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SALEENG-01 MHAMILTONGRAVES
<br /> CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
<br /> 11/26/2019
<br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
<br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED
<br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
<br /> IMPORTANT: If the certficate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed.
<br /> If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on
<br /> this certificate does not confer rights to the certificate holder in lieu of such endorsements.
<br /> PRODUCER License#OE02096 Co TACT
<br /> A
<br /> D)Buduo&DeFendis Insurance Brokers,LLC PHONE _..___
<br /> P.O.Box 5479 AC,No,Ext):(559)432-0222 FAXLAJCNo):(559)431-7941
<br /> Fresno,CA 93755-5479 E- AI
<br /> ss:
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> INSURER A:Valley Forge Insurance Co _ 20508
<br /> INSURED INSURER B:Transportation Insurance Company 20494
<br /> Salem Engineering Group,Inc. INSURER C:Continental Insurance Company 35289
<br /> 4729 W.Jacquelyn Ave. INSURER D:American Casualty Company ofi Readin PA 20427
<br /> Fresno,CA 93722
<br /> INSURER E:Continental Casualty Company 20443
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br /> ILTRNSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP
<br /> LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000
<br /> CLAIMS-MADE OCCUR X 6015893246 12/01/2019 12/01/2020 °AMGE5 RENTED 300,000
<br /> - a orcurrence)
<br /> MED EXP An one, eJr rson 15,009
<br /> --- — PERSONAL&ADV INJURY $ 2,000,000
<br /> GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 4,000,000
<br /> POLICY FV-I '-I PES E:1 Loc 4,000,000
<br /> PRODUCTS-COMP/OP AGG
<br /> OTHER:
<br /> S
<br /> B AUTOMOBILE LIABILITY COMccBINdED gt1 SINGLE LIMIT 1,000,000
<br /> _
<br /> X O
<br /> OWNED 6045473729 12/01/2019 12/01/2020 BODILY INJURY1
<br /> Per person)
<br /> OWNED SCHEDULED — _ _—.
<br /> AUTOS ONLY _ _ AUTOS BODILY INJURY Per accident
<br /> AUTOS ONLY Y AUTOS ONEY PROPERTY GE
<br /> Per acutlent
<br /> C X UMBRELLA LIAB X OCCUR EACH OCCURRENCE S,000,OOO
<br /> EXCESS LIAB CLAIMS-MADE 6015893232 12/01/2019 12/01/2020
<br /> DED X RETENTION$ 10,000 AGGREGATE 5,000,000
<br /> D WORKERS COMPENSATION
<br /> AND EMPLOYERS'LIABILfTY
<br /> !E!
<br /> OTH•ANY PROPRIETOR/PA BILrrYEXECIIIVE YIN 020581635 12/01/2019 12/01/2020QQF�FICER/MEEMBER EXCLUDED? ❑YNIA ACCIDENT 1,000,000(f yes,dorylnandSE-EA EMPLOYE 1,000,000
<br /> Dyes, IPTIONunder 1,000,000
<br /> DESCRIPTION OF OPERATIONS below SE-POLICY UMIT
<br /> E (Prof./Pollution Liab EH591895527 12101/2019'12101/2020 Each Claim 2,000,000
<br /> E (Prof./Pollution Liab AEH591895527 12/0112019 12/01/2020 Aggregate I 4,000,000
<br /> I
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES'LACORD 101,Additional Remarks Schedule,may be attached If more space is required)
<br /> Actual Certificate to be issued upon request
<br /> Certificate Holder is named Additional Insured(including Ongoing&Completed Operations and Primary Non-Contributory Wording)as respects General
<br /> Liability per attached blanket policy form CNA75079XX(10-16).
<br /> **Professlonal/Pollution Liability deductible per claim-$25,000
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> "SAMPLE CERTIFICATE" THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> AUTHORIZED REPRESENTATIVE
<br /> ACORD 25(2016/03) ©1988-2015IICORD CORPORATION. All rights reserved.
<br /> The ACORD name and logo are registered marks of ACORD
<br />
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