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�..••., BZSERVI -01 SREFIL ACRO CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 8/6/2021 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 have ADDITIONAL INSURED provisions or 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 CONT Laurie Graves AX Inszone Insurance Services, LLC P(AIC N, Ext): (916) 503 -4813 ()VC, Ne): (916) 636-0134 2721 Citrus Road , Suite A AI E-ML Rancho Cordova, CA 95742 ADDREss: igraves@inszoneins .com INSURERS AFFORDING COVERAGE NAIC # INSURER A : Axis Surplus Insurance Company INSURED INSURER B : Infinity Select Insurance Company 20260 BZ Service Station Maintenance, Inc. INSURER C : National Liability & Fire Insurance Company 20052 P.O. Box 933 INSURER D : West Sacramento, CA 95691 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 CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN RI ADOL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS TYPE OF INSURANCE INSD WVD MMIDDIYYYY MMIDD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 11000 ,000 CLAIMS-MADE ❑X OCCUR EMP20001971 -02 2/15/2021 2/15/2022 DAMAGE TO RENTED 100000 PREMISES Ea occurrence $ MED EXP (Any oneperson) $ 10 ,000 PERSONAL & ADV INJURY $ 11000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 21000 ' 000 POLICY PRO- ❑ LOC PRODUCTS - COMP/OPAGG $ 2 , 0001000 JECT OTHER: $ B AUTOMOBILE LIABILITY COacccidentSINGLE LIMIT $ 1 �OOO� QOQ X ANY AUTO 504610143114001 8/19/2021 8/19/2022 BODILY INJURY Per person) ,$ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ HIRED NON-OV�IJED PROPERTY AMAGE 1 , 000, 000 AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE ,_$, DED RETENTION $ $ C WORKERS COMPENSATION X STATUTE I OERH _ AND EMPLOYERS' LIABILITY 9WC113488 10/27/2020 10127/2021 11000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE YN / A E.L. EACH ACCIDENT $ _ OFFICERIMEMBER EXCLUDED? 15000 ,000 (Mandatory in NH) E. L. DISEASE - EA EMPLOYE $ If yes, describe under 1 ,0001000 DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ A Pollution Liability EMP20001971 -02 2/15/2021 2/15/2022 Aggregate 21000,000 A Professional Liab. EMP20001971 -02 2/15/2021 2/15/2022 Aggregate 21000 ,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101 , Additional Remarks Schedule, may be attached if more space is required) Verification Of Insurance CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Verification Of Insurance ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 19884015 ACORD CORPORATION . All rights reserved . The ACORD name and logo are registered marks of ACORD