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CO0041812
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CO0041812
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Last modified
7/17/2019 3:02:37 PM
Creation date
2/7/2019 1:05:31 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
CO0041812
PE
2546
STREET_NUMBER
6649
STREET_NAME
EMBARCADERO
STREET_TYPE
DR
City
STOCKTON
Zip
95219
APN
09815011
ENTERED_DATE
7/6/2016 12:00:00 AM
SITE_LOCATION
6649 EMBARCADERO DR DOCK E SLIP24
RECEIVED_DATE
7/5/2016 12:00:00 AM
P_LOCATION
01
QC Status
Approved
Scanner
ADMIN
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FilePath
\MIGRATIONS\E\EMBARCADERO\6649\CO0041812.PDF
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EHD - Public
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GEICO <br /> Marine Insurance <br /> 880 South Pickett Street CLAIMS <br /> Alexandria, VA 22304 Tel: 877.970.2628 <br /> Fax: 703.461.2843 <br /> October 19, 2016 <br /> San Joaquin County Environmental Health Dept. <br /> 1868 E Hazelton Ave <br /> Stockton, CA 95205 <br /> RE: GEICO Marine Insurance Company, formerly Seaworthy Insurance Company <br /> Policy No. BSP3159726 <br /> Claim No. 16SSPUn86 - -- <br /> Date of Loss: 07/04/2016 <br /> Our Insured: John Gaetano <br /> To Whom It May Concern: <br /> We are in receipt of the invoice for your services relating to the pollution clean up and <br /> discharge of pollutants from John Gaetano's vessel. Claim payment in the amount of <br /> $1,150.30 is enclosed. This will represent full and final payment for your services, including <br /> any and all subcontractors. <br /> Please complete the enclosed Release form, sign it in the presence of a notary public and <br /> return it to us in the enclosed envelope. This Release acknowledges your responsibility to <br /> pay any and all subcontractors and properly contain, clean up and dispose of pollutants. The <br /> Release further agrees to indemnify and hold harmless the boat, its owner and the insurance <br /> company from any and all claims or causes of action arising out of any failure to pay a <br /> subcontractor and/or properly contain, clean up and dispose of pollutants now or in the <br /> future. <br /> If there are no subcontractors involved,please sign the$attom of this letter and return it to us <br /> in the enclosed envelope. <br /> I am available from 8am-5pm ET Monday - Friday. Please feel free to contact me if you have <br /> any questions regarding this claim. <br /> Sincerely, <br /> ffgvA d', f&%&r <br /> Angela S. Farkas <br /> GEICO Marine Insurance <br /> 1-877-970-2628 Ext. 3448 <br /> AF/af <br /> I, certify that no subcontractors were used in the <br /> pollution clean up and containment of this vessel. <br /> Signature <br />
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