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CRAW&AS-01 THOMASR ACORN" CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYVV)9/8/2021 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 License # OE67768 CONTACT Gloria Page NAME: HONE FAX (A/c, No, Ext): (925) 918 4540 (A/c, No): IOA Insurance ServicesP 3875 Hogyard Road Suite 200 Pleasanton, CA 94588 A DRIE : Gloria.page@ioausa.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: RLI Insurance Company 13056 INSURED INSURER B: American Casualty Company of Reading, Pennsylvania 20427 INSURER C: Crawford & Associates, Inc. INSURER D: 1100 Corporate Way, Suite 230 Sacramento, CA 95822 INSURER E: INSURER F: 8/28/2021 rnV9RAn1l rFRTIFiCATF NI IIURFR• RFVISIAN NIIMRFR- 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 LTRTYPE OF INSURANCE ADDL INSD SUBR WV POLICY NUMBER POLICY EFF M DD/YYYY POLICY EXP D LIMITS A X COMMERCIAL GENERAL LIABILITY2,000,000 EACH OCCURRENCE CLAIMS -MADE 7 OCCUR X X PSB0007236 8/28/2021 8/28/2022 DAMAGE To RENTaccED $ 1,000,000 MED EXP (Any oneperson) $ 10,000 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY a JECT 7 LOC GENERAL AGGREGATE $ 4,000,000 4'000'000 PRODUCTS - COMP/OP AGG OTHER: A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) BODILY INJURY Perperson) X ANY AUTO X X PSA0002401 8/28/2021 8/28/2022 OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ Pe�accidentDAMAGE $ W p AUTOS ONLY ATOS ON LV A UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 AGGREGATE 1,000,000 XI EXCESS LIAB CLAIMS -MADE PSE0003614 8/28/2021 8/28/2022 DED I I RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILfTY Y ANY PROPRIETOR/PARTNER/EXECUTIVE X WC585648142 11/29/2020 11/29/2021 X I PERTUTE I I OTH- ER E.L. EACH ACCIDENT 1,000,000 OFFICER/MEMBER EXCLUDED? ❑ (Mandatory In NH) N / A E.L. DISEASE - EA EMPLOYE 1'000'000 E.L. DISEASE - POLICY LIMIT 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: UP Folder # 03265-66 All operations of the Named Insured, including the aforementioned project. General Liability: Union Pacific Railroad Company is included as Additional Insured on Primary & Non -Contributory basis with Waiver of Subrogation included, as required by written contract. Auto Liability: Union Pacific Railroad Company is included as Additional Insured with Waiver of Subrogation included, as required by written contract. Workers' Compensation: Waiver of Subrogation is in favor of Union Pacific Railroad Company, as required by written contract. rFRTIFIrATF wnl IIFR rANrFI I ATInN ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. San Joaquin County - Environmental Health Dept. AUTHORIZED REPRESENTATIVE 1868 Hazelton Avenue Stockton, CA 95205 ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD