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DATE(MM/DD/YYYY) <br /> CjERTIFI E OF LIABILITY INSURA& 9/13/2010 <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 certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. if SUBROGATION IS WAIVED, subject to <br /> the terms and conditions of the policy, certain policies may require an endorsement. Astatement on this certificate does not confer rights to the <br /> certificate holder in lieu of such endorsement(s). <br /> PRODUCER UUNIAGI <br /> NAME: <br /> GALEN HAYES INSURANCE AGENCY O,,"NE.,Ezt: 800 869-8643 (ac,Ne):(510) 222-6162 <br /> 3550 SAN PABLO DAM RD. , STE. C ADDRESS: <br /> EL SOBRANTE, CA 94803 PRODUCER <br /> CUSTOMER ID#: <br /> INSURER(S) AFFORDING COVERAGE NAIC# <br /> INSURED SUTFIN, JOHN INSURER A: WESTCHESTER SURPLUS LINES INS. CO. <br /> SUT'S SUPERIOR UNDER GROUND TANK SERV. INSURER B: DELOS INSURANCE COMPANY <br /> P.O. BOX 1487 INSURER C: STATE COMPENSATION INSURANCE FUND <br /> SAN RAMON, CA 94583 INSURER D: NAVIGATORS INSURANCE COMPANY <br /> INSURER E: <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 /> INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS <br /> LTR POLICY NUMBER MM/DD/YYYY MM/DD/YYYY <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1 000, 000 <br /> X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ .50, 000 <br /> CLAIMS-MADE CI OCCUR MED EXP(Anyone person) $ 5 000 <br /> A G2207507AO05 06/15/10 06/15/11 PERSONAL&ADV INJURY $ 1, 000, 000 <br /> GENERAL AGGREGATE $ 2f 000, 000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2, 000, 000 <br /> POLICY PRO LOC $ <br /> X JECT <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> (Ea accident) $ 1, 000, 000 <br /> ANYAUTO BODILY INJURY(Per person) $ <br /> ALLOWNED AUTOS BODILY INJURY(Per accident) $ <br /> B X SCHEDULED AUTOS DPA5503202 08/14/10 08/14/11 <br /> PROPERTY DAMAGE $ <br /> HIRED AUTOS (Per accident) <br /> NON-OWNED AUTOS $ <br /> $ <br /> UMBRELLA LAB F1 OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DEDUCTIBLE $ <br /> RETENTION $ $ <br /> WORKERS COMPENSATION YIN WWI <br /> OTH- <br /> AND EMPLOYERS'LIABILITY X TORY LIMITS ER <br /> 02/01/10 02/01/11 <br /> C'' ANY PRMEMBEOR/PARTUDE,ECUTIVE ❑ N/A 14 2 0 3 6 8-10 E.L.EACH ACCIDENT $ 1, 000, OOO <br /> OFFICER/MEMBER EXCLUDED? <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1, 000, 000 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1 000, 000 <br /> A POLLUTION LIAB. G2207507AO05 06/15/10 06/15/11 $1f000, 000 <br /> D I INLAND MARINE 04-IM000594 06/29/10 06/29/11 $88, 000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) <br /> CERTIFICATE IS PROVIDED AS PROOF OF INSURANCE WITH RESPECT TO <br /> COVERAGES, LIMITS AND EFFECTIVE DATES AS SHOWN. <br /> CERTIFICATE HOLDER CANCELLATION <br /> CERTIFICATE OF INSURANCE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> AUTHORIZED REPRESENTATIVE <br /> © <br /> 1988-2009-"AC' <br /> RD COR RA ION. is reserved. <br /> ACORD25(2009/09) The ACORD name and logo are registered marks of ACORD <br />