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ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICER/MEMBER EXCLUDED?
<br />INSR ADDL SUBR
<br />LTR INSD WVD
<br />PRODUCER CONTACT
<br />NAME:
<br />FAXPHONE
<br />(A/C, No):(A/C, No, Ext):
<br />E-MAIL
<br />ADDRESS:
<br />INSURER A :
<br />INSURED INSURER B :
<br />INSURER C :
<br />INSURER D :
<br />INSURER E :
<br />INSURER F :
<br />POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY)(MM/DD/YYYY)
<br />AUTOMOBILE LIABILITY
<br />UMBRELLA LIAB
<br />EXCESS LIAB
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />AUTHORIZED REPRESENTATIVE
<br />EACH OCCURRENCE $
<br />DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence)
<br />MED EXP (Any one person)$
<br />PERSONAL & ADV INJURY $
<br />GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $
<br />PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT
<br />OTHER:$
<br />COMBINED SINGLE LIMIT
<br />$(Ea accident)
<br />ANY AUTO BODILY INJURY (Per person)$
<br />OWNED SCHEDULED
<br />BODILY INJURY (Per accident)$AUTOS ONLY AUTOS
<br />HIRED NON-OWNED PROPERTY DAMAGE
<br />$AUTOS ONLY AUTOS ONLY (Per accident)
<br />$
<br />OCCUR EACH OCCURRENCE
<br />CLAIMS-MADE AGGREGATE $
<br />DED RETENTION $
<br />PER OTH-
<br />STATUTE ER
<br />E.L. EACH ACCIDENT
<br />E.L. DISEASE - EA EMPLOYEE $
<br />If yes, describe under
<br />E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below
<br />INSURER(S) AFFORDING COVERAGE NAIC #
<br />COMMERCIAL GENERAL LIABILITY
<br />Y / N
<br />N / A
<br />(Mandatory in NH)
<br />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 />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 />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 />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, 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 endorsement(s).
<br />COVERAGES CERTIFICATE NUMBER:REVISION NUMBER:
<br />CERTIFICATE HOLDER CANCELLATION
<br />© 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03)
<br />CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
<br />$
<br />$
<br />$
<br />$
<br />$
<br />The ACORD name and logo are registered marks of ACORD
<br />4/27/2026
<br />(818) 986-7283 (818) 986-4949
<br />24856
<br />Advanced Lighting Services, Inc.
<br />2010 Crow Canyon Pl
<br />Ste 100
<br />San Ramon, CA 94583
<br />19046
<br />19879
<br />22322
<br />A 1,000,000
<br />X X CA00005054403 6/8/2025 6/8/2026 300,000
<br />5,000
<br />1,000,000
<br />2,000,000
<br />2,000,000
<br />EB Aggregate 2,000,000
<br />1,000,000B
<br />X X BA -6W469259-25-42-G 6/8/2025 6/8/2026
<br />9,000,000A
<br />X X GX00000690803 6/8/2025 6/8/2026 9,000,000
<br />C
<br />X SWC1558585 6/8/2025 6/8/2026 1,000,000
<br />Y 1,000,000
<br />1,000,000
<br />D Property 2939208 6/8/2025 BPP 312,000
<br />D Installation / Build 2939208 6/8/2025 6/8/2026 Installation Floater 50,000
<br />D) Property Location#2: B.P.P. $101,000. E) Pollution Liability: Policy No.CEEPP25000031200 Effective Date: 06/08/25-06/08/26 Aggregate Limit: $3,000,000.
<br />Each Pollution Incident Limit $3,000,000 F) Pollution Liability: Policy #CPLMOL136375 Effective 12/18/2025-12/18/2026 Aggregate Limit: $5,000,000. Each
<br />Pollution Incident Limit: $5,000,000 G) Cyber Liability: Policy No: ESN0340387452. Effective Date: 6/8/2025 TO 6/8/2026. Limit: $5,000,000 Each Claim.
<br />PROJECT NAME/NUMBER: COP, ICE On-Call Services/ Project No. 119075
<br />DESCRIPTION AND LOCATION OF WORK: Electrical Engineering services for City of Pleasanton
<br />infrastructure located in Pleasanton, California
<br />SEE ATTACHED ACORD 101
<br />City of Pleasanton
<br />Attn: City Manager
<br />PO Box 520
<br />Pleasanton CA 94566
<br />ADVALIG-02 RGONZALEZ
<br />Paramount Exclusive Insurance Services, Inc.
<br />15760 Ventura Blvd. Suite 500
<br />Encino, CA 91436 service@paramountexclusiveins.com
<br />Admiral Insurance Company
<br />Travelers Casualty Insurance Company of Americ
<br />Security National Insurance Co
<br />Greenwich Insurance Company
<br />GL/BA/WC/EB
<br />X
<br />6/8/2026
<br />X
<br />X
<br />X
<br />X
<br />X
<br />X
<br />Docusign Envelope ID: 3B72E0E1-49B0-81A0-82B4-6F3690F68EF8
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