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CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) <br />11/27/2023 <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(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 <br />NAME:TWFG General Agency LLCTWFG General Agency LLC <br /> DBA Penguin Insurance Services <br /> 1201 Lake Woodlands Suite 4020 <br /> The Woodlands CA 77380 <br />PHONE <br />(A/C, No. Ext):(209) 442-4200 FAX <br />(A/C, No): <br />E-MAIL <br />ADDRESS Monica.torres@uspenguin.com <br />INSURER(S) AFFORDING COVERAGE NAIC # <br />INSURED <br />Agency Lic#: 0I67785 INSURER A: <br />INSURER B: <br />Oak River Insurance Company 34630 <br />S.D. ELECTRIC INC <br />DBA S.D. ELECTRIC <br />1852 W 11TH ST 327 <br />TRACY CA 95376 <br />INSURER C: <br />INSURER D: <br />INSURER E: <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER:157311 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 <br />LTR TYPE OF INSURANCE ADDL <br />INSRD <br />SUBR <br />WVD <br />POLICY EFF <br />DATE (MM/DD/YY) <br />POLICY EXP <br />DATE (MM/DD/YY)POLICY NUMBER <br />EACH OCCURRENCE <br />LIMITS <br />$COMMERCIAL GENERAL LIABILITY <br />DAMAGE TO RENTED <br />PREMISES (Ea occurence)$CLAIMS MADE OCCUR <br />MED EXP (Any one person)$ <br />PERSONAL & ADV INJURY $ <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRO- <br />JECT <br />GENERAL AGGREGATE $ <br />POLICY LOC <br />PRODUCTS-COMP/OP AGG $ <br />OTHER: <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />$ <br />AUTOMOBILE LIABILITY $ <br />ANY AUTO BODILY INJURY (Per person)$ <br />OWNED <br />AUTOS ONLY <br />SCHEDULED <br />AUTOS BODILY INJURY (Per accident)$ <br />HIRED <br />AUTOS ONLY <br />NON-OWNED <br />AUTOS ONLY <br />PROPERTY DAMAGE $(Per accident) <br />$ <br />UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br />EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br />DED RETENTION $$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />SDWC459907 11/18/23 <br />11/18/24 X PER <br />STATUTE <br />OTH- <br />ER <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />(Mandatory in NH) <br />Y/N N/A E.L. EACH ACCIDENT $1,000,000 <br />E.L. DISEASE-EA EMPLOYEE $1,000,000 <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below E.L. DISEASE-POLICY LIMIT $1,000,000 <br />RE: All jobs for the City of Pleasanton Location: Pleasanton, CA <br />The City of Pleasanton is in favor of the Waiver of Subrogation, respect workers compensation, per attached form WC 99 04 10 C, as <br />required by written <br />contract or agreement <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />CERTIFICATE HOLDER CANCELLATION <br />City of Pleasanton <br />PO Box 520 <br />Pleasanton, CA 94566 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Attention: Monica TorresLic # <br />ACORD 25 (2016/03)Certificate #157311 © 1988-2015 ACORD CORPORATION. All right reserved. <br />The ACORD name and logo are registered marks of ACORD <br />Docusign Envelope ID: 2752ED72-4A96-4FA4-BC69-B6FC3FB87AF1