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AC V CERTIFICATE OF LIABILITY INSURANCE DATE(MMfDD/YYYY) 0811112019 THIS CERTIFICATE IS ISSUED ASA 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 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 CONTACT Kathy Stutts NAME: Tolman&Wiker Insurance Services LLC#OE52073 PHONE (805)585-6156 x (805)585-6256 A/C.No Exti: AIC,NO: 196 S.Fir Street E-MAIL SS kstutts@tolmanandwiker.com PO Box 1388 INSURER(S)AFFORDING COVERAGE NAIC Y Ventura CA 93002-1388 INSURER A: Capitol Specialty Ins Corp 10328 INSURED INSURER B: United Financial Casualty Co. 11770 INSURER C: State Compensation Ins Fund 35076 Middle Earth Geo Testing,Inc. INSURER D: 954 North Lemon St. INSURER E: Orange CA 92867 INSURER F: COVERAGES CERTIFICATE NUMBER: 19/20 GL/AU/WC/POLL 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. IAUUL1tiUUK1 POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVO POLICY NUMBER MMIDD/YYYY MM/DDNYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 EN CLA!MS-MADE FX]OCCURPREMISES Ea occurrenceS 50,000 MED EXP(Any one person) S 5,000 A EV20182696-02 08108/2019 08/08/2020 PERSONAL&ADV INJURY $ 1.000,000 GEN'L AGGREGATE LIMIT APPLIES PER2,000,000 GENERALAGGREGATE 5 POLICYX PRO- JECT F1 LOC PRODUCTS-COMP/OPAGG S 2.000,000 OTHER S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT s 1,000,000 Ea accident) X ANY AUTO BODILY INJURY(Per person) s B OWNED SCHEDULED 02106265-6 03/12/2019 03/12/2020 BODILY INJURY(Per accident) S AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE s AUTOS ONLY AUTOS ONLY (Per a=dent) $ UMBRELLA UABOCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE AGGREGATE S DED I I RETENTION$ $ WORKERS COMPENSATION X STATUTE —FORTH AND EMPLOYERS'LIABILITY YIN C ANY PROPRIETOR/PARTNER ID EXEOUTIVE ❑ NIA 9059223-2019 06!02/2019 06/02/2020 E L.EACH ACCIDENT s 1,000,000 OFFICER/MEMBER EXCLUDE (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S 1.000,000 if yes descnbeunder 1,000,000 DESCRIPTION OF OPERATIONS Below E L DISEASE-POLICY LIMIT S CONTRACTOR'S POLLUTION A PROFESSIONAL LIABILITY EV20182696.02 08/08/2019 08108/2020 LIMIT: $1,000,000 LI I DEDUCTIBLE: $10,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Verification of Coverage CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN San Joaquin County Environmental Health Department ACCORDANCE WITH THE POLICY PROVISIONS. 1868 E Hazelton Ave. AUTHORIZED REPRESENTATIVE Stockton CA 95205 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD