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DAVES4 OP ID: DF CERTIFICATE OF LIABILITY INSURANCE FD 1111 ,DDIYYYY) 11/13/2018 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 CONTACT M.D Manouel Insurance Agency PHONE Trac D.Hodge PAx License#0649928 A/c .559-446-0588 JAIC,No): 59-446-0595 7447 N.Flrst Street,Suite 101 E-MAIL Fresno,CA 93720 ADDRESS:thodge@mdmig.com Tracy D.Hodge INSURERS AFFORDING COVERAGE NAIC# INSURER A:State Compensation Ins Fund 35076 INSURED Dave's Drilling -INSURERB:WestAmerican Ins Company 44393 5830 W Fir INSURER C:U.S.Specially Ins Company Fresno,CA 93722 INSURER D: INSURER E: _ INSURER F: COVERAGES CERTIFICATE NUMBER: 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. ILTR TYPE OF INSURANCE B POLICY NUMBER POLICY EFF MM/DDNYYY LIMITS B X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 _UAMAGE TO CLAIMS-MADE T OCCUR BLW56262691 12/14/2017 12/14/2018 PREMISES fEa occurrence $ 500,00 MED EXP(Any one person) $ 16,0 PERSONAL&ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY PRO- JECT LOC PRODUCTS-COMP/OPAGG $ 2,000,00 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,00 B ANY AUTO BAW1966262691 04/19/2018 04/1912019 BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED BODILY INJURY Per accident AUTOS AUTOS ( ) $ NON-OWNED PROPERTY DAMAGE X HIRED AUTOS X AUTOS Peraccident $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESSIJAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATIONPER OTH- AND EMPLOYERS'LIABILITY X STATUTE ER A ANY PROPRIETOR/PARTNERIEXECUTIVE YIN N 906118118 07/19/2018 07/19/2019 E.L EACH ACCIDENT $ 1,000,00 OFFICER/MEMBER EXCLUDED? � N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,00 If yes,describe under — DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,00 C U.S Specialty 100290502 11/06/2017 11/06/2018 Street& 25,00 T1 I Excavatio DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) '" I ' .SEVt, NOV 1 1 2018 ENVIRONMENTAL HEALTH PERMIT/SEWCFS CERTIFICATE HOLDER CANCELLATION PROOF-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Proof of Insurance THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORIZED REPRESENTATIVE E� ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD