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ABLEMAI- CL DWATTS DATE (MM/DD/YYYY) CERTIFICATE F LIABILITY INSURANCE 9/28/2020 MATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER . THIS THIS CERTIFICATE IS ISSUED AS A MATTER OF INFOR CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND , EXTEND OR ALTER THE COVERAGE AFFORDS D 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 have ADDITIONAL INSURED provis ions or be endorsed . if SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorseriient. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s) . CONTACT '.. PRODUCER NAME : a Petersen Insurance Agency, Inc . PHONE Geor 7FAX f4o): (707 ) 525.4175 g (AIC, No, Ext): � 07 ) 525-4150 P .O . Box 3539 E-MAIL info ins . co Santa Rosa , CA 95402 ADDRESS : �gp m INSURERS AFFORDING COVERAGE NAIL N INSURER A : Homeland Insurance Company of Nil York 34452 INSURER B : West American Insurance Company 44393 INSURED Able Maintenance Inc . INSURER C : State Compensation Insurance Fund 35076 3224 Regional Parkway INSURER D : Amerlcan Fire $ Casualty Company. 24066 Santa Rosa , CA 95403 INSURER E : 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 C014DITIONS OF SUCH POLICIES . LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ADDL SUER POLICY EFF POLICY EXP LIMITS INSR POLICY NUMBER MM DD MM DD YY LTR TYPE OF INSURANCE INSD WV 10 000 000 A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ PREMISES 10111 /2020 10/11 /2021 DAMAGE RENTED 5p000 CLAIMS-MADE ® OCCUR 793- 00 -26-72-0006 PREMISESS ( Ea occ «ence X Pollution & Professi MED EXP An one person ) $ 5, 000 PERSONAL & ADV INJURY $ 10000 '000 GENERAL AGGREGATE $ 10 ,000 ,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 10 ,000 ,000 POLICY ® PE o 1:1 LOC MOLD SEE REMARK $ 1 , 000 , 000 OTHER: COMBINED SINGLE LIMIT 1 � 000 � 000 B AUTOMOBILE LIABILITY Ea accident $ X ANY AUTO BAW (21 ) 58661065 4/1 /2020 4/1 /2021 BODILY INJURY Per erson $ OWNED SCHEDULED BODILY INJURY Per accident $ '... AUTOS ONLY AUTOS PROPERTY DAMAGE '... HIRED NON-OWIJED Per accident $ AUTOS ONLY AUTOS ONLY UMBRELLA LAB OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATEI. DED I I RETENTION $ PER _ C WORKERS COMPENSATION X STATUTE OERH AND EMPLOYERS' LIABILITYy / N 9073219-20 10/112020 10/1 /2021 1 ' 000'000 ❑ E. L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE NIA OFFICER/MEMBER EXCLUDED? E . L. DISEASE - EA EMPLOYE $ 1 ' 000 '000 (Mandatory in NH) 130001000 If yes, describe under E .L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS below4/1 /2020 4/1 /2021 A re ate/OCC . 4, 000 , 000 D Excess Auto/WC only ESA (21 ) 58661065 99 g DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101 , Additional Remarks Schedule , may be attached if more space is required) RE : Proof of Coverage CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF , NOTICE WILL BE DELIVERED IN Able Maintenance, Inc , ACCORDANCE WITH THE POLICY PROVISIONS , 3224 Regional Parkway Santa Rosa , CA 95403 AUTHORIZED REPRESENTATIVE 1 1✓ Y . ACORD 25 (2016/03 ) © 1988 -2015 ACORD CORPORATION . All rights reserved . The ACORD name and logo are registered marks of ACORD