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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 />INSURER(S) AFFORDING COVERAGE
<br />INSURER F :
<br />INSURER E :
<br />INSURER D :
<br />INSURER C :
<br />INSURER B :
<br />INSURER A :
<br />NAIC #
<br />NAME:CONTACT
<br />(A/C, No):FAX
<br />E-MAILADDRESS:
<br />PRODUCER
<br />(A/C, No, Ext):PHONE
<br />INSURED
<br />REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsement(s).
<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 />OTHER:
<br />(Per accident)
<br />(Ea accident)
<br />$
<br />$
<br />N / A
<br />SUBRWVDADDLINSD
<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 />$
<br />$
<br />$
<br />$PROPERTY DAMAGE
<br />BODILY INJURY (Per accident)
<br />BODILY INJURY (Per person)
<br />COMBINED SINGLE LIMIT
<br />AUTOS
<br />AUTOSAUTOSNON-OWNEDHIRED AUTOS
<br />SCHEDULEDALL OWNED
<br />ANY AUTO
<br />AUTOMOBILE LIABILITY
<br />Y / N
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />OFFICER/MEMBER EXCLUDED?(Mandatory in NH)
<br />DESCRIPTION OF OPERATIONS belowIf yes, describe under
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />$
<br />$
<br />$
<br />E.L. DISEASE - POLICY LIMIT
<br />E.L. DISEASE - EA EMPLOYEE
<br />E.L. EACH ACCIDENT
<br />EROTH-STATUTEPER
<br />LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />EXCESS LIAB
<br />UMBRELLA LIAB $EACH OCCURRENCE
<br />$AGGREGATE
<br />$
<br />OCCUR
<br />CLAIMS-MADE
<br />DED RETENTION $
<br />$PRODUCTS - COMP/OP AGG
<br />$GENERAL AGGREGATE
<br />$PERSONAL & ADV INJURY
<br />$MED EXP (Any one person)
<br />$EACH OCCURRENCE
<br />DAMAGE TO RENTED $PREMISES (Ea occurrence)
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS-MADE OCCUR
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />POLICY PRO-JECT LOC
<br />CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
<br />CANCELLATION
<br />AUTHORIZED REPRESENTATIVE
<br />ACORD 25 (2014/01)
<br />© 1988-2014 ACORD CORPORATION. All rights reserved.
<br />CERTIFICATE HOLDER
<br />The ACORD name and logo are registered marks of ACORD
<br />6/13/2025
<br />Blue Lagoon Insurance Services LLC
<br />15303 Ventura Blvd
<br />9th Floor
<br />Sherman Oaks CA 91403
<br />818-306-8333 818-206-8222
<br />Service@BLISins.com
<br />BCG Water, LLC.
<br />4225 Solano Ave
<br />#694
<br />Napa CA 94558-1611
<br />Homeland Insurance Company of New York 34452
<br />Employers Preferred Insurance Co 10346
<br />Technology Insurance Company 42376
<br />A
<br />6
<br />6
<br />6
<br />Y Y 793-01-31-86-0001 3/25/2025 3/25/2026
<br />1,000,000
<br />50,000
<br />5,000
<br />1,000,000
<br />2,000,000
<br />2,000,000
<br />A 6 6 793-01-31-76-0001 3/25/2025 3/25/2026
<br />1,000,000
<br />1,000,000
<br />B Y Y EIG5924114-00 3/25/2025 3/25/2026
<br />6
<br />1,000,000
<br />1,000,000
<br />1,000,000
<br />This Policy '793-01-31-86-0001' has Other Coverage 'Non-Owned Disposal Site Liability - Not Incl Short-Term Environmental Premises Liability' With
<br />Limit '1,000,000 Ea Poll Cond'. Carrier: 'Homeland Insurance Company of New York', Effective Date: '03/25/2025', Expiration Date: '03/25/2026'.
<br />This Policy '793-01-31-86-0001' has Other Coverage 'Professional Services Liability' With Limit '1,000,000 Ea Prof Svcs Wrongful Act'. Carrier:
<br />'Homeland Insurance Company of New York', Effective Date: '03/25/2025', Expiration Date: '03/25/2026'.
<br />This Policy 'TCL1742323 00' has Other Coverage 'Cyber Liability' With Limit '500,000 Aggregate'. Carrier: 'Technology Insurance Company', Effective
<br />Date: '04/29/2024', Expiration Date: '04/29/2025'.
<br />The City of Pleasanton
<br />A Trannsportation Pollution Liability 793-01-31-86-0001 3/25/2025 3/25/2026 Limit: $1,000,000 Ea Poll Cond
<br />Limit: $1,000,000 Ea Poll Cond3/25/20263/25/2025793-01-31-86-0001Contractors Pollution LiabilityA
<br />Docusign Envelope ID: 475A1271-5695-469B-9AA9-36C5437FA957
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