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�=tet <br /> A t <br /> /� �j y_ /� j- I t� { [ �j�hf'ORC� <br /> CER [ IRGATE OF LIA8ILI`�Y WSUi\ANCE DATE(MM/DD/YYYY) <br /> -----_� 01/11/2019 <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 /> FBELOW. 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 INS%emenA <br /> be endorsed. <br /> If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require statement on <br /> this certificate does not confer ri hts to the certificate holder in lieu of such endorsements . <br /> PRODUCER 916-960-8718 CONTACT LOry Williams <br /> ISU/Francis-Pinney Ins. <br /> 2266 Lava Rfdge Court Ste 200 PHONE 316-960.8718 —P.O.Box 619050 (A/C,No,Ext: 773-4484Roseville,CA 85661-9050 E-MAIL wl lams lSUOFS.COmLory Williams A D EsINSURERAFFORDING COVEINSURER A:Redwood Fire and CasualtNAlcr <br /> INSURED Nor-Cal PUMP&Well Drilling <br /> 1325 Barry Raad INSURER B: _ <br /> Yuba City, CA 95993 I <br /> NSURERC <br /> D <br /> E: <br /> COVERAGES <br /> CERTIFICATE NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE 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 TYPE OF INSURANCE DDL <br /> POLICY NUMBER POLICY F POLICY EXP <br /> COMMERCIAL GENERAL LIABILITY POLICY LIMITS <br /> CLAIMS-MADE E]OCCUR EACH OCCURRENCE $ <br /> DDAAEMM GE TO RENTED <br /> _ n $ <br /> MED EXP An one erson <br /> GEN'L AGGREGATE LIMIT APPLIES PER PERSONAL d ADV INJURY $ <br /> POLICY❑JECT <br /> PRC- 0 LOC GENERAL AGGREGATE <br /> OTHER. iPRODUCTS-COMP/OP-GG <br /> AUTOMOBILE LIABILITY <br /> ANY AUTO EOMBINED SINGLE LIMIT <br /> OWNED SCHEDULED BODILY INJURY Per erson <br /> Alri05 ONLY _ ALIT" <br /> HIRED NDN OWNEp BODILY INJURY Per accident <br /> AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE <br /> (Per accident) $ <br /> UMBRELLA LIAB OCCUR I <br /> EXCESS LIAB CLAIMS-MADE EACH OCCURRENCE $ <br /> DED RETENTION$ AGGREGATE $ <br /> A WORKERS COMPENSATION <br /> AND EMPLOYERS'LIABILfTY X PER OTH- <br /> ANY PROPRIETOR/PARTNER/EXECUrIVE Y/N Y NOWC0083CS D1/01/2019 01/01/1020 <br /> OFFICE tory In NH) <br /> EXCLUDED, NIA E.L.EACH ACCIDENT 1,000,000 <br /> OFFICERW In NH) $ <br /> H as,describe under E.L.DISEASE-EA EMPLOYE 1,000,000 <br /> DESCRIPTION OF OPERATIONS below - <br /> E.L.DISEASE-POLICY UNIT 1,000,000 <br /> DESCRIPTION Or OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be&Mched H more spacers required) <br /> RE: Evidence of Workers'Compensation- Blanket Waiver of Subrogation Form <br /> WC 99 04 10@_(Ed.9-14)is included along with 30-Day Notice Form WC 99 06 <br /> 07 D (Ed, 10-1 when required by Written and Executed Contract. <br /> CERTIFICA HOLDER CANCELLATION <br /> BID1018 <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED <br /> WORKERS COMPENSATION ACCORDANCE WITH THE POLICY PROVISIONS. IN <br /> BID PURPOSES 2019.2020 <br /> AUTHORIZED REPRESENTATIVE <br /> ACORD 25(2016!03) <br /> 1988-2015 <br /> The ACORD name and Logo are registered marks of ACORpCORD CORPORATION. All rights reserved. <br />