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AC40 CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) <br /> 03/03/2023 <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 CONTACT Shala Pearson <br /> NAME: <br /> TLB Insurance Services PHONE (g16) 790-5863 FAX (888) 329-8842 <br /> A1C No Ext): AIC, No <br /> CA License #OB82095 E-MAIL shala-pearson@leavitt. com <br /> ADDRESS: <br /> 2358 Maritime Dr, Ste 100 INSURER(S) AFFORDING COVERAGE NAIC # <br /> Elk Grove CA 95758 INSURER A : Westchester Surplus Lines Insurance Company 10172 <br /> INSURED INSURER B : Travelers Property Casualty Company of America 25674 <br /> Walton Engineering , Inc. INSURERC : Service American Indemnity Company 39152 <br /> P. O . Box 1025 INSURER D : Travelers Property Casualty Company. 36161 <br /> INSURER E : <br /> West Sacramento CA 95691 INSURER F : <br /> COVERAGES CERTIFICATE NUMBER: 23/24 Master REVISION NUMBER : <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 AIJULSLIUR POLICY EFF POLICY EXP <br /> LTR TYPE OF INSURANCE INSD WVD POLICYNUMBER MM/DDIYYYY MMIDD/YYYY LIMITS <br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1 , 000 , 000 <br /> CLAIMS-MADE ❑X OCCUR DAMAGE TO RENTED 50 , 000 <br /> PREMISES Ea occurrence $ <br /> X Inc. Pollution Liability MED EXP (Any one person) $ 5 ,000 <br /> A X Inc. Professional Liability G47393735001 03/06/2023 03/06/2024 PERSONAL & ADV INJURY $ 1 ,0001000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,0001000 <br /> POLICY PRO ❑ LOC PRODUCTS - COMP/OPAGG $ 2, 000 , 000 <br /> JECT <br /> OTHER: $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 13000, 000 <br /> Ea accident <br /> X ANYAUTO BODILY INJURY (Per person) $ <br /> B OWNED SCHEDULED 81081.785302 03/06/2023 03/06/2024 BODILY INJURY (Per accident) $ <br /> AUTOS ONLY AUTOS <br /> X HIRED �/ NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY X AUTOS ONLY Per accident <br /> Uninsured motorist $ 1 , 000, 000 <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE REN E $ 1010001000 <br /> A X EXCESS LIAB CLAIMS-MADE G47393747001 03/06/2023 03/06/2024 AGGREGATE $ 1010001000 <br /> DED I X1 RETENTION $ 0 $ <br /> WORKERS COMPENSATION X1 <br /> SPER TATUTE EORH <br /> AND EMPLOYERS' LIABILITY <br /> C <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE Y❑ N / A SAMTWC10020101 10/01 /2023 10/01 /2024 E.L. EACH ACCIDENT $ 1 , 000 , 000 <br /> OFFICER/MEMBMBER EXCLUDED? <br /> (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ <br /> D 1 ,000 , 000 <br /> yes, describe under <br /> DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 11000 , 000 <br /> Inland Marine <br /> D Leased/Rented/Borrowed 66081<816207 03/06/2023 03/06/2024 Limit $300, 000 <br /> Deductible $2 , 500 <br /> DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101 , Additional Remarks Schedule, may be attached if more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> To Whom it May Concern Evidence of Insurance ACCORDANCE WITH THE POLICY PROVISIONS, <br /> AUTHORIZED REPRESENTATIVE <br /> © 1988-2015 ACORD CORPORATION . All rights reserved . <br /> ACORD 25 (2016/03 ) The ACORD name and logo are registered marks of ACORD <br />