My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
WP0039911
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
W
>
WILSON
>
4343
>
4200/4300 - Liquid Waste/Water Well Permits
>
WP0039911
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
9/24/2019 1:47:45 PM
Creation date
9/24/2019 11:13:09 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0039911
PE
4372
STREET_NUMBER
4343
Direction
N
STREET_NAME
WILSON
STREET_TYPE
WAY
City
STOCKTON
Zip
95205-
APN
13202022
ENTERED_DATE
8/2/2019 12:00:00 AM
SITE_LOCATION
4343 N WILSON WAY
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
Scanner
TSok
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
6
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
SALEENG-01 MMAZZA <br /> '4�vRo° CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYW) <br /> 11/29/2018 <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 /> PRODUCER License#OE02096 CONTACT <br /> DiBuduo&DeFendis Insurance Brokers,LLC aoNN,Ext: 559 432-0222 FAX <br /> P.O.Box 5479 ( ( ) (A/C,No):(559)431-7941 <br /> Fresno,CA 93755-5479 EAI <br /> -ML <br /> INSURERS AFFORDING COVERAGE NAIC# <br /> INSURER A:Valley Forge Insurance Co 20508 <br /> INSURED INSURER B:Continental Casualty Company 20443 <br /> Salem Engineering Group,Inc. INSURER C:Continental Insurance Company 35289 <br /> 4729 W.Jacquelyn Ave. INSURER p:American Casualty Company of Reading PA 20427 <br /> Fresno,CA 93722 <br /> INSURER E <br /> INSURER F, <br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS <br /> LTR INSD WVD MM/DDIYYYY MM/DDNYYY <br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 <br /> CLAIMS-MADE [X]OCCUR X 6016893246 12/01/2018 12/01/2019 DAMAGE TO REMISES(FRENTED $ 300 000 <br /> MED EXP(Any oneperson) $ 15,000 <br /> PERSONAL 8 ADV INJURY $ 2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $ 4,000,000 <br /> POLICY❑X E ❑LOC 4�������� <br /> JT <br /> OTHER: $ <br /> B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 <br /> (Ea accident) $ <br /> X ANY AUTO 045473729 12/01/2018 12/01/2019 BODILY INJURY Per person) <br /> OWNED SCHEDULED <br /> AUTOS ONLY AUTOS <br /> SSyV p BODILY INJURY Per accident $ <br /> AUT0.S ONLY AUTOS ON Y PROPERTY <br /> accRident DAMAGE <br /> C X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 6,000'000 <br /> EXCESS LIAR CLAIMS-MADE 6015893232 12/01/2018 12/01/2019 AGGREGATE $ 6,000,000 <br /> DED I X I RETENTION$ 10,000 <br /> D WORKERS COMPENSATION X PER OTH- <br /> AND EMPLOYERS'LIABILITY STATUTE ER <br /> YIN 020581635 12/01/2018 12/01/2019 1,000,000 <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ <br /> EXCLUDED? <br /> OFFICER/MEMBER EXCLUDED? N/A <br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 <br /> It yes,describe under 1,000,000 <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> B Prof./Pollution Liab AEH591895527 12/01/2018 12/01/2019 Each Claim 2,000,000 <br /> B Prof./Pollution Liab AEH591896527 12/01/2018 12/01/2019 Aggregate 4,000,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> "Actual Certificate to be issued upon request** <br /> Certificate Holder is named Additional Insured(including Completed Operations and Primary Non-Contributory Wording)as respects General Liability per <br /> attached blanket policy form CNA75079XX(10-16). <br /> Professional/Pollution Liability deductible per claim-$25,000 <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> "SAMPLE CERTIFICATE" THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> AUTHORIZED REPRESENTATIVE <br /> ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />
The URL can be used to link to this page
Your browser does not support the video tag.