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BZSERVk01 SREFIL ACOROp CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) `... 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 CONTACT Laurie Graves NAME: Inszone Insurance Services, LLC PHONE FAX 2721 Citrus Road, Suite A (A/c, No, Ext): (916) 5034813 (A1C, Ne): (916) 636=0134 Rancho Cordova, CA 95742 AoDRIEss : (graves@inszoneins .com INSURERS AFFORDING COVERAGE NAIC 0 INSURER A : Axis Surplus Insurance Company INSURED INSURER B : InfiniSelect 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF . POLICY EXP LIMITS LTR INSD D MM1DD/YYYY MM/DDNYYY A X COMMERCIAL GENERAL LIABILITYEACH OCCURRENCE $ 1 ' 0001000 REMI CLAIMS-MADE ❑X OCCUR EMP20001971 -02 2/15/2021 2/15/2022 PETORENTED 100, 000 PREMISES Ea occurrence $ MED EXP (Any oneperson) $ 10 ,000 PERSONAL & ADV INJURY $ 1 ' 000' 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 21000' 000 POLICY ❑X PR� F] LOC PRODUCTS - COMP/OP AGG $ 2, 0001000 OTHER: $ B AUTOMOBILE LIABILITY COaBBINEDtSINGLE LIMIT $ 19000, 000 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-OWNED PROPERTY DAMAGE 1 , 0003000 AUTOS ONLY AUTOS ONLY Per acc dent $ 1 ICESSRELLALIAB OCCUR EACH OCCURRENCE $LIAB CLAIMS-MADE_ J AGGREGATE 5 RETENTION $ $ C WORKERS COMPENSATION X AND EMPLOYERS' LIABILITY STATUTE _ _ EORH Y / N 9WC113488 10/27/2020 10/27/2021 110001000 ANY PROPRIETOR/PARTNER/EXECUTIVE E. L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N I A (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ 13000' 000 If yes, describe under 1 , 000, 000 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. EMP2000197142 2/15/2021 2/15/2022 Aggregate 2, 000, 000 DESCRIPTION OF OPERATIONS / LOCATIONS / 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 Verification Of Insurance THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION . All rights reserved . The ACORD name and logo are registered marks of ACORD