KIZH NATION RESOURCES MANAGEMENT (2)

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A� EI CERTIFICATE OF LIABILITY INSURANCE DA E MMrcD2D arr) 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(tes) 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 Irvine CONTACT Fjed D Premier Digit e (949) 727-9219AC No: 100 Pc✓I ADORES FreV.Dean@PremierOne.com OGCOVERAGE NAIC# L VBA RRH Co 30104 :EA INSURED m $ 29424 H Naticn Resources Mgml, DBA: KIZH at ,n Reso r�.(U' ^te e r a I[rUS� V ��O (j'(_I_NSURER D: `V �28 Er Covina CA 1 2 INSURER F: COVPRar:FR CFRTl:: ATP NIIMRPR• CL2451412729 RCVICIr1M MI IURPR- 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 SUER WVD POLICY NUMBER POLICYEFF MMIDD/YYYY POLICY UP MMIDDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIM&MADE ❑X OCCUR RE ISES Ea oca PREME To EOnence $ 1,000,000 MED EXP (Any one person) $ 10,000 PERSONAL&ADV INJURY $ 2,000,000 A Y Y 72SBMBF9NU5 05/16/2024 05/16/2025 GEN'LAGGREGATE LIMITAPPLIES PER: GENERALAGGREGATE $ 4,000,000 POLICY ❑ j COT 7 LOC PRODUCTS-COMP/OPAGG $ 4,000,000 $ OTHElt I AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea naden $ 2,000.000 BODILY INJURY (Par Person) $ ANYAUTO A OWNED SCHEDULED AUTOS ONLY AUTOS 72SBMBF9NU5 05/16/2024 05/16/2025 BODILY INJURY (Per accitlen) $ PROPERTY DAMAGE Per accident $ HIRED NON-0WNED AUTOS ONLY AUTOS ONLY H $ X UMBRELLA LIAR OCCUR - EACH OCCURRENCE $ 4,000,000A AGGREGATE $ 4,000,000 EXCESS UAB CIAIMSMADE 72SBMBF9NU5 05/16/2024 05/16/2025 LIED RETENTION $ $ WORKERS COMPENSATION PER OTH- !� B ANDEMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNER/EXECUTIVE AI OFFICEREMBER EXCLUDED? (Mandatory in NH) NIA Y 72WECBF9NZS 05/16/2024 05/16/2025 STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE -EA EMPLOYEE $ 1,000,000 If yes, dmanbe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) If required by Contract the certificate holder is designated as a primary non-contributory additional insured with a Waiver of Subrogation for the General Liability coverage detailed in this certificate per endorsement forms SL30320621 & SLOOOO1D18, Also if required by Contract the Workers Compensation includes a Waiver of Subrogation for the Certificate holder per form (WC040306) Project Name/Address-Washington Well Improvements Well Drilling (Phase 1) 215 S. Center Street Santa Ana, CA 92703 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL RE DELIVERED IN City of Santa Ana Risk Management Division ACCORDANCE WITH THE POLICY PRO) 20 Civic Center Plaza ,r„� RideManagemndDWIon AUTHORIZED REPRESENTATIVE REVIEvvED&APPRLT/BD BY. ry Santa Ana CA 92702 °I a A-ju A , Risk Management Spedahst ©1988-2015 ACOF ol ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD