My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
WP0039980
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
L
>
LOUISE
>
500
>
4200/4300 - Liquid Waste/Water Well Permits
>
WP0039980
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
3/5/2020 3:06:13 PM
Creation date
3/5/2020 2:39:36 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0039980
PE
4372
STREET_NUMBER
500
Direction
E
STREET_NAME
LOUISE
STREET_TYPE
AVE
City
LATHROP
Zip
95330-
APN
19812008
ENTERED_DATE
8/19/2019 12:00:00 AM
SITE_LOCATION
500 E LOUISE AVE
P_LOCATION
07
P_DISTRICT
003
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.
/
8
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
A`oRo® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYV) <br /> 08/11/2019 <br /> THIS CERTIFICATE IS ISSUED ASA 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 CONTACT Kathy Stutts <br /> NAME: <br /> Tolman&Wiker Insurance Services LLC#OE52073 PHONE Ext: (805)585-6156 n/c No: (805)585-6256 <br /> 196 S.Fir Street E-MAIL kstutts@tolmanandwiker.com <br /> ADDRESS: <br /> PO Box 1388 INSURER(S)AFFORDING COVERAGE NAIC# <br /> Ventura CA 93002-1388 INSURER A; Capitol Specialty Ins Corp 10328 <br /> INSURED INSURER B: United Financial Casualty CO. 11770 <br /> INSURER C: State Compensation Ins Fund 35076 <br /> Middle Earth Geo Testing,Inc. INSURER D: <br /> 954 North Lemon St. INSURER E: <br /> Orange CA 92867 INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 19/20 GL/AU/WC/POLL 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 POLICY EFF POLICY EXP <br /> LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM DDfYYYY MM DDIYYYY LIMITS <br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> CLAIMS-MADE 1 OCCUR DAMAGE TO RENTED 50,000 <br /> PREMISES Ea occurrence $ <br /> MED EXP(Any one person) $ 5,000 <br /> A EV20182696-02 08/08/2019 08/08/2020 PERSONAL&ADV INJURY $ 1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE s 2,000,000 <br /> POLICY N PRO ❑LOC PRODUCTS-COMP/OP AGG g 2,000,000 <br /> JECT <br /> OTHER. $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT g 1,000,000 <br /> Ea accident <br /> X ANYAUTO BODILY INJURY(Per person) $ <br /> B OWNED SCHEDULED 02106265-6 03/12/2019 03/12/2020 BODILY INJURY(Per accident) $ <br /> AUTOS ONLY AUTOS <br /> HIRED NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY AUTOS ONLY "Per accident <br /> UMBRELLA UAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LAB CLAIMS-MADE AGGREGATE $ <br /> DED I I RETENTION$ $ <br /> WORKERS COMPENSATION X1 <br /> SPIER <br /> EORH <br /> AND EMPLOYERS'LIABILITY Y/N <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT g 1.000,000 <br /> C OFFICERIMEMBER EXCLUDED? N/A 9059223-2019 06/02/2019 06/02/2020 <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE g 1,000,000 <br /> If yes,describe under 1,000,000 <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> CONTRACTOR'S POLLUTION <br /> A PROFESSIONAL LIABILITY EV20182696-02 08/08/2019 08/08/2020 LIMIT: $1,000,000 <br /> DEDUCTIBLE: $10,000 <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> Verification of Coverage <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN <br /> Evidence of Insurance ACCORDANCE WITH THE POLICY PROVISIONS. <br /> AUTHORIZED REPRESENTATIVE <br /> ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) 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.