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ABLEMAI -CL DWATTS DATE (MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 9/20/2021 IS THIS CERTIFICATE IS ISSUED ASMATTER TION AMEND ,ONLY E TEND OCONFERS R A TER NO THE COVERAGE AFFORDED BY THE POLICIIES CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY BELOW. THIS CERTIFICATE OF ITHCERTNSUNCE IES FICATE CATEHOLDER NOT CONSTITUTE ACONTRACT BETWEEN THE ISSUING INSUF2fER(S ) , AUTHORIZE REPRESENTATIVE OR PRODUCER, AND E IMPORTANT: if the certificate holder is an ADDITIONAL INSURED, the policy( jes ) must have ADDITIONAL INSURED provisions or 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 CONTACTorsement(s ) . PRODUCER NAME' PHONE 707 525-4150 FAX nro): (707) 525-4175 George Petersen Insurance Agency , Inc . (AIC, No, Ext): ( ) P . O . Box 3539 Eoo IE , info@gpins .com Santa Rosa , CA 95402 INSURERS AFFORDING COVERAGE NAIC If INSURER A : Homeland Insurance Company of New York 34452 INSURER B : WestAmerican Insurance Company 44393 INSURED Able Maintenance, Inc . INSURER c : State Compensation Insurance Fund 35076 3224 Regional Parkway INSURER D : Santa Rosa , CA 95403 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER : REVISION NUMBER : IIOD NDICATED.T CERTIFY THAT NOTWITHSTANDING ANYPOLICIES REQUIREMENT, TERMF INSURANCE OR CONDITION ONSTED BELOW AOF ANY CONTRACT OR OTHER DOCUMENT WITH REVE BEEN ISSUED TO THE INSURED NAMED ABOVE E PECT OR THE LWHICH ICY THIIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN , THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECTTOALLTHETERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAEFF ID CLAIMS, LIMITS rA ADDL SUBR POLICY NUMBER D D TYPE OF INSURANCE 5 10 ,0009000 X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 10/11 /2020 10/11 /2021 DAMAG ' To S ( RENTED 50 ,000 CLAIMS-MADE ® OCCUR X X 793-00-26-72-0006 P EM E a occu a ce *�---. 59000 X Pollution & Professi MED EXP An one person) $ _, PERSONAL BADV INJURY $ 10 '000 '000 10 ,000 ,000 GENERAL AGGREGATE GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 10'000 '000 POLICY ® JE C LOC MOLD SEE REMARK $ 110001000 OTHER: E0aBINEDSINGLE LIMIT $ 11000 ,000 B AUTOMOBILE LIABILITY '.. X X BAW (22) 58661065 4/1 /2021 4/1 /2022 BODILY INJURY Per person) $ X ANY AUTO OWNED SCHEDULED BODILY INJURY (Peraccdent 5, W _.._ — AUTOS ONLY AUTOS PROPERTY AMAGE HIRED NON-RVeED Peraccldent $ AUTOS ONLY AUTOS ONLY $ EACH OCCURRENCE $ UMBRELLA LIAB OCCUR EXCESS LIAR 7CLAIMS-MADE AGGREGATE $ DED RETENTION $ X PEA T EOT EH- C WORKERS COMPENSATION 10/1 /202 1 ,000,000 AND EMPLOYERS' LIABILITY YIN X 9073219 -21 1 10/1 /2022 E.L. EACH ACCIDENT ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ NIA 110002000 OFFICER/MEMBER EXCLUDED9 E.L. DISEASE - EA EMPLOYE �_.,,_ (Mandatory In NH) 130009000 I7 yes, describe under E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS below Additional Remarks Schedule, may be attached It more space is required) DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101 , RE : All Operatins (Vacaville Fuel Oil Project) Air Systems Service and Construction , Inc. , the General Contractor, its officers , directors and employees and the Project Owner are GE 319 s Addittional of Insured with respects to General Liability per OBENV GE 301 (02 11 ) & OBENV GE 304 (02 11 ) . Primary Wording applies p ( ) ' regate Limit applies per OBENV GL 300 (0211 ). Auto Liability Additional Insured applies per Subrogation applies per OBENV GE 320 (04 11 ) . Per Project Agg CA 88 10 01 13 includes Waiver of Subrogation & Cancellation Wording . Auto Primary Wording applies per CA 00 01 03 06. Worker's Compensation Waiver of Subrogation applies per 2572, All forms are attached . CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Air Systems Service and Construction , Inc . ACCORDANCE WITH THE POLICY PROVISIONS . 1155 Beecher Street, Suite 100 San Leandro , CA 94577 AUTHORIZED REPRESENTATIVE © 1988 -2015 ACORD CORPORATION . All rights reserved . ACORD 25 ( 2016103 ) The ACORD name and logo are registered marks of ACORD