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This <br /> r- 'RTIFICATE OF INSURANCE Q <br /> This certificate is issued c.._ a matter of information C. v and confers no rights <br /> upon the certificate holder. This certificate does not amends extend or alter <br /> the coverage afforded by they Policies listed below. <br /> Name and Address of A<_#Gnev C Latter A Transamerica Insurance Company <br /> S. N. Potter Insurance Amu Inc 0 Son Francisco <br /> F. J. Dietrich - Gianelli Iris. M Letter B <br /> P. 0. Bore 7187 F <br /> Stockton CA 95207 A Letter C <br /> Name: and Mailing Address of Insured N <br /> Stockton Services Station I Letter D <br /> Eauipment Company E <br /> P 0 Box 508 S Letter E <br /> Stockton CA 95201 <br /> This is to certify that Policies of insurance listed below have been issued to <br /> the insured named above for the Policy Period :indicated. `lotwithstandi.nn any <br /> reouirements term or condition of any contract or other document, with respect <br /> to which this certificate may bre issued or may Pertain9 the insurance afforded <br /> orded <br /> be the Policies described herein is subject to all the termsp exclusions and <br /> conditions of such }sol.icies + <br /> Co. Type of Policy I Policy Policy Limits (000 's) <br /> Insurance Effective Expiration Occur Awarnmate <br /> ---- GENERAL LIABILITY --------------------------------------------------------- <br /> A (X) Comprehensive f-7 30213119 12117/86 1.2/17/87 B. I . <br /> (X) Premises & Oris . <br /> ( ) Exp/Coll/Under P.D. <br /> (X ) Product/Comp Ota CSL. $0000 $11000 <br /> (X) Contractual <br /> (X ) Broad Form PD <br /> (X) Ind Contractors <br /> (X) Personal I.ni. Personal Inj $0000 <br /> ---- AUTOMOBILE LIABILITY -------------------•----------------------------------- <br /> A (X ) Anis Auto T•-7 30 .'.1 1119 12117186 12/17/87 B. I ./Person <br /> Owned Priv Pass B. I ./Accidnt <br /> ( ) Owned OT Priv P P. D. <br /> (X) Hired CSL $0000 <br /> (X ) Non-Owned <br /> ( ) Berate Liab <br /> ---- EXCESS LIABILITY ---------------------------------------------------------- <br /> ( } Umbrella Form B . I . `1, P+D. Combined <br /> ( } O.T. Umbrella <br /> ---- WORKERS COMPENSATION ------------------------------------------------------ <br /> A W.C . WC:801517 2RAI 12/31/86 12/31/87 STATUTORY <br /> Employers Liab. Each Accident <br /> Diseasse/Pol <br /> Disse asse/E'ma. <br /> ---- OTHER ------------------------------------------------------------ <br /> Description of Operations/Locations/Vehicles <br /> Workers Compensation Policy Provides Unlimited Employers Liability <br /> Limits <br /> CANCELLATION: Should any of the above described Policies be cancelled <br /> before the expiration date the7re?ofp the issuing company will endeavor <br /> to mail 30 days written notice to the certificate holder named below <br /> but failure to mail such notice shall impose no obligation or <br /> liability of any kind upon the companur its agents or represe:`n'tat.ive's + <br /> Name and Address of Certificate Holder <br /> Major Engineering I+ate Issued: 7 <br /> 100 Park Placer Suite 220 <br /> San Ramonr CA 94583-1760 A � ...��.._ <br /> Uc <br /> ORD Attention: Jim Thompson A�_cthc}r:i:=r_cS hc�}�rE�<.snt�7ti14/8ve <br />