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HomeMy WebLinkAbout3/6/2013 - AGREEMENTS (5)ACORCf CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 01/09/2019 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 Desert Insurance Solutions 51625 Desert Club Drive Suite 202 La Quinta OA 92253 Carrie BabiJ (A/c.'No.Ext): (760)564-6800 i r^.No): (760)564-6801 ADT^ESS: carrie(gdesertinsuranc»solutions.com INSURER(S) AFFORDING COVERAGE NAIC » INSURER A: NAVIGATORS INSURANCE COMPANY INSURED Selene Palm Springs, LLC INSURER B: INSURER C: INSURER D: INSURER E: INSURER F: 1 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 LTR TYPE OF INSURANCE AODLSUBR tNSDiWVD POLICY NUMBER POLICY EPF POLICY EXP (MM/PmYYYl (MM/DPYYYYH LIMITS X COMMERCIAL GENERAL UABILITY I CLAIMS-MADE | X I OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: X LOC IS18CGL234249IC 01/02/2018 01/02/2020 EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence)$ 50,000 MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG $ Excluded $ 1,000,000 $ 2,000,000 $ 2,000,000 AUTOMOBILE LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY SCHEDULED AUTOS NON-OWNED AUTOS ONLY COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per acddent) UMBRELLA LIAB >0 EXCESS LIAB OCCUR CLAIMS-MADE I DED iXi RETENTIONS 0 SE17EXC916854IC 01/01/2018 EACH OCCURRENCE $ 5,000,000 01/01/2020 AGGREGATE $ 5,000,000 PR/COMP OPS AGG ! $ 5,000,000 WORKERS COMPENSATION AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y/N □ PER STATUTE OTH ER N/Al E.L EACH ACCIDENT i $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT ; $ DESCRIPTION OF 0PBIAT1ONS / LOCATIONS / VEHICLES (ACORD101, Additional Remarks Schedule, may be attached if more space is required) Certificate holder is Additional Insured per form CG 20 12 04 13 attached In regards to the Dream Hotel Project A6329 CERTIFICATE HOLDER CANCELLATION City of Palm Springs SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 3200 E Taquitz Canyon Way Palm Springs CA 92262 AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03)The ACORD name and logo are registered marks of ACORD POLICY NUMBER:IS18CGL234249IC COMMERCIAL GENERAL LIABILITY CG 20 12 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE State Or Governmental Agency Or Subdivision Or Political Subdivision: Any State Or Governmental Agency Or Subdivision Or Political Subdivision for whom during the policy period you and such State Or Governmental Agency Or Subdivision Or Political Subdivision have agreed in writing in a contract or agreement that such State Or Governmental Agency Or Subdivision Or Political Subdivision be added as an additional insured on your policy. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to include as an additional insured any state or governmental agency or subdivision or political subdivision shown in the Schedule, subject to the following provisions: 1. This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. However: a. The insurance afforded to such additional insured only applies to the extent permitted by law; and b. 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. 2. This insurance does not apply to: a. "Bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the federal government, state or municipality; or b. "Bodily injury" or "property damage" included within the "products-completed operations hazard". 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. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 12 0413 © Insurance Services Office, Inc., 2012 Page 1 of 1