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AC" CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 03/03/2023 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 Shala Pearson NAME: TLB Insurance Services PHONE (9 16) 790-5863 FAX (888) 329-8842 (A/Cl /C No Ext): AIC, No): CA License #01382095 E-MAIL shala-pearson@leavitt. com ADDRESS : 2358 Maritime Dr, Ste 100 INSURER(S) AFFORDING COVERAGE NAIC # Elk Grove CA 95758 INSURERA : Westchester Surplus Lines Insurance Company 10172 INSURED INSURER B : Travelers Property Casualty Company of America 25674 Walton Engineering, Inc. INSURERC : Service American Indemnity Company 39152 P. O . Box 1025 INSURER D : Travelers Property Casualty Company. 36161 INSURER E : West Sacramento CA 95691 INSURER F : COVERAGES CERTIFICATE NUMBER: 23/24 Master 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 AU1JL SUUR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICYNUMBER MMIDDIYYYY MMIDD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 13000,000 CLAIMS-MADE ❑X OCCUR DAMA ET RENTED 501000 PREMISES Ea occurrence $ X Inc. Pollution Liability MED EXP (Any one person) $ 51000 A X Inc. Professional Liability G47393735001 03/06/2023 03/06/2024 PERSONAL & ADV INJURY $ 110003000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 210002000 POLICY X PRO LOC 2, 0003000JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 110002000 Ea accident JX ANYAUTO BODILY INJURY (Per person) $ BOWNED SCHEDULED 8108L785302 03/06/2023 03/06/2024 BODILYINJURY (Peraccident) $ AUTOS ONLY AUTOS HIRED �/ NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY X AUTOS ONLY Per accident Uninsured motorist $ 13000 , 000 UMBRELLA LIAB RREN OCCUR EACH OCCURRENCEE $ 10 , 000, 000 A X EXCESS LIAB CLAIMS-MADE G47393747001 03/06/2023 03/06/2024 AGGREGATE $ 10 ,0003000 DED I X1 RETENTION $ 0 $ WORKERS COMPENSATION X1 SPER TATUTE EORH AND EMPLOYERS' LIABILITY IN C ANY PROPRIETOR/PARTNER/EXECUTIVE Y❑ NIA SAMTVVC10020101 10/01 /2023 10/01 /2024 E.L. EACH ACCIDENT $ 1 , 000, 000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 1 , 000, 000 EL If yes, describe under 1 , 000, 000 DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ Inland Marine D Leased/Rented/Borrowed 6608K816207 03/06/2023 03/06/2024 Limit $3003000 Deductible $2 , 500 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101 , Additional Remarks Schedule, may be attached if more space is required) is included as an additional insured when required by written contract as respects General Liability and Auto Liability per forms CG2010 0704 , CG2037 0704 , CAT353, CAT474 . Insurance is Primary and Noncontributory form ENV3251 1218 , Per Pproject Aggregate applies per form ENV7124 0314 . Waiver of Subrogation , when required in written contract applies to General Liability, Auto Liability and Work Comp per forms ENV3143 0305 , CAT3530215 , 10217718 , 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, AUTHORIZED REPRESENTATIVE © 1988-2015 ACORD CORPORATION . All rights reserved . ACORD 25 (2016/03 ) The ACORD name and logo are registered marks of ACORD