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<br />I rWF VIMPOMIYY?Y,
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<br />CERTIFICATE OF LIABILITY INSURANCE I
<br />01� 211,2015
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HO -DER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY TW POLICIES
<br />BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING IN Ai THORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER,
<br />— ---- -----
<br />iMPORTANF. itWholder is an AOD!TIONAL INSURED, the poliCy(ies) must, be endorsed, if SUBROGATION IS WAIVEL sub,ieft to
<br />�ertific�t�'
<br />the terms and conditions of the policy, certain policies may require an endorsement, A statement on this certificate does nat confer > grits to the
<br />certificate holder in lieu of such endorsement(s)
<br />PROUI)CERDeidre Hagen
<br />InterWest Insurance Services
<br />License#0801094 530-895-1010 530-8)5-1313
<br />P.O. box 8110 6,VAft,
<br />Chico, CA 95927-8110 AooRFSK
<br />Select Business Unit COVERAGE
<br />4113URF4i A: State COMP Irs Fund (CA, 35076
<br />INSURFr, 1MVP Petroleum Engineering, Inc
<br />INSURFR B
<br />PQ Box 281
<br />Folsom, CA 96763-0281
<br />INSURER 0,
<br />illsJRER C
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<br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
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<br />TH is I S _0 CER, T -1 IN&k R, P, I_EL S'! LL E, F; H"\vF El E LN, !S`5 JL 1, 0 f HE !N, -3I R i_ -D N 7r ,ikO Jf I R THE PO"
<br />INDiCATEL) ANY "FRV CR COND"TiON nr NY (W; N -RAC' O."H!
<br />CERT!FiCA_if. MAY BF J,rSWA) C'R MAIPFR UON, THE' WSiiPANC-L By 1HE L)AU, i�
<br />WSR ADOL 2!Ubk POUCY iJf. POLICY EXP
<br />TP TYPE OF MSURANCE I
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<br />_�P_WYD
<br />COMMERCIAL GENERAL LIABILITY
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<br />'eWCRKERS CCMPENSA10&
<br />'ANG ENIPI,OYEAV;JAHNIATY
<br />AA 90730762016
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<br />DESCRIPYION OF OPCRANON$ / LOCATIONS! VEHICI Fs ACORLI 101,AdditiWal R.mar" Zch.d.)O, SSwy 1,& iittaclwj if,,tom pRt. I,,4Wmj)
<br />'onfirmation of Coverage, REGEIVEE
<br />SEP 2 8 2015
<br />ENVIRONMEN L
<br />CERTIFICATE HOLDER CANCELLA110141
<br />MVP0281
<br />SHOULD ANY OF THE ABOVE OESCRIBEE) FIOL10ES BE CANCELLE BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL. BE DELP ,RE,) IN
<br />MVP Petroleum Engineering, Inc ACCORDANCE WITH THE POLICY PROVISIONS.
<br />PO Box 281
<br />Folsom, CA 95763 AUTHORVED REP SENiATry
<br />(P1988-2014 ACORD CORPORATION, All rights r( ierved.
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
<br />t"q A),
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<br />10/0112016 1010112016
<br />1,000,00
<br />1,000,00
<br />-T
<br />DESCRIPYION OF OPCRANON$ / LOCATIONS! VEHICI Fs ACORLI 101,AdditiWal R.mar" Zch.d.)O, SSwy 1,& iittaclwj if,,tom pRt. I,,4Wmj)
<br />'onfirmation of Coverage, REGEIVEE
<br />SEP 2 8 2015
<br />ENVIRONMEN L
<br />CERTIFICATE HOLDER CANCELLA110141
<br />MVP0281
<br />SHOULD ANY OF THE ABOVE OESCRIBEE) FIOL10ES BE CANCELLE BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL. BE DELP ,RE,) IN
<br />MVP Petroleum Engineering, Inc ACCORDANCE WITH THE POLICY PROVISIONS.
<br />PO Box 281
<br />Folsom, CA 95763 AUTHORVED REP SENiATry
<br />(P1988-2014 ACORD CORPORATION, All rights r( ierved.
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
<br />
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