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COI - W.C. Drilling, Inc. - Expires 2022-01-01A` C?R®® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 12/31 /2020 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 po icy, 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 .. Brown & Brown` Insurance Services of California, Inc 3697 Mt. Diablo Blvd, Ste 100 - - -. - Lafayette CA 94549-3745 CONTACT Mindy Krieger NAME: PHONE o, ExN (800) 733-3131 FAX No): E-MAIL mkrieger@bbnca.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Evanston Insurance Company INSURED W.C. Drilling, Inc. PO Box 254 i Pinole CA 94564 INSURER B : Vantapro Specialty Insurance Company INSURER C : INSURER D INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 21/22 MASTER REVISION NUMBER: 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 LTR TYPE OF INSURANCE - ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY �. Y MKLV5ENV102813 01/01/2021 01/01/2022 - EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR DAMAGES RENTED PREMISES ( (Ea occurrence) $ 50,000 MED EXP (Any one person) $ 5,000 PERSONAL&ADV INJURY $ 2,000,000 GEN'LAGGREGATE P POLICY OTHER: X LIMIT APPLIES PRO JECT PER: LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS 2,000,000 $ $ - - B AUTOMOBILE X • XHIRED LIABILITY ANY AUTO OWNED /� X SCHEDULED AUTOS NON -OWNED AUTOS ONLY -. 5087-0795-00 .. 01/01/2021 01/01/2022 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 " BODILY INJURY (Per person) $ - ---' BODILY INJURY (per accident) $ - - - PROPERTY DAMAGE (Per accident) $ $ A X UMBRELLA LIAB ' EXCESS LIAB — • OCCUR - CLAIMS -MADE MKLV5EFX100688 - - 01/01/2021" 01/01/2022 EACH OCCURRENCE - $" 5000000 AGGREGATE $" 5000000 DED X RETENTION $ 0 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N / A PER STATUTE OTH- ER E,L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ A Pollution Liability Retro Date 1/1/2001 MKLV5ENV102813 01/01/2021 01/01/2022 Per Claim Aggregate Per Claim Deductible 2,000,000 Included 10,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Gilroy is included as Additional Insured if required by written contract and per form CG2010/CG2037 attached to the General Liability policy with respect to their interest in liability arising from the operations of the Named Insured CERTIFICATE HOLDER CANCELLATION CITY OF GILROY 7351 ROSANNA STREET Gilroy I CA 95020 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE �/�/�/ .dr! j 14,t4t9? ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserve The ACORD name and logo are registered marks of ACORD