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71 ACOOREIr CERTIFICATE OF LIABILITY INSURANCE DATE(4/20Y TYPE OF INSURANCE 3/14/20 6 16 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(les) 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 NCONT AMEACT Heidi. Gable TLB Insurance Services, Inc. PHO N (925) 395-2600 FAX No: (925)287-0710 CA License #OB82095 ADDE-MRIESS:heidi-gable@leavitt.com 3000 Oak Road, Suite 210 MED EXP (Any one person) $ 5,000 INSURERS AFFORDING COVERAGE NAIC# Walnut Creek CA 94597 INSURER AAdmiral Insruance Company a24856 INSURED INSURER B:IntE on National Insurance Company 29742 Walton Engineering, Inc. INSURERC:State Compensation Insurance Fund 35076 P.O. Box 1025 INSURER D:Hartford Casualty Insurance Company 29424 INSURER E: West Sacramento CA 95691 INSURER F: 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 LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MWDD/YYYY POLICY EXP MWDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR ,000,000 EACH OCCURRENCE $ l'000'000 DAMAGE TO RENTED PREMISES Ea occurrence $ 50, 000 MED EXP (Any one person) $ 5,000 X Incl. Pollution Liab. FEIRCC1358703 3/6/2016 3/6/2017 X Incl. Professional Liab. PERSONAL &ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY ❑ PRO- ❑ LOC JECT GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OPAGG $ 2,000,000 EMPL BENEFITS LIAB $ OTHER: AUTOMOBILE LIABILITYOMBINEDiSINGLE LIMIT $ 1,000,000 BALL JX ANY AUTO OWNED SCHEDULED AUTOS AUTOS 12003162 3/6/2016 3/6/2017 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ HIRED AUTOS X NON-OWNEDPROPERTYDAMAGEAUTOS Peraccdent$ Uninsured motorist combined $ 500,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 10, 000, 000 A X EXCESS LIAB CLAIMS -MADE AGGREGATE $ 10,000,000 DED I I RETENTION $ FBIEXS1358803 3/6/2016 3/6/2017 C WORKERS COMPENSATION_ AND EMPLOYERS' LIABILITY Y/ N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICEWMEMBER EXCLUDED? (Mandatory in NH) If yes, describe under N/A 911333915 10/1/2016 10/1/2017 X STATUTE EERH E.L. EACH ACCIDENT $ 11000,000 E.L. DISEASE - EA EMPLOYE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below D Inland Marine 57UUMZC1966 3/6/2016 3/6/2017 Limit $ 300,000 Rented, Leased or Borrowed Deductible..,,2,500 DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space �Q V � ZOti EN`1 0, i 6 9 NI � p� To Whom It May Concern I IVI`1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE is Cote/JUBAUT 9 1 983-201 4 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 001401)