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Insurance Certificates 2022/23 DSUSD - Homecomming Parade September 2022Southern California ReLiEF CERTIFICATE OF COVERAGE Issue Date 9/2/2022 ADMINISTRATOR: LICENSE # 0451271 Keenan & Associates 4204 Riverwalk Parkway Suite 400 Riverside, CA 92505 951-715-0190 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS NOT AMEND, EXTEND OR ALTER AFFORDEDTE BYTOHE ES COVERAGE DOCUMENTS BELOW THE COVERAGE ENTITIES AFFORDING COVERAGE: ENTITY A: Southern California ReLiEF ENTITY B: ENTITY C: Star Insurance Company ENTITY D: ENTITY E: COVERED PARTY: Desert Sands Unified School District Riverside Schools' Insurance Authority 47-950 Dune Palms Road La Quinta CA 92253 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 THE TERMS AND CONDITIONS OF SUCH COVERAGE DOCUMENTS. ENT LTR TYPE OF COVERAGE COVERAGE DOCUMENTS EFFECTIVE/ EXPIRATION DATE MEMBER RETAINED LIMIT I DEDUCTIBLE LIMITS A GENERAL LIABILITY [ vff GENERAL LIABILITY [ GOVERNMENT CODES [ [ ERRORS & OMISSIONS t I SCR 00101-36 7/1/2022 7/1/2023 $ 50,000 COMBINED SINGLE LIMIT EACH OCCURRENCE $ 1,000,000 A AUTOMOBILE [ JANY I [ f [/GARAGE [ .% LIABILITY AUTO HIRED AUTO NON -OWNED AUTO LIABILITY AUTO PHYSICAL DAMAGE SCR 00101-36 7/1/2022 7/1 /2023 $ 50,000 COMBINED SINGLE LIMIT EACH OCCURRENCE $ 1,000,000 A PROPERTY [ /ALL RISK [ EXCLUDES EARTHQUAKE & FLOOD [ ] BUILDER'S RISK SCR00101-36 7/1/2022 7/1/2023 $ 25,000 $ 250,250,000 EACH OCCURRENCE A STUDENT PROFESSIONAL LIABILITY SCR 00101-36 7/1/2022 7/1/2023 $ 50,000 $ Included EACH OCCURRENCE WORKERS COMPENSATION [ ] EMPLOYERS' LIABILITY $ [ ] WC STATUTORY LIMITS [A OTHER $ 1,000,000 E.L. EACH ACCIDENT $ 1,000,000 DISEASE - EACH EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMITS C EXCESS WORKERS COMPENSATION I EMPLOYERS' LIABILITY WCE-0953361-22 7/1/2022E.L. 7/1/2023 $ 500,000 OTHER $ $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL PROVISIONS: La Quinta High School homecoming parade in the City of La ()Dlnta on Wednesday September 21, 2022. 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 Homecoming Parade 9/21/2022 City of La Quinta 78495 Calla Tampico La Quinta CA 92553 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS John Stephens AUTHORIZED REPRESENTATIVE „ww.cCerbOnlinecom 70102935 I DESERSAN 122/23 Super Pool P&L w/WC I Tiffany Lyon 19/2/2022 3:23:43 PM (PDT) I Page 1 of 4 Southern California ReLiEF CERTIFICATE OF COVERAGE Issue Date 8/2/2022 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 ENTITY C: Star Insurance Company 47-950 Dune Palms Road ENTITY D: La Quinta CA 92253 ENTITY E: THIS IS TO CERTI FY 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 THE TERMS AND CONDITIONS OF SUCH COVERAGE DOCUMENTS MEMBER ENT LTR TYPE OF COVERAGE COVERAGE DOCUMENTS EFFECTIVE/ EXPIRATION DATE RETAINED LIMIT I DEDUCTIBLE LIMITS A GENERAL LIABILITY COMBINED SINGLE LIMIT EACH OCCURRENCE [ GENERAL LIABILITY` CLAIMS MADE OCCURRENCE SCR 00101-36 7/1/2022 $ 50,000 $ 1,000,000 [ p�1 g [ VERNMENTCODeS 7/1 /2023 [ ERRORS & OMISSIONS A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT EACH OCCURRENCE [ ANY AUTO SCR 00101-36 7/1/2022 $ 50,000 $ 1,000,000 [ HIRED AUTO [ NON-OWNEDAUTO 7/1 /2023 [ GARAGE LIABILITY [ AUTO PHYSICAL DAMAGE A PROPERTY SCR 00101-36 7/1/2022 $ 25,000 s 250,250,000 [ ALL RISK 7/1 /2023 EACH OCCURRENCE [ EXCLUDES EARTHQUAKE & FLOOD [ ] BUILDER'S RISK A STUDENT PROFESSIONAL LIABILITY SCR 00101-36 7/1/2022 $ 50,000 $ Included 7/1 /2023 EACH OCCURRENCE WORKERS COMPENSATION �G [ ] WC STATUTORY LIMITS [✓ OTHER [ ] EMPLOYERS' LIABILITY S $ 1,000,000 E L EACH ACCIDENT $ 1,000,000 EXCESS WORKERS COMPENSATION $ 500,000 C [ ✓] EMPLOYERS' LIABILITY WCE-0953361-22 7/1/2022 El DISEASE -EACH EMPLOYEE 7/1/2023 $ 1,000,000 E.L. DISEASE - POLICY LIMITS OTHER $ $ DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/RESTRICTIONS/SPECIAL PROVISIONS: La Quinta High School homecoming parade in the City of La Quinta on Wednesday September 21, 2022 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 Homecoming Parade 9/21/2022 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 Jahn Stephens AUTHORIZED REPRESENTATIVE .r.cC«ich�line �� 69558093 1 DESERSAN 1 22/23 Super Pool P&L w/WC I Wiski-Linnette Lee 1 8/2/2022 9:37:13 AM (PDT) I Page 1 of 3 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. eCensOnline corn 70102935 1 DESERSAN 122/23 Super Pool P&L w/WC 1 Tiffany Lyon 19/2/2022 3:23:43 PM (PDT) 1 Page 2 of 4 ENDORSEMENT ADDITIONAL COVERED PARTY COVERED PARTY Desert Sands Unified School District Riverside Schools' Insurance Authority COVERAGE DOCUMENT SCR 00101-36 ADMINISTRATOR Keenan & Associates 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. Additional Covered Party: City ot'La Quints 78495 Celle Tampico La Quinta•CA 92553 As Respects: La Quinta High School homecoming parade in the City of La Quinta on Wednesday September 21, 2022. Thiscoverage 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. The Covered Party waives their rights to subrogation, as specified in the agreement between the Covered Party and Certificate Holder, subject to the terms and conditions of the MOC. Authorized Representative Issue Date: 9/2/2022 70102935 I DESERSAN 122/23 Super Pool P&L w/WC I Tiffany Lyon 19/2/2022 3:23:43 PM (PDT) I Page 3 of 4 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 7/1/2023. 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-0953361-22 Endorsement Number: 8 Endorsement Effective: 7/01/2022 Printed on: 5/19/2022 Form No. 46 93 WC 0807 © Copyright 1983 National Council on Compensation Insurance, Inc. 70102935 I DESERSAN 122/23 Super Pool P&L w/WC I Tiffany Lyon 19/2/2022 3:23:43 PM (PDT) I Page 4 of 4