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AC�® DATE (MM/DD/YYYY) CC) CERTIFICATE OF LIABILITY INSURANCE 9/8/2023 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 NAME : Lauren Hand Basi Ins Services-HUB International Insurance Services Inc. PHONE FAX 1491 East G Street c Ext)7 209-847-3065 (AIC No): 209-848-4931 Oakdale CA 95361 E-MAIL lauren . hand hubinternational .com INSURERS) AFFORDING COVERAGE NAIC # INSURER A : PartnerRE Insurance Company Bermuda , LTD INSURED XPREAUT-03 INSURER B : American Summit Insurance 19623 Xpress Technical Services DBA IEC Services P . O . Box 11160 INSURER C : National Casualt Company 11991 Oakdale CA 95361 INSURER D : Lloyd's of London 15792 INSURER E : Liberty Surplus Insurance Corporation 1 10725 INSURER F : COVERAGES CERTIFICATE NUMBER: 920597997 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DDIYYYY MMIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY VCP2023075 01 8/29/2023 8/29/2024 EACH OCCURRENCE $ 1 , 000, 000 DAMAGE TO RENTED CLAIMS-MADE FRI OCCUR PREMISES (Ea occurrence $ 50, 000 MED EXP (Any one person) $ 5 , 000 PERSONAL & ADV INJURY $ 1 , 000, 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2 ,0001000 X POLICY FI PECOT- LOC PRODUCTS - COMP/OP AGG $ 2 ,0003000 OTHER: $ B AUTOMOBILE LIABILITY ASCA001000244100 8/29/2023 8/29/2024 COMBINED SINGLE LIMIT $ 1 , 000 , 000 Ea accident _ X ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ A UMBRELLA LIAB X OCCUR VCX2023061 01 8129/2023 8/29/2024 EACH OCCURRENCE $ 5, 000 , 000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ C WORKERS COMPENSATION WCC349007A 8/29/2023 8/29/2024 X PER OTH- AND EMPLOYERS' LIABILITY YIN , STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ E.L. EACH ACCIDENT $ 1 , 000 , 000 OFFICER/MEMBER EXCLUDED? N / A (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ 1 , 000 , 000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1 , 000, 000 D Professional Liability B0621PXPRE000122 11 /10/2022 11 /10/2023 Aggregate $130003000 E Pollution Liability ICELLUW00132857 10/9/2022 10/9/2023 Aggregate $31000 , 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101 , Additional Remarks Schedule, may be attached if more space is required) Information Purposes Only CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS . Evidence of Insurance AUTHORIZED EPRESENTATIVE © 1988-2015 ACORD CORPORATION . All rights reserved . ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD