Loading...
Insurance Certificates 2023/24 DSUSD - Homecomming Parade September 2023Southern California ReLiEF CERTIFICATE OF COVERAGE Issue Date 7/25/2023 ADMINISTRATOR: LICENSE # 0451271 Keenan & Associates 4204 Riverwalk Parkway Suite 400 Riverside, CA 92505 �allieonona Pacon License No. 4249881 310-212-0363 x1116 aeenan.com THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE COVERAGE DOCUMENTS BELOW. 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 / DEDUCTIBLE LIMITS A GENERAL LIABILITY [GENERALLIABILITY [ CLAIMS MADE [ vfOCCURRENCE [ GOVERNMENT CODES [ ERRORS & OMISSIONS [ SEXUAL ABUSE AND MOLESTATION [1 SCR00101-37 7/1/2023 7/1/2024 $ 50,000 COMBINED SINGLE LIMIT EACH OCCURRENCE $ 1,000,000 A AUTOMOBILE [/ANY j /HIRED j,/NON-OWNED [...GARAGE j /AUTO LIABILITY AUTO AUTO AUTO LIABILITY PHYSICAL DAMAGE SCR00101-37 7/1/2023 7/1/2024 $ 50,000 COMBINED SINGLE LIMIT EACH OCCURRENCE $ 1,000,000 A PROPERTY [ 1ALL RISK [ EXCLUDES EARTHQUAKE 8 FLOOD [ ] BUILDER'S RISK SCR00101-37 7/1/2023 7/1/2024 $ 25,000 $ 250,250,000 EACH OCCURRENCE A STUDENT PROFESSIONAL LIABILITY SCR 00101-37 7/1/2023 7/1/2024 $ 50,000 $ Included EACH OCCURRENCE WORKERS COMPENSATION [ ] EMPLOYERS' LIABILITY $ [ 3 WC STATUTORY LIMITS [14 OTHER $ 1,000,000 EL EACH ACCIDENT $ 1,000,000 EL, DISEASE- EACH EMPLOYEE $ 1,000,000 E.L. DISEASE- POLICY LIMITS C EXCESS WORKERS COMPENSATION [ VIEMPLOYERS' LIABILITY WCE-0953470-23 7/1/2023 7/1/2024 $ 500,000 OTHER $ $ DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/RESTRICTIONS/SPECIAL PROVISIONS: For use of the City of La Quinta's facilities by La Quinta High School for their homecoming parade on Wednesday September 13, 2023 $2,000,000 annual aggregate applies to general liability as per contract. CERTIFICATE HOLDER: La Quinta HS Homecoming Parade 9/13/2023 City of La Quinta 78495 Calle 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 6:9_,:„.i John Stephens AUTHORIZED REPRESENTATIVE awe. CC'rnAlnhnc.a,m 75470456 I DESERSAN 123/24 Super Pool P&L w/WC I Halliona Bacon 17/25/2023 4:12:25 PM (PST) I Page 1 of 4 DISCLAIMER The Certificate of Coverage on the reverse side of this form does not constitute a contract between the issuing entity(es), 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. ct'.n3OnHnecom 75470456 1 DESERSAN 123/24 Super Pool P&L w/WC I Halliona Bacon 17/25/2023 4:12:25 PM (PST) 1 Page 2 of 4 ENDORSEMENT ADDITIONAL COVERED PARTY COVERED PARTY Desert Sands Unified School District Riverside Schools' Insurance Authority COVERAGE DOCUMENT SCR 00101-37 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 of La Quinta 78495 Calle Tampico La Quinta CA 92553 As Respects; For use of the City of La Quinta's facilities by La Quinta High School for their homecoming parade on Wednesday September 13, 2023. $2,000,000 annual aggregate applies to general liability as per contract. This coverage shall be primary to the certificate holder's coverage, but only as respects to liability arising directly from the actions and activities of the Covered Party. The insurance of the Additional Covered Party shall not be called upon to contribute to a loss covered by the Covered Party's coverage. Authorized Representative Issue Date: 7/25/2023 75470456 I DESERSAN 123/24 Super Pool P&L w/WC I Halliona Bacon 17/25/2023 4:12:25 PM (PST) 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 untill the next Anniversary Rating date of 7/1/2024. 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-0953470-23 Endorsement Number: 8 Endorsement Effective: 7/01/2023 Printed on: 5/05/2023 Form No. 46 93 WC 0807 © Copyright 1983 National Council on Compensation Insurance, Inc. 75470456 I DESERSAN 123/24 Super Pool PO. w/WC 1 Halliona Bacon 17/25/2023 4:12:25 PM (PST) I Page 4 of 4