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Insurance Certificates 2021/22 DSUSD - Homecomming Parade October 2021Southern California ReLiEF CERTIFICATE OF COVERAGE Issue Date 10/15/2021 ADMINISTRATOR: LICENSE # 0451271 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY Keenan & Associates AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS 4204 Riverwalk Parkway Suite 400 CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE Riverside, CA 92505 AFFORDED BY THE COVERAGE DOCUMENTS BELOW. ENTITIES AFFORDING COVERAGE: Maris Ne des 310-212-0363 x1187 mnealesVkeenan.com ENTITYA: Southern California ReLiEF ENTITY B: COVERED PARTY: Desert Sands Unified School District Riverside Schools' Insurance Authority an ENTITY c: Star Insurance Company P y 47-950 Dune Palms Road ENTITY D: La Quinta CA 92253 ENTITY E: THIS IS TO CERTIFY THAT THE COVERAGES LISTED BELOW HAVE BEEN ISSUED TO THE COVERED PARTY NAMED ABOVE FOR THE 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 COVERAGE AFFORDED HEREIN IS SUBJECT TO ALL TH E TERMS AND CONDITIONS OF SUCH COVERAGE DOCUMENTS. MEMBER ENT TYPE OF COVERAGE COVERAGE EFFECTIVE/ RETAINED LIMIT LIMITS LTR DOCUMENTS EXPIRATION DATE I DEDUCTIBLE A GENERAL LIABILITY COMBINED SINGLE LIMIT EACH OCCURRENCE [✓[GENERALLIABIUTY CLAIMSMADE OCCURRENCE SCR00101-35 7/1/2021 $ 50,000 s 1,000,000 [ [ �GOVERNMFNT CODES 7/1/2022 [ ERRGRSE OMISSIONS A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT EACH OCCURRENCE [ ANY AUTO SCR00101-35 7/1/2021 $ 50,000 $ 1,000,000 [ HIREDAUTO [ NON:QWNEDAUTO 7/1/2022 [ GARAGE LIABILITY [ AUTO PHYSICAL DAMAGE A PROPERTY SCR 00101-35 7/1/2021 $ 25,000 s 250,250,000 [ ALL RISK 7/1/2022 EACH OCCURRENCE [ EXCLUDES EARTHQUAKE& FLOOD [ ] BUILDER'S RISK A STUDENT PROFESSIONAL LIABILITY SCR 00101-35 7/1/2021 $ 50,000 s Included 7/1/2022 EACH OCCURRENCE WORKERS COMPENSATION [ ] WC STATUTORY LIMITS OTHER [ ] EMPLOYERS' LIABILITY .5 $ 1,000,000 EL. EACH ACCIDENT $ 1,000,000 EL. DISEASE - EACH EMPLOYEE C EXCESS WORKERS COMPENSATION I VIEMPLOYERS' LIABILITY WCE-0937813-21 7/1/2021 $ FJ00'000 7/1/2022 S 1,000,000 EL. DISEASE- POLICY LI MITS OTHER $ DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES/RESTRICTIONSISPECIAL PROVISIONS: La Quinta High School homecoming parade in the City of La Quinta on October 20, 2021. This coverage shall be primary to the Certificate holder's coverage as respects to the actions and activities of the Covered Party due to their sole negligence. $2,000,000 annual aggregate as requested by contract. CERTIFICATE HOLDER: La Quinta HS Homcoming Parade 10/20/021 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of La Quinta THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 78495 Calle Tampico ACCORDANCE WITH THE POLICY PROVISIONS La Quinta CA 92553 John Stephens AUTHORIZED REPRESENTATIVE ..: c�umhnc Com 64572446 1 DESERSAN 1 21/22 Super Pool P&L w/WC I Marisa Neades 1 10/15/2021 12:35:28 PM (PDT) I Page 1 of 4 Southern California ReLiEF Issue Date CERTIFICATE OF COVERAGE 9/13/2021 ADMINISTRATOR: LICENSE # 0451271 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY Keenan & Associates AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS 4204 Riverwalk Parkway Suite 400 CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE Riverside, CA 92505 AFFORDED BY THE COVERAGE DOCUMENTS BELOW. ENTITIES AFFORDING COVERAGE: 951-715-0190 ENTITYA: Southern California ReLiEF ENTITY B: COVERED PARTY: Desert Sands Unified School District Riverside Schools' Insurance Authority ENTITYc: Star Insurance Company 47-950 Dune Palms Road ENTITY D: La Quinta CA 92253 ENTITY E: THIS IS TO CERTIFY THAT THE COVERAGES LISTED BELOW HAVE BEEN ISSUED TO THE COVERED PARTY NAMED ABOVE FOR THE PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN THE COVERAGE AFFORDED HEREIN IS SUBJECT TO ALL THE TERMS AND CONDITIONS OF SUCH COVERAGE DOCUMENTS. MEMBER ENT TYPE OF COVERAGE COVERAGE EFFECTIVE/ RETAINED LIMIT LIMITS LTR DOCUMENTS EXPIRATION DATE I DEDUCTIBLE A GENERAL LIABILITY COMBINED SINGLE LIMIT EACH OCCURRENCE [VJGENEFULLL,DILJTY [ MADE {OCCURRENCE SCR 00101-35 7/1/2021 $ 50,000 $ 1,000,000 llCLAIMS g [ VERNMENT CODES 7/1/2022 [ ��jjjj ERRORS 6 OMISSIONS A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT EACH OCCURRENCE [ ANY AUTO SCR00101-35 7/1/2021 $ 50,000 $ 1,000,000 [ HIREDAUTO [ NOWO'WNEDAUTO 7/1/2022 [ GARAGE LIABILITY [ AUTO PHYSICAL DAMAGE A PROPERTY SCR 00101-35 7/1/2021 $ 25,000 $ 250,250,000 [ ALL RISK [ EXCLUDES EARTHQUAKE 8 FLOOD 7/1/2022 EACH OCCURRENCE [ ] BUILDER'S RISK A STUDENT PROFESSIONAL LIABILITY SCR 00101-35 7/1/2021 $ 50,000 $ Included 7/1/2022 EACH OCCURRENCE WORKERS COMPENSATION [ I WC STATUTORY LIMITS [ OTHER [ ] EMPLOYERS' LIABILITY $ $ 1,000,000 E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EACH EMPLOYEE C EXCESS WORKERS COMPENSATION (yj EMPLOYERS' LIABILITY WCE-0937813-21 7/1/2021 $ 500,000 7/1/2022 $ 1,000,000 E.L. DISEASE- POLICY LIMITS OTHER $ $ DESCRIPTION OF OPERATIONSILOCATIONS/VEHICLESIRESTRICTIONSISPECIAL PROVISIONS: La Quinta High School homecoming parade in the City of La Quinta on October 20, 2021 CERTIFICATE HOLDER: La Quinta HS Homcoming Parade 10/20/021 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of La Quinta THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 78495 Calle TatTlpico p553 ACCORDANCE WITH THE POLICY PROVISIONS La Quinta CA 9 John Stephens AUTHORIZED REPRESENTATIVE 63662015 1 DESERSAN 1 21/22 Super Pool P&L w/WC I Brenda Oliver 1 9/13/2021 11:04:11 AM (PDT) I Page 1 of 2 DISCLAIMER The Certificate of Coverage on the reverse side of this form does not constitute a contract between the issuing entity(ies), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the coverage documents listed thereon. �C�L"Iin n 64572446 1 DESERSAN 1 21/22 Super Pool P&L W/WC I Marisa Neades 1 10/15/2021 12:35:28 PM (PDT) I Page 2 of 4 ENDORSEMENT ADDITIONAL COVERED PARTY COVERED PARTY COVERAGE DOCUMENT ADMINISTRATOR Desert Sands Unified School District SCR 00101-35 Keenan & Associates Riverside Schools' Insurance Authority Subject to all its terms, conditions, exclusions, and endorsements, such additional covered party as is afforded by the coverage document shall also apply to the following entity but only as respects to liability arising directly from the actions and activities of the covered party described under "as respects" below. Cis}} of La Quinta 74A Callu'rampico LaQuinta CA 9 553 La Quinta High School homecoming parade in the City or La Quinta on October 20, 2021. This coverage shall be primary to the certificate holder's coverage as respects to the actions and activities of the Covered Party due to their sole negligence. S2,000,000 annual aggregate as requested by contract. Authorized Representative Issue Date: 10/15/2021 64572446 1 DESERSAN 1 21/22 Super Pool P&L W/WC I Marisa Neades 1 10/15/2021 12:35:28 PM (PDT) I Page 3 of 9 EXCESS WORKERS' COMPENSATION AND EMPLOYER'S LIABILITY POLICY 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 third party who requires you to provide this waiver. This endorsement is effective until the next Anniversary Rating date of 7/1/22. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated, Company No Insured: Desert Sands Unified School District Policy Number: WCE-0937813-21 Endorsement Number: 8 Endorsement Effective: 7/01/2021 Printed on: 6/17/2021 Form No. 46 93 WC 0807 © Copyright 1983 National Council on Compensation Insurance, Inc. 64572416 1 DESERSAN 1 21/22 Super Pool P&L w/WC I Marisa Neades 1 10/15/2021 12:35:28 PM (PDT) I Page 4 of 4