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n A� R® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDNYYY) I TYPE OF INSURANCE 3/21/2018 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 CT Shala Pearson NAME: TLB Insurance Services PHONE (916)691-5555 FAX (888)329-8842 AIC No: CA License #OB82095 E-MAIL ADDRESS: shala-pearson@leavitt. com 3000 Oak Road, Suite 210 INSURER(S) AFFORDING COVERAGE NAIC# Walnut Creek CA 94597 INSURERAAdmiral Insruance Company a24856 INSURED INSURERB:Travelers Casualty Co. of America 19046 Walton Engineering, Inc. INSURERC:State Compensation Insurance Fund 35076 P.O. Box 1025 -INSURER D:Travelers Casualty Co. of America 19046 INSURER E West Sacramento CA 95691 INSURERF: 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 LTR I TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X❑ OCCUR EACH OCCURRENCE $ 1,000,000 PREMDAMAGE TO RENTED 50, 000 PREMISES Ea occurrence) $ X Incl. Pollution Liab. FBIECC1358705 3/6/2018 3/6/2019 MED EXP (Any one person) $ 5,000 X Incl. Professional Liab. PERSONAL &ADV INJURY $ 11000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JERT D LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OPAGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY Ea aB tleD SINGLE LIMIT $ 11000,000' B XANY AUTO ATOSCHEDULED AUUTOSS AUTOS 81068992397 3 6/2018 / 3/6/2019 BODILY INJURY (Per person) $ BODILY $ ) NON-OWNED X HIRED AUTOS LXAUTOS PROPERTY DAMAGE Per accident) ccident $ A UMBRELLA LIAB X EXCESS LIAB X OCCUR CLAIMS -MADE EACH OCCURRENCE $ 10, 000, 000 AGGREGATE $ 10, 000, 000 DED I RETENTION$ $ FEIEXS1358805 3/6/2018 3/6/2019 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If es, describe under DESCRIPTION OF OPERATIONS below NIA A 9113339-2017 10/1/2017 10/1/2018 PER OTH- X STATUTE ER E.L. EACH ACCIDENT $ 11000,000 E.L. DISEASE - EA EMPLOYE $ 1,000,000 E.L. DISEASE - POLICY LIMIT I $ 1,000,000 D Inland Marine 3/6/2018 3/6/2019 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) To Whom it May Concern SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Shala Pearson/SHPEAR IW55-2074 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401)