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8-4�36-1047 Page: 001 v� <br />ACORDTM CTIFICA OF LIABILITY INSU N <br />05/06/2009 <br />PRODUCER (559)436-0833 FAX (559) 256-6590 <br />Arthur J. Gallagher & Co. Ins. Brokers of CA Inc. <br />45 East River Park Place West <br />Suite 408 <br />Fresno, CA 93720 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />INSURERS AFFORDING COVERAGE MAIC # <br />INSURED Reme Tation Risk Management, Inc. - <br />dba: Triton Construction <br />2560 Soquel Ave., Suite #202 <br />Santa Cruz, CA 95062 <br />INSUPERA: Nationwide Mutual 23787 <br />INSURER&: Delos Ins Co <br />INSURER C: <br />INSURER D. <br />INSURER E. <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATEMAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />ILTR <br />DD' <br />N <br />TYPE OF INSURANCE <br />POLICYNUMBER <br />DATE EFFECTIA <br />MJD <br />POLICY EXPIRATION <br />MMJ D <br />LIMITS <br />GENERAL LIABILITY <br />EACH OCCURRENCE $ <br />COMMERCIAL GENERAL LIABILITY <br />DAMAGE TO RENTED $ <br />CLAIMS MADE OCCUR <br />MED EXP (Any one person) $ <br />PERSONAL& AOV INJURY $ <br />GENERAL AGGREGATE $ <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COAD/OP AGG $ <br />POLICY JE'c LOC <br />AUTOMOBILE <br />LIABILITY <br />ACP 7813367391 <br />05/11/2009 <br />05/11/2010 <br />X <br />ANY AUTO <br />COMBINED SINGLE LIMIT <br />$ <br />(Ea accident) <br />1,000,00 <br />ALL OWNED AUTOS <br />BODILY INJURY $ <br />A <br />SCHEDULED AUTOS <br />(Per person) <br />HIREDAUTOS <br />BODILY INJURY $ <br />NON-OWTIED AUTOS <br />(Per accident) <br />PROPERTY DAMAGE $ <br />(Per accident) <br />GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT $ <br />ANY AUTO <br />OTHER THAN EA ACC $ <br />AUTO ONLY: AGG $ <br />EXCESSIUMBRELLA LIABILITY <br />EACH OCCURRENCE $ <br />OCCUR a CLAIMS MADE <br />AGGREGATE $ <br />$ <br />DEDUCTIBLE <br />RETENTION $ <br />$ <br />WORKERS COMPENSATION AND <br />01DKRM12006615 <br />05/01/2009 <br />05/01/2010 <br />X We srATu- 0TH - <br />go <br />EMPLOYERS' LIABILITY <br />E.L. EACH ACCIDENT $ 1,000,000 <br />B <br />ANY PROPRIETOR/PARTNEWEXECUTIVE <br />OFFICERMEMBER EXCLUDED? <br />If yes, describe ceder <br />E.L. DISEASE - EA EMPLOYEEI $ 1,000,000 <br />E.L. DISEASE -POLICY LIMIT I $ 1,000,000 <br />SPECIAL PROVISIONS below <br />OTHER <br />ten day notice Of cancellation <br />applies for nonpayment of <br />premium <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT lSPECIAL PROVISIONS <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL <br />30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY <br />I OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. <br />*For informational purpose only I AUTHORIZED REPRESENTATIVE n I � , 0,,,,A.A.„ <br />At—unu ZD ttuuTtuts) ©ACORD CORPORATION 1988 <br />