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08/28/2001 12:07 7075686096 CLEAR HEART DRILLING PAGE 03/06 <br /> ACORDTe /03 CERTIFICATE OF LIABILITY INSURANCE 83 D° <br /> 0 /03/200 <br /> 01 <br /> PaonuCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> P"TWOOD INSURANCE AGENCY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> 0 BOX 406 HOLDER- THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> IZTE-ORGETOWN CA 95634 <br /> 530 333 4362 INSURERS AFFORDING COVERAGE <br /> INSURED CLEAR HEART DRILLING,-INC. INSURERA THE HARTFORD INSURANCE COMPANY <br /> INSURER B: <br /> 483 W. COLLEGE AVENUE INSURER C• <br /> SANTA ROSA, CA 95401 INSURER O: <br /> 707-568-6095 INSURER E: <br /> COVERAGES <br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING <br /> ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br /> MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH <br /> POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> l TYPE OF INSURANCE POUJCY NUMBER POLI EcrnE POLICY IRATION <br /> TC MMn] DATE Imminarcri LIMITa <br /> GENERAL LIABILITY LACH OCCURRENCE 31000000 <br /> X COMMERCIAL GENERAL LIABlUTY FIRE DAMAGE(Any one IIIv) 350000 <br /> CLAIMS MADE �OCCUR MED EXP(My one parson) $5000 <br /> A 22 UUV DE 4198 DD 07152001 07152002 PERSONAL 6,ADV INJURY $1000000 <br /> GENERAL AGGREGATE $2 0 0 0 0 0 0 <br /> r 'L AGGREGATE LIMIT APPLIES PER. PRODUCTS-COMP/OP AGG 5 2 0 0 0 0 0 0 <br /> POLICY PRO- LOC <br /> AUTOMOBILE LIABILITY <br /> COMBINED SINGLE LIMIT <br /> X ANY AUTO (Es aw(lent) S 1000000 <br /> ALL OWNED AUTOS <br /> BODILY INJURY <br /> SCHEDULED AUTOS $ <br /> (Perperocny <br /> A HIRED AUTOS 22 UUV DE 4198 DD 07 152 001 07152002 BODILY INJURY <br /> NONAwNED AUTOS (Par o=aent) $ <br /> X MED PAY $5, 000 <br /> PROPERTY DAMAGE $ <br /> (Per soudent) <br /> GARAGE LIABILITY AUTO ONLY-EA ACCIDENT 6 <br /> ANY AUTO <br /> OTHER THAN `ACC S <br /> AUTO ONLY; AGG S <br /> Exuas LIABILITY EACH OCCURRENCE $1000000 <br /> X OCCUR CLAIMS MADE AGGREGATE $ <br /> 22 RHV DE 4543 07152001 07152002 s <br /> A DEDUCTIBLE <br /> S <br /> RETENTION $ 10, 000 <br /> WORKERS COMPENSATION AND WC STATU- H- <br /> RMPLOVERS'LABILITY I ER <br /> E.L EACH ACCIDENT $ <br /> EL,DISEASE.EA EMPLOYEE I S <br /> E.L. <br /> OTHER EADISSE-POLICY LIMB $ <br /> DESCRIPTION OF OPERAYYONWLOCATIONSNEHICLESrEXCLUSIONS ADDED BY ENOOR9EMENT/SPECIAL PROVISIONS <br /> WATER WELL DRILLERS <br /> CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED PER CG 20 10 11 85. <br /> CERTIFICATE HOLDER X I ADDITIONAL INSURED;INSURER LETTER: A CANCELLATION <br /> SHOULD ANY OP THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EJU4RATION <br /> COUNTY OF SAN JOAQUIN DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR To MAIL 10 DAYS WRITTEN <br /> 304 EAST WEBER AVE . 3RD FLOOR NOTICE TO THE CERTIFICATS HOLDER arMFA TO THE LEFT,BUT FAILURE TO DO SO SNAIL <br /> STOCKTON, CA. 95202 IMPOSE NO OBLIGATION ORLAgIL14IIw a"AA xvgt�'R <br /> REPRESENTATIVES, <br /> ENVIRONMENTAL HEALTH DIVISION AUTHORIZED REPRESENTATIVE <br /> FAX 209-4640138 <br /> ACORD 26-S(7/97) 0 ACORD CORPORATION IS88 <br />