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SALEENG-01 MIJANIII.TON GRAVES
<br /> CERTIFICATE OF LIABILI �12K12(119 INSURANCE DACE RI2019 -
<br /> _ _
<br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERT"FICATE HOLD'=R,THIS
<br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED 3YTHE POLICIES
<br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),ALTFIDRIZED
<br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
<br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions Or bt.endorsed.
<br /> If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorseirl A statement on
<br /> this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br /> License#OE02096
<br /> PRODUCER COyT_ACT ---'-------
<br /> DiBuduo&DeFendis Insurance Brokers,LLC PHONr — ---- -
<br /> P.O.Bax 5479 Arc,No,Ext):(559)432-0222 Wc_No):,[559)431••7941
<br /> Fresno,CA 93755-5479 E AI ss: — -- ---- —
<br /> INSURERS)AFFORDING COVERAGE _— ---!!AIC 0
<br /> INSURER A:Valiey Forge Insurance Co 20508 —
<br /> INSURED INSURER B:Transportation Insurance Company M(gq_�____
<br /> Salem Engineering Group,Inc. INSURER C:Continental Insurance Company 352£99 J
<br /> 4729 W.Jacquelyn Ave. INSURER D:American Casualty Company of Readinu F'A :204_7.7 —_
<br /> Fresno,CA 93722 _ _
<br /> INSURER E:Continental Casualty Company____ _1,20443
<br /> - INSURER F
<br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:__
<br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR TIME PCL Cl'PERIOD
<br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TC l JHiCH THIS
<br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFCRDED BY THE POLICIES DESCRIBED HEREIN IS SUBJI=C"r TO ALL.T 1E TERMS,
<br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
<br /> INSR ADDL SUBR - -
<br /> LTRTYPE OF INSURANCE V V POLICY NUMBER POLICY EFF POLICY EXP ---
<br /> A X COMMERCIAL GENERAL LIABILITY D LIMITS EACH OCCURRENCE S �2+000,(ICO
<br /> CLAIMS-MADE �J OCCUR X 6015893246 12/01/2019 12/01/2020 DDAMAGESORENTED_PS300,C100
<br /> _MED EXP An one person__ _—_--15,o00
<br /> -- --- PERSONAL&AOV INJURY 2,000,000
<br /> GEN'LAGGREGATELIMITAPPLIESPER: GENERAL AGGREGATE 4,0'OO,QUO
<br /> � 1.-----—'-- --
<br /> POLICY X JECT LOC PRODUCTS-COMP/OP,4GG 4,000,000
<br /> OTHER:
<br /> t-----—-----
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 'I'000,000
<br /> ii acciden l _ $
<br /> X ANY AUTO 6045473729 1210112019 12/01/2020 BODILYIWURY(Per person
<br /> OWNED SCHEDULED
<br /> AU��TEEOS ONLY I
<br /> AUTOS BODILY INJURY Per accident
<br /> AUT03 ONLY AUTOS
<br /> NON-OWNED
<br /> PROPEF2TY MAGE --- --"
<br /> eracatlont -- ,6—__-------
<br /> $
<br /> C+ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE
<br /> EXCESS LIAB CLAIMS-MADE 6015893232 12/01/2019 12/01/2020 AGGREGATE 5,000,000
<br /> DED X RETENTION$ 10,000 -- -----------
<br /> D I,WORKERS COMPENSATION X PER OTH-
<br /> AND EMPLOYERS'LIABILITY Y r N 020581635 12/01/2019 12/01/2020
<br /> ANY CERIMEPROPRIETOR/EXCLUDR/EXECIlTIVE 1,000,00(
<br /> �jTATUTF ER_
<br /> F nctatoMEn NH)EXCLUDED? ❑Y N 1 A I E.L.EACH ACCIDENT _—__—_
<br /> lfgs,awry In and E;L DISEASE-EA EMPLOYE — — i,(If10+Ot1(1
<br /> DyS IPTIOeunder 1,(100,00(1
<br /> DESCRIPllu OF OPERATIONS below E.L.DISEASE-POLICY LIMIT
<br /> E Prof./Pollution Liab EH591895527 12101!2019 12101/2020 Each Claim 2,000,00(
<br /> E Prof./Pollution Liab AEH591895527 12/01/2019 12/01/2020 Aggregate 4,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required)
<br /> *'Actual Certificate to be issued upon request'L
<br /> Certificate Holder is named Additional Insured(including Ongoing&Completed Operations and Primary Non-Contributory Wording)as respects Sin iral
<br /> Liability per attached blanket policy form CNA75079XX(10-16).
<br /> `*Professional/Pollution Liability deductible per claim-$25,000
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE _I
<br /> '*SAMPLE CERTIFICATE** THE EXPIRATION DATE THEREOF, NOTICE WILL BE Del.VEREED IN
<br /> ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> AUTIIOR17ED REPRESENTATIVE —
<br /> ACORD 25(2016103) ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> The ACORD name and logo are registered marks of ACORD
<br />
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