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COMPLIANCE INFO 2003 - 2007
EnvironmentalHealth
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2300 - Underground Storage Tank Program
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PR0231669
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COMPLIANCE INFO 2003 - 2007
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Entry Properties
Last modified
7/6/2020 4:40:07 PM
Creation date
11/8/2018 9:43:46 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2003 - 2007
RECORD_ID
PR0231669
PE
2361
FACILITY_ID
FA0001480
FACILITY_NAME
TESORO (MOBIL) 68222
STREET_NUMBER
2132
STREET_NAME
MARIPOSA
STREET_TYPE
RD
City
STOCKTON
Zip
95205
APN
17306035
CURRENT_STATUS
01
SITE_LOCATION
2132 MARIPOSA RD
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Supplemental fields
FilePath
\MIGRATIONS3\M\MARIPOSA\2132\PR0231669\COMPLIANCE INFO\COMPLIANCE INFO 2003 - 2007.PDF
QuestysFileName
COMPLIANCE INFO 2003 - 2007
QuestysRecordDate
6/24/2016 3:46:18 PM
QuestysRecordID
3117371
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
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_–, SERVISTAT <br />r — <br />ACORM CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MMIDDfrYYY) <br />6/512007 <br />-'•ODUCER Commercial Lines Unit (707) 769-2900 <br />' <br />ABO Insurance & Financial Services <br />1039-A N. McDowell Blvd <br />Petaluma, CA 94954-5507 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />INSURERS AFFORDING COVERAGE NAIC # <br />INSURED Service Station Systems, Inc. <br />3224 Regional Parkway <br />Santa Rosa, CA 95403 <br />INSURER A: Oak River Insurance Company 34630 <br />INSURER B: <br />INSURER C: <br />INSURER D: <br />INSURER E: <br />Covt;w UL* <br />LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />THE POLICIES OF INSURANCE <br />OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />ANY REQUIREMENT, TERM OR CONDITION <br />AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />MAY PERTAIN, THE INSURANCE <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />(LTR <br />k-UDILPOLICY <br />EFFECTIVE <br />POLICY EXPIRATION <br />LIMITS <br />NSRE <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />DATE I <br />EACH OCCURRENCE f <br />GENERAL LIABILITY <br />DAMAGE TO RENTED f <br />COMMERCIAL GENERAL LIABILITY <br />urrencel <br />CLAIMS MADE ❑ OCCUR <br />MED EXP (Any one person) f <br />PERSONAL & ADV INJURY f <br />GENERAL AGGREGATE f <br />GEN'L AGGREGATE <br />LIMIT APPLIES PER: <br />PRODUCTS-COMPIOP AGO S <br />POLICY <br />PECT LOC <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT S <br />E. sxldent) <br />ANY AUTO <br />BODILY INJURY f <br />ALL OWNED AUTOS <br />(Per person) <br />SCHEDULED AUTOS <br />BODILY INJURY f <br />HIRED AUTOS <br />(Per accMent) <br />I <br />NON -OWNED AUTOS <br />PROPERTY DAMAGE f <br />(Par accMent) <br />GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT S <br />OTHER THAN EA ACC S <br />ANY AUTO <br />AUTO ONLY: AGO f <br />EXCESSIUMBRELLA LIABILITY <br />EACH OCCURRENCE S <br />AGGREGATE $ <br />OCCUR CLAIMS MADE <br />S <br />f <br />DEDUCTIBLE <br />$ <br />RETENTION $ <br />X OR STMT OTH- <br />A <br />WORKERS COMPENSATION AND <br />2210020636071 <br />61412007 <br />6/4/2006 <br />E.L. EACH ACCIDENT S 1,000,000 <br />EMPLOYERS' LIABILITY <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />E.L. DISEASE- EA EMPLOYEE $ 1,000,000 <br />OFFICERIMEMBER EXCLUDED) <br />E.L. DISEASE -POLICY LIMIT f 1.000.000 <br />Nyes,descdCeunder <br />SPECIAL PROVISIONS below <br />OTHER <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br />RE: License #485184 <br />Evidence of Coverage. <br />(Contractors State License Board <br />PO Box 26000 <br />Sacramento CA 95826 <br />ACORD 25 (2001106) 46340 <br />I en UaY Notice Tor Not <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />30 <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />O ACORD CORPORATION 1988 <br />
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