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ACORO� DATE(MMIDD/YYYY)
<br /> � CERTIFICATE OF LIABILITY INSURANCE 1/15/2019
<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 be endorsed. If SUBROGATION IS WAIVED, subject 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 CONTACT
<br /> NAME: Donna M.Bo da
<br /> JLT Specialty USA PHONE FAX
<br /> 135 Main Street Alc No •415-930-9049 ac No:
<br /> AIL
<br /> Suite 1600 ADDRESS: donna.bor'a 'ltus.com
<br /> San Francisco CA 94105 INSURER(S) AFFORDING COVERAGE NAIC#
<br /> INSURER A:Axis Surplus Insurance Company 26620
<br /> INSURED GREGDRI-01 INSURER a;Zurich American Insurance Company 16535
<br /> Gregg Drilling, LLC
<br /> 2726 Walnut Avenue INSURERC:
<br /> Signal Hill CA 90755 INSURERD:
<br /> INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER:593946122 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 TYPE OF INSURANCE ADDL UBR POLICY NUMBER MN DONYYY MCY EFF W
<br /> ICY EXP
<br /> LTR DD /YYYY LIMITS
<br /> A GENERAL LIABILITY SP002682-02-2018 8/1/2018 8/1/2019 EACH OCCURRENCE $1,000,000
<br /> DAMAGE 0 RENTED
<br /> X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $500,000
<br /> CLAIMS-MADE LK OCCUR MED EXP(Any one person) $25,000
<br /> PERSONAL&ADV INJURY $1,000,000
<br /> GENERAL AGGREGATE $2,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000
<br /> 17 POLICYFX PRO- LOCI I $
<br /> B AUTOMOBILE LIABILITY BAP0235382-01 8/1/2018 8/1/2019 COMBINED SINGLE LIMIT
<br /> Ea accident $1,000,000
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS AUTOS PROPERTY DAMAGE $
<br /> X HIREDAUTOS X AUTOSSWNED Per accident
<br /> I
<br /> A X UMBRELLA LIABX OCCUR SX002683-02-2018 8/1/2018 8/1/2019 EACH OCCURRENCE $4,000,000
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $4,000,000
<br /> DED RETENTION$ 1 $
<br /> B WORKERS COMPENSATION WCO235381-01 8/12018 8/1/201WC9 X STATU- OTH-
<br /> AND EMPLOYERS'LIABILITY
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE YIN E.L.EACH ACCIDENT $1,000,000
<br /> OFFICER/MEMBER EXCLUDED? ❑Y N I A
<br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000
<br /> A Contractors Pollution Liability SP002682-02-2018 8/12018 8/12019 each claim $1,000,000
<br /> Professional Liability each claim $1,000,000
<br /> retro date:2/6/1985
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required)
<br /> The certificate holder Geosyntec Consultants,its affiliates,employees,volunteers,contractors,subcontractors,consultants,agents,representatives,directors,
<br /> officers,officials are all additional insured on the General,Automobile and Excess Liability policies where required by written contract or agreement subject to
<br /> policy terms,conditions and exclusions.
<br /> Professional Liability is claims made.Per Project General Aggregate excludes Professional Liability.Umbrella is excess over General Liability,Pollution and
<br /> Professional Liability,Automobile and Employer's Liability coverages.
<br /> This Insurance is Primary and Non-Contributory on the General Liability policy subject to the policy terms,conditions and exclusions.
<br /> Waiver of subrogation applies in favor of the certificate holder Geosyntec Consultants,its affiliates,employees,volunteers,contractors,subcontractors,
<br /> consultants,agents,representatives,directors,officers,officials are all on the General,Automobile,Workers Compensation and Excess Liability policies where
<br /> See Attached...
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Geosyntec Consultants ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 3043 Gold Canal Dr.
<br /> Suite 100 AUTHORIZED REPRESENTATIVE
<br /> Rancho Cordova CA 95670
<br /> ©1988-2010 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD
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