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,.•-�•� DIAMO-4 OP ID: AS <br /> ACOR®" <br /> 1„�,,., CERTIFICATE OF LIABILITY INSURANCE DATE (MMroDrYYYY) <br /> 09/24/2021 <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, EXTEND OR 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) must 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 NONE CT P.J . Chawla <br /> Peck & Peck Insurance Brokers PHONE 650-592-5591 ac Ne : 6S0-592-0404 <br /> 1724 Laurel Street Suite 225 <br /> San Carlos, CA 94070 anDREss: MYBROKER USA.COM <br /> P.J. Chawla <br /> INSURER(S) AFFORDING COVERAGE NAIC # <br /> INSURER A : Mesa Underwriters Specialty <br /> INSURED Diamond Petroleum Services Inc INSURER B : State Compensation Ins Fund 35076 <br /> Guadalupe Sanchez <br /> 3619 King Rd INSURER C : <br /> Antioch , CA 94509 INSURER D : <br /> INSURER E : <br /> INSURER F : <br /> COVERAGES CERTIFICATE NUMBER: REVISION 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 /> ILTR TYPE OF INADDL SUB SURANCE POLICY NUMBER MMtuDD EFF POLICY <br /> M/LDI D EXP LIMITS <br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE E 11000,00 <br /> DAMAGE TO RLNILIY� 0 <br /> CLAIMS=MADE I OCCUR MP0002008001026 0910912021 0910912022 PREMISES Ea ocarrrence $ 100,00 <br /> MED EXP (Any one person) $ 5100 <br /> PERSONAL 8, ADV INJURY S 11000900 <br /> GENLAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,00 <br /> X POLICY ❑ jECT F LOC PRODUCTS • COMP/OP AGG $ 29000,00 <br /> OTHER: $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> Ea accident <br /> ANY AUTO BODILY INJURY (Per person) $ <br /> ALLOOWNED SCHEDULED BODILY INJURY (Per accident) $ <br /> UTOS <br /> NON•OWNED PROPERTY DAMAGE y <br /> HIREDAUTOS AUTOS <br /> S <br /> UMBR6LLAUAB H OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED RETENTIONS $ <br /> OR <br /> WK ERSCOMPENSA71ON X STATUTE ERTM <br /> AND EMPLOYERS' LIABILITY <br /> B ANY PROPRIETOR/PARTNER/EXECUTIVE Yl�N NIA 9214798-21 0712112021 0712112022 E.L. EACHACCIDENT $ 19000100 <br /> OFFICERWEMBER EXCLUDED? <br /> (Mandatory In NH) E.L. DISEASE - EA EMPLOYE $ <br /> 1 ,000,00 <br /> If yes, describe under <br /> DESCRIPTION OF OPERATIONS below EL. DISEASE - POLICY LIMIT $ 12000100 <br /> A Property Coverage MP0002008001026 09/0912021 0/10912022 10100 <br /> DESCRIPTION OF OPERATIONS f LOCATIONS t VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br /> Proof of Insurance Only. <br /> CERTIFICATE HOLDER CANCELLATION <br /> BLANK-1 <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ***Proof of Insurance*** ACCORDANCE WITH THE POLICY PROVISIONS. <br /> AUTHORIZED REPRESENTATIVE <br /> © 1988 .2014 ACORD CORPORATION . All rights reserved. <br /> ACORD 25 (2014101 ) The ACORD name and logo are registered marks of ACORD <br />