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MVPPE-1Oa. �..P ID: <br />CERTIFICATE OF LIABILITY INSURANCE„moi <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURE, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subiect to <br />the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER Phone: 530-895-1016 C;O;�ec'r 6eidre Hagen <br />InterWest Insurance ServicesVAX— <br />License #OB01094 Fax: 530-896-1313�1 <br />P.O. Box 8110 E4AIRUL <br />D Ess- dha en 1winscom <br />Chico, CA 95927-8110 <br />Chip Arenchild IIS!�RER(§�) •- r:, COYERAGF IC # <br />INSURER A t Admiral Insurance Company <br />INSURED <br />MVP Petroleum Engineering, Inc INSURERS: <br />PO Box 281 1 1 INSURER C: <br />Folsom, CA 95763-0281 1 INSURER D: A D 1 # IMI <br />'14 1 1 <br />,f'.OVERAGES CERTIFICATE NUMBER: REVISION NUMIW""v <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FONTWIFOL101VIDIE""Cl I -r <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 />ELVR <br />ADDL SUE” 060CY EFF POLICY EXP <br />NS MMIDD= <br />LTR TYPE OF INSURANCE POLICY NUMBER (MMIDR=) LIMITS — <br />GENERAL LIABILITY I EACH OCCURRENCE $ 1,000,000 <br />A X COMMERCIAL GENERAL LIABILITY 7FEIECC1732301 109101/2014 0910112016 , <br />50 00 <br />PREMISES (Ea opowi <br />CLAIMS -MADE <br />OCCUR MED EXP (Any one person)5,00C <br />PERSONAL & ADV INJU$ 1,000,00( <br />. ......... <br />MVP0281 <br />A 1 X <br />Con tr Poll I M12M <br />FEIECC1732301 09101/2014 <br />t <br />---------- <br />09/0112016 GENERAL AGGREGATE <br />PRODUCTS - COMP/OP AGG <br />I $ 2,000,00( <br />I_GEWL AGGREGATE LIMIT APPLIES PER: <br />PRO- JECT LOC <br />X1 POLICY F-1 <br />$ 2,000,00( <br />$ <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTOMOBILE LIABILITY <br />ANY AUTO <br />ALL OWNED AUTHOOULED <br />S <br />NON-OWNED—PRO—PERTV <br />HIRED AUTOS AUTOS <br />PO Box 281 <br />1 COMBINED SINGLE LIMIT <br />Ea accident) <br />BODILY INJURY (Per person) <br />BODILY INJURY (P accident) <br />AUTOS <br />DAMAGE <br />Per -a—lem)-_ <br />$ <br />$ <br />S <br />$ <br />$ <br />UMBRELLA LIAR <br />EXCESS UAB <br />OCCUR <br />CLAIMS -MADE <br />EACH OCCURRENCE <br />AGGREGATE <br />$ <br />$ <br />DEC) RETENTION <br />$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y/N <br />ANY P OPRIETOR/PARTNEREXECUTIVE <br />R <br />OFFICERIMEMBER EXCLUDED D <br />(Mandatory in NH) <br />Udescribe under <br />-SdRIP'TION OF OPERATIONS below <br />NIA <br />___t:-,L_jOTH_ <br />T_Zy <br />c WLT <br />E -L, EACH ACCIDENT <br />i <br />E.L.DISEASE - EA EMPLOYEE <br />LE, L DISEASE -POLICY LIMIT <br />$ <br />$ <br />$ <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, AddWonal Rem s <br />Confirmation of.Coverage. <br />rks Schedule, If mom space Is required) <br />. ......... <br />MVP0281 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE, MLL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />MVP Petroleum Engineering, Inc <br />PO Box 281 <br />AUNTATM <br />Folsom, CA 95763 <br />L'L <br />ACID RD 25 (2010105) <br />The ACORD name and log are <br />wD*-AU-Iu A.-Umu L'VmrwI ivm. Mfg F1911w Fewelveu. <br />ad marks of ACORD <br />