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AC®!2®� CERTIFICATE OF LIABILITY INSURANCE DATE ( MM/DD/YYYY) ilkw.� F 11 / 5 / 2018 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( ies) 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 CONTACT Shala Pearson NAME: _ _ __ TLB Insurance Services PHONE Ext : ( 91-6 ) 691 - 5555 FAX No): ( 888 ) 329 - 8842 CA License # OB82095 ADMRIEss : shala -MAI 3000 Oak Road , Suite 210 INSURER(S) AFFORDING COVERAGE NAIC # Walnut Creek CA 94597 INSURERA :Admiral Insruance Company a24856_ INSURED INSURERB :Travelers Casualty Co. of America 19046 Walton Engineering , Inc . INSURERc : State Compensation Insurance Fund 35076 P . O . Box 1025 INSURERD :Travelers Casualty Co . of America 19046 INSURER E : West Sacramento CA 95691 1 INSURER F : COVERAGES CERTIFICATE NUMBER : 18 / 19 All Policies 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, INSR ADDL SUBR POLICY EFF POLICY EXP - LTR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MM/DDIYYYY LIMITS '.. X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1 , 000 , 000 '.. A CLAIMS-MADE ❑X OCCUR DAMAGE TO RENTED 50 , 000 '.. PREMISES Ea occurcence $ X Incl . Pollution Liab . FEIECC1358705 3 / 6 / 2018 3 / 6 / 2019 MED EXP (Any one person) $ 51000 X Incl . Professional Liab . PERSONAL & ADV INJURY 1 $ 11000 , 000 GENIAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2 , 0001000 - -- - -- -- POLICY X PEI° LOC PRODUCTS - COMP/OPAGG S 2 , 0001000 OTHER: AUTOMOBILE LIABILITY Ea aBINED( SINGLE LIMIT $ 11000 , 000 '.. B XANY AUTO BODILY INJURY (Per person) $ - ALL OWNED SCHEDULED 81068992397 3 / 6 / 2018 3 / 6 / 2019 BODILY INJURY Per accident $ AUTOS AUTOS X ( ) NON-OWNED PROPERTY DAMAGE S HIRED AUTOS X AUTOS (Per accident _ - UMBRELLA LIAB X OCCUR EACH OCCURRENCES 10 , 000 , 000 A X EXCESS LIAB CLAIMS-MADE AGGREGATE _ S _ 10 , 000 , 000 _ '.. DED RETENTIONS IFEIEXS1358805 3 / 6 / 2018 3 / 6 / 2019 S WORKERS COMPENSATION X PEROTH- AND EMPLOYERS' LIABILITY Y / N STATUTE ER — — — ANY PROPRIETOR/PARTNER/EXECUTIVE E. L. EACH ACCIDENT S _ 11000 , 000 OFFICER/MEMBER EXCLUDED? ❑ NIA A C -- - (MandatoryinNH) 9113339 10 / 1 / 2018 10 / 1 / 2019 E. L. DISEASE - EA EMPLOYEE S 1 , 000 , 000 If yes, describe under — DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT S 1 , 000 , 000 D Inland Marine 660BK816207 3 / 6 / 2018 3 / 6 / 2019 Limit $ 300 , 000 Rented , Leased or Borrowed Deductible $ 2 , 500 I DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101 , Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Evidence of Insurance THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS , AUTHORIZED REPRESENTATIVE '.. Shala Pearson / SHPEAR © 1988 -2014 ACORD CORPORATION . All rights reserved . ACORD 25 ( 2014/01 ) The ACORD name and logo are registered marks of ACORD INS025 (201401 )