Insurance Certificates 2023/24 South Coast Air Quality Mgmt District - LQ Evidence of CoverageEVIDENCE OF COVERAGE June 28, 2023 5:36 PM
COVERAGE PROVIDER
MEMBER
California Joint Powers Insurance Authority
La Quinta
8081 Moody Street
78-495 Calle Tampico
La Palma CA 90623
www.cjpia.orq
La Quinta, CA 92253-2839
(760) 777-7123
Contact Name: Jim Thyden, Insurance Programs Manager
Phone: (562) 467-8784
Laurie McGinley
lmcginley@laquintaca.gov
EOC Number 20190313130121006468
1 (760) 777-7123
THIS IS TO CERTIFY THAT THE MEMBER LISTED ABOVE PARTICIPATES IN THE CALIFORNIA JOINT POWERS INSURANCE AUTHORITY'S SELF-
INSURANCE AND COMMERCIAL INSURANCE PROGRAM WITH THE COVERAGES AND LIMITS LISTED BELOW, SUBJECT TO ALL THE TERMS,
DEFINITIONS, EXCLUSIONS, CONDITIONS, AND RESPONSIBILITIES OF THE MEMORANDA OF COVERAGE FOR EACH LINE OF COVERAGE.
COVERAGES
THE COVERAGES LISTED BELOW HAVE BEEN ISSUED TO THE MEMBER NAMED ABOVE FOR THE COVERAGE PERIOD INDICATED,
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
EVIDENCE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE MEMORANDA DESCRIBED HERIN IS SUBJECT TO ALL THE
TERMS, EXCLUSIONS AND CONDITIONS OF SUCH MEMORANDA. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
COVERAGE
TYPE OF COVERAGE
MEMORANDUM
EFFECTIVE DATE
LIMITS
(MM/DD/YY)
LIABILITY
OCCURRENCE
07/01/22-06/30/24
AGGREGATE
$1,000,000
X
PRODUCTS-COMP/OP AGG
$ N/A
X
PERSONAL INJURY
M O C L P
PERSONAL & ADV INJURY
$1,000,000
X
ERROR & OMISSIONS
EACH OCCURRENCE
$1,000,000
X
EMPLOYMENT PRACTICES
FIRE DAMAGE (Any one fire)
$ N/A
X
SEXUAL ASSAULT AND
MED EXP (Any one person)
$ N/A
MOLESTATION
AUTOMOBILE
LIABILITY
ANY AUTOS
ALL OWNED AUTOS
SCHEDULED AUTOS
07/01/22-06/30/24
COMBINED SINGLE LIMIT
$1,000,000
X
BODILY INJURY
(Perperson)
$ N/A
BODILY INJURY
$ N/A
HIRED AUTOS
NON -OWNED AUTOS
(Per accident)
PROPERTY DAMAGE
$ N/A
WORKER'S COMPENSATION AND
X
WC STATUTORY LIMITS
$ N/A
EMPLOYER'S LIABILITY
M O C W C
07/01/22-06/30/24
X
EMPLOYER'S LIABILITY
$1,000,000
ADDITIONAL REMARKS
EVIDENCE HOLDER
CANCELLATION
The California JPIA will endeavor to provide at least thirty (30) days
South Coast Air Quality Management District
notice of any cancellation of coverage or reduction in coverage limits to
21865 Copley Drive
the Evidence Holder.
Diamond Bar, CA 91765-4178
Cynthia Ravenstein
cravenstein@aqmd.gov
AUTHORIZED REPRESENTATIVE, Jim Thyden
California Joint Powers Insurance Authority is a joint powers authority pursuant to Article 1 (commencing with Section 6500) Chapter 5 of Division 7 of Title 1 of the California
Government Code.
EVIDENCE OF COVERAGE June 28, 2023 5:56 PM
ADDITIONAL COVERAGE NOTES
Mobile Source Air Pollution agreement for grant funding. Mobile Source Air Pollution agreement for grant funding
CC LIST