SUPERIOR HOT TAPPING SERVICES, INC (2)

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/ A� " CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 01 /13/2026 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 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 CONTACT Nataly Hague CISR NAME: James G. Parker Insurance (559) 222-7722 q/c, (559) 222-1724 ACNE. Ext : No): License #0554959 E-MAIL nhague@jgparker.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # P O Box 3947 Fresno CA 93650 INSURERA: Mesa Underwriters Specialty Ins Co 36838. INSURED INSURER B : Infinity Select Ins Co 20260. Superior Hot Tapping Services Inc INSURER C : Palomar Excess and Surplus Ins Co 16754 7923 Old Oak Court INSURER D : State Compensation Ins Fund 35076. INSURER E Riverside CA 92506 INSURER F COVERAGES CERTIFICATE NUMBER: 25-26 GL UMB BA WC 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 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 INSD WVD POLICY NUMBER POLICY EFF MWDD/YYYY POLICY EXP MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE OCCUR DAMAGE TO PREM SES Ea 0NcurrDence $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL &ADV INJURY $ 1,000,000 A Y Y MP0082001009708 03/15/2025 03/15/2026 LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY ❑X PRO ❑ LOC JECT: MOTHER PRODUCTS-COMP/OPAGG $ 2,000,000 $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ ANYAUTO B OWNED SCHEDULED AUTOS ONLY AUTOS Y Y 50001616302 09/02/2025 09/02/2026 BODILY INJURY (Pe r accide nt) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 C EXCESS LAB CLAIMS -MADE PESXS014672 03/15/2025 03/15/2026 DED I I RETENTION $ $ D WORKERS COMPENSATION AND EMPLOYERS' LIABI LI TY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) NIA Y 9334957-2025 03/15/2025 03/15/2026 X STATUTE EORH E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1,000,000 $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Digitally sig Certificate holder is included as additional insured with respects to General Liability per form CG2010 1185 attached. Waiver of Subrogation applies Tu Tran by Tu Tran regarding the General Liability per form CG2404 1093. Waiver of subrogation applies to the Workers compensation per form 2572 attached. Additional Nguyen Insured, Waiver of Subrogation and Primary Non-contributory wording basis in respects to Auto per form 50461AIS01, 50461SWF01, and 500PNCV01 Ng uyen Date: 2026. attached. 12:54:22 -08 APPROVED CERTIFICATE HOLDER CANCELLATION ley Tu Tran Nguyen at 12:54 pm, Jan 14, 2026 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Heidi Chou AUTHORIZED REPRESENTATIVE 215 S Center Street M-85 Santa Ana CA 92701 / X Ali V-4 �w � @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD