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HomeMy WebLinkAboutContract 1614-1 ION - I CAVIGNAC :ASSOCIATES INSURANCE BROKERS License No. 0A99520 450 B Street. Suite 1800 San Diego, CA 92101-8005 Tel. 619.234.6848 • Fax 619.234.1239 • Web www.cavignac.com City of Cathedral City 68-7 Avenida Lalo Guerrero Cathedral City, CA, 92234 Mar 09, 2015 Re: Engineering Resources of Southern California, Inc. To Whom It May Concern: Enclosed is a certificate of insurance, as requested. If you have questions or require changes, please contact our office via email (certificates @cavignac.com) or fax (619-234-1239). Please include a copy of the certificate with your request or reference ID number 307236. Sincerely, Cavignac & Associates Certificate Department certificates @cavignac.com 619-234-1239 (fax) cc: Laura Reguero (LReguero @erscinc.com) Engineering Resources of Southern California, Inc. - Certificate of Insurance Page 1 of 4 ® DATE(MM/DD/YYYY) A a CERTIFICATE OF LIABILITY INSURANCE 3/9/2015 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 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 CONTACT Certificate Department Cavignac & Associates PHONE FAX 619 234-8601 IA/C.No.Extj:619-234-6848 (A/C,No): 450 B Street, Suite 1800 E-MAIL San Diego, CA 92101-8005 ADDRESS: certificates @cavignac.com License No. 0A99520 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:TRAVELFBS PROP CAS CO OF AMRP 75674 INSURED INSURERB:HARTFORD ACCIDENT & IND CO 22357 Engineering Resources of Southern California, Inc. INSURERC:HUDSON INS CO 25054 3550 E. Florida Avenue Suite B Hemet, CA 92544 United States INSURERD: — INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:307236 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' ADDL SUBRI POLICY EFF I POLICY EXP LIMITS LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MMIDD/WYY) (MM/DD/YYYY) A GENERAL LIABILITY 6904769L126 ,9/1/2014 1 9/1/2015 • EACH OCCURRENCE 1$ 1,000,000 DAMAGE TO RENTED 1,000,000 I X I COMMERCIAL GENERAL LIABILITY , PREMISES(Ea occurrence) $ CLAIMS-MADE i OCCUR MED EXP(Any one person) $ 10,000 X • Cross Liab/Sev of Int X X PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 I POLICY X IF I LOC Deductible $ 0 A AUTOMOBILE LIABILITY BA4914L684 9/1/2014 9/1/2015 (EaCOMaccidenBINED t)SINGLE LIMIT $ 1,000,000 p BODILY INJURY(Per person) $ ALL OWNED i I SCHEDULED AUTOS AUTOS X X ! BODILY INJURY(Per accident) $ ANY AUTO ___ NON-OWNED j � I! PROPERTY DAMAGE $ HIRED AUTOS AUTOS (Per accident) ( $ UMBRELLA LIAB I OCCUR EACH OCCURRENCE $ —7 --- EXCESS LIAB 'CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION 72WEGGG6371 9/1/2014 .9/1/2015 X WC STATU- OTH- B AND EMPLOYERS'LIABILITY AND LIMITS ER YIN E.L.EACH ACCIDENT $ 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N I A X (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 C Professional Liability AEE7237905 9/1/2014 9/1/2015 Ea Claim & Aggreg $2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Additional Insured coverage applies to General and Automobile Liability for City of Cathedral City, its elected or appointed officers, officials, employees, agents and volunteers per policy form. Primary coverage applies to General and Automobile Liability per policy form. Waiver of subrogation applies to General and Automobile Liability and Workers Compensation per policy form. Prof. Liab. - Claims made, defense costs included within limit. CERTIFICATE HOLDER CANCELLATION City of Cathedral City 68-7 Avenida Lalo Guerrero SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cathedral City, CA 92234 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN United States ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Dorothy Amundson I( - / /I ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD EXIGIS-CAVIGNAC R.ASSOCIATES 307236 Page 2 of 4 POLICY NUMBER: 6804769L126 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following is added to WHO IS AN INSURED(Section available to such additional insured which covers such II): additional insured as a named insured, and we will not Any person or organization that you agree in a "contract share with the other insurance, provided that: or agreement requiring insurance" to include as an (1) The"bodily injury"or"property damage"for additional insured on this Coverage Part, but only with which coverage is sought occurs; and respect to liability for"bodily injury", "property damage" or (2) The"personal injury"for which coverage is "personal injury" caused, in whole or in part, by your acts sought arises out of an offense committed; or omissions or the acts or omissions of those acting on after you have entered into that "contract or agreement your behalf: requiring insurance". But this insurance still is excess over a. In the performance of your ongoing operations; valid and collectible other insurance, whether primary, b. In connection with premises owned by or rented to excess, contingent or on any other basis, that is available you; or to the insured when the insured is an additional insured c. In connection with "your work" and included within the under any other insurance. "products-completed operations hazard". C. The following is added to Paragraph 8. Transfer Of Such person or organization does not qualify as an Rights Of Recovery Against Others To Us in additional insured for"bodily injury", "property damage" or COMMERCIAL GENERAL LIABILITY CONDITIONS "personal injury" for which that person or organization has (Section IV): assumed liability in a contract or agreement. We waive any rights of recovery we may have against any The insurance provided to the additional insured is limited person or organization because of payments we make for as follows: "bodily injury", "property damage" or "personal injury" d. This insurance does not apply on any basis to any arising out of "your work" performed by you, or on your person or organization for which coverage as an behalf, under a"contract or agreement requiring insurance" additional insured specifically is added by another with that person or organization. We waive these rights endorsement to this Coverage Part. only where you have agreed to do so as part of the e. This insurance does not apply to the rendering of or "contract or agreement requiring insurance" with such failure to render any"professional services". person or organization entered into by you before, and in f. The limits of insurance afforded to the additional effect when, the "bodily injury" or "property damage" insured shall be the limits which you agreed in that occurs, or the"personal injury" offense is committed. "contract or agreement requiring insurance" to D. The following definition is added to DEFINITIONS provide for that additional insured, or the limits shown (Section V): in the Declarations for this Coverage Part, whichever "Contract or agreement requiring insurance" means that are less. This endorsement does not increase the part of any contract or agreement under which you are limits of insurance stated in the LIMITS OF required to include a person or organization as an INSURANCE (Section III)for this Coverage Part. additional insured on this Coverage Part, provided that the B. The following is added to Paragraph a. of 4. Other "bodily injury" and "property damage" occurs, and the Insurance in COMMERCIAL GENERAL LIABILITY "personal injury"is caused by an offense committed: CONDITIONS(Section IV): a. After you have entered into that contract or However, if you specifically agree in a "contract or agreement; agreement requiring insurance"that the insurance provided b. While that part of the contract or agreement is in to an additional insured under this Coverage Part must effect; and apply on a primary basis, or a primary and non-contributory c. Before the end of the policy period. basis, this insurance is primary to other insurance that is ©2007 The Travelers Companies, Inc. CG D3 81 09 07 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 1 of 1 Page 3 of 4 ' WC 04 03 06 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 9/1/2014 at 12:01 A.M. standard time, forms a part of Policy No. 72WEGGG6371 Endorwment No. Of the HARTFORD ACCIDENT & IND CO NCCI Carrier Code Issued to:Engineering Resources of Southern California, Inc. 3550 E. Florida Avenue Suite B Hemet, CA 92544 United States Policy Expiration Date: 9/1/2015 Premium (if any)$ (/ � Authorized Representative Dorothy Amundson 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.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be % of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description ANY PERSON OR ORGANIZATION FROM WHOM YOU ARE ALL REQUIRED BY WRITTEN CONTRACT OR AGREEMENT TO OBTAIN THIS WAIVER OF RIGHTS FROM US Page 4 of 4