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ACS® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 3 / 3 / 2020 THIS CERTIFICATE IS ISSUED ASA 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 '.. Leavitt United Insurance Services , Inc . AHCN E t • ( 925 ) 395 - 2600 FAX No ; ( sxs) zav-ono CA License $ OJ02939 E-MAIL shala-pearson@leavitt . com ADDRESS: 2358 Maritime Dr , Ste 100 INSURERS AFFORDING COVERAGE NAIC # Elk Grove CA 95758 INSURERA : Admiral Insurance Company 24856 INSURED INSURER B : Travelers Property Casualty Company . 36161 Walton Engineering , Inc . INSURERC : State compensation Insurance Fund 35076 P . O . Box 1025 INSURER D : INSURER E West Sacramento CA 95691 INSURER F : COVERAGES CERTIFICATE NUMBER: 20 - 21 Master 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 CONTRACTOR OTHER DOCUMENT WTH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 I TYPE OF INSURANCE ADDL SUER POLPOLICY NUMBER MMD I POLICY EXP LTR DNYEFFY MM DD/Y YY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 11000 , 000 A CLAIMS-MADE ❑X OCCUR PREMISES (Ea occurDAMAGE TO rence) $ 501000 X Pollution Liability FEIECC1358706 3/ 6/2020 3 / 6/2021 MED EXP (Any one person) $ 51000 X Professional Liability PERSONAL & ADV INJURY $ 11000 , 000 GENIAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 21000 , 000 POLICY a JEo F] LOC PRODUCTS - COMP/OP AGG $ 21000 , 000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 11000 , 000 Ea accident XANY AUTO BODILY INJURY (Per person) $ B ALL OWNED SCHEDULED AUTOS AUTOS e108L785302 3/ 6/2020 3/ 6/2021 BODILY INJURY (Per accident) $ NON-OWNED PROPERTY DAMAGE $ X HIREDAUTOS X AUTOS Per accident Uninsured motorist combined single $ 11000 , 000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 10 , 000 , 000 A X EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10 , 000 , 000 DED X RETENTION $ 0 FEIEXS1358806 3/ 6/2020 3/ 6/2021 $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS' LIABILITY STATUTE ER Y / N ANY PROPRIETOR/PARTNERIEXECUTIVEN NIA C (Mandatory inFil E.L. EACH ACCIDENT $ 11000 , 000 OFFICER/MEMBER in NH) EXCLUDED? 9113339 10 / 1 /2019 10/ 1 /2020 E.L. DISEASE - EA EMPLOYEE $ 11000 , 000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1 000 000 B Inland Marine QT6608KB16207 3 / 6/2020 3/ 6/2021 Limit $ 300 , 000 Leased , Borrowed , Rented Deductible $ 2 , 500 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101 , Additional Remarks Schedule, may be attached if more space is required) Where required by written contract , Certificate Holder is Additional Insured with respects to the General Liability per attached policy endorsement form CG20370704 ; and with respects to the Auto , Additional Insured with Waiver of Subrogation and Primary and Noncontributory clauses apply when required by written contract per attached endorsement forms CAT3530215 and CAT4740216 . General Liability insurance is Primary and Noncontributory where required by written contract per attached endorsement form ECC5480712 . A separate Designated Construction Project General Aggregate Limit applies to each designated construction project of the Named Insured when agreed to and required under written contract per attached endorsement 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 Evidence of Insurance ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Shala Pearson / SHFRED © 1988-2014 ACORD CORPORATION . All rights reserved . ACORD 25 (2014101 ) The ACORD name and logo are registered marks of ACORD INS025 (201401 )