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CERTIFICATE OF LIABILITY INSURANCEOP ID AE (MMIDD/YYYY) L!03/02 CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 12 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: the cert) icate holder is an ADDITIONAL INSURED, the po icy(ies) must be endorsed. f SUBROGATION IS WAVED, 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 United Valley Insurance Agency Lic.# 0655225 NAME: Jeanie Swan, CISR PHONE FAX AIC,No,Ext: 800-549-4242 (AIC, No): 888-329-884 AODREss: iies@unitedvalley.com P.O. Box 27020 CUSTOMERIDA RU1AEX-1 Fresno CA 93729 INSURER(S) AFFORDING COVERAGE NAICff Phone:559-244-4670 Fax:888-329-8842 INSURED INSURER A: American Safety Indemnity Co. 25433 RUMEX CONSTRUCTION CORP 4670 N BENDEL AVE INSURER B: Wesco Insurance Company 25011 INSURER C: State Compensation Ins Fund FRESNO CA 93722-3904 INSURER D: 01/01/13 INSURER E: LLJ CLAIMS -MADE ® OCCUR 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. LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MMIDDIYYYY) (MMIDDIYYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1000000 PREMISES (Ea occurrence) $ 50000 A X COMMERCIAL GENERAL LIABILITY ENV0244111203 01/01/12 01/01/13 CLAIMS -MADE ® OCCUR MED EXP (Any one person) $ 5000 PERSONAL BADV INJURY $ 1000000 ENV024411120301/01/12 01/01/13 X POLLUTION GENERAL AGGREGATE $ 2000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2000000 POLICY PROJECT LOC Pollution $ 2000000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1000000 (Ea accident) B X ANY AUTO WPA1029803 01/19/12 01/19/13 BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE (Per accident) $ $ NON -OWNED AUTOS $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DEDUCTIBLE $ $ RETENTION $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVC OFFICERIMEMBEREXCLUDED? u (Mandatory in NH) NIA 3Q 23 03 O1 12 03 O1 13 X " ER TORY LIMITS E.L. EACH ACCIDENT $ 1000000 E.L. DISEASE - EA EMPLOYE $ 1000000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT $ 1000000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) "VERIFICATION PURPOSES ONLY" CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE PROOF -1 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. PROOF OF COVERAGE ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD