Laserfiche WebLink
MVPPE-1 OP ID: D6 <br />"-IF DATE/YCERTIFICATE OF LIABILITY INSURANCE <br />09/23!2016 <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, EXTEND611 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(les) trust 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 <br />InterWest Insurance Services <br />License81 01094 <br />P.O. Box 8110 <br />Chico, CA 95927-8110 <br />Cilie Arenchild <br />CONTACT <br />NAME: deidre Hagen <br />PHONNE ;530$95-1010 ac N]—. 530-895-1313 <br />- oRcom <br />I� s: dha an iwins. <br />INSURER S AFFORDING COVERAGE MAIC # <br />INSURER A: State COMP Ins Fund CA !35076 <br />INSURER 8: <br />INSURED MVP Petroleum Engineering, Inc <br />PO Box 281 <br />INSURER C: <br />Folsom, CA 95763-0281 <br />INSURER D : <br />1 <br />INSURER E: i <br />a a� <br />INSURER F: <br />CCOVFRArtFC <br />-®"' - ""'-^• KF -VISION 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 />INSRAbw <br />LTR=OTHER <br />NSURANCEit <br />MMM <br />WVV D <br />POLICY NUMBER <br />MMM FFYYI <br />POtJC EX <br />LIMITS <br />NERAL LIABILITY <br />E D OCCUR <br />1 <br />II,�� <br />a a� <br />EACH OCCURRENCE $ <br />PREMISES Eat $ <br />MED EXP ( one person) $ <br />PERSONAL & ADV INJURY $ <br />GENMIT APPLIES PER: <br />C ❑ LOC <br />GENERAL AGGREGATE $ <br />PRODUCTS - COMP/OP AGO $ <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />ALIOWNED SCHEDULED <br />AUTOS AUTOS <br />HIRED AUTOS NON OWNED <br />AUTOS <br />e <br />%® <br />EOMBINED SINGLE LIMI $ <br />BODILY INJURY (Per person) $ <br />BODILY INJURY (Par accident) $ <br />PR PER E <br />Peracddent $ <br />A <br />_ <br />UMBRELLA UAB <br />EXCESS UAB <br />OCCUR <br />CLAIMS -MADE <br />I <br />f <br />NIA 1 <br />I <br />� <br />` <br />190730752016 <br />I <br />10/01/2016 <br />10/0112017 <br />EACH OCCURRENCE $ <br />AGGREGATE $ <br />DED RETENTIONS <br />WORKERS COMPENSATION <br />AND EMPLOYERS LIABILITY YIN <br />ANY PROPRIETORIPARTNERIEXECUTIVE <br />OFFICERIMEMBER EXCLUDED? I <br />(Mandatory in NH) F -11 <br />y scribe under <br />DESCRIPTION OF OPERATIONS below <br />$ <br />X I STA TEERTH <br />E.L. EACH ACCIDENT $ 1,000,® <br />E.L. DISEASE - EA EMPLOYEE $ 1 000 OO <br />> > <br />E.L. DISEASE -POLICY LIMIT $ 1,000,0 <br />7 <br />i <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remaft Schedule, may be attached if more space Is required) <br />Confirmation of Coverage. Re: License #768938. <br />i <br />n�nr�r�.wrr uA• -.e-w , <br />Contractors State <br />License Board <br />P.O. Box 26000 <br />Sacramento, CA 95826 <br />ACORD 25 (2014101) <br />CON2600 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED <br />®;1988-2014 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered !narks of ACORD <br />