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Insurance Certificates 2022/23 Gonsalves & SonSHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 3/29/2022 McGee & Thielen Insurance Brokers, Inc. 3840 Rosin Court, Suite 245 Sacramento, CA 95834 916-646-1919 916-646-0995 www.mcgeethielen.com 0633187 Travelers Indemnity Company of CT 25682 Hartford Accident and Indemnity Company 22357 A 2,000,000I6609794P909-TCT-21 6/17/2021 6/17/2022 100,000 3 5,000 3 Excluded 2,000,000 2,000,000 A I6609794P909-TCT-21 6/17/2021 6/17/2022 1,000,000 3 3 B 57WECZI5671 4/1/2022 4/1/2023 3 1,000,000Y 1,000,000 1,000,000 Charlotte Brown Joe A Gonsalves and Sons Inc. 925 L Street Suite 250 Sacramento CA 95814 67417968 3 3 3 blanket form CG D0 37. Waiver of subrogation applies per the attached endorsement CG2404 10 93 City of La Quinta 78495 Calle Tampico La Qunita CA 92253 Certificate holder is an additional insured per the attached blanket form CG D1 05. Primary and Non-Contributory wording applies per the attached Waiver of subrogation applies to workers compensation per attached WC 040306 form. 67417968 | *22/23 Master GL/AL/WC | Charlotte Brown | 3/29/2022 10:07:43 AM (PDT) | Page 1 of 5 I6609794P909-TCT-21 67417968 | *22/23 Master GL/AL/WC | Charlotte Brown | 3/29/2022 10:07:43 AM (PDT) | Page 2 of 5 67417968 | *22/23 Master GL/AL/WC | Charlotte Brown | 3/29/2022 10:07:43 AM (PDT) | Page 3 of 5 I6609794P909-TCT-21 67417968 | *22/23 Master GL/AL/WC | Charlotte Brown | 3/29/2022 10:07:43 AM (PDT) | Page 4 of 5 Joe A Gonsalves and Sons Inc. 57WECZI5671 4/1/2022 City of La Quinta 78495 Calle Tampico La Qunita CA 92253 4/1/2023 67417968 | *22/23 Master GL/AL/WC | Charlotte Brown | 3/29/2022 10:07:43 AM (PDT) | Page 5 of 5