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WP0038678
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4200/4300 - Liquid Waste/Water Well Permits
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WP0038678
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Entry Properties
Last modified
10/25/2018 2:25:33 PM
Creation date
10/25/2018 1:40:37 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0038678
PE
4371
STREET_NUMBER
2121
Direction
N
STREET_NAME
ZUCKERMAN
STREET_TYPE
RD
City
STOCKTON
Zip
95206-
APN
12908009
ENTERED_DATE
8/17/2018 12:00:00 AM
SITE_LOCATION
2121 N ZUCKERMAN RD
P_LOCATION
99
P_DISTRICT
003
QC Status
Approved
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EHD - Public
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DATE(MM/DD/YYYY) <br /> ACORO® CERTIFICATE OF LIABILITY INSURANCE <br /> 7/1/2019 6/20/2018 <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 /> CONTACT <br /> PRODUCER Lockton Companies NAME: <br /> Three City Place Drive,Suite 900 PHONE I aC No <br /> St.Louis MO 63141-7081 EMAIL <br /> (314)432-0500 ADDRESS: <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURER A:XL Insurance America Inc. 24554 <br /> INSURED Coro Companies,Inc. INSURER B:ACE American Insurance Com an 22667 <br /> 1316614 6445 Marindustry Dr. INSURER C:Indemnity Insurance Co of North America 43575 <br /> San Diego CA 92121 INSURER D: <br /> INSURER E: <br /> INSURER F: <br /> COVERAGES CORC002 CERTIFICATE NUMBER: 13180758 REVISION NUMBER: XXx{XXX <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 /> INSR ADDLSUBRTYPE OF INSURANCE IVSD WVD POLICY NUMBER <br /> POLICY EXP <br /> LTR MM/DPOLIUY EFF MMIDDNYYY LIMITS <br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 <br /> A X N N CGD300084903 7/1/2018 7/1/2019 <br /> A CLAIMS-MADE ❑X OCCUR XCU/BROAD FORM PD PREMISES E occurrence $ 1 000 000 <br /> MED EXP(Anyone person) $ 10,000 <br /> PERSONAL&ADV INJURY $ 2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 <br /> PJ <br /> I LOC PRODUCTS-COMP/OP AGG $ 4,000,000 <br /> POLICY a <br /> OTHER: $ <br /> B AUTOMOBILE LIABILITY N N ISA H25158945 7/1/2018 7/1/2019 Ea BINEDtSINGLE LIMIT $ 5,000,000 <br /> I <br /> ANY AUTO BODILY INJURY(Per person) $ XX.)�X <br /> OWNED SCHEDULED BODILY INJURY(Per accident) $ XXXXXXX <br /> AUTOS ONLY AUTOS <br /> HIRED NON-OWNED PROPERTY DAMAGE $ XXXXXXX <br /> AUTOS ONLY AUTOS ONLY Per accident <br /> $ XXXXXXX <br /> UMBRELLA LIAB OCCUR NOT APPLICABLE EACH OCCURRENCE $ XXXXXXX <br /> EXCESS LIAB HCLAIMS-MADE AGGREGATE $ XXX xxx <br /> DED RETENTION$ $ XXXXXXX <br /> WORKERS COMPENSATION PER OTH- <br /> B AND EMPLOYERS'LIABILITY N WLRC65224987(CA/MA) 7/1/2018 7/1/2019 X STATUTE ER <br /> C ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N WLRC6522494A(AOS) 7/1/2018 7/1/2019 E.L.EACH ACCIDENT $ 1,000,000 <br /> C OFFICER/MEMBER EXCLUDED? N N/A (EXCLUDING MONOPOLISTIC <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1 000 000 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1 000 000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> CERTIFICATE HOLDER CANCELLATION See Attachments <br /> 13180758 <br /> FOR INFORMATIONAL PURPOSES ONLY 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 /> AUTHORIZED REPRESENTATI <br /> 61 <br /> ©1988-2 ACORD CORPORATI N. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />
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