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YELLO-2 OP ID: DS ,aco/rc� CERTIFICATE OF LIABILITY INSURANCE r ATE 03//MM/30/22018018 ) 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 INSURERS), 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 8 Usher LLC NAME: Commercial Service Team Insurance. Bonds.Benefits. AICDNo El:602-956-4220 ac No: 602-956-4418 3033 North 44th Street,#300 E-MAIL Phoenix,AZ 85018ADDR :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 Richard LeBlanc dba INSURER C:Travelers Indemnity Cc 25658 Yellow Jacket Drilling INSURER D:Homeland Insurance Co of NY 34452 PO Box 801 Gilbert,AZ 85299-0801 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. INSR TYPE OF INSURANCE ADDL UB POLICY EFF POLICY EXP LTR POLICY NUMBER MM/DDIYYYY MMIDDIYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS-MADE X OCCUR X X DT-CO-2J407688-PHX-18 04/01/2018 04/01/2019 PREMISES RENTED $ $00,00 MED EXP(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2,000,00 POLICY JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,00 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,00 B X ANY AUTO X X DT-810-2J354550-TIL-18 04/01/2018 04/01/2019 BODILY INJURY(Per person) $ ALLOWNED SCHEDULED id P BODILY INJURY(Per accent AUTOS AUTOS ( ) $ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident X UMBRELLA UAB X OCCUR EACH OCCURRENCE $ 10,000,00 B EXCESS UAB CLAIMS-MADE CUP-2]444660-17-26 04/01/2018 04/01/2019 AGGREGATE $ 10,000,00 DED I X I RETENTION$ 10000 $ WORKERS COMPENSATIONX PER OTH- 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? ry N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,00 B Equipment Flo ater 6601367M582 04/01/2018 04/01/2019 Insd equi as sche D POLL/PROF �HAU0003302018 04/01/2018 04/01/2019 0CC/Agg 10,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required( RE: DRILLING SERVICES ADDITIONAL INSURED FORMS CGD46, OBENVGE301 S CAT353 ATTACHED. WAIVER OF SUBROGATION FORMS CGD316, OBENVGE319, CAT353 S 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 6c�_6 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD