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AC"R" CERTIFICATE OF LIABILITY INSURANCE 9/11/2017DATE(MM/ D/YYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must 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 Alliant Specialty Insurance Services, Inc. PO Box 609015 San Diego CA 92160 CONTACT NAME: Lisa Rossignol PHONENo, 559-437-3360 FAX 559-437-3385 E-MAIL DRESS: Irossignol@alliant.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: Everest National Insurance Company 10120 EACH OCCURRENCE $ —------------ ---- - INSURED -- INSURER B: INSURER C: Briski Well Drilling Co., Inc. P.O. Box 1539 San Andreas CA 95249 INSURER D: J PRODUCTS - COMP/OP AGG $ INSURER E: INSURER F: AUTOMOBILE LIABILITY ANY AUTO AUTOWNED SCHEDULED AUTOS NON -OWNED HIRED AUTOS AUTOS COVERAGES CERTIFICATE NUMBER: 242351104 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS AUTHORIZED REPRESENTATIVE COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F OCCUR EACH OCCURRENCE $ DAMAGE TO RENTED-- - _ PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ElPRO- JECT [_]LOC OTHER: GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ _ $ AUTOMOBILE LIABILITY ANY AUTO AUTOWNED SCHEDULED AUTOS NON -OWNED HIRED AUTOS AUTOS Ea accidentsINGLE LIMIT $ _ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident) UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? � (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 7600004345151 1/1/2017 1/1/2018 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $1,000,000 -- E. L. DISEASE - EA EMPLOYE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Proof of Insurance. CERTIFICATE HOLDER CANCELLATION © 1988-2014 ACORD CORPORATION. All rights reserved. ,CORD 25 (2014101) The ACORD name and locio are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE San Joaquin Environmental Health Department THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1868 East Hazelton Ave. ACCORDANCE WITH THE POLICY PROVISIONS. Stockton CA 95205 AUTHORIZED REPRESENTATIVE © 1988-2014 ACORD CORPORATION. All rights reserved. ,CORD 25 (2014101) The ACORD name and locio are registered marks of ACORD