ISSUE DATE EVIDENCE OF INSURANCE 09/15/22
PRODUCER THIS EVIDENCE OF INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST. THIS EVIDENCE OF INSURANCE 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.
C/O ALLIANT INSURANCE SERVICES, INC.
18100 VON KARMAN AVENUE, 10TH FLOOR
IRVINE, CA 92612
P (949) 756-0271 / F (619) 699-0901
COVERAGE INFORMATION
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, EXCLUSION AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE
DATE
POLICY EXPIRATION
DATE
LIMITS
CANCELLATION
AUTHORIZED REPRESENTATIVE
INSURED
ADDITIONAL INTEREST
NATIONAL UNION FIRE INSURANCE COMPANY OF
PITTSBURGH, PA (AIG)
REMARKS (INCLUDING SPECIAL CONDITIONS)
AS RESPECTS EVIDENCE OF COVERAGE FOR AGREEMENT BETWEEN CITY OF REDONDO BEACH AND LOS ANGELES COUNTY DEVELOPMENT AUTHORITY FOR PROJECT NUMBER B40003-22, CONTRACT NUMBER 112558 FOR TEMPORARY EMERGENCY SHELTER PALLET SITE.
LOS ANGELES COUNTY DEVELOPMENT AUTHORITY
COMMUNITY DEVELOPMENT DIVISION
GRANTS MANAGEMENT UNIT
700 W MAIN ST
ALHAMBRA, CA 91801
LICENSE #0C36861 COMPANY AFFORDING COVERAGE
GOVERNMENT CRIME POLICY INCLUDING:
FAITHFUL PERFORMANCE
MONEY & SECURITIES
FORGERY OR ALTERATION
ROBBERY & SAFE BURGLARY
MONEY ORDER AND
COUNTERFEIT PAPER CURRENCY
COMPUTER FRAUD
01-468-30-06
THIS EVIDENCE OF INSURANCE REPRESENTS SOLELY A CURRENT STATEMENT THAT A BOND OR POLICY IS IN EFFECT FOR THE NAMED INSURED ONLY,
THAT SUCH BOND OR POLICY CONVEYS NO PROTECTION OR RIGHTS TO ANYONE OTHER THAN THE NAMED INSURED, AND THAT REFERENCE TO THE BOND OR POLICY MUST BE MADE FOR THE TERMS AND CONDITIONS OF THE COVERAGE THEREUNDER. THIS EVIDENCE OF INSURANCE IS BEING ISSUED AS A MATTER OF INFORMATION ONLY AND DOES NOT PROVIDE ANY BENEFIT TO THE ADDITIONAL INTEREST. THIS EVIDENCE OF INSURANCE IN NO WAY AMENDS, EXTENDS OR ALTERS THE POLICY TERMS AND CONDITIONS.
CERTIFICATE NUMBER
CRIME-943
CITY OF REDONDO BEACH
ATTN: DIANE STRICKFADEN
415 DIAMOND STREET
REDONDO BEACH, CA 90277
PUBLIC RISK INNOVATION, SOLUTIONS, AND
MANAGEMENT (PRISM) MEMBER
/EMPLOYEE DISHONESTY
06/30/22 06/30/23
LOS ANGELES COUNTY DEVELOPMENT AUTHORITY
$2,500 DEDUCTIBLE
NATURE OF INTEREST
EVIDENCE ONLY JOINT LOSS PAYABLE
$10,000,000 PER OCCURRENCE LIMIT
SUBJECT TO
X
EXCESS GOVERNMENTAL CRIME POLICY BGOV-45003949-22 06/30/22 06/30/23 $5,000,000 PER OCCURRENCE LIMIT $1,000,000
SUBLIMIT APPLIES TO FAITHFUL
PERFORMANCE
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
CITY OF REDONDO BEACH
REDBC
BERKLEY INSURANCE COMPANY
ISSUE DATE
CERTIFICATE OF COVERAGE 09/15/2022
PUBLIC RISK INNOVATION,
SOLUTIONS, AND MANAGEMENT
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 BELOW. THIS
CERTIFICATE OF COVERAGE DOES NOT CONSTITITUE A CONTRACT BETWEEN THE
ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER C/O ALLIANT INSURANCE SERVICES, INC. 18100 VON KARMAN AVENUE, 10TH FLOOR
IRVINE, CA 92612
PHONE (949) 756-0271 / FAX (619) 699-0901
Coverages
THIS IS TO CERTIFY THAT THE MEMORANDUMS OF COVERAGE AND POLICIES LISTED BELOW HAVE BEEN ISSUED TO THE MEMBER
NAMED ABOVE FOR THE 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 COVERAGE AFFORDED
BY THE MEMORANDUMS AND POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDITIONS OF SUCH MEMORANDUMS AND POLICIES.
CO
LTR
TYPE OF COVERAGE MEMORANDUM/
POLICY NUMBER
COVERAGE EFFECTIVE
DATE
COVERAGE EXPIRATION
DATE LIABILITY LIMITS
Cancellation
AUTHORIZED REPRESENTATIVE
Public Risk Innovation, Solutions, and Management
Member:
Certificate Holder
COVERAGE
AFFORDED BY:
COVERAGE
AFFORDED BY:
COVERAGE
AFFORDED BY:
COVERAGE
AFFORDED BY:
A - See attached schedule of insurers
B
C
D
AS RESPECTS EVIDENCE OF COVERAGE FOR AGREEMENT BETWEEN CITY OF REDONDO BEACH AND LOS ANGELES COUNTY DEVELOPMENT AUTHORITY FOR PROJECT NUMBER B40003-22, CONTRACT NUMBER 112558 FOR TEMPORARY EMERGENCY SHELTER PALLET SITE.
CITY OF REDONDO BEACH
ATTN: DIANE STRICKFADEN
415 DIAMOND STREET
REDONDO BEACH, CA 90277
LOS ANGELES COUNTY DEVELOPMENT AUTHORITY
COMMUNITY DEVELOPMENT DIVISION
GRANTS MANAGEMENT UNIT
700 W MAIN ST
ALHAMBRA, CA 91801
LICENSE #0C36861
07/01/2022 07/01/2023 WORKERS' COMPENSATION:
WC-4809
CERTIFICATE NO.
$750,000 Retention
Retention
Description of Operations/Locations/Vehicles/Special Items:
LIMITS APPLY PER OCCURRENCE FOR ALL PROGRAM MEMBERS COMBINED.
LOS ANGELES COUNTY DEVELOPMENT AUTHORITY
A
IMPORTANT: If the certificate holder is requesting a WAIVER OF SUBROGATION, the Memorandums of Coverage must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
EXCESS WORKERS’
COMPENSATION &
EMPLOYER’S LIABILITY
Difference between
Statutory and Member's
Difference between $5,000,000
and Member’s $750,000
SHOULD ANY OF THE ABOVE DESCRIBED MEMORANDUMS OF COVERAGE/POLICIES
BE CANCELLED BEFORE THE EXPIRATION THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE MEMORANDUMS OF COVERAGE/POLICIES PROVISIONS.
See attached
Schedule of
Insurers for policy
numbers
EMPLOYERS' LIABILITY:
REDBC
CITY OF REDONDO BEACH
PUBLIC RISK INNOVATION, SOLUTIONS, AND MANAGEMENT
EXCESS WORKERS' COMPENSATION PROGRAM
CITY OF REDONDO BEACH
Public Risk Innovation, Solutions,
and Management
PROVIDER MEMORANDUM /
POLICY NUMBER
LIMIT
PRISM PE 22 EWC-153
Liberty Insurance Corporation
Workers’ Compensation:
$50,000,000
(Difference between $50,000,000 and the
individual member’s retention)
Employers’ Liability:
(Difference between $5,000,000 and the
individual member’s retention)
each accident/each employee
for disease
$5,000,000 each accident/each employee
for disease
Statutory each accident/each employee
for disease excess of
$50,000,000
2022/2023 SCHEDULE OF INSURERS
EW7-64N-444785-012
ISSUE DATE
CERTIFICATE OF COVERAGE 09/15/2022
Public Risk Innovation,
Solutions, and Management
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 BELOW. THIS CERTIFICATE OF COVERAGE DOES NOT CONSTITUTE A
CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
C/O ALLIANT INSURANCE SERVICES, INC.
18100 VON KARMAN AVENUE, 10TH FLOOR
IRVINE, CA 92612
PHONE (949) 756-0271 / FAX (619) 699-0901
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED and/or requesting a WAIVER OF SUBROGATION, the Memorandums of Coverage must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
AI
Coverages
THIS IS TO CERTIFY THAT THE MEMORANDUMS OF COVERAGE LISTED BELOW HAVE BEEN ISSUED TO THE MEMBER NAMED ABOVE FOR
THE 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 COVERAGE AFFORDED BY THE MEMORANDUMS DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDITIONS OF SUCH MEMORANDUMS. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO
LTR
TYPE OF COVERAGE MEMORANDUM
NUMBER
COVERAGE EFFECTIVE
DATE
COVERAGE EXPIRATION
DATE LIABILITY LIMITS
Cancellation
AUTHORIZED REPRESENTATIVE
Public Risk Innovation, Solutions, and Management
Member:
Certificate Holder
COVERAGE
AFFORDED
COVERAGE
AFFORDED
COVERAGE
AFFORDED
COVERAGE
AFFORDED
A- Public Risk Innovation, Solutions, and Management
B
C
D
CITY OF REDONDO BEACH
ATTN: DIANE STRICKFADEN
415 DIAMOND STREET
REDONDO BEACH, CA 90277
LOS ANGELES COUNTY DEVELOPMENT AUTHORITY
COMMUNITY DEVELOPMENT DIVISION
GRANTS MANAGEMENT UNIT
700 W MAIN ST
ALHAMBRA, CA 91801
LICENSE #0C36861
CERTIFICATE NO.
GL1-8668
PAGE 1 OF 2
Description of Operations/Locations/Vehicles/Special Items:
AS RESPECTS AGREEMENT BETWEEN CITY OF REDONDO BEACH AND LOS ANGELES COUNTY DEVELOPMENT AUTHORITY FOR PROJECT NUMBER B40003-22, CONTRACT NUMBER 112558 FOR TEMPORARY EMERGENCY SHELTER PALLET SITE.
LOS ANGELES COUNTY DEVELOPMENT AUTHORITY, THE COUNTY, ITS SPECIAL DISTRICTS, ELECTED AND APPOINTED OFFICERS,
EMPLOYEES, AGENTS AND VOLUNTEERS ARE INCLUDED AS ADDITIONAL COVERED PARTIES, BUT ONLY INSOFAR AS THE OPERATIONS UNDER THIS CONTRACT ARE CONCERNED.
THIS INSURANCE SHALL BE PRIMARY AND NO OTHER INSURANCE SHALL CONTRIBUTE PURSUANT TO ENDORSEMENT NUMBER U-9.
SHOULD ANY OF THE ABOVE DESCRIBED MEMORANDUMS OF COVERAGES BE CANCELLED
BEFORE THE EXPIRATION DATE THEREOF, NOTICE WIL BE DELIVERED IN ACCORDANCE WITH THE MEMORANDUMS OF COVERAGE PROVISIONS.
A
LOS ANGELES COUNTY DEVELOPMENT AUTHORITY
Excess General Liability PRISM PE 22 EL-110
Auto Liability
07/01/2022 07/01/2023 $1,000,000
Limits inclusive of the
Member's Self-Insured
Retention of $500,000
General Liability Aggregate $2,000,000
$1,000,000
X
X
X
CITY OF REDONDO BEACH
REDBC
June 29, 2022
It is agreed that the “ , Covered Persons or Entities” section of the Memorandum is amended to include the person or organization named on the Certificate of Coverage, but only with respect to liability arising out of premises owned by or rented to the Member, or operations performed by or on behalf of the Member or such person or organization so designated.
Coverage provided under this endorsement is limited to the lesser of the limits stated on the Certificate of Coverage or the minimum limits required by contract.
ADDITIONAL COVERED PARTY:
It is further agreed that nothing herein shall act to increase PRISM’s limit of liability.
This endorsement is part of the Memorandum and takes effect on the effective date of the Memorandum unless another effective date is shown below. All other terms and conditions remain unchanged.
Authorized Representative
ENDORSEMENT NO. U-1
GENERAL LIABILITY 1
ADDITIONAL COVERED PARTY AMENDATORY ENDORSEMENT
Covered Party
Memorandum No.: PRISM 22 EL-00
AS RESPECTS:
NAME OF PERSON OR ORGANIZATION SCHEDULED PER ATTACHED CERTIFICATE OF COVERAGE
PER ATTACHED CERTIFICATE OF COVERAGE
Issue Date:
Effective Date:
PAGE 2 OF 2
Issued to: ALL MEMBERS
PUBLIC RISK INNOVATION, SOLUTIONS, AND MANAGEMENT
Public Risk Innovation, Solutions, and Management
ENDORSEMENT NO. U-9
GENERAL LIABILITY 1
AMENDATORY ENDORSEMENT - PRIMARY/NON-CONTRIBUTORY
It is understood and agreed that Condition 7. OTHER COVERAGE of the Memorandum to which it is attached, is deleted in its entirety and replaced by the following:
7. OTHER COVERAGE
If collectible insurance with an insurer, or collectible group coverage through another joint powers authority, interlocal cooperative agreement, self-insurance or other public entity group coverage is available to the covered party covering a loss also covered hereunder (whether on a primary, excess or contingent basis), the coverage hereunder shall be: (a) in excess of, and shall not contribute with, such insurance; and (b) shall contribute only with any excess group coverage available through another joint powers authority according to a pro-rata, time on the risk basis. However, this clause does not apply with respect to excess insurance purchased specifically to be in excess of this Memorandum, or to insurance or reinsurance which is intended to provide the remainder of the limit of liability stated in the Declarations of this Memorandum when the coverage afforded under this Memorandum provides less than 100 percent of the limit set forth in the Declarations.
However, if the covered party has entered into a written agreement, prior to any loss event, in which it is agreed that this coverage shall be primary and/or non-contributory with respect to an additional covered party as specified in Endorsement U-1 of this Memorandum, then this coverage shall respond as primary and/or non-contributory, but shall be limited to the lesser of the limits stated on the Certificate of Coverage or the minimum limits required by the written agreement.
Notwithstanding the foregoing paragraph, if coverage for a claim or suit is available under this Memorandum and a memorandum of coverage issued in connection with the PRISM’s Medical Malpractice Program, this Memorandum shall afford primary coverage only where the gravamen of the claim or suit involves liability covered hereunder. EIA staff will preliminarily assess the gravamen of the claim or suit and refer it to the committee responsible for the coverage believed to be applicable under this paragraph.
Where that committee disputes PRISM’s assessment of the gravamen of the claim or suit and rejects primary coverage, PRISM will thereafter refer the claim or suit to the committee responsible for the other applicable coverage. If that committee also rejects the primary coverage responsibility, the Executive Committee will determine which of PRISM’s coverages is primary under this paragraph.
If the Member disputes the acceptance of primary coverage by a committee of PRISM's responsible for the coverage, the Member may appeal that decision to the Executive Committee. Appeal must be requested within 60 days of the coverage acceptance by PRISM.
PUBLIC RISK INNOVATION, SOLUTIONS, AND MANAGEMENT
Effective Dat
Issued to: ALL MEMBERS
Issue Date: June 29, 2022
Memorandum No.: PRISM 22 EL-00
Authorized Representative
If the Member is not satisfied with the outcome of the Executive Committee appeal or the determination by the Executive Committee as to which of PRISM's coverages is primary where no committee agreed to accept primary responsibility, the Member may invoke Section (d) and (e) of Article 31 of PRISM’s Joint Powers Agreement and proceed to arbitration and, if necessary, litigation. For purposes of this paragraph, the Member must request to invoke Article 31 dispute resolution process within 60 days of the Executive Committee’s determination as to which of PRISM’s coverages is primary.
Where a memorandum of coverage issued in connection with PRISM’s Medical Malpractice Program is determined to afford primary coverage pursuant to this section, the exhaustion of PRISM’s limit of liability under the Medical Malpractice Program will satisfy the covered party’s self-insured retention under this Memorandum.
Coverage for the additional covered party under this endorsement is limited to the written contract or agreement as specified on the Certificate of Coverage and Endorsement U-1 of this Memorandum.
It is further agreed that nothing herein shall act to increase PRISM's limit of liability.
This endorsement is part of the Memorandum and takes effect on the effective date of the Memorandum unless another effective date is shown below. All other terms and conditions remain unchanged.
Public Risk Innovation, Solutions, and Management