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_COlby�1AM 1S �, I Ake ? P CERTIFICATE OF LIABILITY INSURANCE D10/5/2017Y) �� to/s/zol7 THIbf'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 pollcy(les) must 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 Ileu of such endorsement(s). PRODUCER CONTACT Heidi Gable NAME: TLB Insurance Services NO,son 2 00 FAX (925)267-0710 PHONE ®lN.P. CA License #OB82095 IIULto i5gable2eavitt.comADDRE88: 3000 Oak Road, Suite 210 INBU S AFFORDING COVERAGE HAIOe Walnut Creek CA 94597 MSURERAAdmiral Insruance Company a24856 INSURED INSURER B:Inte On National Insurance Company 29742 Walton Engineering, Inc. INSURERC:State Compensation Insurance Fund 35076 P.O. Box 1025 INSURERD:Hartford Casualty Insurance Company29424 INSURER E: West Sacramento CA 95691 1 INSURER F: COVERAGES CERTIFICATE NUMBER:17/18 All Policies 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. LTR TYPE OF INSURANCE B POLICY NUMBER POLICY EFF POIIOY EXP LIMITS X COMMERCIAL GENERAL LLAMLrrY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE OCCUR DAMA ET RENTED 50,000 PREMISES Eeocrosrenre $ X IDCl. Pollution Liab. FEI-ECC-13587-04 3/6/2017 3/6/2018 MED EXP(Any one Person) $ 5,000 X Incl. Professional Liab. PERSONAL S ADV INJURY $ 11000,000 GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY 0JECT El LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LUUNLRY COMBINED IN LE LIMIT $ 1,000,000 Ea ecGEent BX ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED 12003162 3/6/2017 3/6/2018 BODILY INJURY(Per eWtlent) $ AUTOS AUTOS X HIREDAUTOS X AUTOS PPW-cdRdwt) IsAGE IS UMBRELLA"JAB X OCCUR EACH OCCURRENCE $ 10,000,000 A X EXCESS lU1B CLAIMS-MADE AGGREGATE $ 10,000,000 DED RETENTION$ PBI-EXS-13588-04 3/6/2017 3/6/2018 $ WORKERS COMPENSATION PER OTH. AND EMPLOYERS'LIABILITY YIN X STATUTE ER ANY PROPRIETORMARTNEWEXECUTIVE ❑ NIA E.L.EACH ACCIDENT $ 1,000,000 C OFFICERIMEMBER EXCLUDED? (Mandatory In NH) 9113339-2017 1D/1/2017 10/1/2018 E.L.DISEASE-EA EMPLOYE $ 1,000,000 If es,dasoibe under DESCRIPTION OF OPERATIONS balm E.L DISEASE-POLICY LIMIT $ 1100 0 000 D Inland Marine 571tUMZC1966 3/6/2017 3/6/201$ Limit $ 300,000 Rented, Leased or Borrowed Dedudible $ 2,500 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Adddonal Remarks Schedule,may be eaached R more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TO WHOM IT MAY CONCERN THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AI THORGED REPRESENTATIVE Q,� Heidi Gable/HEGABL � ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401)