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DATE(MM/DDIYYYY) ACOR" CERTIFICATE OF LIABILITY INSURANCE 11/29/2023 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 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 NAME: Trina Nesbitt Van Oppen&Co. 2, Inc. PHONE FAX VOCO 2 Insurance&Risk Control Services A/C No Ext: 800-746-0048 A/c No), P.O. Box 793 ADDRESS: service@vanoppenco2.com Teton Village WY 83025 INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:State Compensation Insurance Fund of California 35076 INSURED CONFL-2 INSURER B: Homeland Insurance Company of New York 34452 Confluence Technical Services, Inc.DBA Confluence INsuRERc:Starstone Specialty Insurance Company 44776 6821 8th Street INSURERD:Atlantic Specialty Insurance Company 27154 Rio Linda CA 95673 INSURER E:Westchester Surplus Lines 10172 INSURER F: COVERAGES CERTIFICATE NUMBER:1461734357 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MM/DDIYYYY MM/DDIYYYY B X COMMERCIAL GENERAL LIABILITY Y Y 793-01-19-30-0001 11/29/2023 11/29/2024 EACH OCCURRENCE $1,000,000 Fv� DAMAGE TO CLAIMS-MADE OCCUR PREMISES ('a a oNcur ence) $100,000 X CPL(Pollution) MED EXP(Any one person) $25,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY❑ PRO- JECT ❑ LOC PRODUCTS-COMP/OP AGG $2,000,000 X OTHER: $ D AUTOMOBILE LIABILITY Y Y 793-01-19-31-0002 11/29/2023 11/29/2024 COMBINEDSINGLELIMIT $1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident C UMBRELLA LIAB X OCCUR Y Y M89129232AEM 11/29/2023 11/29/2024 EACH OCCURRENCE $9,000,000 E G47437477 001 11/29/2023 11/29/2024 X EXCESS LIAB X CLAIMS-MADE AGGREGATE $9,000,000 DED RETENTION$ XS of GL/CPL/EO/AL/WC $ A WORKERS COMPENSATION Y 9222020-23 11/29/2023 11/29/2024 X PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? Y NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 B Professional Liability 793-01-19-30-0001 11/29/2023 11/29/2024 Per Claim $1,000,000 "Cliams Made" Aggregate $2,000,000 Subject to GL Aggregate DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Note: Excess coverage is provided by StarStone Specialty Insurance Company and Westchester Surplus Lines for total excess limits of$9M/$9M. General Information Only CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. General Information Only AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD