SALEENG-01 MSELT2
<br />,�►coRo CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
<br />12/02/2020
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<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 be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br />PRODUCER License # OE02096 CONTACT
<br />NAME:
<br />DiBuduo & DeFendis Insurance Brokers, LLC lA C,"No, Ext): (559) 432-0222 FAX, No):(559) 431-7941
<br />P.O. Box 5479 E-MAIL
<br />Fresno, CA 93755-5479 ADDRESS:
<br />INSURED
<br />Salem Engineering Group, Inc.
<br />4729 W. Jacquelyn Ave.
<br />Fresno, CA 93722
<br />F:
<br />V.
<br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<br />PA
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />INSD
<br />SUBR
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MM DD Y YY
<br />POLICY EXP
<br />MM DDIVYYY
<br />LIMITS
<br />A
<br />X COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE 2,000,000
<br />CLAIMS -MADE � OCCUR
<br />X
<br />6015893246
<br />12/01/202
<br />2/01/2021
<br />DREAGETO RMISS (EaENToCcEDn 300,000
<br />MED EXP (Any oneperson) $ 15,000
<br />PERSONAL & ADV INJURY $ 2,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE $ 4,000,000
<br />POLICY Fxl JECT F-1 LOC
<br />PRODUCTS - COMP/OP AGG 4,000,000
<br />OTHER:
<br />B
<br />AUTOMOBILE LIABILITYCOMBINED
<br />SINGLE LIMIT 1,000,000
<br />BODILY INJURY Perperson)
<br />X ANY AUTO
<br />6045473729
<br />12/01/2020
<br />12/01/2021
<br />BODILY INJURY Per accident $
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />���,,,,///
<br />PROPERTY AMAGE
<br />Per accident $
<br />HIRED NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />C
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />EACH OCCURRENCE 5,000,000
<br />AGGREGATE 5,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />6015
<br />12/01/2020
<br />12/01/2021
<br />DED I X I RETENTION $ 10,000
<br />$
<br />D
<br />WORKERS COMPENSATION
<br />X I PER I OTH-
<br />AND EMPLOYERS' LIABILITY
<br />YIN
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />6020581635
<br />12/01 /2020
<br />12/01 /2021
<br />1,000,000
<br />E.L. EACH ACCIDENT $
<br />OFFICER/MEMBER EXCLUDED?
<br />(Mandatory in NH)
<br />NIA
<br />E.L. DISEASE - EA EMPLOYEE 1,000,000
<br />E.L. DISEASE - POLICY LIMIT 1,000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E
<br />Prof./Pollution Liab
<br />AEH59185527
<br />12/01/2020
<br />12/01/2021
<br />Each Claim 2,000,000
<br />E
<br />Prof./Pollution Liab
<br />AEH59185527
<br />12/01/2020
<br />12/01/2021
<br />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 **
<br />Certificate Holder is named Additional Insured (including Ongoing & Completed Operations and Primary Non -Contributory Wording) as respects General
<br />Liability per attached blanket policy form CNA75079XX (10-16).
<br />** Professional/Pollution Liability Deductible per claim - $25,000
<br />CERTIFICATE HOLDER CANCELLATION
<br />ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />** SAMPLE CERTIFICATE **
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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