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YELLO-2 OP ID: DS ,d►c'oRO CERTIFICATE OF LIABILITY INSURANCE DATE/30/2 Y01 03/30/28 8 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 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 Hill 8r Usher LLC NAME: Commercial Service Team Insurance. Bonds. Benefits. ac NN Ell:602-956-4220 ac No: 602-956-4418 3033 North 44th Street,#300 E-MAIL Phoenix,AZ 85018 ADDRESS:doccontrol@hillusher.com Steve R.Shields INSURERS AFFORDING COVERAGE NAIC# _ INSURER A:Travelers Property Casualty Co 25674 INSURED Yellow Jacket Drilling INSURER B:Travelers Property Casualty Co 25674 Services LLC INSURER C:Travelers Indemnity Co 25658 Richard LeBlanc dba _ Yellow Jacket Drilling INSURER D:Homeland Insurance CoofNY 34452 PO Box 801 Gilbert,AZ 85299-0801 1 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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. ILICY EXP TR TYPE OF INSURANCE INgn iv POLICY NUMBER MMIDPOLDYMEFF MIDDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS-MADE I-XI OCCUR X X DT-CO-2J407688-PHX-18 04/01/2018 04/01/2019 PREMISESEaoccurre�- $ 300,00 MED EXP(Any one person) $ 5,00 PERSONAL BADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY T, PRO- JECT 0 LOC PRODUCTS-COMP/OP AGG $ 2,000,00 OTHER. $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,00 Ea accident B X ANY AUTO X X DT-810-2J354550-TIL-18 04/01/2018 04/01/2019 BODILY INJURY(Per person) $ ALLOWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,00 B EXCESS LIAB ICLAIMS-MADE CUP-2J444660-17-26 04/01/2018 04/01/2019 AGGREGATE $ 10,000,00 DED I X I RETENTION$ 10000 $ WORKERS COMPENSATIONX PE TH- AND EMPLOYERS'LIABILITY STATUTE ER C ANY PROPRIETOR/PARTNER/EXECUTIVE YIN X UB-2J440716-17-26 04/01/2018 04/01/2019 E.L.EACH ACCIDENT $ 1,000,00 OFFICER/MEMBER EXCLUDED? Y� NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEq$ 1,000,00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,00 B Equipment Floater 6601367M582 04/01/2018 04/01/2019 Insd equi as sche D IPOLUPROF HA00003302018 04/01/2018 04/01/2019 OCc/Agg 10,000,00 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE: DRILLING SERVICES ADDITIONAL INSURED FORMS CGD46, OBENVGE301 & CAT353 ATTACHED. WAIVER OF SUBROGATION FORMS CGD316, OBENVGE319, CAT353 & WC000313 ATTACHED. CERTIFICATE HOLDER CANCELLATION GEOSYNT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN GEOSYNTEC CONSULTANTS INC ACCORDANCE WITH THE POLICY PROVISIONS. 10220 OLD COLUMBIA RD STE A COLOMBIA, MD 20146 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD