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Insurance Certificates 2022/23 Box of KittensACORD CERTIFICATE �� CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 08/16/2022 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 Hiscox Inc. d/b/a/ Hiscox Insurance Agency in CA 520 Madison Avenue 32nd Floor New York, New York 10022 CONTACT NAME: PHONE FAX (A/C No Est): (88g ) 202-3007 (NC No): IL ADDRESS: contact@hiscox.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Hiscox Insurance Company Inc 10200 INSURED Box of Kittens 30 Clancy Lane Estates Rancho Mirage, CA 92270 INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : 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 ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY Y P100.264.263.2 05/10/2022 05/10/2023 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR DAMAGE RENTE PREMISESO(Ea occurrence) $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL&ADVINJURY $ 1,000,000 GEN'L X AGGREGATE POLICY OTHER: LIMIT APPLIES PRO- JECT PER: LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ AUTOMOBILE LIABILITY SCHEDULED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N / A PER STATUTE OTH- ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City Of La Quinta is an additional insured. The Hiscox General Liability Policy is Primary and Non -Contributory, subject to the policy's terms and conditions. CERTIFICATE HOLDER CANCELLATION 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 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AV�� (Liawunesa PERSO O FER TO RENIEWPOLICY Insurance COVER PAGE Named Insured and Address awanesa General Insurance Company ANNDEE L LASKOE 30 CLANCY LANE ESTATES RANCHO MIRAGE CA 92270 WAWANESA INSURANCE PO BOX 82867 SAN DIEGO CA 92138-9492 TELEPHONE: 800-640-2920 Policy Number 10418360 Account Number 918101-1 Policy Period From Jul 19, 2022 to Jan 19, 2023 12:01 A.M. standard time at the address of the Named Insured as stated herein Thank you for your continued business with Wawanesa General Insurance Company ("Wawanesa Insurance"). We appreciate the opportunity to provide you with quality coverage and peace of mind knowing that we strive to provide the most dependable coverage at the lowest price possible. Please review your Renewal Declaration. This Declaration is an offer only. Payment of the premium renews your policy for the period shown. If your payment is not received before Jul 19, 2022, this Offer to Renew becomes null and void. Your coverage expires Jul 19, 2022 at 12:01 A.M. If you are responsible for the payment due on this policy, please refer to the invoice statement (enclosed or mailed separately). You should also carefully review your coverage limits for Bodily Injury Liability and Property Damage Liability to ensure they are appropriate for your lifestyle, income, and risk tolerance. If you are found legally responsible for damages which exceed your Liability coverage limits, personal assets such as your savings or even your home could be at risk. Industry organizations and consumer groups recommend limits higher than what the law requires. By accepting this policy and the Declaration pages you consent to be legally bound by the provisions of the policy, including the coverage limits, options and endorsements. Important Information (This page is part of your Policy Declaration): Due to changing claims costs, we've made some adjustments to our rates. These adjustments were made to ensure that Wawanesa will be able to continue supporting our policyholders when they file a claim, while still maintaining our competitive prices. Questions? If you'd like to make change to your policy, please contact us at renewals.us@wawanesa.com and provide your name and policy number, or call our office and our Knowledgeable Customer Service Representatives will be happy to assist you. Did you know? For more information regarding our products and services, visit our website at wawanesa.com. You can also submit changes to your policy, report a claim, or receive an insurance quote in minutes. Jun 18, 2022 00:27 CT Thank you for being a valued customer. Earning Your Trust Since 1896 "Wawanesa Insurance" is a trademark of Wawanesa General Insurance Company AV lUawaaesA Insurance PERSONAL AUTOMOBILE POLICY DECLARATION Supersedes any previous declaration bearing the same policy number. Renewal Declaration effective Jul 19, 2022 Named Insured and Address awanesa General Insurance Company ANNDEE L LASKOE 30 CLANCY LANE ESTATES RANCHO MIRAGE CA 92270 WAWANESA INSURANCE PO BOX 82867 SAN DIEGO CA 92138-9492 TELEPHONE: 800-640-2920 Policy Number Account Number 10418360 918101-1 Policy Period From Jul 19, 2022 to Jan 19, 2023 12:01 A.M. standard time at the address of the Named Insured as stated herein Named Insured's Phone Number: 760-844-3222 Named Insured's Email Address: anndeelaskoe@yahoo.com Your 6 month premium for two (2) vehicle(s) is $1,014.28. Refer to the breakdown of premiums below. Description of Owned Vehicle(s) Vehicle Year Make Model Vehicle Identification Number Premium per Vehicle($) 1 2019 Tesla MODEL 3 STANDARD/ STANDARD PLUS/MID/ LONG 5YJ3E1EA9KF428952 $407.86 2 2021 Jeep WRANGLER JL UN PHEV 4XE SAH/HGHALT AWD 1C4JJXP68MW765884 $606.42 Premium Subtotal for Vehicles $1,014.28 Insurance is provided only with respect to the coverages for which a Premium is stated, subject to all conditions of the policy. Coverage and Limits of Liability See Policy for Coverage Details Bodily Injury Liability $100,000 per person/$300,000 each occurrence Property Damage Liability $50,000 each occurrence Medical Payments $5,000 each person Comprehensive $500 deductible Collision $500 deductible Uninsured/Underinsured Motorists Protection $100,000 per person/$300,000 each occurrence Uninsured Motorists Collision Deductible Waiver Total Premium Per Vehicle ($) All premiums listed are for the full 6-month term. Premiums per Vehicle ($) 1 2 79.06 99.89 53.65 67.74 11.28 12.63 29.62 58.92 194.43 320.44 38.21 45.19 1.61 1.61 407.86 606.42 Jun 18, 2022 00:27 CT "Wawanesa Insurance" is a trademark of Wawanesa General Insurance Company lUauianesa Insurance PERSONAL AUTOMOBILE POLICY DECLARATION Supersedes any previous declaration bearing the same policy number. Renewal Declaration effective Jul 19, 2022 Named Insured and Address awanesa General Insurance Company ANNDEE L LASKOE 30 CLANCY LANE ESTATES RANCHO MIRAGE CA 92270 WAWANESA INSURANCE PO BOX 82867 SAN DIEGO CA 92138-9492 TELEPHONE: 800-640-2920 Policy Number Account Number 10418360 918101-1 Policy Period From Jul 19, 2022 to Jan 19, 2023 12:01 A.M. standard time at the address of the Named Insured as stated herein Vehicle Rating Information Chart Vehicle Description Previous Estimated Annual Mileage Estimated Annual Mileage Used for Rating Rated Driver No. of Years Licensed Vehicle Usage Zip Code Discounts Applied (See code definition below) # of Traffic convictions for driver rated on this vehicle # of Chargeable at - fault accidents for driver rated on this vehicle 2019 Tesla 1200 2200 26 Pleasure 92270 1, 2, 4 0 0 2021 Jeep 7000 8000 32 Pleasure 92270 1,2,4 0 0 Discount Codes: 1. Good Driver 2. Multi -Vehicle 3. Mature Driver 4. Loyalty or Affinity Group Important Information Regarding Estimated Annual Mileage: State law requires us to periodically verify the miles you plan to drive annually. Please review the estimated annual mileage for each vehicle listed above. If the amount provided does not reflect your anticipated mileage in the next 12- months, please contact us so we can update your policy. We may ask for additional information to support your estimate. If we don't hear from you, the estimated mileage shown will be used for your upcoming renewal. Depending on the information you provide, we may use a mileage amount different than your estimate to set your upcoming term's premium. Driver(s) Driver Name Principal Operator of Vehicle Number Occasional Operator of Vehicle Number ANNDEELLASKOE 2 DAVID HUGHES 1 Exclusion of Named Driver(s) Excluded Driver(s) Jett Udcoff Additional Interest(s) Lienholder(s) Vehicle 1 Vehicle 2 Relationship to Insured Child Wells Fargo PO BOX 29710 Phoenix AZ 85038 Ally Smart Lease 9715 E Firestone Blvd Downey CA 90241 Jun 18, 2022 00:27 CT "Wawanesa Insurance" is a trademark of Wawanesa General Insurance Company AV lUawaaesA Insurance PERSONAL AUTOMOBILE POLICY DECLARATION Supersedes any previous declaration bearing the same policy number. Renewal Declaration effective Jul 19, 2022 Named Insured and Address awanesa General Insurance Company ANNDEE L LASKOE 30 CLANCY LANE ESTATES RANCHO MIRAGE CA 92270 WAWANESA INSURANCE PO BOX 82867 SAN DIEGO CA 92138-9492 TELEPHONE: 800-640-2920 Policy Number Account Number 10418360 918101-1 Policy Period From Jul 19, 2022 to Jan 19, 2023 12:01 A.M. standard time at the address of the Named Insured as stated herein Additional Interest(s) Leasing Company Vehicle 2 Ally Smart Lease 9715 E Firestone Blvd Downey CA 90241 Applicable Forms Disclosure of Fees - California Auto (CADCFA 04 22), Vehicle Identification Cards (VID 1), Minimum Liability Coverage Limits and Available Discounts (CADIS 09 21), Available Coverages & General Coverage Descriptions (CACOV 09 21) Jun 18, 2022 00:27 CT "Wawanesa Insurance" is a trademark of Wawanesa General Insurance Company AV lUawaaesA Insurance PERSONAL AUTOMOBILE POLICY DECLARATION Supersedes any previous declaration bearing the same policy number. Renewal Declaration effective Jul 19, 2022 Named Insured and Address ■ awanesa General Insurance Company ANNDEE L LASKOE 30 CLANCY LANE ESTATES RANCHO MIRAGE CA 92270 Policy Number 10418360 Account Number Policy Period 918101-1 From Jul 19, 2022 to Jan 19, 2023 Important Information - Consumer Services - California WAWANESA INSURANCE PO BOX 82867 SAN DIEGO CA 92138-9492 TELEPHONE: 800-640-2920 12:01 A.M. standard time at the address of the Named Insured as stated herein Because of the complicated nature of the insurance business, there may be times when you will have questions regarding your coverage or the premium charged, or a problem may arise with your policy. If this occurs we urge you to contact our Customer Service Department to answer your questions or resolve your problem. If after this you are still not satisfied, you may contact the following state agency: California Department of Insurance, Consumer Services Division, 300 South Spring Street, South Tower, Los Angeles, California 90013 Toll free number: 1-800-927-HELP Website: www.insurance.ca.gov NOW YOU CAN MANAGE VOUK vUL.tY ONLINE (4 • VIEW AND PRINT REVIEW POLICY Nor ACCESS YOUR MAKE QUICK AND INSURANCE ID CARDS RENEWALS INFORMATION 24/7 EASY PAYMENTS Set up your online account today at wawanesa.com YOUR PRIVACY RIGHTS. We use information about you to provide you with insurance and adjust claims. We collect this information from you as well as from other sources. In certain circumstances, we may disclose this information to third parties without your consent. You have the right to access and correct any information about you that we collect. For more details about our privacy practices, please visit us at www.wawanesa.com. To receive a copy of our full privacy notice call us toll -free at 1-800-640-2920, or write to us at the address shown above. Visit wawanesa.com/online to view information about your policy or contact Customer Service for additional assistance. Online Service: Make payments, check billing activity, update policy details, or view claims information. wawanesa.com/online Our helpful agents are available: Monday to Friday 7:30 am - 7:30 pm and Saturday 8:00 am - 4:30 pm Phone: 800-640-2920 Fax: 619-285-2711 Mail: PO Box 82867 San Diego, CA 92138-9492 Email: service.us@wawanesa.com Jun 18, 2022 00:27 CT "Wawanesa Insurance" is a trademark of Wawanesa General Insurance Company nSA HISCOX Policy Number: P100.264.263.2 Named Insured: Box of Kittens Endorsement Number: 14 Endorsement Effective: 05/10/2022 Hiscox Insurance Company Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy, pro- vided: 1. you have agreed in a written contract or agreement to add such additional insured to a policy providing the type of coverage af- forded by this policy; and 2. you have agreed in a written contract or agreement with such additional insured that this insurance would be primary and would not seek contribution from any other insur- ance available to the additional insured. CGL E5581 CW (03/16) Includes copyrighted material of Page 1 of 1 Insurance Services Office, Inc., with its permission Declaration of Sole Proprietor DECLARATION AND ADDENDUM TO ALL CONTRACTS AWARDED TO BOX OF KITTENS I declare for the purpose of inducing the City of La Quinta to go forward with any contracts awarded to BOX OF KITTENS as follows: I am the authorized representative of BOX OF KITTENS, an independent contractor for the purposes of the California Workers' Compensation and Labor laws. This organization will hire no employees other than the parents, spouses, or children of its board members for work required for any bid or contract awarded to BOX OF KITTENS. All worked required will be performed personally and solely by me, other board members of the organization, their parents, spouses or children, or persons who perform voluntary service without pay to the organization. If, however, the organization shall ever hire employees to perform this contract or any portion thereof, the organization shall obtain Workers' Compensation Insurance and provide proof of Workers' Compensation Insurance coverage to the City of La Quinta. If the organization shall ever hire a subcontractor to perform this contract or any portion thereof, and the subcontractor has employees, then the organization shall require its subcontractor to obtain Workers' Compensation Insurance Coverage, or the organization shall obtain Workers' Compensation Coverage for that subcontractor's employees. This document constitutes a declaration by the organization against its financial interest, relative to any claims it should assert under the California Workers' Compensation and/or Labor laws against City of La Quinta relating to any bid or contract awarded to BOX OF KITTENS. The organization will defend, indemnify and hold harmless the City of La Quinta from any and all claims and liability, including Workers' Compensation claims and liability that may be asserted or established by any party in the event the organization hires an employee in violation of this addendum, and the organization will further indemnify the City of La Quinta for all damages the City of La Quinta thereby suffers. I agree that these declarations shall constitute an addendum to any bid or contracts awarded to BOX OF KITTENS. Date Authorized Representative