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CLEAR BLUE <br />ENERGY CORP <br />APPENDIX D - EVIDENCE OF INSURANCE <br />CERTIFICATE OF LIABILITY INSURANCE <br />OTEWmvaYrnI <br />102912019 <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(n AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED. the policy(its) must have ADDITIONAL INSURED provisions or be "domed <br />N SUBROGATION IS WANED, 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 endersemem(s). <br />FRCGUOEA <br />Merrick Commercial Insurance Solutions <br />PO Box 130276 <br />wecT Customer Service <br />Nsue: <br />'HONE ,760-5193350 ao. NF <br />ADQRQ`. merickinsumncesolLrUon hotmaii.com <br />Carlsbad CA 92013 <br />HtVREP t AFFOPDMOCOVEFAOE <br />N41Ct <br />Ndu ,:Ategnty Specialty Insurance Company <br />tun <br />NSW40 Clear Blue Energy Corp <br />17150 Via Del Campo, Suite 3203 <br />San Diego CA 92127 <br />.1,0111RO,FirstMercuryInsuranceCompany <br />10c57 <br />MIURERC- <br />HIDRFR D: <br />NtUIEP E, <br />efDRER F' <br />COVERAGES CERTIFICATE NUMBER REVISION NUMBER: <br />THUS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN M.LIED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERN OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT LYITH F-SPECT 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 SEEN REDUCED BY PAID CLAIMS. <br />Im <br />TYPe DFMi1RIAN6 <br />Pd.1CYM49®el <br />111mt <br />A <br />esaRreecuLOENtauLLuelurY <br />eJUAa awE © oxLq <br />0"-GL-P00000094-0 <br />BMn5120t9 <br />01012020 <br />eX++CatwAENcE <br />11,000,000 <br />mt+nseb iEaaemrcer <br />i 100,000 <br />seD ExP wa rns x+'�1 <br />15,000 <br />FERxawLanDVInAXr <br />11000,000 <br />wr_LUTAF1��€a FS, <br />FaxY0 107 LJ <br />cEV=ra�Ln — k7E <br />52,000,000 <br />FReDucr;-ccMwcwADo <br />$ 2,000,000 <br />f <br />AIrr0110lQaYAdlrY <br />ANY AUTO <br />CANED I a DOLFD <br />AUTCE ONLY #oNLv <br />ONLY KT06 GIP.Y <br />exeiNo <br />ea xLDCIG <br />i <br />ecpLY WLWft io <br />t <br />_4'.pLY ruuRY lPs xe2eel <br />a <br />4}YD)1M1DE <br />B <br />uI®REuwuAe <br />D MSLw <br />G <br />CLALYs+xtiE <br />CA-EX-0000087 816-01 <br />OI2312014 <br />011252020 <br />EUIoccavlcE <br />i5,000,000 <br />.UGRLWTE <br />$5,000,000 <br />f� CHi <br />i <br />axp. e7RWEaLLRELIr'! YrN <br />AYFPRCP!tiTp4wMTKR'FxENTNE ® <br />am�uE mmaF>ALo�ra:L <br />tsss.4scsa,nda <br />CEECWKWN Or n raw <br />N=♦ <br />,rt <br />'T' <br />Et. WCIl ACG0F11T <br />�• - <br />f <br />DUEnaE•uEArr_ <br />s <br />EL OHUSE•Pp.KY MVIT <br />i <br />LEtCNPiIpI CF (H[RATICIr11 L0GTpNf IYEtUCLEI VCORD101.IORD®1WnfreeaMOYLmrYDr YioNMrverraor KeYWl�q <br />This Certificate is to serve as proof of Insurance for above named Insured. <br />CERTIFICATE HOLDER CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES Be CANCELLED BEFORE <br />THE CORATIDN DATE THEREOF, NOTICE WVA BE DELIVERED IN <br />ACCORDANCEWITHTIE POLICY PROVISIONS. <br />YmgN®RK"MNW ATM <br />James Christ <br />01988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (MGM) The ACORD name and logo are registered marks of ACORD <br />ftMIUNd Yi1,e Fa1s4 e%i wo toftm IQ) MO ft FJfw, N0.20r.Ilr <br />0 <br />