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Alco/ ® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) ka 3 / 3 / 2020 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 CONTCT NAME Shala Pearson Leavitt United Insurance Services , Inc . PHONEExtl: ( 925 ) 395 - 2600 FAX No : ( 925 ) 287 - 0710 CA License # OJ02939 ADDRESS: shala -MAIL 2358 Maritime Dr , Ste 100 INSURERS AFFORDING COVERAGE NAIC # Elk Grove CA 95758 INSURER A : Admiral Insurance Company 24856 INSURED INSURER B : Travelers Property Casualty Company , 36161 Walton Engineering , Inc . INSURERC : State Compensation Insurance Fund 35076 P . O . BOX 1025 INSURER D : INSURER E : West Sacramento CA 95691 INSURERF : COVERAGES CERTIFICATE NUMBER: 20 - 21 Master 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 ADDL SUBR I POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSO WV0 POLICY NUMBER MM/DDNYYY MM/DDNYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 11000 , 000 DAMAGE TO RENTED 50 , 000 A CLAIMS-MADE X OCCUR PREMISES Ea occurrence $ _ X Pollution Liability PHIECC1358706 3 / 6 / 2020 3 / 6 / 2021 MED EXP (Any one person) $ 51000 X Professional Liability PERSONAL & ADV INJURY $ 11000 , 000 GENIAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 21000 , 000 POLICY � PRO � LOC [PRODUCTS $ 2 , 000 , 000 OTHER: $ AUTOMOBILE LIABILITY EOMaBIINdEeDISINGLE LIMIT $ 1 , 000 , 000 B X ANYAUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED 8108L785302 3 / 6 /2020 3 / 6/2021 BODILY INJURY Per accident $ AUTOS AUTOS ( ) X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE AUTOS Per accident $ Uninsured motorist combined single $ 11000 , 000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 10 , 000 , 000 A X EXCESS LIAB CLAIM&MADE AGGREGATE $ . _ 10 , 000 , 000 DED I X I RETENTION $ 0 FEIEXS1358806 3 / 6 /2020 3 / 6/2021 $ WORKERS COMPENSATION _ AND EMPLOYERS' LIABILITY Y / N X 5 ATUTE EOR' ANY PROPRIETOR/PARTNER/EXECUTIVEE.L. EACH ACCIDENT $ 11000 , 000 OFFICER/MEMBER EXCLUDED? y N / A C (Mandatory in NH) 9113339 10 / 1/2019 10 / 1 / 2020 If yes, describe under E.L. DISEASE - EA EMPLOYEE $ 11000 , 000 DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1 $ 1 , 000 , 000 B Inland Marine OT660BK816207 3 / 6 / 2020 3 / 6 / 2021 Limit $ 300 , 000 Leased , Borrowed , Rented Deductible $ 2 , 500 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101 , Additional Remarks Schedule, may be attached if more space is required) Where required by written contract , Certificate Holder is Additional Insured with respects to the General Liability per attached policy endorsement form CG20370704 ; and with respects to the Auto , Additional Insured with Waiver of Subrogation and Primary and Noncontributory clauses apply when required by written contract per attached endorsement forms CAT3530215 and CAT4740216 . General Liability insurance is Primary and Noncontributory where required by written contract per attached endorsement form ECC5480712 . A separate Designated Construction Project General Aggregate Limit applies to each designated construction project of the Named Insured when agreed to and required under written contract per attached endorsement CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE To Whom it May Concern THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Evidence of Insurance ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORIZED REPRESENTATIVE Shala Pearson/ SHFRED -- -- © 1988-2014 ACORD CORPORATION . All rights reserved. ACORD 25 (2014/01 ) The ACORD name and logo are registered marks of ACORD INS026 (201401)