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Insurance Certificates 2022/23 Marketplace CityINSURANCE REVIEW W �W FORNIA RE: MARKETPLACE CITY, INC. - SOURCING, EVALUTION, AND PROCUREMENT OF VENDORS FOR PRODUCTS AND SERVICES Please list the Contracting Party / Vendor Name, type of agreement to be executed, including any change orders or amendments, and the type of services to be provided. Make sure to list any related Project No. and Project Name. Insurance certificates required per the Agreement: ACCORD Certificate dated 10-days prior or less 06/02/2023 enter ACCORD issue date Commercial General Liability Insurance: �✓ $1,000,000 per occurrence/$2,000,000 aggregate OR $2,000,000 per occurrence/$4,000,000 aggregate �✓ Additional Insured Endorsement naming City of La Quinta �✓ Primary and Non -Contributory Endorsement Automobile Liability: �✓ $1,000,000 combined single limit for bodily injury and property damage. Workers' Compensation: �✓ Statutory Limits / Employer's Liability $1,000,000 per accident or disease �✓ Workers' Compensation Endorsement with Waiver of Subrogation ❑ Sole Proprietor Professional Liability (Errors and Omissions): �✓ Errors and Omissions Liability insurance with a limit of not less than $1,000,000 per claim Cyber Liability/Technology Errors and Omissions Liability Insurance: �✓ $1,000,000 per occurrence/loss Other: List other insurance types such as - molestation, harassment, etc. Approved by: Date: L CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THI; CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIE! BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZE[ 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 of PRODUCER NAME: Heather PHONE Stolarick &Company, Inc. ��1. 847 3 ennalF 4673 Old Grand Avenue �q. heather( INSURED Marketplace.city 500 W Madison Street, Suite 1000 COVERAGES CERTIFICATE NUMBER: Insurance Co I 39608 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOI INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THI, CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERM: EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IPOLICY LTR TYPE OF INSURANCE INSO won SUER POLICY NUMBER EFF MM/DD/YYYYI POLICY EXP flMM/DDNYYY1 LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR DAMAGE PREMISES TO RENTED Ea occurrence)- $ 1,0001000__ MED EXP Anyone person)$ 10,000 &ADV INJURY $ 1,000,000 A Y B6025317730 08/14/2022 08/14/2023 GEN'L AGGREGATE LIMIT APPLIES PER: -PERSONAL GENERAL AGGREGATE $ 2,000,000 PRO- LOG POLICY JECT X PRODUCTS - COMP/OP AGE y 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED [dent) SINGLE LIMIT $ 11000,000 ANY AUTO BODILY INJURY(Perperson) $ A OWNED SCHEDULED AUTOS ONLY AUTOS B6025317730 08/14/2022 08/14/2023 BODILY INJURY (Per accident) $ X Pere ken DAMAGE $ HIRED NON -OWNED AUTOS ONLY H AUTOS ONLY $ UMBRELLA LIAB i OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE YIN OFFICER/MEMBEREXCLUDED? F (Mandatory in NH) N/A Y 36WECAU8A1B 11/01/2022 11/01/2023 �/ STATUTE OTRH- E.L. EACH ACCIDENT $ 1,000,000 F.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT 1 $ 11000,000 C ERRORS & OMISSIONS AND CYBER LIABILITY EKS3302514 08/14/2022 08/14/2023 EA OCCURRENCE AGGREGATE $1,000,000 $11000,000 DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) Additional Insured on a primary and non-contributory basis as it relates to General Liability where required by written contract: City of LaQuinta California. r waiver of subrogation applies to the Workers Compensation in favor of the additional insured where required by written contract. City of LaQuinta California 78495 Calle Tampico SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORI THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED II ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORI2E0 REPRESENTATIVE FaX: EI1laII:DKinley@LaQuintaCA.Gov ©1988-2015 ACORD ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD All rights reserve