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ACORDa CERTIFICI46E OF LIABILITY INSU NCEDATE(MM/DD/YY) <br /> 08/28/2001 <br /> PRODUCER (916)646-1919 FAX (916)646-0995 'b <br /> McGee, Thiel en & Purves Insurance Brokers, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATEHOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> 3780 Rosin Court Suite 200 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Lic # 0633187 <br /> Sacramento, CA 95834 INSURERS AFFORDING COVERAGE <br /> INSURED Jim Thorpe Oil , Inc. INSURER A, American Int'l Spec Lines Ins <br /> 677 E. Lockeford St. - INSURER e: Golden Eagle Insurance Co. <br /> Lodi , CA 95240 INSURER C: <br /> INSURER D: <br /> INSURER E: <br /> COVERAGES <br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING <br /> ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br /> MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH <br /> POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> LTR TYPE OF INSURANCE POLICY NUMBER DATE(MM/DDIYY) DATE(MM/DD/YY) LIMITS <br /> GENERAL LIABILITY PR09342000 08/15/2001 08/15/2002 EACH OCCURRENCE $ 11000,000 <br /> X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any one fire) It 100,000 <br /> CLAIMS MADE OOCCUR MED EXP(Any one parson) It 25,000 <br /> A X Prof Liab clms md- PERSONAL B ADV INJURY $ 1,000,000 <br /> 1,000,000 GENERAL AGGREGATE $ 2,000,000 <br /> GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG It 2,000,000 <br /> X POLICY PRO LOC <br /> JECT <br /> AUTOMOBILE LIABILITY CP64140101 03/01/2001 03/01/2002 COMBINED SINGLE LIMIT <br /> X ANY AUTO (Ea accident) $ <br /> 1,000,000 <br /> ALL OWNED AUTOS <br /> BODILY INJURY $ <br /> SCHEDULED AUTOS (Per person) <br /> B HIRED AUTOS <br /> BODILY INJURY $ <br /> NON-OWNED AUTOS (Per amkenl) <br /> PROPERTY DAMAGE $ <br /> .(Per accident) <br /> GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ <br /> ANY AUTO OTHER THAN EA ACC $ <br /> AUTO ONLY: AGG $ <br /> EXCESS LIABILITY EACH OCCURRENCE $ <br /> OCCUR O CLAIMS MADE AGGREGATE $ <br /> It <br /> DEDUCTIBLE It <br /> RETENTION $ $ <br /> WORKERS COMPENSATION AND TORYLIMITS ER <br /> EMPLOYERS'LIABILITY <br /> E.L.EACH ACCIDENT $ <br /> E.L.DISEASE-EA EMPLOYEE $ <br /> E.L.DISEASE-POLICY LIMIT $ <br /> OTHER CP64140101 03/01/2001 03/01/2002 $100,000 limit; $250 ded. <br /> Hired, leased equip <br /> B <br /> DESCRIPTION OF OPERATIONS/LOCATIONSfVEHICLEVEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS <br /> e: All California Operations <br /> �o`ca4©�C1� <br /> CERTIFICATE HOLDER ADDITIONAL INSURED;INSURER LTTER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL <br /> San Joaquin Local Health District 3_DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br /> Attn: Air Pollution Control BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY <br /> P.O. Box 2009 OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. <br /> Stockton, CA 95201 AUTHORIZED REPRESENTATIVE <br /> Craig Wubben/RENEE <br /> c <br />