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HomeMy WebLinkAboutA6564 - MV Transportation IncCERTIFICATE OF LIABILITY INSURANCE 5/1/2026 DATE (MM/DD/YYYY) 04/14 /2025 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), AUTI-IORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(les) 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 on this certificate does not confer rights to the certificate holder In lleu of such endorsement(s). PRODUCER Lockton Companies, LLC 444 W . 4 7th St., Ste. 900 Kansas City MO 64112-1906 (816) 960-9000 kcasu@lockton.com INSURED M V TRANSPORTATION , INC, ANDS 536275 271 1 N . HASKELL, SUITE 1500 DALLAS TX 7 5204 MAY O 5 2025 OFFICE OF THE CIT INSURE S AFFORDING COVERAGE INSURER A : ACE American Insurance Com an INSURER e : l ndemnl Insurance Co of North America INSURERC : RER F : NAIC# 22667 43575 COVERAGES CERTIFICATE NUMBER: 20236264 REVISION NUMBER: XXXXXX:X 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 • I THI= Tl=RMS CVf'I I ""l()NS ·••D ,.,,..,. nITIr,,,c, r,c "'' ,,., ... 01"11 lf'ICC:, I IMITS c:,,..r,w IJ •~AV ....... ,c RCCII.I c,cn, ,r-cn RY DA In"' AIUC:, INSR ,DDL sue, ,:'~JJ.Uv, r3~8~ LIMITS LT R TYPE OF INSURANCE INSD WVD POLICY NUMBER A X COMMERCIAL GENERAL LIABILITY Huv G48961 162 05,ui/202 05/011202f EACH OCCURRENCE s 5.000 000 I CLAIMS-MADE [K] OCCUR ~~-~~':.~Ye'.:".::'"" $ 100 000 MED EXP /Anv one DArsonl $ xxxxxxx ,__ y y S 5 000 000 PERSONAL & NJV INJURY "°GE:N'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s 5.000 000 ~POLICY□ PRO-□Loe PRODUCTS • COMP/OP AGG s 5 000 000 JECT OTHER: $ A AUTOMOBILE LIABILITY ISA H10818461 .. 05/01/2025 05/01 /2026 1pE~=~~ll NGLE LIMIT $ 5 000 000 x ANY AUTO BODIL y INJURY (Per person ) s xxxxxxx ,__ OWNED -SC HEDULED y y .___ AUTOS ONLY -AUTOS BODILY INJURY (Per aocldenl $ xxxxxxx HIRED NON-OWNED f.f~~~1~AMAGE $ xxxxxxx ,__ AUTOS ONLY -AUTOS ONLY $ xxxxxxx UMBRELLA UAB ~CUR NOT APPLICABLE EACH OCCURRENCE $ xxxxxxx ,__ EXCESS LIAB LAIMS-MADE AGGREGATE s xxxxxxx OED I I RETENTION s $ WORKERS COMPENSATION X I STAnITE I l"~R'-A AND EMPLOYERS' LIABILITY Y/N W C U C72631791 (CA,OH ,WA 05101/202;; 05/01/202 A Nff PROPRtETORIPARmERIEXECUTIVE [BJ N I A y WLR C72631833 f ALIMA) 05/01/202 05/01/2021 E.L. EACH ACCIDENT s 1000000 B OFFICER.-MEMSER EXQ.Ul)El)7 WLR C72631870 AOS) 05/01/2025 05/01/202€ s 1000000 (M•ndoto,y In NH) E.L. DISEASE· EA EMP\.OYEE :\r~~~~TIOl<Sbelow E L. DISEASE· POLICY LIMIT $ 1000000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may~ attached If mo,. epace ls ,.quired) . TliE CITY OF PALM SPRINGS, rrs OFFICIALS, EMPLOYEES. AND AGENTS ARE ADDITIONAL INSUREDS ON A PRIMARY AND NON-CONTRIBUTORY BASIS AS RESPECTS GENERAL AND AUTO LIABILITY COVERAGE WH ERE REQUIRED BY WRITTEN ANO SIGNED CONTRACT SU6JECT TO POLICY TERMS, CONDITIONS. LIMrrs AND EXCLUSIONS. WORKERS" COMPENSATION WAIVER OF SUBROGATION APPLIES WHERE REQUIRED BY WRITTEN CONTRACT. MV TRANSPORTATION , INC. IS SELF-INSURED FOR WORKERS COMPENSATION IN THE STATE OF CALIFORNIA. THE ABOVE WORK COMP POI.ICY PROVIDES COVERAGE EXCESS OF A $1 M SELF-INSURED RETENTION . CERTIFICATE HOLDER CANCELLATION see Attachments SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 20236264 AUTHORIZED REPRESENTATIVE CITY OF PALM SPRINGS ATTN : CITY MANAGER & CITY CLERK 3200 E . TAHQUITZ CANYON WAY t ~ PALM SPRINGS CA 92262 ~ ~ © 191SlhlU15 ACORD .. ,.,,. 1 JUN. All rl, Ihts reserved g ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD ,acoRO® CERTIFICATE OF LIABILITY INSURANCE DATE pAM DD YYYY) 5/12025 05/01/2024 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 have ADDITIONAL INSURED previsions or be endorsed. H 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 endorsement(s). Lockton Companies, LLC Kansas City MO 641112-1906 DEC 0 2 2024 (816)960-9000 kcasu@lockton.Com OFFICE OF THE CITN MV TRANSPORTATION, INC, AND SUBSIDIARIES 2711 N. HASKELL, SUITE 1500 DALLAS TX 75204 COVERAGES CERTIFICATE NUMBER: 20236264 REVISION NUMBER: XXXXXXX 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 THE EXCLUSIONICIES LIMIT WN MAY HAVE Y PAID CLAIMS. INSR LTR TYPE OF INSURANCE DDL INSO WVUB D POLICY NUMBER POUCYEFF MMIDD POUCYEXP MMID LIMITS )( COMMERCIAL GENERAL LIABILITY HD G48958 54 V01/ 02 05/012D EACH OCCURRENCE $ 5.000.000 CLAIMS -MADE Fx] OCCUR PREMISES (Fa �.l $ 100,000 MED EXP An ona ewon $ XXXXXXX Y Y PERSONAL S ADV INJURY $ 5,000,000 AGGREGATE LIMIT APPLIES PER: POLICY�JECT ❑LOC GENERAL AGGREGATE $S000000 GENL X PRODUCTS - COMP/OP AGO $S000000 $ OTHER: A AUTOMOBa-E LUBILfrY ISAH10824758 11/01/202 05/01/2025 E°MB�INEDSINGLE LIMIT eno f5D0U 000 BODILY INJURY (Per peram) $ XXXXX)(X ANY AUTO DINNED SCHEDULED ONLY AUTOS HIRED NON-0WTJED AUTOS ONLY AUTOS ONLY y y N BODILY INJURY (Pe, axdeM S XXXXXXXAUTOS P4OPEaR eVnl AMAGE f)()()V()U(X $XXXXXXX UMBRELLA LMB CUR NOT APPLICABLE EACH OCCURRENCE SXX)OO()(X AGGREGATE S XXXXX)(X EXCESS LIAB LAIMS-MADE DED I I RETENTION$ $ WORKERS COMPENSATION )( A A B AND EMPLOYERS•LIABILRY YIN ANYPROPRIETOIVPARTNEEMPo ECWT OFFICEWMBER UOLUDEDi lMVMa in NH) MIA Y WCUC72631626 CA, OH,W WLRC72631663 MA/AZ) WLRC72631705 �AOS) )l 1/01202 11/01/2D2 11/01202 0-1202 05/01202 05/01202 E.L. EACH ACCIDENT S 1,000,000 EL DISEASE - EA EMPLOYEE $ 11000,000 OEV IPTO OF OPERATIONS IXhY E.L. DISEASE - POLICY LIMn $ 1,000,000 DESCRIPTION OF OPERATIONS 1 LOCATK)NS I VEHICLES (ACORD 101, Addifitmal Remarks Schedule, may be attached If more apace Is raeuN ) MV TRANSPORTATION, INC. IS SEIF-INSURED FOR AUTO LIABILITY AND IN KERS COMPENSATION IN THE STATE OF CAUFORNIA., THE CrTY OF PALM SPRINGS, ITS OFFICIALS, EMPLOYEES, AND AGENTS ARE ADDITIONAL INSUREDS ON A PRIMARY AND NON-CONTRIBUTORY BASIS AS RESPECTS GENERAL AND AUTO LIABILITY COVERAGE INHERE REQUIRED BY WRNTEN AND SIGNED CONTRACT SUBJECT TO POLICY TERMS, CONDITIONS, LIMITS AND EXCLUSIONS. WORKERS' COMPENSATION WAVER OF SUBROGATION APPLIES MERE REQUIRED BY WRITTEN CONTRACT. MV TRANSPORTATION. INC. IS SELF -INSURED FOR WORKERS COMPENSATION IN THE STATE OF CALIFORNIA THE ABOVE MRK COMP POLICY PROVIDES COVERAGE EXCESS OF A$1M SELF -INSURED RETENTION. 20236264 CITY OF PALM SPRINGS ATTN: CITY MANAGER & CITY CLERK 32DO E. TAHQUITZ CANYON WAY PALM SPRINGS CA 92262 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORRED REPRESENTATIVE _#V7 P1-7 w7w_ -(tom ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Attachment Code : D646490 Certificate ID : 20236264 POLICY NUMBER: HDO G48958254 2 Endorsement Number: 1 COMMERCIAL GENERAL LIABILITY CG 20 26 1219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Name Of Additional Insured Person(s) Or Organization(s): Any person or organization whom you have agreed to include as an additional insured under.a written contract, provided such contract was executed prior to the date of loss. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the,additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. In the performance of your ongoing operations; or 1. Required by the contract or agreement; or 2. In connection with your premises owned by or rented to 2 Available under the applicable limits of insurance; you. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. whichever is less. This endorsement shall not increase the applicable limits of insurance. CG 20 26 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 Attachment Code: D646489 Certificate ID : 20236264 POLICY NUMBER: HDO G48958254 1 Endorsement Number: 8 COMMERCIAL GENERAL LIABILITY CG 24 04 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART ELECTRONIC DATA LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS SCHEDULE Name Of Person(s) Or Organization(s):Any person or organization against whom you have agreed to waive your right of -recovery in a written contract, provided such contract was executed prior to the date of loss. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery against the person(s) or organization(s) shown in the Schedule above because of payments we make under this Coverage Part. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person(s) or organization(s) prior to loss. This endorsement applies only to the person(s) or organization(s) shown in the Schedule above. CG 24 0412 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 Attachment Code: D646566 Certificate ID : 20236264 ADDITIONAL INSURED - DESIGNATED PERSONS OR ORGANIZATIONS Named Insured MV Transportation, Inc. Endorsement Number 1 Policy Symbol Policy Number Policy Period Effective Date of ISA H10824758 11/01/2024 To 05/01/2025 Endorsement Issued By (Name of Insurance Company) ACE American Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM AUTO DEALERS COVERAGE FORM MOTOR CARRIER COVERAGE FORM EXCESS BUSINESS AUTO COVERAGE FORM Additional Insured(s): Any person or organization whom you have agreed to include as an additional insured under a written contract, provided such contract was executed prior to the date of loss. A. For a covered "auto," Who Is Insured is amended to include as an "insured," the persons or organizations named in this endorsement. However, these persons or organizations are an "insured" only for "bodily injury" or "property damage" resulting from acts or omissions of: 1. You. 2. Any of your "employees" or agents. 3. Any person operating a covered "auto" with permission from you, any of your "employees" or agents. B. The persons or organizations named in this endorsement are not liable for payment of your premium. Authorized Representative DA-91-174c (03/16) Page 1 of 1 Attachment Code: D646565 Certificate ID: 20236264 POLICY NUMBER: ISA 1-110824758 Endorsement Number: 4 COMMERCIAL AUTO CA 04 43 1120 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) - AUTOMATIC WHEN REQUIRED BY WRITTEN CONTRACT OR AGREEMENT This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. The Transfer Of Rights Of Recovery Against Others To Us Condition does not apply to any person(s) or organization(s) for whom you are required to waive subrogation with respect to the coverage provided under this Coverage Form, but only to the extent that subrogation is waived: A. Under a written contact or agreement with such person(s) or organization(s); and B. Prior to the "accident' or the "loss." CA 04 43 1120 © Insurance Services Office, Inc., 2019 Page 1 of 1 Attachment Code: D646559 Certificate ID : 20236264 Wnr4pre' Cmmnonanfinn and Fmnlnvprs' I inhility Pnliry Named Insured Endorsement Number MV TRANSPORTATION, INC. 2711 N. HASKELL AVE SUITE 1500 Policy Number DALLAS TX 75204 Symbol: WLR Number: C58085881 Policy Period Effective Date of Endorsement 05-01-2024 TO 05-01-2025 05-01-2024 Issued By (Name of Insurance Company) ACE AMERICAN INSURANCE COMPANY Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. This endorsement. changes the policy to which it is attached and is effective on the date issued unless otherwise stated. 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 any one not named in the Schedule. Schedule ANY PERSON OR ORGANIZATION AGAINST WHOM YOU HAVE AGREED TO WAIVE YOUR RIGHT OF RECOVERY IN A WRITTEN CONTRACT, PROVIDED SUCH CONTRACT WAS EXECUTED PRIOR TO THE DATE OF LOSS. For the states of CA, UT, TX, refer to state specific endorsements. This endorsement is not applicable in KY, NH, and NJ. The endorsement does not apply to policies in Missouri where the employer is in the construction group of code classifications. According to Section 287.150(6) of the Missouri statutes, a contractual provision purporting to waive subrogation rights against public policy and void where one party to the contract is an employer in the construction group of code classifications. For Kansas, use of this endorsement is limited by the Kansas Fairness in Private Construction Contract Act(K.S.A.. 16-1801 through 16-1807 and any amendments thereto) and the Kansas Fairness in Public Construction Contract Act(K.S.A 16-1901 through 16-1908 and any amendments thereto). According to the Acts a provision in a contract for private or public construction purporting to waive subrogation rights for losses or claims covered or paid by liability or workers compensation insurance shall be against public policy and shall be void and unenforceable except that, subject to the Acts, a contract may require waiver of subrogation for losses or claims paid by a consolidated or wrap-up insurance program. Authorized Agent WC 00 03 13 (11/05) 0 Copyright 1983-2017 National Council on Compensation Insurance, Inc. All Rights Reserved. Attachment Code: D646568 Certificate ID: 20236264 WnrkPrs' Cmmnensatinn and Emoinvers' Liability Policv Named Insured Endorsement Number MV TRANSPORTATION, INC. 2711 N. HASKELL AVE SUITE 1500 Policy Number DALLAS TX 75204Symbol: WLR Number: C72631705 Policy Period Effective Date of Endorsement 11-01-2024 TO 05-01-2025 1-01-2024 Issued By (Name of Insurance Company) INDEMNITY INS. CO. OF NORTH AMERICA Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. 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 any one not named in the Schedule. Schedule ANY PERSON OR ORGANIZATION AGAINST WHOM YOU HAVE AGREED TO WAIVE YOUR RIGHT OF RECOVERY IN A WRITTEN CONTRACT, PROVIDED SUCH CONTRACT WAS EXECUTED PRIOR TO THE DATE OF LOSS. For the states of CA, UT, TX, refer to state specific endorsements. This endorsement is not applicable in KY, NH, and NJ. The endorsement does not apply to policies in Missouri where the employer is in the construction group of code classifications. According to Section 287.150(6) of the Missouri statutes, a contractual provision purporting to waive subrogation rights against public policy and void where one party to the contract is an employer in the construction group of code classifications. For Kansas, use of this endorsement is limited by the Kansas Fairness in Private Construction Contract Act(K.S.A.. 16-1801 through 16-1807 and any amendments thereto) and the Kansas Fairness in Public Construction Contract Act(K.S.A 16-1901 through 16-1908 and any amendments thereto). According to the Acts a provision in a contract for private or public construction purporting to waive subrogation rights for losses or claims covered or paid by liability or workers compensation insurance shall be against public policy and shall be void and unenforceable except that, subject to the Acts, a contract may require waiver of subrogation for losses or claims paid by a consolidated or wrap-up insurance program. Authorized Agent WC 00 03 13 (11/05) Attachment Code: D646634 Certificate ID: 20236264 G. Omnibus Reconciliation Act - Government Access Clause We will make available this policy and all documents needed to confirm the premium paid by you if the Secretary of Health and Human Services or the Comptroller General of the United States find that the policy is a contractor described in Section 1861 of the Social Security Act, 42 U.S.C. Section 1395, or any amendment to it, and they or you ask for our documents. If the Secretary of Health and Human Services or the Comptroller General asks for access to our documents, we will immediately notify you and make these documents available to you, unless prohibited by law. The right to access will be determined by the above statute, or any amendment to it, or any rules or regulations established under it. H. Other Insurance If the Insured carries other valid insurance, reinsurance or indemnity with any other insurer covering a loss covered by this policy (other than insurance that is purchased to apply in excess of the sum of Your Retention and the Limit of Indemnity hereunder), we shall not be liable for a greater proportion of such loss than the applicable Limit of Indemnity of all valid and collectible insurance, reinsurance or indemnity against such loss. If the Insured carries other insurance with us covering a loss within the limit covered by this policy, the insured must elect which policy shall apply and we shall be liable under the policy so elected and shall not be liable under any other policy. I. Recovery From Others We have your rights, and the rights of persons entitled to the benefits of this insurance, to recover our payments from anyone liable for the injury. You will do everything necessary to protect those rights for us and to help us enforce them. Any amount recovered as a result of such proceedings, together with all expenses necessary to the recovery of any such amount, shall be apportioned as follows: 1. if there is insurance coverage in excess of Our Limit of Indemnity, that insurer shall first be reimbursed to the extent of its actual payment; 2. we shall then be reimbursed to the extent of our actual payment and then we will pay the balance, if any, to you. The expenses of all proceedings necessary to the recovery of any such amount shall be apportioned between you and us in the ratio of their respective recoveries as finally settled. If there should be no recovery in proceedings instituted solely on our initiative, the expenses thereof shall be bome by us. In the event of any payment under this policy for a Loss for which you have waived the right of recovery in a written contract entered into prior to the Loss, we hereby agree to also waive our right of recovery but only with respect to such Loss. J. Sole Representative The insured first named in Item 1 of the Information Page will act on behalf of all insureds to give or receive notice of cancellation, accept indemnity, receive return premium or request changes in this policy. K. Transfer of Your Rights and Duties Your rights or duties under this policy may not be transferred without our written consent. L: Unintentional Errors and Omissions Your failure or omission to disclose all hazards existing as of the inception date of the policy shall not prejudice you with respect to the coverage afforded by this policy provided such failure or omission is not intentional and you did not know about such hazards prior to the commencement of the policy period. CKE-1167M (01115) ©ACE AMERICAN INSURANCE COMPANY Page 10 of 11 A 40.s-G � MVTRANS-01 MHERNAND CERTIFICATE OF LIABILITY INSURANCE oar21720D3 212/2023 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(les) 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 on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER C ACT E: Fairly Consulting Group, LLC PHONE FAX 1800 S. Washington, Suite 400 talc, No, Exi): (806) 378.4781 (AIC, No):(806) 376-5136 .Amarillo, TX 79102 EMAIL - - - - ADDRESS: INSURERIS) AFFORDING COVERAGE NAIL e INSURER A: ACE American Insurance Company 22667 INSURED INSURER B : MV Transportation, Inc. and subsidiaries 2711 N Haskell, Suite 1500 Dallas, TX 75204 INSURER C : INSURER D : INSURER E : COVERAGES CERTIFICATE NUMBER: 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 TYPE OF INSURANCE ADDL SUERIN D MID POLICY NUMBER PoLN:Y EFF POLICY E%P UNITS A X COMMERCIAL GENERAL LABILITY EACH OCCURRENCE $ 5,000,000 CLAIMS -MADE X OCCUR HDOG72961006 2/1/2023 2/1/2024 DAMAGE TO RENTED 100,000 PREMISES(Faomurrencel_ ,$ _MED EXP JAn i0m Personl _ S _ PERSONAL& ADV INJURY $ 5,000,000 _ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 5,000,000 X POLICY jPCOT LOC PRODUCTS-COMP/OP AGO S 5,000,000 OTHER: $ A AUTOMOBILE UABILoY COMBINED SINGLE LIMIT 5,000,000 (Ea accident) -- S X ANY AUTO ISAH2557803A 2/1/2023 8/1/2023 BODILY INJURY(Pwpereon) $ -OWNED SCHEDULED AUTOS ONLY AUUTµOSSWNEo BODILY INJUORY(Peraccidenl) $ _ AUTOS ONLY AUTOS ONLY jPw aartlenl) AMAGE $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE S _ DED RETENTIONS $ A WORKERS COMPENSATION X PER OTH- AND EMPLOYERS' LIABILITY STATUTE - ER _ ANY PROPRtETOR/PARTNEWEXECUTIVE YIN WCUC70315294 2/1I2D23 2/1/2024 1,000,000 ����FICERIMEEMg��EXCLUDEDT N NIA E,L.-EACHACCIDENT $ _ (Mandatoryln NH) -- E.L. DISEASE -EA EMPLOYEE$ 1,000,000 d�eess _ OESCRI ON OF OPERATIONS babe E.L. DISEASE- POLICY LIMIT 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may M aeachad If mom space Is required) The City of Palm Springs, its officials, employees, and agents are Additional Insureds on a primary and non-contributory basis as respects General and Auto Liability coverage where required by written and signed contract subject to policy terms, conditions, limits and exclusions. Workers' Compensation waiver of subrogation applies where required by written contract. MV Transportation, Inc. is self -insured for Workers Compensation in the state of California. The above Work Comp policy provides coverage excess Ole $1M self -insured retention. RLCEIVEL City of Palm Springs FEB 13 2023 Attn: City Manager & City Clerk 3200 E. Tahqultz Canyon Way City Hall Palm Springs, CA 92262 Reception Desk SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ox T ACORD 25 (2016103 © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CERTIFICATE HOLDER 4094 03/06 Insurance Company: FOREMOST INSURANCE COMPANY GRAND RAPIDS, MICHIGAN Policy Number: 361 5007601982 02 Effective Date: 01/31/23 Expiration Date: 01/31/24 Named Insured: LINH TRAN STE 157-834 751 S WEIR CANYON RD ANAHEIM CA 92808-1962 Property Location: 399 W SANTA CATALINA RD Certificate Holder: CITY OF PALM SPRINGS A CALL CHARTER CITY & MCP. CORP 3200 E TAHOUITZ CANYON WAY PALM SPRINGS CA 92262-6959 The dwelling described on this certificate is insured by the policy shown. If this policy is terminated, notice will also be mailed to the Certificate Holder named above. This certificate does not amend or supercede any provision of the policy. 4094 03/06 RECEIVED FEB 13 2023 City Hall Reception Desk 11114L_ 9-IRr" CERTIFICATE OF LIABILITY INSURANCE DA05/01/202Y) 5/1/2025 05/01/2024 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 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 on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Lockton Companies 444 W. 47th Street, Suite 900 Kansas City MO 64112-1906 (816)960-9000 MEA PHONE F E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # kcasu@lockton.com INSURERA: ACE American Insurance Company 22667 INSURED MV TRANSPORTATION, INC, AND SUBSIDIARIES 536275 2711 N. HASKELL, SUITE 1500 DALLAS TX 75204 INSURER B : Indemnity Insurance Co of North America 43575 INSURER C : INSURER D : INSURER E : INSURER F : lxr_rl Iwll 11VIIIIuCr%. 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 SLIBR POLICY EFF I POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY)I (MM/DDfYYYYI1 LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR HDOG48901104 05/01/202 05/01/202E EACH OCCURRENCE $ 5,000,000 DA PREMISES (Ea occurrence) $ 100,000 MED EXP (Any oneperson) $ XXXXXXX Y Y PERSONAL & ADV INJURY $ 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY❑ PRO- ❑ LOC JECT GENERAL AGGREGATE $ 5,000.000 PRODUCTS - COMP/OP AGG $ 5,000,000 OTHER: A AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY Y Y ISAH10824746 05/01/202 05/01/202 EaaBcideDtSINGLELIMIT $ 5,000,000 X BODILY INJURY (Per person) $ XXXXXXX BODILY INJURY (Per accident) $XXXXXXX PROPERTY AMAGE Per accident $XXXXXXX $XXXXXXX UMBRELLA LIAB OCCUR NOT APPLICABLE EACH OCCURRENCE $ XXXXXXX 41 AGGREGATE $ XXXXXXX EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ A A B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANYPROPRIETOR/P/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, descnbe under DESCRIPTION OF OPERATIONS below N/A Y WCUC58085510 (CA, OH, W WLRC58085881 (MA/AZ) WLRC58085984 (AOS) )05/01/202 05/01/202 05/01/202 05/01/202 05/01/2025 05/0112025 X _ E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) MV TRANSPORTATION, INC. IS SELF -INSURED FOR AUTO LIABILITY AND WORKERS COMPENSATION IN THE STATE OF CALIFORNIA.. THE CITY OF PALM SPRINGS, ITS OFFICIALS, EMPLOYEES, AND AGENTS ARE ADDITIONAL INSUREDS ON A PRIMARY AND NON-CONTRIBUTORY BASIS AS RESPECTS GENERAL AND AUTO LIABILITY COVERAGE WHERE REQUIRED BY WRITTEN AND SIGNED CONTRACT SUBJECT TO POLICY TERMS, CONDITIONS, LIMITS AND EXCLUSIONS. WORKERS' COMPENSATION WAIVER OF SUBROGATION APPLIES WHERE REQUIRED BY WRITTEN CONTRACT. MV TRANSPORTATION, INC. IS SELF -INSURED FOR WORKERS COMPENSATION IN THE STATE OF CALIFORNIA. THE ABOVE WORK COMP POLICY PROVIDES COVERAGE EXCESS OF A $1M SELF -INSURED RETENTION. RECEIVED SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN MAY 0 6 2024 ACCORDANCE WITH THE POLICY PROVISIONS. 20236264 AUTHORIZED REPRESENTATIVE CITY OF PALM splGFRCE OF THE CITY CLERK ATTN: CITY MANAGER & CITY CLERK 3200 E. TAHOUITZ CANYON WAY PALM SPRINGS CA 92262 _ 9? A?wlowz m%,ur[U AD kzu 101U3) I ne AGUKL) name and logo are registered marks of ACORD 445yy ,a►coRo® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 5/1/2024 01/24/2024 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 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 on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Lockton Companies 444 W. 47th Street, Suite 900 PHONE /C Kansas City MO 64112-1906 E-MAIL (816)960-9000 INSURERS AFFORDING COVERAGE NAIC # kcasu@lockton.com INSURER A: ACE American Insurance Company 22667 INSURED MV TRANSPORTATION, INC, AND SUBSIDIARIES INSURER B : Indemnity Insurance Co of North America 43575 536275 2711 N. HASKELL, SUITE 1500 INSURER C : DALLAS TX 75204 INSURER D : INSURER E : INSURER F : rMAr 11C0TIC1f'ATC Ki"upFRe 9n9gA9AA REVISION NUMBER: XXXXXXX 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 LTR A TYPE OF INSURANCE X COMMERCIAL GENERAL LIABILITY ADDL INSD SUB WVD POLICY NUMBER HDOG72961006 POLICY EFF MMIDD/YYYY 02/01 /202 POLICY EXP MM/DD/YYYY 05101/2024 LIMITS EACH OCCURRENCE $ 5 000 000 DAMAGE TO RENTED $ 100,000 CLAIMS -MADE � OCCUR MED EXP (Any oneperson) $ XXXXXXX PERSONAL & ADV INJURY $ 5,000,000 Y Y GENERAL AGGREGATE $ 5 00O 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG 5,000,000 X POLICY❑ PE ❑ LOC CT $ OTHER: A AUTOMOBILE LIABILITY ISAH2557803A 02/01/202 05/01/202 Ee acccidentSINGLE LIMIT $ 5,000,000 BODILY INJURY (Per person) $ XXXXXXX X ANY AUTO BODILY INJURY (Per accident) $ XXXXXXX OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY Y Y PROPERTY DAMAGE Per accident $ XXXXXXX $XXXXXXX UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE NOT APPLICABLE EACH OCCURRENCE $ XXXXXXX AGGREGATE $ XXXXXXX DED RETENTION $ A A B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE a OFFICER/MEMBEREXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A Y WCUC70315294(CA,OH,WA) WLRC5551947A(AZ,MA) WLRC55519675 (AIDS) ( ) 02/01/202 02/01/202 02/01/202 05/01/202 05/01/202 05/01/202 X E.L. EACH ACCIDENT $ 000000 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 E.L. DISEASE - POLICY LIMIT $ i 000 000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) MV TRANSPORTATION, INC. IS SELF -INSURED FOR AUTO LIABILITY AND WORKERS COMPENSATION IN THE STATE OF CALIFORNIA. - THE CITY OF PALM SPRINGS, ITS OFFICIALS, EMPLOYEES, AND AGENTS ARE ADDITIONAL INSUREDS ON A PRIMARY AND NON-CONTRIBUTORY BASIS AS RESPECTS GENERAL AND AUTO LIABILITY COVERAGE WHERE REQUIRED BY WRITTEN AND SIGNED CONTRACT SUBJECT TO POLICY TERMS, CONDITIONS, LIMITS AND EXCLUSIONS. WORKERS' COMPENSATION WAIVER OF SUBROGATION APPLIES WHERE REQUIRED BY WRITTEN CONTRACT. MV TRANSPORTATION, INC. IS SELF -INSURED FOR WORKERS COMPENSATION IN THE STATE OF CALIFORNIA. THE ABOVE WORK COMP POLICY PROVIDES COVERAGE EXCESS OF A $1M SELF -INSURED RETENTION. FEB 2 0 2024 City Mall 20236264 Reception Desk CITY OF PALM SPRINGS ATTN: CITY MANAGER & CITY CLERK 3200 E. TAHQUITZ CANYON WAY PALM SPRINGS CA 92262 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE % /7 r ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD I , .