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FIELD DOCUMENTS_FILE 2
EnvironmentalHealth
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3500 - Local Oversight Program
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PR0545028
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FIELD DOCUMENTS_FILE 2
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Last modified
12/6/2019 5:08:09 PM
Creation date
12/6/2019 2:54:13 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
FileName_PostFix
FILE 2
RECORD_ID
PR0545028
PE
3528
FACILITY_ID
FA0003919
FACILITY_NAME
VAN DE POL ENTERPRISES
STREET_NUMBER
5491
STREET_NAME
F
STREET_TYPE
ST
City
BANTA
Zip
95304
CURRENT_STATUS
02
SITE_LOCATION
5491 F ST
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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ROE 920316-INS A-1 <br /> Form Approved,AVP-law <br /> Exhibit AA <br /> Union Pacific Railroad <br /> Third Party Right of Entry <br /> Licensee shall, at its sole cost and expense, procure and maintain during the life of this Agreement the <br /> following insurance coverage: <br /> A. Commercial General Liability insurance. This insurance shall contain broad form contractual <br /> liability with a single limit of at least $5,000,000 each occurrence or claim and an aggregate limit <br /> of at least $10,000,000. Coverage must be purchased on a post 1998 ISO or equivalent form, <br /> including but not limited to coverage for the following: <br /> • Bodily injury including death and personal injury <br /> • Property damage <br /> • Fire legal liability (Not less than the replacement value of the portion of the premises <br /> occupied) <br /> • Products and completed operations <br /> The policy shall also contain the following endorsements, which shall be indicated on the <br /> certificate of insurance: <br /> • The employee and worker's compensation related-exclusions in the above policy apply <br /> only to Licensee's employees <br /> • The exclusions for railroads (except where the Job Site is more than fifty feet (50') from <br /> any railroad including but not limited to tracks, bridges, trestles, roadbeds, terminals, <br /> underpasses or crossings), and explosion, collapse and underground hazard shall be removed. <br /> Waiver of subrogation <br /> B. Business Automobile Coverage insurance. This insurance shall contain a combined single limit <br /> of at least $5,000,000 per occurrence or claim, including but not limited to coverage for the <br /> following: <br /> • Bodily injury and property damage <br /> • Any and all motor vehicles including owned, hired and non-owned <br /> The policy shall also contain the following endorsements,which shall be indicated on the <br /> certificate of insurance: <br /> • The employee and worker's compensation related exclusions in the above policy <br /> apply only to Licensee's employees <br /> • The exclusions for railroads (except where the Job Site is more than fifty feet (50') <br /> from any railroad including but not limited to tracks, bridges, trestles, roadbeds, terminals, <br /> underpasses or crossings),and explosion, collapse and underground hazard shall be removed. <br /> • Motor Carrier Act Endorsement-Hazardous materials cleanup (MCS-90) if required <br /> by law <br /> C. Workers Compensation and Employers Liability insurance including but not limited to: <br /> • Licensee's statutory liability under the workers' compensation laws of the state(s) affected by <br /> this Agreement. <br /> • Employers'Liability(Part B)with limits of at least$500,000 each accident, $500,000 disease <br /> policy limit$500,000 each employee <br /> Exhibit A4 <br />
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