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�iAd 7gl,aq -►� DATE(MM/DD/YYYY) A�" CERTIFICATE OF LIABILITY 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 CONTACT Shala Pearson NAME: AX TLB Insurance Services PH°NE (916)691-5555 F C No; (888)329-8842 CA License #OB82095 ADDRESS:shala-pearson@leavitt.com 3000 Oak Road, Suite 210 INSURERS 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 INSURERD:Travelers Casualty Co. of America 19046 INSURER E: West Sacramento CA 95691 INSURER F: COVERAGES CERTIFICATE NUMBER:18/19 All Policies REVISION NUMBER: 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 ADDLTYPE OF INSURANCE 1=SUER POLICY NUMBER MM DDPOLICY YYY MPOLICY EXP LTR I DYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 11000,000 A CLAIMS-MADE OCCUR DAMAGE TO RENTED 50,000 PREMISES Ea occurrence $ X Incl. Pollution Liab. FEIECC1358705 3/6/2018 3/6/2019 MED EXP(Any one person) $ 5,000 X Incl. Professional Liab. PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY[X]jE' LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COEaMBINED accident SINGLE LIMIT $ 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ B ALL OWNED SCHEDULED AUTOS AUTOS 8106K992397 3/6/2018 3/6/2019 BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ X HIRED AUTOS X AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 10,000,000 A X EXCESS LIAB XCLAIMS-MADE AGGREGATE $ 10,000,000 DED RETENTION$ FEIEXS1358805 3/6/2018 3/6/2019 $ OTH- WORKERS COMPENSATION X PER EIR AND EMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE YH N/A E.L.EACH ACCIDENT $ 11000,000 C OFFICER/MEMBER EXCLUDED? 9113339 10/1/2018 10/1/2019 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ E 1 0000 000 D Inland Marine 6608KB16207 3/6/2018 3/6/2019 Limit a $$ $ ,0 ow �4"-"% Rented, Leased or Borrowed D uct V DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) It n 5 2oIs ENVIPtONMENT ENT AL-fH CiEPARTM CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE To Whom it May Concern THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Shala Pearson/SHPEAR ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401)