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CERTIFICATE OF LIABILITY INSURANCE FDA (MNUDD/YYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THEHOLDER. THIS CERTIFICATE CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED TE 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 certillcate holder Is an ADDITIONAL INSURED,Inc POIICy(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 lieu of such endorsement(s). PRODUCER CONTACT NA E: Heidi Gable TLB Insurance Services, Inc, vHONE , (925)395-2600 FAx (AM ftk(916)297-0730 CA License #OB62095 E-SAIL haidi-gabllNleavitt.com ISIS 3000 Oak Road, Suite 210 WORRIES! AFFORDING COVERAGE Man 0 Walnut Creek CA 94597 INSURED INSUSERAAdmiral Inarnaaoe Cc an a24936 INSUIIERD,late On National Inurance CO as 29742 Walton wriag, Inc. INSUREI3CIState C nation Insurance Pund 35076 P.O. Boxx 11025025 INSURERD2lartford Canualt Inurance C as 29424 NSURER E: WeSt Sacramento CA 95691 INSURER F: COVERAGES CERTIFICATE NUMBER:16-17 PRG w/ 15-16 WC 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. INSP TYPE OF MBURANCE POLICY NUMBER POL30YEFF POLICYEXP uLffB E COMMERCIAL GENERAL nWwoD/YYYYIEACH OCCURRENCE 1,000,000 A CLAIMS-MAGE x-1OCCUR p E „ $ 50,000 E Incl. Pollution Liab, Pan3CC1359703 3/6/2016 3/6/2017 MEDEXP one ) 0 51000 Y Incl. Professional Liab. PERSONALE ADV INJURY Is 11000,000 OENL AGGREGATE UNpIT. APPLES PER. GENERALAGGREGATE 5 2,000,000 Y POLICY El ZT F PRODUCTS-COMPIOP AGO 6 2,000,000 OTHER; EMPL BENEFITS LIAB 4 AUTOMOBILE LIABILITY N L LI 6 11000,000 Ea eCd0e11 H E ANY AUTO BCOILYINJURY(Pw FeneO) 0 AUROS OS AUTOS SCHEDULED AL12006162 3/6/2016 3/6/1017 BODILY INJURY(ParaxJOax) III NONOWNEO PROPERTY DAMAGE HIRED AUTOS Y AUTOS er SnId 6 Y U ".w D,olalsl=TbIDIKI6 500,000 UMBRELLA LIAR �� EACH OCCURRENCE 4 10,000,000 A E EXCESS DAB CLAIMS-MADE AGGREGATE f 10.000,000 DED I I RETENTION fa1T 1390BC3 3/6/2016 3/6/2017 WORKERS COMPENSATION Y AND EMPLOYERS'UABILITY YIN ANY PROPRIETOWPARTNEWEXECUTIVE E.L.EACH ACCIDENT f 1,000,000 C OFFICEWMEMSER EXCLUDED? N/A (ManOatm In NH) 911333915 10/1/2016 10/1/2017 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 IIryae tlemnbeunder DESCRIPTIONOFOPERATIONSWe E.L.DISEASE-FOUCY LIMIT 6 1,000,000 D Inland Marine 5700HZC1966 3/6/2016 3/6/2017 UDA $ 3001000 Rented, Leaaed ar Borrowed oiwJ 01e $ 21500 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Addftlenal Remark.Sc duh,may beaeachetl N morespace IsregWR NOV 0 1 2016 r-NVIRONMENTAL HEALTH CERTIFICATE HOLDER CANCELLATION nFPARI 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. AUTHORIZED REPRESENTATIVE Dennis Cote/JUBAUT ®1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025 r?nrann