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HomeMy WebLinkAboutA4037 - TENET HEALTHCARE - VEHICLE MNTNCE MO 6257Arthur J. Gallagher Risk Management Services, LLC 500 N Brand Blvd Ste 100 Glendale CA 91203 MDG2024 00007824 01 IhrulhlhllPuh4.h lhl ulhh lhllnll lnu l� t l City of Palm Springs P.O. Box 2743 Palm Springs, CA 92263 RECEIVED AUG 13 2024 OFFICE OF THE CITY CLERK We are providing you with a Certificate of Insurance confirming our client's coverage. Want to get certificates of insurance faster? "Go Green with Gallagher" by receiving digital copies of certificates via e-mail in the future. Or, do you no longer require a certificate of insurance for our client? Please contact us at COI.UpdateMyEmail@AJG.com and provide the following information for processing: 1. Confirmation that a certificate of insurance is no longer required; or 2. E-mail address to send future certificates of insurance in lieu of U.S. Mail delivery 3. Insured Code: TENEHEA-02 4. This Certificate Number: 344042622 To learn more about the Insurance and Risk Management Services offered by Gallagher, please visit us at www.ajg.com/us/about-us/how-we-work/core-360. Gallagher does not share your e-mail as detailed in our privacy policy found at https:// www.ajg.com/us/privacy-policy/. 25 IN ACC) EY CERTIFICATE OF LIABILITY INSURANCE pATas/zoza Yn 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(a). PRODUCER "-' Arthur J. Gallagher Risk Management Services, LLC N. Brand' Boulevard Suite 100 Glendale CA 91203 ' /= "'} • - "LleenseikOD69293 CONTACT - NAME: Global, Risk Management RxoNE F00 •816-539-2300 INC.No:818-539-1801 n DRESS: rm certificates a' .com INSURERS AFFORDING COVERAGE NAIC 0 INSURER A: National Union Fire Insurance Company of Pittsburg19445 INSURED TENEHEA-0 Tenet Healthcare Corp. 14201 Dallas Parkway INSURER B: Various — INSURER Or INSURER O: Dallas, TX 75254 INSURER E: INSURER F: - COVERAGES CERTIFICATE NUMBER: 344042622 — - -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. INSfl LTR TYPE OF INSURANCE ADDL SUBR POLICYNOMSER POLICY EFF MWDD/YYY POLICY up MMA1D/YY LIMITS A X COMMERCIAL GENERALUABIUTY 1728920 6/112024 61112025 EACH OCCURRENCE g1.000,000 PREMISES Es occurrence) $1.000.000 CLAIMS -MADE MOCCUR MED EXP (Any one person $ PERSONAL& ADV INJURY $1.000,000 GEN'L AGGREGATE LIMIT APPLIES PER: %( POLICY OJER F]LOC GENERALAGGREGATE $1.000,000 PRODUCTS - COMP/OPAGG $1,000,000 S OTHER: AUTOMOBILE LIABILITY - - COMBINED SINGLE LIMIT Me accident) S BODILY INJURY (Per person) S ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ HIRED NON -OWNED' AUTOSONLY AUTOSONLY PROPERTY DAMAGE PeracGdenl S S UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $' EXCESSLIAB CLAIMS -MADE DED I I RETENTIONS S B WORKERS COMPENSATION AND EMPLOYERS' UABIUTY YIN ANYPROPRIETOR/PARTNER�EXECUOVE ❑ OFFICERIMEMBEREXCLUDEDI NIA See Attached 6/1/2024 6H/2025 q X STATUTE OERH E.LEACHACCIDENT $2,006,000 E.L. DISEASE -EA EMPLOYEE $2.000.000- (Mandatory In NH) If es, describe under DESCRIPTION OFOPERATIONS below E.L. DISEASE -POLICY LIMIT $2,000.000 DESCRIPTION OF OPERATIONS/ LOCATIONS/VEHICLES (ACORD 101, Additional Numerics Schedule, maybe attached if more spew Is required) The Certificate Holder is Included as an Additional Insured, but solely as respects to liability arising out of the Named insured's Opperations or premises owned by or rented by Named Insured, excluding' contract or Agreements for Professional Services, and subject to the terms andconditions of the referenced policy. and as Required by Written Contract. Workers Compensation is Evidence Of coverage with Repect To The Insured's Operations And In accordance with the terms and conditions of the policy. Additional Insured Includes the City of Palm Springs Officers, Agents and employees. The American Home Assurance Company will Waive any right of Recovery they may have against the Certificate Holder because oi. Payments made Arising out of the Named Insured's Ongoing Operations or Work Performed under Contractwith The Certificate Holder. It is further agreed that such Insurance as is afforded The City of Palm Springs, shall be primary and non-contributory with any other insurance in farce for or which maybepurchased by The City of Palm Springs. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED. POLICIES BE CANCELLED BEFORE • THE EXPIRATION DATE THEREOF,, NOTICE WILL BE DELIVERED IN City. of Palm Springs ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 2743 Palm Springs CA 92263 .. USA AUTHgRIZED REPRESENTATIVE q Cj 41 91988-2015 ACORD CORPORATION. All rights. reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Tenet Healthcare Corporation Workers' Compensation Program Layer Insurance Company Policy Number Policy Term NAIC No. Work Comp -AOS AIU Insurance Company 20396129 06/01/24-06/01125 19399 Work Comp - WI AIU Insurance Company 20396130 06/01/24-06/01/25 19399 National Union Fire Insurance Company Excess Work Comp -AL, CA, to of Pittsburgh, Pa. 3332320 06/01/24- 06/01/25 ' =•4a3 Excess Work Com. p - MI (VHS of Michi an Inc) Safety National Casualty Corporation SP 4066571 06/01/24- 06/01/25 15105 POLICY NUMBER: 1728920 COMMERCIAL GENERAL LIABILITY CG 2011 1219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - MANAGERS OR LESSORS OF PREMISES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designation Of Premises (Part teased To You): PER THE CONTRACT OR AGREEMENT Name Of Persons) Or Organization(s) (Additional Insured): ANY PERSON OR ORGANIZATION FROM WHOM YOU LEASE PREMISES OR WHO MANAGES PREMISES YOU OWN AND TO WHOM YOU BECOME OBLIGATED TO INCLUDE AS AN ADDITIONAL INSURED UNDER THIS POLICY AS A RESULT OF ANY LEASE, OR MANAGEMENT AGREEMENT YOU ENTER INTO WITH SUCH PARTIES Additional Premium: $ INCLUDED 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 the person(s) or organization(s) shown in the Schedule, but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you and shown in the Schedule and subject to the following additional exclusions:- _ ---- — This insurance does not apply to: 1. Any 'occurrence" which lakes place after you cease to be a tenant in that premises. 2. Structural alterations, new construction or demolition operations performed by or on behalf 'of the person(s) or organization(s) shown in the Schedule: 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. B. With respect to the insurance afforded to these additional- insdreds; 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. - CG2011.1219 0 Insurancy,gervices Office, Inc., 2012 Page 1 of 1 r, Tenet Healthcare Systems • Vehicle Fleet Maintenance Service & Fueling AGREEMENT #4037 M06257, 10-21-98 AGREEMENT FOR -- -- -- VEHICLE FLEET MAINTENANCE SERVICES AND FUELING THIS AGREEMENT FOR VEHICLE/FL,EET MAINTENANCE SERVICES ("AGREEMENT") is made and entered into this 2 day of September 1998, by and between the CITY OF PALM SPRINGS (CITY)and TENET HEALTHCARE SYSTEMS, DESERT, INC. D.B.A. DESERT REGIONAL MEDICAL CENTER, A CA]LLFORNIA CORPORATION, ("HOSPITAL") DOING BUSINESS AS DESERT REGIONAL MEDICAL CENTER RECITALS A. HOSPITAL owns, operates &maintains numerous vehicles ("HOSPITAL VEHICLES") in the Palm Springs area. B. HOSPITAL has no facility in the Palm Springs area capable of maintaining the HOSPITAL VEHICLES or of providing them with gasoline. C. CITY owns and operates a City Yard in the City of Palm Springs, which include a full- service vehicle maintenance:and repair facility(MAINTENANCE FACILITY) and facilities for the storage and self-service dispensing of unleaded gasoline ("GASOLINE FACILITY"). D. HOSPITAL desires to contract with CITY and CITY desires to contract with HOSPITAL for CITY to provide HOSPITAL VEHICLES with maintenance services at the MAINTENANCE FACILITY and self-service gasoline dispensing at the GASOLINE FACILITY. ���;��� + �INGII�i Nw �i01 1 AGREEMENT CITY and HOSPITAL agree as follows: CITY shall provide and HOSPITAL,shall purchase maintenance services and self-service gasoline dispensing services for HOSPITAL VEHICLES, pursuant to the following terms and conditions: 1.0 MAINTENANCE SERVICES 1.1 Provision of Maintenance Services. CITY shall provide maintenance services to HOSPITAL VEHICLE'S at CITY's MAINTENANCE FACILITY, together with road services in the Palm Springs Area. 1.2 Scope of Maintenance Services. CITY shall provide maintenance services as set forth on the attached Exhibit "A", which is incorporated into this AGREEMENT by this reference. CITY anticipates reviewing and adjusting its labor rates annually. CITY expressly reserves the right in CITY's sole discretion to change the scope of maintenance services provided or the cost of providing those services, to be effective upon thirty(30) days'written notice. 1.3 Scheduled of Routine Maintenance Services. Concurrently with the execution of this Agreement and on or before each succeeding year, HOSPITAL shall provide CITY a list of HOSPITAL VEHICLES. The nature of routine maintenance services to be provided for those vehicles shall be coordinate by CITY and Hospital's schedules with the schedule of CITY and of any other users of CITY maintenance services. The final schedules will be completed by CITY in connection with its annual budget review process 2.0 GASOLINE DISPENSING SERVICES. 2.1 Provision of Gasoline Dispensing Services CITY shall make available to HOSPITAL its GASOLINE FACILITY for use by HOSPITAL VEHICLES. Hospital may dispense 2 unleaded gasoline into HOSPITAL VEHICLES at CITY's GASOLINE FACILITY at any time the GASOLINE FACILITY is open and operating. HOSPITAL'S right to use the GASOLINE FACILITY is non-exclusive. HOSPITAL and CITY shall use their best efforts to accommodate other users. 2.2 Cost of Gasoline Ilispensing Services. HOSPITAL shall pay to CITY for each gallon of gasoline purchased the sum which is equal to the cost of gasoline to the CITY plus five cents ($0.5). Cost to CITY shall be the price per gallon of unleaded gasoline most recently purchased by the CITY on the date of any monthly billing. 2.3 Fuel Keys. Because the GASOLINE FACILITY gasoline pump must be activated by a computer identification key, CITY shall issue one computer identification key to each vehicle designated by HOSPITAL. HOSPITAL shall pay to CITY the sum of$7.00 for each vehicle identification key issued. If an identification key is lost or damaged, CITY shall, upon written notification, replace the lost or damaged identification key and HOSPITAL shall pay to the CITY the sum of$7.00 for each identification key replaced. 3.0 AVAILABILITY OF MAINTENANCE SERVICES AND GASOLINE DISPENSING SERVICES 3.1 Maintenance facility Hours of Operation. The MAINTENANCE FACILITY is presently operated five(5) days per week, nine an a half(9 1/2)hours per day, between 7:00 A.M. and 4:30 PM., Monday through Friday. 3.2 Gasoline Facility Hours of Operations. The GASOLINE FACILITY is presently operated twenty-four(24)hours per day, seven (7) days per week. 3 3.3 Changes in Hours of Operation. CITY makes no representation that either the MAINTENANCE FACILITY or GASOLINE FACILITY will continue to be operating at the schedules presently in effect. CITY expressly reserves the right to set any hours of operation for the MAINTENANCE FACILITY OR GASOLINE FACILITY which CITY deems to be convenient for itself. 4.0 BILLING AND PAYMENT. 4.1 Billing. CITY shall prepare and present to HOSPITAL, on or before the lOs day of each month that this AGREEMENT is in effect, a bill and statement for maintenance services performed on HOSPITAL VEHICLES and for unleaded gasoline purchased by HOSPITAL during the previous month. 4.2 Pa•m . HOSPITAL shall make full and complete payment of each bill on or before the last day of the month. 5.0 GENERAL PROVISIONS. 5.1 Liability Insurance During the entire term of this AGREEMENT each party agrees to procure and maintain public liabillity at its sole expense or to maintain sufficient reserves in any program of self-insurance to protect against loss from liability imposed by law for damage on account of bodily injury, including death, suffered or alleged to be suffered by any person or persons whomsoever, resulting directly or indirectly from any act or activities of that parry or any person acting for that party or under its control or direction, and also to protect against loss from liability imposed by law for damages to any property of any person caused directly or indirectly by or from acts or activities or that party or any person acting for or under that party's control or direction. The public liability and property damage insurance shall also provide for and protect the other party against incurring any legal costs in defending claims for alleged loss. The public liability and property damage insurance shall be maintained in full force and effect throughout the term of this AGREEMENT in the following minimum limits: C4,1 /9-5� 4 Bodily Injury $ 50,000 each person $ 100,000 each occurrence Property Damage $ 50,000 each occurrence $ 100,000 aggregate A combined single limit policy with aggregate limits in the amount of$100,000 will be considered equivalent to the required minimum limits. All insurance provided pursuant to this AGREEMENT shall be primary insurance and shall name the other party as an additional insured. Each party agrees that provisions of this Paragraph as to maintenance of insurance shall not be construed as limiting in any way the extent to which a party may be held responsible for the payment of damages to persons or property resulting from its activities, or the activities of any person or persons for which that party is otherwise responsible. 5.2 Hold Harmless Each party to this AGREEMENT agrees, pursuant to Government Code Section 895.4, to defend, and indemnify and hold harmless the other party, its officers, agents and employees, from and against any and all liability, damages, costs, losses, claims and expenses, however caused, resulting directly or indirectly from or connected with the indemnifying parry's performance of this AGREEMENT. 5.3 Service of Notice. Any notice to a party to this AGREEMENT shall be mailed,postage prepaid and with return receipt personally, delivered or sent by telephone facsimile transmission, and addressed as follows: Desert Regional Medical Center 1150 N. Indian Canyon Palm Springs, Ca. 92262 5 5.4 Entire Agreement: Amendment. This document contains the entire AGREEMENT between the parties and shall not be changed in any way except by written amendment properly executed by the parties. 5.5 Termination of Agreement. This AGREEMENT shall continue in full force and effect unless and until terminated by either party, with or without cause, upon thirty (30) days written notice. 5.6 Corporate Authority. The persons executing this Agreement on behalf of the parties hereto warrant that(i) such party is duly organized and existing, (ii)they are duly authorized to execute and deliver this Agreement, on behalf of said party, (iii) by so executing this Agreement, such party is formally bound to the provisions of this Agreement, and (iv) the entering into this Agreement does not violate any provision of any other Agreement to which said party is bound. IN WITNESS WHEREOF, the patties have executed and entered into this Agreement as of this date first written above. ATTEST: CITY OF PALM SPRINGS, CALIFORNIA , —" City Clerk City Manager APPROVED AS TO FORM: .., I9otl�_ Ci ttomey 6 CONTRACTOR: Desert Regional Medical Center i,crfIY EVEAETT-FILLET rw �iatu;-cnuwr.. (Check One: individual, '= Comm,41172794 ,side County partnership,_x corporation) pOBLIC-CALIFORN[A N _� Feb.1,200� county 7,2002j .-AIUED) Byyi""n BETTY EVEAETT-FILLET Signature Comm,#1172794 NOTARY PUBLIC-CALIFORNIA ° Riverside County My Comm. Expires Feb.7,2002 " Print Name and Title (NOTARIZED) By: �. � re. /y BEl'TV EVEflETT-FILLET Print Name and Title Comm.N 1172194 N `�s� � NOTARY pUBIIGCALIFOANIA V' ,} ` Riverside County " Mailing Address: P.O. Box 2739 My Comm. Expires Feh.7,2002 Palm Springs, CA 92263-2739 (Corporations require two signatures; one,from each of the following: A. Chairman of Board, President, any Vice President; AND B. Secretary, Assistant Secretary, Treasurer, Assistant Treasurer, or Chief Financial Officer). End of Signatures 7 EXMBIT "A" SCOPE OF MAINTENANCE SERVICES Services Provided Preventive Maintenance $ 35.00 per hour Tire Work $ 35.00 per hour Major Repairs $45.00 per hour Minor Repairs $ 40.00 per hour Road Service $ 40.00 per hour Parts Cost plus 10% 8 ALI-PURPOSE ACKNOWLEDGMENT • ��v` l r State of Califonyia d County of G�S/���G ss. / I On �D%0! /(� , �%�� before me, �p�`'' �� / p ' (NOTA Y) 9 personally appeared � Z//7? R/' / 1 �GS /2G/� ! V2�66 � � slcnSeR(s) ❑ personally known to me - OR- ❑ proved to sale on the basis of satisfactory evince to be the persot�vvhose nameCl is/ re'subsciibed to the within instrument and ° acknowledged to me that he/she/t� "executed e the same in has/hen-/tI ae i) authorized ° capacity(i s; and that by his/her/ heir signatur on the instrument the persoas(s)) ° or theeentity upon behalf of which the person&.acted, executed the instrument. o , . BETTY EVERETT•FILLET • 4 Comm. #1172794 N � �`e � NUTAAYPUSLIC-CALIFOANIA ° ' , Aiverside county WIT SS my hand and official seal. My Comm. Expires Feb.7,2002 9 NOTARY'S SIGNATURE `� U OPTIONAA, INFdkRM1liTION The information below is not required by law. However, it could prevent fraudulent attachment of this acknowl- edgment to an unauthorized document. CAPACITY CLAIMED BY SIGNER (PRINCIPAL) DESCRIPTION DP ATTACI3EID IDOCUPKENT ❑ INDIVIDUAL ❑ CORPORATE OFFICER • f TITLE OR TYPE OF DOCUMENT TTTLE(5) B � ❑ PARTNER(S) NUMBER OF PAGES ® ❑ ATTORNEY-IN-FACT ❑ TRUSTEE(S) ° ❑ GUARDIAN/CONSERVATOR DATE OF DOCUMENT ❑ OTHER: o OTHER P.IGHT THUMBPRINT SIGNER IS REPRESENTING: OF NAME OP PERSON(S)OR ENTITY(IES) E SIGNER �®�°�:w°ro°e�•e�°�>°•..e>B.•°�n�a®c:ess►a�aaro®�,�°�.°.®.-®®°.®.�s�t APA 5/97 VALLEY-SIERRA, 800-362-3369 FACILITY: DESERT REGIONAl EDICAL CONTRACTOR: CITY PALM SPRINGS c�PFTt,� NOTIFICATION REGARDING CORPOIL4TE INTEGRITY AGREEMENT, GOVERNMENT ALLEGATIONS AND IMPORTANCE OF COMPLIANCE THIS IS NOTIFICATION TO CONTRACTORS OF TENET HEALTHCARE CORPORATION (-TENET-),FORMERLY KNOWN AS NATIONAL MEDICAL ENTERPRISES, INC. (-NME-),AND ITS SUBSIDIARIES (COLLECTIVELY, "TENET") OF THE FOLLOWING: A. THE FACT AND SUBSTANCE OF THAT CERTAIN CORPORATE INTEGRITY AGREEMENT("AGREEMENT-) DATED JUNE 29, 1994, BETWEEN THE DEPARTMENT OF HEALTH AND HUMAN SERVICES ("HHS")AND NME,AS PART OF THE SETTLEMENT AGREEMENT("SETTLEMENT AGREEMENT") ENTERED INTO AS OF JUNE 29, 1994 BY AND AMONG THE UNITED STATES OF AMERICA,ACTING THROUGH THE DEPARTMENT OF JUSTICE,THE UNITED STATES ATTORNEY FOR THE DISTRICT OF COLUMBIA ON BEHALF OF PERSONNEL MANAGEMENT,THE OFFICE OF INSPECTOR GENERAL OF HHS ON BEHALF OF HHS,AND THE OFFICE OF CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE UNIFORM SERVICES ON BEHALF OF THE CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE UNIFORM SERVICES (COLLECTIVELY, "THE GOVERNMENT")AND NME,THE SUBSTANCE THEREOF BEING AS FOLLOW - TENET SHALL CAUSE THE FOLLOWING TO OCCUR: I. ANNUAL REVIEW OF TENET BILLING POLICIES,PROCEDURES AND PRACTICES AND REPORTING OF MATERIAL DEFICIENCIES. 2. SEMI-ANNUAL INDEPENDENT REVIEW OF MEDICAL NECESSITY AND QUALITY OF SERVICES,AND REPORTING OF MATERIAL DEFICIENCIES. 3. ANNUAL REVIEW OF POLICIES AND PROCEDURES FOR REPORTING OF BAD DEBTS TO MEDICARE. 4. ADOPTION OF FORMAL CORPORATE INTEGRITY PROGRAM. S. PROMOTION OF ADHERENCE TO TENET CORPORATE INTEGRITY PROGRAM AS A MEASUREMENT OF PERFORMANCE OF EACH MANAGER AND SUPERVISOR. 6. ANNUAL REPORT OF COMPLIANCE;HHS' RIGHT TO EXAMINE TENET'S BOOKS AND RECORDS ON COMPLIANCE. 7. REPORTING OF CREDIBLE EVIDENCE OF MISCONDUCT WHICH MAY CONSTITUTE A VIOLATION OF CRIMINAL LAW RELATING TO FEDERALLY FU14DED HEALTH CARE PROGRAM. 8. AGREEMENT NOT TO EMPLOY OR CONTRACT WITH INDIVIDUAL WHO HAS BEEN CONVICTED OF A CRIMINAL OFFENSE RELATED TO HEALTH CARE OR WHO HAS BEEN DEBARRED FROM FEDERAL PROGRAM PARTICIPATION. 9. NOTIFICATION OF PROPOSED CHANGES IN CORPORATE INTEGRITY PROGRAM, PROCEDURES AND COMPLIANCE,AND OF RESIGNATION OF CERTAIN OFFICERS. 10. NOTIFICATION TO ALL EMPLOYEES AND CONTRACTORS OF THE FACT AND SUBSTANCE OF THE AGREEMENT,THE NATURE OF THE ALLEGED WRONGDOING AND THE IMPORTANCE OF ABIDING BY THE TERMS OF THE AGREEMENT AND FEDERAL PROGRAM LEGAL REQUIREMENTS. 11. CONTRIBUTION OF $2.5 MILLION TO THE U.S.PUBLIC HEALTH SERVICE. 12. LEGAL REVIEW OF ALL CONTRACT'S WITH REFERRAL SOURCES. 13. IMPLEMENTATION OF AGREEMENT'S RELEVANT PROVISIONS AT NEW TENET BUSINESS UNITS. 14. PSYCHIATRIC FACILITIES ONLY: REVIEW(BY TENET OFFICIAL NOT EMPLOYED AT FACILITY INVOLVED) OF DECISIONS TO ADMIT FEDERAL PROGRAM PATIENTS, INDEPENDENT QUARTERLY REVIEW OF ADMISSIONS POLICIES AND PRACTICES,AND REPORTING OF MATERIAL DEFICIENCIES:NOTIFICATION TO HHS IN EVENT OF SALE OF PSYCHIATRIC FACILITIES, INDEPENDENT REVIEW OF PSYCHIATRIC FACILITIES PRIOR TO SALE, AND AFTER DISPOSITION,CESSATION OF USING PROVIDER NUMBERS AND EMPLOYING CERTAIN EXECUTIVES. B. THE NATURE OF THE GOVERNMENT'S ALLEGATIONS IN THE SETTLEMENT AGREEMENT OF WRONGDOING BY PSYCHIATRIC FACILITIES: (A) FILING FALSE AND FRAUDULENT CLAIMS AND COST REPORTS REGARDING FEDERAL PROGRAM PATIENTS (FOR SERVICES ALLEGEDLY NOT RENDERED AS CLAIMED AND FOR SERVICES ALLEGEDLY NOT NECESSARY), (B) MAKING ALLEGEDLY IMPROPER PAYMENTS AND INCENTIVES TO INDUCE PATIENT REFERRALS,AND (C) ROUTINELY WAIVING MEDICARE COPAYMENTS AND DEDUCTIBLES. C. THE IMPORTANCE OF EACH CONTRACTOR'S AND EMPLOYEE'S ABIDING BY THE TERMS OF THE CORPORATE INTEGRITY AGREEMENT,ALL FEDERAL PROGRAM LEGAL REQUIREMENTS AND TENET POLICIES AND PROCEDURES. ACKNOWLEDGMENT OF RECEIPT OF NOTIFICATION THE U DEER�SIGN}ED HEREBY KNO LEDGES RECEIPT'OF A COPY OF THIS NOTIFICATION: SIGNATURE`( N DATE: F homn\law\wp\man \cam96\nah caxi Hospital Underwriting Certificate of Insurance Group, Inc. ROPW3,M5�MADE POLICY 150-942 DATE ISSUED: May 14, 1998 ISSUED TO: Desert Hospital ADDRESS: 1150 N. Indian Canyon Drive Palm Springs, CA 92263,_, THIS IS TO CERTIFY that insurance has been effected with Hospital Underwriting Group, Inc. , Nashville, Tennessee (the "Company"), under Policy Number 98-050 as follows: NAMED INSURED: Tenet Healthcare Corporation Desert Hospital and all Subsidiaries and/or ADDRESS- 3820 State Street 1150 N. Indian Canyon Drive Santa Barbara, California 93105 Palm Springs, California 92263 COVERAGE: Comprehensive General Liability, Medical Professional Liability, Contractu- al Liability, Personal Injury Liability, Druggist' s Liability, Employer's Liability, Managed Care Organizations' Errors and Omissions Liability, and Employment Practices Liability WRITTEN ON A CLAIMS-MADE BASIS. AMOUNT OF INSURhNCE-. Not less than $25,000,000 per claim. Not less than $25,000,000 per claim (General Liability) . Not less than $50,000,000 annual aggregate. Not less than $50,000,000 annual aggregate (General Liability) SELF INSURANCE RETENTION: $1,000,000 per claim POLICY TERM: June 1, 1998 at 12:01 A.M. to June 1, 1999 12:01 A.M. STANDARD TIME at the address of the Named Insured. THIS CERTIFICATE is not transferable and may be cancelled by giving thirty days written notice to the party to which this Certificate is issued prior to the effective date of the cancellation of the insurance described herein. THIS CERTIFICATE is for information only; it is not a contract of insurance, but attests that a policy as numbered herein, and as it stands at the date of this Certificate, has been issued by the Company. Said policy is subject to change by endorsement. and cancellation in accordance with its terms. EFFECTIVE DATE OF THIS CERTIFICATE* June 1, 1998. CERTIFICATE EXPIART-i- June 1' unless cancelled sooner. ,ccare,'C'm BY: Risk Manaj�, cc: Tenet Hear rp ment -Depai-tment_ arlv,4y, z41kite 20J 14001 Dalil P Dallas, Texas 753240 ASSISTANT SECRETARY 25 Century Boulevard • Suite 103 • Nashville,TN 37214-3688 (615) 885-5333 • FAX(615) 885-5983 OF ?ALAI S''A 1p'0 0 City of Palm Springs V Office of the City Clerk e"oR�TE°s 3200 Tahgwa Canyon Wav• Palm Springs,California 92262 Cq4 r FO R�sP TEL (760)323-8204 •TDD:(760)864-9527 January 13, 1999 Desert Regional Medical Center 1150 Indian Canyon Palm Springs, CA 92262 RE: Certificate of Insurance: Fleet Vehicle Maintenance Services & Fueling A4037 Policy: General Liability It is the City's requirement to obtain a Certificate of Insurance from you. We must be notified prior to any changes, renewals or cancellations of said policy. Such notice cannot contain "will endeavor" language and shall name the City as an additional insured. Send a certificate, at your earliest convenience, to: City Clerk, City Of Palm Springs P.O. Box 2743 Palm Springs, CA 92263-27'43 If you have any questions, please contact our office at (760) 323-8204. Sincerely, Judith Sumich City Clerk 099 Post Office Box 2743 • Palm Springs, California 92263-2,743 , 4 Li_-" > ., A.^R0® C EVIDENCE OF COMMERCIAL PROPERTY INSURA CE DATE tMMIDDIYYri) /V 04/0312024 THIS EVIDENCE OF COMMERCIAL PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE ADDITIONAL INTEREST. PRODUCER NAME, PHONE 41S743B000 CONTACT PERSON AND ADDRESS COMPANY NAME AND ADDRESS NAIL NO: MARSH RISK 8 INSURANCE SERVICES See Additional Page for Participating Carriers FOUR EMBARCADERO CENTER, SUITE 1100 CALIFORNIA LICENSE NO.0437153 SAN FRANCISCO, CA 94111 CN102166225-PROP-24-25 IF MULTIPLE COMPANIES, COMPLETE SEPARATE FORM FOR EACH FAX E-MI1N. LAIC, N.: ADDRESS: CODE: SUB CODE: POLICY TYPE AGENCY NAMED INSURED AND ADDRESS LOAN NUMBER POLICY NUMBER Tenet Healthcare Corporation SEE ATTACHED 14201 Dallas Parkway EFFECTIVE DATE EXPIRATION DATE Dallas, TX 75254 04A1/2024 04/01/2025 CONTINUED UNTIL TERMINATED IF CHECKED ADDITIONAL NAMED INSURED(S) THIS REPLACES PRIOR EVIDENCE DATED: PROPERTY INFORMATION ACORD 101 may be attached if mores ace is required) ❑ BUILDING OR IN BUSINESS PERSONAL PROPERTY LOCATION / DESCRIPTION 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 EVIDENCE OF PROPERTY INSURANCE 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. r AVFRARF IMFrTRMATIrTN ocou c iucnocnI IoncirI I I X cocrrel COMMERCIAL PROPERTY COVERAGE AMOUNT OF INSURANCE: $ 50,000,000 DED: 5,000,000 YES NO NIA [%9 BUSINESS INCOME IN RENTAL VALUE X 1f YES, LIMIT: 50000,000 X I Actual Loss Sustained; # of months: 12 BLANKET COVERAGE X If YES, indicate value(s) reported on property identified above: $ TERRORISM COVERAGE X Attach Disclosure Notice / DEC IS THERE A TERRORISM -SPECIFIC EXCLUSION? X IS DOMESTIC TERRORISM EXCLUDED? X LIMITED FUNGUS COVERAGE X If YES, LIMIT: DED: FUNGUS EXCLUSION (if "YES", specify organization's form used) X REPLACEMENT COST X AGREED VALUE X COINSURANCE X If YES, EQUIPMENT BREAKDOWN (if Applicable) X If YES, LIMIT: Induced DED: 100,000 ORDINANCEORLAW -Coverage for loss to undamaged portion of bldg X BYES, LIMIT: Included DED: Included - Demolition Costs X If YES, LIMIT: Included DED: Included - Incr. Cost of Construction X If YES, LIMIT: Included DED: included EARTH MOVEMENT (if Applicable) X If YES, LIMIT: induced DED: Vanous FLOOD (If Applicable) X If YES, LIMIT: Included DED: WIND/HAIL INCL a YES ❑NO Subject to Different Provisions: X If YES, LIMIT: Included DED: per policy NAMED STORM INCL [AYES ❑ NO Subject to Different Provisions: X If YES, LIMIT: Included DED: per policy PERMISSION TO WAIVE SUBROGATION IN FAVOR OF MORTGAGE HOLDER PRIOR TO LOSS X CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AFIFIT111MAI IIJTFRFST Q9A_M'1117RiA9R CONTRACT OF SALE MORTGAGEE X LENDER'S LOSS PAYABLE X LOSS PAYEE LOSS PAYEE LENDER SERVICING AGENT NAME AND ADDRESS NAMEANDADDRESS City of Palm Springs P.O.Box 2743 APR 09 2024 Palm Springs, CA 92263 AUTHORIZED REPRESENTATIVE oFFICE OF THE CITY CLERK 7&W4 Ra & Ie WT {NEC Seu4cci © 2003-2016 ACORD CORPORATION. All rights reserved. ACORD 28 (2016103) The ACORD name and logo are registered marks of ACORD 0000253 SP 0130-001-Po0 04 City of Palm Springs P.O.Box 2743 Palm Springs, CA 92263 iM 0130-01-00-0000253-0001-000 W 88 AGENCY CUSTOMER ID: CN102166225 LOC #: San Francisco ACOI AGENCY MARSH RISK & INSURANCE SERVICES POLICY NUMBER CARRIER ADDITIONAL REMARKS SCHEDULE NAIC CODE NAMED INSURED Tenet Healthcare Corporation 14201 Dallas Parkway Dallas, TX 75254 EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 28 FORM TITLE: Evidence of Commercial Property Insurance Participating Carvers: All Risks of Direct Physical Loss or Damage Including Earthquake and Flood excluding Boiler & Machinery Policy No.: ZMD2094278-27 Carrier. Zurich American Insurance Company Tenn: 04/012024 to 04101/2025 Unritplo$50,000,0001'dmary' All Risks of Direct Physical Loss or Damage including Earthquake and Flood excluding Boiler & Machinery Policy No.: RPIP000086-241 Cartier. Everest Indemnity Insurance Company Tenn: (141012024 to 041012D25 Limit pro $50,000,000 Primary All Risks of Direct Physical Loss or Damage including Earthquake and Flood excluding Bailer & Machinery Policy No.: BOWPN2450858 Carver. Lloyds of London Lexington Tenn: 041012024 to 04101/2025 _.Limit: p/o$50.000.000 Primary---- — ---- ' All Risks of Direct Physical Loss or Damage including Earthquake and Flood excluding Boiler & Machinery Policy No.: BOWPN2450533 Carrier. Houston Casualty Company Tenn: 04/0112024 to 041012025 Limit p/o $50,000,000 Primary All Risks of Direct Physical Loss or Damage including Earthquake and Flood excluding Boiler & Machinery Policy No.: P0159651013 Cartier. Allied World Assurance Company, Ltd (Bermuda) Term: 04/012024 to 04/012025 Limit plo $50,000,000 Primary' All Risks of Direct Physical Loss or Damage including Earthquake and Flood excluding. Boiler & Machinery' Policy No.: P158047 Cartier. Argo Re (Bermuda) Tenn: 041012024 to 041012025 Umit plo $50,000,000 Primary All Risks of Direct Physical Loss or Damage including Earthquake and Flood excluding Boiler & Machinery Policy No.: LSMAPR444629A Cartier. Uberty (Bermuda) Tenn: 04/0112024 to 041OW025 Limit plo $50,000,000 Primary The All Risk, Policy Numbers P0159651013; P158047; LSMAPR444629A placement was made by Bowring Marsh (Bermuda). March USA Inc. has only acted in the role of a consultant to the client with respect to this placement, which is indicated here for your convenience Page 2 of 4 0130.01-00-000025E-00024000789 ACORD CORPORATION. All rights I The ACORD name and logo are registered marks of ACORD 1 AGENCY CUSTOMER ID: CN102166225 LOC #: San Francisco - ACORO® lk.—� ADDITIONAL REMARKS SCHEDULE Page 3 of 4 AGENCY MARSH RISK & INSURANCE SERVICES NAMED INSURED Tenet Healthcare Corporation 14201 Dallas Parkway Dallas, TX 75254 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: zo FORM TITLE: All Risks of Direct Physical Loss or Damage including Earthquake and Flood excluding Boiler & Machinery Policy No.: RMP7016787837 Cartier. Continental Casualty Company Term: 04/012024 to 04101/2025 Limit p/o $50,000,000 Primary Ali Risks of Direct Physical Loss or Damage including Earthquake and Flood excluding Boiler & Machinery Policy No.: BOWPN2450860 Cartier. Lloyds of London- Inigo Term: 04M/2024 to 04/01/2025 Limit plo$50.000,000 Primary AO Risks of Direct Physical Loss or Damage including Earthquake and Flood excluding Boiler & Machinery Policy No.: BOWPN245053 Carder. Lloyds of London - Canopius Term: 041012024 to 0410112025 Limit p/o $50,000,000 Primary All Risks of Direct Physical Loss or Damage including Earthquake and Reed excluding Boiler & Machinery _ Policy No: FA00547042024�1 Cartier. General Security Indemnity Company of Ari xma SCOR Tenn: 04/012024 to 04101/2025 Limit plo $50,000,000 Primary All Risks of Direct Physical Loss or Damage including Earthquake and Flood excluding Boiler & Machinery Policy No.: CX D38062141018 Cartier. Chubb US Tenn: 04/012024 to 041012025 Limit: pro $50,000,000 Primary All Risks of Direct Physical Loss or Damage including Earthquake and Flood excluding Boiler & Machinery Policy Ni SLSTPTY12C07024 Cartier. Start Surplus lines Insurance Company Term: 04/012024 to 0410112025 Limit pro $50,000,000 Primary All Risks of Direct Physical Loss or Damage including Earthquake and Flood excluding Boiler & Machinery Policy No.: 42-PRP-307403-06 Cartier. National Fire & Marine Insurance Company (Berkshire) Tenn: 04/012024 to 0410112025 Limit: plo $50,000,000 Primary All Risks of Direct Physical Loss or Damage including Earthquake and Flood excluding Boiler & Machinery Policy No.: LCP6480533A2 Cartier. Tokko Marine America Insurance Company Tenn: 041012024 to 04101/2025 Limit plo $50,000,000 Primary 01 (2008101) © 2008 ACORD CORPORATION- All riohls reserved The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN102166225 AGENCY MARSH RISK & INSURANCE SERVICES POLICY NUMBER CARRIER LOC #: San Francisco ADDITIONAL REMARKS SCHEDULE NAMED IN5URED Tenet Healthcare Corporation 14201 Dallas Parkway Dallas, TX 75254 NAIC CODE EFFECTIVE DATE: Page 4 of 4 THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 28 FORM TITLE: Evidence of Commercial Property Insurance Boiler & Machinery coverage is provided by Federal Insurance Company., Policy #76417952 - $50,000,000 Deductible - Property Damage locations with total valueless than $10,000,000 - $100,000 (deductible) Property Damage locations with total value of $10,000,000 to $100.000,000 - $500K (deductible) Property Damage locations with total value greater $100,000,000$1M(deductble) .. .. - Earthquake and Flood coverage are subject to an annual aggregate. DEDUCTIBLES All losses, damages or expenses arising out of any one occurrence shall be adjusted as one loss, and from the amount of such adjusted loss shall be deducted $5,000,000 Per Occurrence except:5%1$5,000,000 minimum EO in CA and 2%1$5,000,000 minimum EO in New Madrid and HI and 5%1$5,000,000 minimum Named Windstorm Other deductibles may apply as per policy terms and conditions. RneArts located at: Desert Hospital, 1150 N. India Canyon Drive, Palm Springs. CA. The City, of Palm Springs, its officers, employees and agents are named as Loss Payee as respects the statue Located in front of Desert Hospital — - - - — ----^ ^---� © 2005 ACORD CORPORATION. All rights I The ACORD name and logo are registered marks of ACORD 0130-01-00-0000253-0003-0000790 t Dear Certificate Holder: To streamline certificate delivery for our clients and in an effort to support our firm's commitment to sustainability, going forward, we will only be providing renewal certificates of insurance electronically. If you need to continue receiving a copy of the attached certificate, please send an email to USOperations.email@marsh.com and include the following: Certificate H (Shown below Insured Name— e.g., ABC-123456789-01) — E-Mail for future delivery For your convenience, If we do not receive your response, we will conclude that you no longer require proof of insurance from the named insured and will remove you from our records. Thank you, US Operations, Marsh USA, U-C A business of Marsh McLennan l r ACORN® CERTIFICATE OF LIABILITY INSURANCE TE (MM/DDlVVYY) 5/31 /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 CONTACT NAME: Global Risk Management _ Arthur J. Gallagher Risk Management Services, LLC PHONN 500 N. Brand Boulevard 818-539-2300 _ �alc, No:818-539-1801 Suite 100 ADDRESS: grm_certificates@ajg.com Glendale CA 91203 INSURERS AFFORDING COVERAGE NAICU License#: oD69293 INSURER A: National Union Fire Insurance Company of Pittsburg19445 INSURED TENEHEA-02 INSURERB: Various Tenet Healthcare Corp. 14201 N. Dallas Parkway INSURERC: Dallas, TX 75254 INSURER D: INSURER E : COVERAGES CERTIFICATE NUMBER: R..51870612 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. INSRPOLICY LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY 1728920 6/1/2024 6/1/2025 EACH OCCURRENCE $ 1,000.000 CLAIMS-MADEu OCCUR $1,000,000 - A A E PREMISES Ea occurrence MED EXP (Any one person) $ _ PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 1.000,000 POLICY ❑ PECT RO ElLOC X J PRODUCTS - COMP/OP AGG $ 1.000,000 $ OTHER: AUTOMOBILE LIABILITY OMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO 1 OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY L 1 $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DIED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE See Attached 6/1/2024 6/1/2025 PER TH- X STATUTE ER $ 2,000,000 E.L. EACH ACCIDENT OFFICEPJMEMBEREXCLUDED? ❑ N/A - -- E.L. DISEASE - EA EMPLOYEE (Mandatory in NH) $ 2,000,000 If es, describe under DESCRIPTION OF OPERATIONS below _ $ 2,000,000 E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The Certificate Holder is included as an Additional Insured, but solely as respects to liability arising out of the Named insured's Operations or premises owned by or rented by Named Insured, excluding contract or Agreements for Professional Services, and subject to the terms and conditions of the referenced policy and as Required by Written Contract. Workers Compensation is Evidence Of coverage with Repect To The Insured's Operations And In accordance with the terms and conditions of the policy. Additional Insured Includes the City of Palm Springs Officers, Agents and employees. The American Home Assurance Company will Waive any right of Recovery they mrtificate Holder because of Payments made Arising out of the Named Insured's Ongoing Operations or Work Performed under Cate Holder. It is further agreed that such insurance as is afforded The City of Palm Springs, shall be primary and non-contributory with any other insurance in force for or which may be purchased by The City of Palm Springs. r FGTIFIr`ATF H()l IIFR f`ANr`FI 1 ATI(lN OFFICE OF THE CITY CLE1114HOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Palm Springs ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 2743 AUTHORIZED REPRESENTATIVE Palm Springs CA 92263 USA © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Arthur J. Gallagher Risk Management Services, LLC 500 N Brand Boulevard, Suite 100 Glendale CA 91203 MDG2024 00011560 01 I„'I-'I'Il,Illrinnn„I,II„II,I,I,IIn�111,1„Illulll 1llu1 City of Palm Springs r P.O. Box 2743 Palm Springs, CA 92263 We are providing you with a Certificate of Insurance confirming our client's coverage. Want to get certificates of insurance faster? "Go Green with Gallagher" by receiving digital copies of certificates via e-mail in the future. Or, do you no longer require a certificate of insurance for our client? Please contact us at COI.UpdateMyEmail@AJG.com and provide the following information for processing: 1. Confirmation that a certificate of insurance is no longer required; or 2. E-mail address to send future certificates of insurance in lieu of U.S. Mail delivery 3. Insured Code: TENEHEA-02 4. This Certificate Number: 653870632 To learn more about the Insurance and Risk Management Services offered by Gallagher, please visit us at www.ajg.com/us/about-us/how-we-work/core-360. Gallagher does not share your e-mail as detailed in our privacy policy found at https:// www.ajg.com/us/privacy-policy/. Tenet Healthcare Corporation Workers' Compensation Program Layer Insurance Company Policy Number Policy Term NAIC No. Work Comp - AOS AIU Insurance Company 20396129 06/01/24- 06/01/25 23841 Work Comp - WI AIU Insurance Company 20396130 06/01/24- 06/01/25 23841 Excess Work Comp -AL, CA, LA National Union Fire Insurance Company 3332320 06/01/24-06/01/25 19445 of Pittsburgh, Pa. Excess Work Comp - MI VHS of Michigan, Inc. Safety National Casualty Corporation SP 4066571 06/01/24- 06/01/25 15105 M POLICY NUMBER: 1728920 COMMERCIAL GENERAL LIABILITY CG 20 11 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - MANAGERS OR LESSORS OF PREMISES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designation Of Premises (Part Leased To You): PER THE CONTRACT OR AGREEMENT Name Of Person(s) Or Organization(s) (Additional Insured): ANY PERSON OR ORGANIZATION FROM WHOM YOU LEASE PREMISES OR WHO MANAGES PREMISES YOU OWN AND TO WHOM YOU BECOME OBLIGATED TO INCLUDE AS AN ADDITIONAL INSURED UNDER THIS POLICY AS A RESULT OF ANY LEASE OR MANAGEMENT AGREEMENT YOU ENTER INTO WITH SUCH PARTIES Additional Premium: $ INCLUDED 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 the person(s) or organization(s) shown in the Schedule, but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you and shown in the Schedule and subject to the following additional exclusions: This insurance does not apply to: 1. Any 'occurrence" which takes place after you cease to be a tenant in that premises. 2. Structural alterations, new construction or demolition operations performed by or on behalf of the person(s) or organization(s) shown in the Schedule. 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. 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 11 12 19 © Insurance Services Office, Inc., 2012 Page 1 of 1