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�+� ® DATE (MMIDD/YYYY) A � R" CERTIFICATE OF LIABILITY INSURANCE 12/1 /2022 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 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 endorsement(s) . PRODUCER CONTACT NAME: Lisa Salciccla Andreini & Company-San Mateo PHONEFAX 220 West 20th Ave c o t • 650-378-4238 A/c No : 650-378-4361 San Mateo CA 94403 ADDRESS: Isalciccia andreini .com INSURERS AFFORDING COVERAGE NAIC q INSURER A : Crum &Forster Specialty Ins Co 44520 INSURED CHARL-1 INSURER B : Federal Insurance Company 20281 Charles E . Thomas Company , Inc 13701 So Alma Avenue INSURER C : Republic Indemnity Co of Calif 43753 Gardena CA 90249 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER : 1911603894 REVISION NUMBER : 1 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 TYpE OF INSURANCE ADDL SUER POLICY NUMBER MMID fYYYY EFF POLICY LIMITS LTR A X COMMERCIAL GENERAL LIABILITY EPK141923 12/1 /2022 12/1 /2023 EACH OCCURRENCE $ 2,000, 000 DAMAGE TO CLAIMS-MADE a OCCUR PREMISES Ea occurrence) $ 100,000 MED EXP (Any one person) $ 10 ,000 X CPL-Pollullon PERSONAL & ADV INJURY $ 2,000, 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000 ,000 POLICY JE� F LOC PRODUCTS - COMP/OP AGG $ 2,000 ,000 OTHER: CPL - per Occurrence $ 2,000 ,000 B AUTOMOBILE LIABILITY 73612365 12/1 /2022 12/1 /2023 COMBINED SINGLE LIMIT $ 1 ,000 ,000 Ea accident X ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident X Comp $1 ,000 Ix Coll $11000 $ A UMBRELLALIAB X OCCUR EFX121690 12/1 /2022 12/1 /2023 EACH OCCURRENCE $ 5 ,000 , 000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,0001000 DED X RETENTION $ n $ C WORKERS COMPENSATION 25532203 12/1 /2022 12/1 /2023 X STATUTE OTH- AND EMPLOYERS' LIABILITY YIN ER ANYPROPRIETORIPARTNERIEXECUTIVE M N / A E.L. EACH ACCIDENT $ I1000t000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH ) E.L. DISEASE - EA EMPLOYEE $ 1 ,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1 ,000,000 A Errors & Omissions EPK141923 12/1 /2022 12/1 /2023 Occurrence $2, 000, 000 Claims Made Aggregate $2,0002000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101 , Additional Remarks Schedule, may be attached If more space Is required) j This certificate Is issued as Proof of Insurance Only. IVIRONMENTAL HEP, LTI I CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS . Proof of Insurance AUTHORIZED REPRESENTATIVE � 60-0000n6J © 1988-2015 ACORD CORPORATION . All rights reserved . ACORD 25 ( 2016/03) The ACORD name and logo are registered marks of ACORD