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HomeMy WebLinkAboutA8567 - BERG & ASSOCIATES, INC.1-1 ACORO® CERTIFICATE OF LIABILITY INSURANCE II03/01 DATE 1/2 /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(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 951-281-3900 McGarry Insurance Services Lic. OD20867 19510 Van Buren Blvd. CONT951-656-2409 NAM Patrick Patrick McCarry iM4�.tlEo-Eao, 951-656-2409 (AICFAXNo:951-281-3900 A ass: pmccarry@yahoo.com INSU s AFFORDING COVERAGE Nwo Ste. F3-142 INSURER A: West American Insurance Company 44393 Riverside CA 92508 INSURED 310-548-9292 310-548-9195 INsunimB: Security National Insurance Company 19879 INSURER C: Berg 8t Associates, Inc. INSURER D: StarStone National Insurance Co. 25496 INSURERE: U. . Specialty Insurance Company 29599 302 W. 5th Street, Suite 210 INSURER F: San Pedro CA 90731 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 03 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 LTR I SUER POLICY NUMBER MMPOLICY EFF ID POLICY EXP M DY7S GENERAL LIABILITY EACH OCCURRENCE $ 1 00O 000 A ✓ COMMERCIAL GENERAL LIABILITY PREMISES E $ 50O 000 NEDEXPIA,yone pe.) 115,010 _ CLAIMS -MADE ✓ OCCUR BLW (24) 60987836 03/0112023 03/01/2024 PERSONAL S ADV INJURY $ 11,000.0w GENERAL AGGREGATE $ 2 OO 000 PRODUCTS-COMP/OP AGG $2000000 GE N'L AGGREGATEUMIT AP_P_LIESPER: ✓ POLICY PRO- LOC $ AUTOMOBILE LIABILITY SPP 16O6450-00 O3IOlI2O23 LIMIT 03/01/2024 CEOMaBII accident) 21,000,000 S B ✓ ANY AUTO BODILY INJURY (Par person) -- ALL OWNED SCHEDULED AUTOS G AUTOS BODILY INJURY (Per accident) $ $ �J H AUTOSN011WNED HIRED AUTOS AUTOS PROPERTY DAMAGE Par actldant $ 5 000 Medical UMBRELLA LIAR OCCUR EACH OCCURRENCE S AGGREGATE S EXCESS LIAR CLAIMS -MADE S DELI RETENTION$ WORKERS COMPENSATION ✓ WC STATU- OTR- AND EMPLOYERS'LIABILITY YIN D OFRCER/MEMBER E%OLUDED?ANY ECUTNE ❑ (Mandatory In NH) NIA 03/01/2023 03/01/2024'- T 10231022 E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $ 1 OOO OOO $ 1 00O 000 It yes, descr0 under DESCRIPTION OF OPERATIONS WM E.L. DISEASE -POLICY LIMIT $ 1 00O 000 Liability each claim: $1,000,000 7EProfessional Liability LISS 23 33614 03/01/2023 03/01/2024 Aggregate: $2,000,000 DESCRIPTON OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more space is required) RECEIVED JUN 0 8 2023 City Hall Reception Desk Attention: City Manager 3200 E. Tahquitz Canyon Way Palm Springs, CA 92262 760-323-8204 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 ACORD 25 (2010105) 198E-2010 The ACORD name and logo are registered marks of ACORD riahts reserved. POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): City of Palm Springs Attention City Manager 3200 E Tahquitz Canyon Way Palm Springs, CA 92262 Location(s) Of Covered Operations 3200 E Tahquitz Canyon Way 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 for "bodily in- jury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing oper- ations for the additional insured(s) at the lo- cation(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permit- ted by law; and 2. If coverage provided to the additional in- sured is required by a contract or agree- ment, 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 addi- tional exclusions apply: This insurance does not apply to "bodily in- jury" or property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than ser- vice, maintenance or repairs) to be per- formed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or or- ganization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20 10 04 13 0 Insurance Services Office, Inc., 2012 Page 1 of 2 C. 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 ap- plicable Limits of Insurance shown in the Dec- larations. Page 2 of 2 0 Insurance Services Office, Inc., 2012 CG 20 10 04 13 COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance avail- able to an additional insured under your poli- cy provided that: (1) The additional insured is a Named In- sured under such other insurance: and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribu- tion from any other insurance available to the additional insured. CG 20 01 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: City of Palm Springs Attention City Manager 3200 E. Tahquitz Canyon Way Palm Springs, CA 92262 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph B. Transfer Of Rights Of Recovery Against Others To Us of Section IV - Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard". This waiver applies only to the person or organi- zation shown in the Schedule above. CG 24 04 05 09 0 Insurance Services Office, Inc., 2008 Page 1 of 1 COMMERCIAL GENERAL LIABILITY CG 80 61 05 11 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT OF CANCELLATION PROVISIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Any term or provision of the Cancellation Conditions of the policy or any endorsement amending or replac- ing such Conditions is amended by the following: A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the person or organization shown in the Schedule below. In no event will the notice to the person or organization scheduled below exceed the notice to the first named insured. B. Our obligation to send notice to the person or organization listed in the Schedule below will terminate at the earlier of the current policy period expiration or when you no longer have a legal or contractual obligation to such person or organization to maintain insurance coverage under a policy which requires that such person or organization be notified in the event of cancellation. SCHEDULE 1. Name: City of Palm Springs Attention City Manager 2. Address: 3200 E Tahquitz Canyon Way Palm Springs, CA 92262 3. Number of days advance notice: s0 All other terms and conditions of this policy remain unchanged. © 2011 Liberty Mutual Agency Corporation. All rights reserved. CG 80 61 05 11 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 1 of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 04-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT—CALIFORNIA 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 WHERE YOU ARE REQUIRED BY WRITTEN CONTRACT TO OBTAIN THIS AGREEMENT FROM US, PROVIDED THE CONTRACT IS SIGNED AND DATED PRIOR TO THE DATE OF LOSS TO WHICH THIS WAIVER APPLIES. IN NO INSTANCE SHALL THE PROVISIONS AFFORDED BY THIS ENDORSEMENT BENEFIT ANY COMPANY OPERATING AIRCRAFT FOR HIRE. `The premium charge for this endorsement shall be 2% of the premium developed in the State of California. but not less than $500 policy minimum premium. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 03/01/23 Policy No. T10231022 Endorsement No. 12 Insured Berg & Associates Inc Policy Effective Date 03/01/23 Insurance Company StarStone Naional Insurance Company Countersigned By WC 04 03 06 (Ed.04-84) 01998 by the Workers' Compensation Insurance Rating Bureau of California. All rights reserved. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY ADVANCE NOTICE OF CANCELATION AND NON -RENEWAL ENDORSEMENT WC990602B (Ed. 12-13) It is hereby understood and agreed that all cancelation provisions in the policy addressing the required number of days notice for cancelation by us or non -renewal by us are amended to be not less than: 30 days notice will be given for notice of cancelation for non-payment of premium. b. 30 days notice will be given for notice of cancelation for any other reason. C. 30 days notice will be given for non -renewal. Notwithstanding the provisions above, in no event will the number of days notice for cancelation or for non -renewal be fewer than the number of days required by statute. ' not applicable in Arizona, Pennsylvania This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy). Endorsement Effective 03/01/23 Policy No. T10231022 Insured Berg & Associates Inc Insurance Company StarStone National Insurance Company Countersigned WC 99 06 02 B (Ed. 12-13) Endorsement No. 19 Policy Effective Date 03/01/23 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 06 01 B (Ed. 01-22) CALIFORNIA CANCELATION ENDORSEMENT This endorsement applies only to the insurance provided by the policy because California is shown in Item 3.A. of the Information Page. The cancelation condition in Part Six (Conditions) of the policy is replaced by these conditions: Cancelation: 1. You may cancel this policy. You must mail or deliver advance written notice to us stating when the cancelation is to take effect. 2. We may cancel this policy for one or more of the following reasons: a. Non-payment of premium; b. Failure to report payroll; c. Failure to permit us to audit payroll as required by the terms of this policy or of a previous policy issued by us; d. Failure to pay any additional premium resulting from an audit of payroll required by the terms of this policy or any previous policy issued by us; e. Material misrepresentation made by you or your agent; f. Failure to cooperate with us in the investigation of a claim, g. Material failure to comply with federal or state safety orders or written recommendations of our designated loss control representatives; h. The occurrence of a material change in the ownership of your business; i. The occurrence of any change in your business or operations that materially increases the hazard for frequency or severity of loss; j. The occurrence of any change in your business or operation that requires additional or different classification for premium calculation; k. The occurrence of any change in your business or operation which contemplates an activity excluded by our reinsurance treaties. 3. If we cancel your policy for any of the reasons listed in (a) through (f), we will give you 10 days advance written notice, stating when the cancelation is to take effect. Mailing that notice to you at your mailing address shown in Item 1 of the Information Page will be sufficient to prove notice. If we cancel your policy for any of the reasons listed in Items (g) through (k), we will give you 30 days advance written notice; however, we agree that in the event of cancelation and reissuance of a policy effective upon a material change in ownership or operations, notice will not be provided. 4. If we mail the notice to you, the stated periods of notice and your right to remedy the condition will be extended by 5 days if the place of mailing and your mailing address is within California, 10 days if the place of mailing or your mailing address is outside of California and 20 days if the place of mailing or your mailing address is outside of the United States. 5. The policy period will end on the day and hour stated in the cancelation notice. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 03/01/23 Policy No. T10231022 Endorsement No. 17 Insured Berg & Associates Inc Policy Effective Date 03/01/23 Insurance Company StarStone National Insurance Company Countersigned By d"gL WC040601B (Ed. 01-22) 2021 WorkersCompensation Insarenoe Rating Bureau of California. All rights reserved. NOTICE OF CANCELLATION. NONRENEWAL OR DECLINATION (California) NA4 AND . WEST AMERICAN INSURANCE COMPANY ADDRESS 1615 Murray Canyon Rd OF INSURANCE Ste 300 COMPANY San Diego CA 92108 NAME AND. BERG &ASSOCIATES,INC. ADDRESS 302 W 5TH ST STE 210 OFINSURED SAN PEDRO TO THE ADDITIONAL INTEREST: CA 90731 KIND OF POLICY: Commercial General Liability POLICY/APPLICATION/BINDER NO.. BLW (24) 60987836 EFFECTIVE DATE OF NOTICE: 3/1/2024 12:01 AM (DATE) (HOUR -STANDARD TIME AT THE ADDRESS OF THE INSURED) DATE OF MAILING: 12/21/2023 NAME AND ADDRESS OF AGENTBROKER: RISK PLACEMENT SERVICES INSURANCE BROKERS 6165 Greenwich Or Ste 200 San Diego CA 92122 (Specific information concerning the cancellation, nonrenewal or declination has been given to the Insured.) RECEIVED JAN 0 3 2024 Office of the City Clerk You are notified that the above policy is cancelled, nomenewed or declined effective on and after the hour and date mentioned above. This notice is being provided to you as you have been provided with a certificate of insurance on the above policy. Any interest you may have in the above policy is terminated. NAME AND City of Palm Springs ADDRESS OF Attention City Manager ADDITIONAL 3200 E Tahquitz Canyon Way INTEREST Palm Springs CA 92262 (E)GU 351q (Ed. 6-20) Wolters Khmer I Uniform Forms 02020 Wolters Kluwer Financial Services, Inc. Ali rights reserved. ADDITIONAL INTEREST COPY AUTHORIZED REPRESENTATIVE RECEIVED ;AN 0 3 2024 City Hall Reception Desk Page 1 of 1 NOTICE OF CANCELLATION, NONRENEWAL OR DECLINATION (California) NAMEAND . ADDRESS OF INSURANCE COMPANY NAME AND . ADDRESS OFINSURED WEST AMERICAN INSURANCE COMPANY 1615 Murray Canyon Rd Ste 300 San Diego CA 92108 BERG &ASSOCIATES, INC. 302 W 5TH ST STE 210 SAN PEDRO CA 90731 KIND OF POLICY: Commercial General Liability POLICY/APPLICATIONBINDER NO.: BLW (24) 60987836 EFFECTIVE DATE OF NOTICE: 3/1/2024 12:01 AM (DATE) (HOUR -STANDARD TIME AT THEADDRESS OF THE NSURED) DATE OF MAILING: 12121/2023 NAME AND ADDRESS OF AGENTIBROKER: RISK PLACEMENT SERVICES INSURANCE BROKERS 6165 Greenwich Dr Ste 200 San Diego CA 92122 (Specific information concerning the cancellation, nonrenewal or declination has been given to the Insured.) TO THE ADDITIONAL INTEREST: You are notified that the above policy is cancelled, nonrenewed or declined effective on and after the hour and date mentioned above. This notice is being provided to you as you have been provided with a certificate of insurance on the above policy. Any interest you may have in the above policy is terminated. AUTHORIZED REPRESENTATIVE NAME AND City of Palm Springs ADDRESS OF Attention City Manager ADDITIONAL 3200 E Tahquitz Canyon Way INTEREST Palm Springs CA 92262 (E)GU 351q (Ed. 6-20) Wolters Kluwer I Uniform Forms 9 2020 Wolters Kluwer Financial Services, Inc. All rights reserved. ADDITIONAL INTEREST'S COPY Page 1 of 1 A /k�TO CERTIFICATE OF LIABILITY INSURANCE I Dm/n,/2ma 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 endorsements). PRODUCER 951-656-2409 951-281-3900 cNA TACT Patrick McCarry McCarty Insurance Services I-C. OD20867 N=mccan@yahoo.com FA" ra:951-281-3900 noo N 19510 Van Buren Blvd. ss: mcca ahoo.com Ste. F3-142 INSURERS1 AFFORDING COVERAGE NAICW Riverside CA 92508 1 INSURERA: Evanston Insurance Corr INSURED 310-548-9292 310-548-9195 iNsuRERB:Security National lnsurar Berg & Associates, Inc. INsuRERc: Capitol Specialty Insurar INSURERD: Stai-Stone National Insur 302 W.5th Street, Suite 210 IN —SURER E. U.S. Specialty Insurance COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 03 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 L1 LTR TYPE OF INSURANCE INSRADDLU D POLICY NUMBER MiniPOLI@ EFF MMADPOLIGDYEXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 COMMERCIAL GENERALUAB LRY CLAIMS -MADE 17V OCCUR 2AA401501 03/01/2024 �GS EaA PREMSEEa�ee 03/01/2025 MED EXP (My we Person) $ 100 000 $ 5 000 $10000 0 PERSONAL &ADV INJURY GENL AGGREGATE LIMIT APPDES PER: f ✓ POLICY PRO- LOC AUTOMOBILE LIABILITY SPP 1808450-01 03/01/2024 03/01/2025 EOMeBc�YdEeDISINGLEumli 1000000 S B ✓ ANY AUTO BODILY INJURY (Per Person) S ALL OWNED SCHEDULED AUTOS OS NON -OWNED HIRED AUTOS AUTOS BODILY INJURY Per accident) PROPERTY DAMAGE r idein $ $ 5 000 Medical UMBRELLA LIAS ✓ OCCUR 03/31/2023 03-31-2024 EACH OCCURRENCE $4,000,000 AGGREGATE $4,000,000 C ✓ EXCESS LIAB CLAIM&MADE XS23024840 DEC RETENTION$ S WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY YIN ANY PROPRIETOR'PARTNERIEXECUTME D OFFICERNIEMBEREXCLUDED' (Myyaeensstlrtory In NH) NIA 03/01/2024 T 10241022 D3/D1/2D25 ✓ WC STATU- OTH- E.L. EACH ACCIDENT -- E.L. DISEASE -EA EMPLOYEE $1,000,000 $ 1 00,000 E.L. DISEASE -POLICY LIMIT $10 0 IDESCRI�ON OF OPERATIONS blow Liability each claim: $1,000,000 E Professional Liability USS 24 34538 03/01/2024 03/01/2025 Aggregate: $2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is requirsE) RECEIVED MAR 2 7 2024 OFFICE OF THE CITY CLERK GENERAL AGGREGATE rcfn arc u rAMrGI I ATInN City o Palm Springs Attention: City Manager 32DO E. Tahquitz Canyon Way rcfn arc u rAMrGI I ATInN City o Palm Springs Attention: City Manager 32DO E. Tahquitz Canyon Way SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Palm Springs, CA 92262 AUTHORIZED REPRESENTATIVE 760-323-8204 1988.2010 ACORD CORPORATION. All rigntE rBServeO. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY CG 20 33 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN A WRITTEN CONSTRUCTION AGREEMENT WITH YOU This endorsement modifies insurance provided under the following: Ke]dih�I=11191_l1111111C91:101[William I_\71III016161TUM_Tel40_\:i1 A. Section II — Who Is An Insured is amended to include as an additional insured any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured. However, the insurance afforded to such additional insured: 1. Only applies to the extent permitted by law; and 2. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are completed. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: 1. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or b. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any professional architectural, engineering or surveying services. CG 20 33 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 2 2. 'Bodily injury" or "property damage" occurring after: a. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of, the covered operations has been completed; or b. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contractor agreement you have entered into with the additional insured; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall, not increase the applicable limits of insurance. Page 2 of 2 © Insurance Services Office, Inc., 2018 CG 20 33 12 19 COMMERCIAL GENERAL LIABILITY CG 20 01 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. CG 20 01 0413 © Insurance Services Office, Inc., 2012 Page 1 of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 04-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT—CALIFORNIA 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 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 WHERE YOU ARE REQUIRED BY WRITTEN CONTRACT TO. OBTAIN THIS AGREEMENT FROM US, PROVIDED THE CONTRACT IS SIGNED AND DATED PRIOR TO THE DATE OF LOSS TO WHICH THIS WAIVER APPLIES. IN NO INSTANCE SHALL THE PROVISIONS AFFORDED BY THIS ENDORSEMENT BENEFIT ANY COMPANY OPERATING AIRCRAFT FOR HIRE. 'The premium charge for this endorsement shall be 2% of the premium developed in the State of California, but not less than $500 policy minimum premium. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 03/01/24 Policy No. T10241022 Endorsement No. 12 Insured Berg & Associates Inc Policy Effective Date 03/01/24 Insurance Company StarStone National Insurance Company \ Countersigned By WC 04 03 06 (Ed. 04-84) 01998 by the Workers' Compensation Insurance Rating Bureau of Califomia. All rights reserved. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 02 B (Ed. 12-13) ADVANCE NOTICE OF CANCELATION AND NON -RENEWAL ENDORSEMENT It is hereby understood and agreed that all cancelation provisions in the policy addressing the required number of days notice for cancelation by us or non -renewal by us are amended to be not less than: a. 30 days notice will be given for notice of cancelation for non-payment of premium. * b. 30 days notice will be given for notice of cancelation for any other reason. C. 30 days notice will be given for non -renewal. Notwithstanding the provisions above, in no event will the number of days notice for cancelation or for non -renewal be fewer than the number of days -required by statute. not applicable in Arizona, Pennsylvania This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy). Endorsement Effective 03-01-2024 Policy No. T10241022 Endorsement No. 19 Insured Berg & Associates Inc Policy Effective Date 03-01-2024 Insurance Company StarStone National Insurance Company Countersigned By WC090602B (Ed. 12-13)