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ACOROa AC� CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 3/14/2016 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 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 TLB Insurance Services, Inc. CA License #0382095 3000 Oak Road, Suite 210 Walnut Creek CA 94597 CONTACT Heidi Gable NAME: PHONE (925)395-2600 FAA/XN :(925)287-0710 ADDRE :haidi-gable@leavitt.com INSURERS AFFORDING COVERAGE NAICS INSURER AAdmiral Insruance Company a24856 INSURED Walton Engineering, Inc. P.O. Box 1025 West Sacramento CA 95691 INSURERB:Inte on National Insurance Company 29742 INSURERC:State Compensation Insurance 35076 INSURER D33artford Casualty Insurance Company 29424 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:16-17 PXG 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. INSR ACCORDANCE WITH THE POLICY PROVISIONS. ADDL SUBR AUTHORIZED REPRESENTATIVE POLICY EFF POLICY EXP TR TYPE OF INSURANCE POLICY NUMBER MWDDNYYY MD M/ LIMBS R COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE a OCCUR DAMAA PREMISES rr 50,000 PREMI ES Ea occunen e $ MED EXP (Any one person) $ 5,000 % Incl. Pollution Liab. FEIECC1358703 3/6/2016 3/6/2017 R Incl. Professional Liab. PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: I GENERAL AGGREGATE $ 2,000,000 POLICY 1:1 PE 4 LOC PRODUCTS - COMP/OP AGG $ 2,000,000 EMPL BENEFITS LIAB $ OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident ANY AUTO BODILY INJURY (Per person) $ 8 BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS 12003162 3/6/2016 3/6/2017 NON -OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident Uninsured motorist combined $ 500,000 X UMBRELLA LIABOCCUR HCLAIMS-MADE EACH OCCURRENCE $ 10, 000, 000 AGGREGATE $ 10, 000, 000 A X EXCESS LIAB DED I RETENTION 1 $ FEIEXS1358803 3/6/2016 3/6/2017 WORKERS COMPENSATION S PER OTH- STATUTE I I ER AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED? ❑ N/A E.L. DISEASE - EA EMPLOYEE $ 1,000,000 C (Mandatory In NH) 911333915 10/1/2015 10/1/2016 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 D Inland Marine 57UUMZC1966 3/6/2016 3/6/2017 Limit $ 300,000 Rented, Leased or Borrowed Deductible $ 2,500 DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) 11 rr `( �. k4..... UV��- MAY 31 2016 CERTIFICATE HOLDER CANCELLATION ACORD 25 (2014/01) INS025 rPmann ®1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 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 ACORD 25 (2014/01) INS025 rPmann ®1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD