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TSADRIL-01 TGALART
<br /> '4w�v CERTIFICATE OF LIABILITY INSURANCE D8/ 1/22112/Y018
<br /> _ _ 08
<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 License#OB50501 CONTACT Teresa Galart
<br /> NAME:
<br /> Armstrong&Associates ac°,No,Ext 530 668-2777 FAX
<br /> 239 W Court St,Bldg A I ):( ) IA/C,No):(530)668-2779
<br /> Woodland,CA 95695 E L .
<br /> INSURERS AFFORDING COVERAGE NAIC#
<br /> INSURER A:Colony Insurance Company 39993
<br /> INSURED INSURER B:West American Insurance Company "393
<br /> TSA Drilling Inc.PeneCore Drilling INSURER C:Wesco Insurance Company Inc. 26011
<br /> 220 North East St INSURER D:Woodland Office
<br /> Woodland,CA 95776 INSURER E:Ohio Security Insurance Company 24082
<br /> INSURER F
<br /> COVERAGES CERTIFICATE NUMBER: 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 I TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS
<br /> A I X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE X OCCUR X X PACEP305708 08/05/2018 08/05/2019 DAMAGMISE TORENTEDn $ 100,000
<br /> X Pollution included RE E MED EXP An one arson $ 5,000
<br /> X Professional Include PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> X POLICY❑jP& LOC PRODUCTS-COMP/OPAGG $ 2,000,000
<br /> OTHER: Poll/Prof each 1,000,000
<br /> B AUTOMOBILE LIABILITY EOMeBIINdE�D SINGLE LIMIT $ 1,000,000
<br /> X ANY AUTO BAW51121954 08/05/2018 08/05/2019 BODILY INJURY Perperson) $
<br /> OWNED SCHEDULED
<br /> AUTOS ONLY AUUTNOSWt� p BODILY INJURY Per accident $
<br /> MRS ONLY AUTO B PPeoPERc ent AMAGE $
<br /> A UMBRELLA LIAB Li X OCCUR EACH OCCURRENCE $ 9,000,000
<br /> X{EXCESS LIAR CLAIMS-MADE) EXC305709 08/05/2018 08/05/2019 AGGREGATE $ 9,000,000
<br /> DED RETENTION$
<br /> C WORKERS COMPENSATION X I PER OTH-
<br /> AND EMPLOYERS'LIABILITY ER
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE YIN X C3364623 08/01/2018 08/01/2019 1,000,000
<br /> E.L.EACH ACCIDENT $
<br /> OFandatoryEn NH)EXCLUDED9 Y NIA 1,000,000
<br /> 1� E.L.DISEASE-EA EMPLOYE $
<br /> If yes,describe under 1,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT
<br /> D Property LOST 08/05/2018 08/05/2018 Building 481,500
<br /> E Equipment Floater BKS56829964 08/05/2018 08/05/7019 Rented Leased Borrow 50,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> Geosyntec Consultants,Inc.and Geosyntec Consultants International,Inc. and client are named additional insured per attached endorsement. Waiver of
<br /> Subrogation attached for the General Liability. Waiver of Subrogation for the Work Comp attached. RE: All Operations
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> Geosyntec Consultants,Inc.and THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> y ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Geosyntec Consultants International,Inc.
<br /> 900 Broken Sound Parkway,Suite 200 ---
<br /> Boca Raton,FL 33487-2775 AUTHORIZED REPRESENTATIVE
<br /> cm azc;ti
<br /> ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> The ACORD name and logo are registered marks of ACORD
<br />
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