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AC"R"® CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) <br /> 03/03/2023 <br /> THIS CERTIFICATE IS ISSUED ASA 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( ies) must have ADDITIONAL INSURED provisions or be endorsed. <br /> If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br /> this certificate does not confer rights to the certificate holder in lieu of such endorsement(s) . <br /> PRODUCER CONTACT Shala Pearson <br /> NAME: <br /> TLB Insurance Services PHONE <br /> A/C No Ext): A/C, No <br /> (916) 790-5863 FAX (888) 329-8842 <br /> CA License #01382095 E-MAIL shala-pearson@leavitt.com <br /> ADDRESS : <br /> 2358 Maritime Dr, Ste 100 INSURER(S) AFFORDING COVERAGE NAIC # <br /> Elk Grove CA 95758 INSURERA : Westchester Surplus Lines Insurance Company 10172 <br /> INSURED INSURER 8 : Travelers Property Casualty Company of America 25674 <br /> Walton Engineering , Inc. INSURER C : Service American Indemnity Company 39152 <br /> P. O . Box 1025 INSURER D : Travelers Property Casualty Company. 36161 <br /> INSURER E : <br /> West Sacramento CA 95691 INSURER F : <br /> COVERAGES CERTIFICATE NUMBER : 23/24 Master 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 /> INSR ADULISUBR POLICY EFF POLICY EXP <br /> LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDD/YYYY MM/DD/YYYY LIMITS <br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 12000, 000 <br /> CLAIMS-MADE ❑X OCCUR DAMAGE TTED 50 , 000 <br /> PREMISES Ea occurrence $ <br /> X Inc. Pollution Liability MED EXP (Any one person) $ 51000 <br /> A X Inc. Professional Liability G47393735001 03/06/2023 03/06/2024 PERSONAL & ADV INJURY $ 1 , 000 , 000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: I GENERAL AGGREGATE $ 21000 , 000 <br /> POLICY ® JECTPRO ❑ LOC PRODUCTS - COMP/OP AGO $ 2 , 0002000 <br /> OTHER: $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 11000 , 000 <br /> Ea accident <br /> X ANY AUTO BODILY INJURY (Per person) $ <br /> B OWNED SCHEDULED 8108L785302 03/06/2023 03/06/2024 BODILY INJURY (Per accident) $ <br /> AUTOS ONLY AUTOS <br /> X HIRED X NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY AUTOS ONLY Per accident <br /> Uninsured motorist $ 11000 , 000 <br /> UMBRELLA LIAB 10 , 000 , 000 <br /> OCCUR EACH OCCURRENCE $ <br /> A X EXCESS LIAB CLAIMS-MADE G47393747001 03/06/2023 03/06/2024 AGGREGATE $ 1010001000 <br /> DED I X RETENTION $ 0 $ <br /> WORKERS COMPENSATION X STATUTE EORH <br /> AND EMPLOYERS' LIABILITY <br /> C ANY PROPRIETOR/PARTNER/EXECUTIVE Y❑ N / A SAMT VC10020101 10/01 /2023 10/01 /2024 E.L. EACH ACCIDENT $ 17000, 000 <br /> OFFICER/MEMBER EXCLUDED? <br /> (Mandatory in NH ) E.L. DISEASE - EA EMPLOYEE $ 12000, 000 <br /> If yes, describe under 1 , 000, 000 <br /> DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ <br /> Inland Marine <br /> D Leased/Rented/Borrowed 6608K816207 03/06/2023 03/06/2024 Limit $3005000 <br /> Deductible $2 , 500 <br /> DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101 , Additional Remarks Schedule, may be attached if more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> To Whom it May Concern Evidence of Insurance ACCORDANCE WITH THE POLICY PROVISIONS , <br /> AUTHORIZED REPRESENTATIVE <br /> © 1988 -2015 ACORD CORPORATION . All rights reserved . <br /> ACORD 26 (2016/03 ) The ACORD name and logo are registered marks of ACORD <br />