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ACC) CERTIFICATE OF LIABILITY INSURANCE °ATE `MM/°°"""' <br /> 164� t 1 11 / 5 / 2018 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to <br /> the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br /> certificate holder in lieu of such endorsement(s) . <br /> PRODUCER CONTACT Shala Pearson <br /> NAME: <br /> HOETLB Insurance Services PA,CN No <br /> Ext : ( 916 ) 691 - 5555 FAX <br /> No ; ( 888 ) 329 - 8842 <br /> CA License # OB82095 AIL <br /> ADDRESS, shala - pearson@leavitt . com <br /> 3000 Oak Road , Suite 210 INSURER(S) AFFORDING COVERAGE NAIL # <br /> Walnut Creek CA 94597 INSURERA :Admiral Insruance Company a24856 <br /> INSURED INSURERB :Travelers Casualty Co . of America 19046 <br /> Walton Engineering , Inc . INSURERC :State Compensation Insurance Fund 35076 <br /> P . O . Box 1025 INSURERD :Travelers Casualty Co . of America 19046 <br /> INSURER E : <br /> West Sacramento CA 95691 INSURER F : <br /> COVERAGES CERTIFICATE NUMBER: 18 / 19 All Policies REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN , THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, <br /> INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF <br /> POLICY EXP <br /> LIMITS <br /> LTR <br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 11000 , 000 <br /> AMAGE TO A CLAIMS-MADE OCCUR PREM SES (Ea occu RENTED <br /> ) $ 50 , 000 <br /> X Incl . Pollution Liab . FEIECC1358705 3 / 6 / 2018 3 / 6 / 2019 MED EXP (Any one person) $ 51000 <br /> X Incl . Professional Liab . PERSONAL & ADV INJURY $ 11000 , 000 <br /> GENI AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2 , 000 , 000 <br /> POLICY F JERK LOC PRODUCTS - COMP/OPAGG $ 21000 , 000 <br /> F1 OTHER: $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 11000 , 000 <br /> Ea accident <br /> B XANY AUTO BODILY INJURY (Per person) $ <br /> ALL OWNED SCHEDULED 8106K992397 3 / 6 / 2018 3 / 6 / 2019 BODILY INJURY (Per accident) $ <br /> AUTOS AUTOS <br /> NON-OWNED PROPERTY DAMAGE <br /> X HIRED AUTOS X AUTOS Per accident) $ <br /> $ <br /> UMBRELLA LIABX OCCUR EACH_OCCURRENCE $ 10 , 000 , 000 <br /> A X EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10 , 000 , 000 <br /> DED RETENTION $ FEIEXS1358805 3 / 6 / 2018 3 / 6 / 2019 $ <br /> WORKERS COMPENSATION X PER OTH- <br /> AND EMPLOYERS' LIABILITY Y / N STATUTE ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVEF-1N / A E.L. EACH ACCIDENT $ 11000 , 000 <br /> C OFFICER/MEMBER EXCLUDED? 9113339 10 / 1 /2018 10 / 1 / 2019 <br /> (Mandatory In NH) E.L. DISEASE - EA EMPLOYE $ 11 000 , 000 <br /> If yes, describe under <br /> DESCRIPTION OF OPERATIONS below E. L. DISEASE - POLICY LIMIT $ 11000 , 000 <br /> D Inland Marine 6608KB16207 3 / 6 / 2018 3 / 6 / 2019 Limit $ 300 , 000 <br /> Rented , Leased or Borrowed Deductible $ 21500 <br /> DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101 , Additional Remarks Schedule, may be attached if more space is required) <br /> I <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Evidence of Insurance THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS, <br /> AUTHORIZED REPRESENTATIVE <br /> I <br />( Shala Pearson / SHPEAR <br /> © 1988-2014 ACORD CORPORATION . All rights reserved. <br /> ACORD 25 (2014/01 ) The ACORD name and logo are registered marks of ACORD <br /> INS026 (201401 ) <br />