ 4,000,000 $ B AUTOMOBILE X LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS AUT�S ONLY X AUOTOS ONLD ACP 3029102473 12/09/2020 12/09/2021 COMBINED SINGLE LIMIT ccident$ 2,000,000 BODILY INJURY Perperson) $ BODILY BODILY INJURY Per accident $ P2OPERd�fDAMAGE $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTIONS $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N pFFICER/M�M EXCLUDED? (Mandatory m �ij If yes, describe under DESCRIPTION OF OPERATIONS below N / A X UB-8M759710-21-42-G 01/01/2021 01/01/2022 X PER OTH- E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE 1,000,000 $ E.L. DISEASE - POLICY LIMIT $ 1,000,00fl C Professional Liab PHSDIS84536 12/09/2020 12/09/2021 Occurence Aggregate 2,000,000 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) The City of La Quinta its officers, officers, employees, agents and volunteers are named as additional insured with respect to the operations of the named insured as required by written contract. Waiver of subrogation attached applies to WC. 30 day notice of cancellation to be mailed to certificate holder; 10 day notic for non-payment of premium. City of La Quinta 78495 Calie 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. ACORD 25 (2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD BUSINESSOWNERS PB 04 48 1114 ADDITIONAL INSURED - DESIGNATED PERSON 01 ORGANIZATION This endorsement modifies insurance provided under the following: PREMIER BUSINESSOWNERS LIABILITY COVERAGE FORM A. The following is added to Section 11. WHO IS AN INSURED: Any person or organization shown in the Schedule of this endorsement is also an insured, 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 omissions of those acting on your behalf in the performance Of your ongoing operations Or in connection with your premises owned by or rented to you. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract 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 additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section 111. LIMITS OF INSURANCE AND DEDUCTIBLE: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 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 applicable Limits Of Insurance shown in the Declarations. C. This insurance, including any duty we have to defend "suits", does not apply to: 1. 'Bodily injury" or "property damage" that arises out of, in whole or in part, or is a result of, in whole or in part, the active negligence of the additional insured shown in the Schedule of this endorsement. 2. 'Personal and advertising injury" that arises out of any independent "personal and advertising injury" offense committed by the additional insured shown in the Schedule of this endorsement. All terms and conditions of this policy apply unless modified by this endorsement. SCHEDULE Name Of Person Or Organization: CITY OF LA QUINTA, ITS OFFICERS, EMPLOYEES AGENTS, AND VOLUNTEERS SEE BLANK ENDORSEMENT Pb2500 78495 CALLE TAMPICO LA QUINTA CA 922532839 PB 04 48 1114 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 ACP BPO 3029102473 INSURED COPY 47 00833 ACP: 3029102473 BUSINESSOWNERS PB 60 72 07 11 This endorsement modifies insurance provided under the following: PREMIER BUSINESSOWNERS COMMON POLICY CONDITIONS Only with respect to any additional insured, in the COMMON POLICY CONDITIONS, form PB 00 09, under condition H. OTHER INSURANCE, paragraph 2.a. is replaced by the following: H. OTHER INSURANCE 2. Under any liability coverage provided by this policy, a. If for injury or loss we cover, there is other valid and collectible insurance available to any additional insured under another policy, our obligations are limited as follows: (1) Issued by another insurer, or if there is self insurance or similar risk retention that applies to a loss covered by this policy, then this insurance provided by us shall be excess over such other insurance, unless you have agreed in a written contract or written agreement signed prior to the loss that this insurance shall be primary: (a) Then this insurance is primary. If other insurance is also primary, we will share with all that other insurance as described in d. below; and (b) The coverage afforded by this insurance is non-contributory with the additional insured's own insurance. Paragraphs (a) and (b) do not apply to other insurance to which the additional insured has been added as an additional insured to any other person or organization's policy.; or (2) Issued by us or any of our affiliate companies, that applies to a loss covered by this policy, then only the highest applicable Limit of Insurance shall apply to such loss. This condition does not apply to any policy issued by us that is designed to provide Excess or Umbrella liability insurance. All terns and conditions of this policy apply unless modified by this endorsement. PB 60 72 07 11 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 TRAVELERS WORKERS COMPENSATION AND ONE rowEa SQUARE EMPLOYERS LIABILITY POLICY aARrFono CT oozua ENDORSEMENT VVCQ4O3OG(01) - oua POLICY NUMBER: UB-8M759710-21-42-G We have the right to recover our payments from anyone liable for aninjury 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. 00% OF THE CALIFORNIA WORKERS, COMPENSATION PREMIUM OTHERWISE DUE UNSUCH REMUNERATION. PERSON ORORGANIZATION czrY OF LA OUzmzA ?a-xys cALLE rAmPzco P.O. BOX zsne LA SCHEDULE JOB DESCRIPTION 000T OF aEavzcEa STUDY FOR rroE RELATED roon