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�+1 GULFS-1 A�iRO CERTIFICATE OF LIABILITY INSURANCE D09/23/2019 Y) 09/23!2019 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 have ADDITIONAL INSURED provisions or 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 530-622-9300 _14AA7EACT Kathleen Verplancken Capital Sierra Ins.Svc.LLC. PHONE 530-622-9300 FAX 530-622-9303 Dia Pleasant Valley Road 19 ac,No,Ext): - I IA/C,No). Diamond Springs,CA 95619 En MAS -- - Kathleen Verplancken - INSURE RfSI AFFORDING COVERAGE NAI; INSURER A:Allstate Insurance Company INSURED INSURERB_TOPA Insurance Co Gulf Shore Construction Svc Inc.dba G S Exploration INSURER C,State Compensation Ins.Fund 35076 PO Box 1501 Shingle springs,CA 95682 INSURER D: INSURER E: _ INSURER F COVERAGES CERTIFICATE BE 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. _ _NSR TYPE OF INSURANCE ADDL SUB POLICY EFF POLICY EXP LIMITS _LTRPOLICY NUMBER EACH GENERAL LIABILITY CH OC URRENCE CLAIMS-MADE I -,OCCUR DAMAGE TO RENTED PRE J8ES1Eq xcurre(1 MED EXP(Ary on_�erson PERS NAL 6 ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE___ S _ POLICY LOC PRODUCTS-COMP/OP ACG__ S OTHER A AUTOMOBILE LIABILITY COMBINED IE, Mdi,.tJSINGLE LIMIT 1,000,000 X ANYAUTO X X 648836933 12/12/2018 12/12/2019 a DILYINJURY Per erson OWNED SCHEDULED — AUTOS ONLY AUTOSBODILYBODILY INJURY(Per accident X AUTOS ONLY X AUTOS ONLY PeOeda I AMAGE B UMBRELLA LIAR X OCCUR 1,000,000 EACH OCCURRENCE_ �_ _ _ X EXCESS LIAR CLAIMS-MADE XL0020021002 02/10/2019 12/1212019 GGREGATE 1$ 1,000,000 DEO RETENTION E C WORKERS COMPENSATION PER OTti- AND EMPLOYERS'LIABILITY X STATUTE ANY PROPRIETOR/PARTNER/EXECUTIVE YINX 9066578-19 08102/2019 08/02/2020 1,000,000 OFFICERIMEM R EXCLUDED? N/A E.L.EACH ACCIDENT _ (Mandatory in NH) F.L. SEASE-EA EMPLOYEE 1,000,000 If yyes,describe under . . $ DFSCRIPTIONOFOPERATIONS elo E-POLICY LIMIT 11000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attachod If more space Is roqulred) Crawford&Associates,Inc.is named as an additional insured as respects commercial auto insurance policy form AACW20101. Additional Insured status is provided on a blanket basis and is triggered by written contract,All California Projects. Revised. CERTIFICATE LD CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Crawford&Associates,Inc ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Corporate Way,Ste 230 Sacramento,CA 95831 AUTHORJZ DREPRES ATTVE K t l nVer !! n ACORD 25(2016/03) ©1988-2016 ORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD