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COMPLIANCE INFO_2009-2013
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2300 - Underground Storage Tank Program
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PR0232494
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COMPLIANCE INFO_2009-2013
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Last modified
11/14/2023 12:52:58 PM
Creation date
6/3/2020 9:57:23 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2009-2013
RECORD_ID
PR0232494
PE
2361
FACILITY_ID
FA0002602
FACILITY_NAME
KAISER PERMANENTE
STREET_NUMBER
7373
STREET_NAME
WEST
STREET_TYPE
LN
City
STOCKTON
Zip
95210
APN
09416023
CURRENT_STATUS
01
SITE_LOCATION
7373 WEST LN
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0232494_7373 WEST_2009-2013.tif
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EHD - Public
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ACO , C IFI F LIABILITY I <br />DATE2011 <br />12/9/2011 <br />PRODUCER <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Dealey, Renton & Associates <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />P. O. Box 10550 <br />Santa Ana CA 92711-0550 <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />POLICY EXPIRATION <br />LIMITS <br />INSURERS AFFORDING COVERAGE <br />INSURED <br />INSURERA: Travelers Prolperty Casualty Co of Ameri <br />INSURER B: Indian Harbor Insurance Company <br />Advanced GeoEnvironmental, Inc. <br />837 Shaw Avenue <br />Stockton CA 95215 <br />INSURER C: Travelers Indemnity Co. of Connecticut <br />FIRE DAMAGE (Any one fire) $1,000, 000 <br />INSURER D: <br />INSURER E: <br />COVFRAGFS <br />HE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. <br />OTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />ERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL <br />HE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LIR <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />t ID IYYIL <br />POLICY EXPIRATION <br />LIMITS <br />C <br />GENERAL LIABILITY <br />6802626L25A <br />7/1/2011 <br />7/1/2012 <br />EACH OCCURRENCE $2,000,000 <br />FIRE DAMAGE (Any one fire) $1,000, 000 <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADE Fx_1 OCCUR <br />MED EXP (Any one person) $10,000 <br />PERSONAL &ADV INJURY $2,000,000 <br />X Contractual <br />Liability <br />GENERAL AGGREGATE $ <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMP/OP AGG $4,000,000 <br />POLICY X PRO- LOC <br />A <br />AUTOMOBILE <br />X <br />LIABILITY <br />ANY AUTO <br />BA3220P835 <br />10/17/2011 <br />10/17/2012 <br />COMBINED SINGLE LIMIT $1,000,000 <br />(Ea accident) <br />BODILY INJURY <br />(Per person) $ <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />BODILY INJURY $ <br />(Per accident) <br />X <br />X <br />HIRED AUTOS <br />NON -OWNED AUTOS <br />PROPERTY DAMAGE $ <br />(Per accident) <br />GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT $ <br />OTHER THAN EA ACC $ <br />ANY AUTO <br />AUTO ONLY: AGG $ <br />A <br />EXCESS LIABILITY <br />CUP6A276348 <br />8/30/2011 <br />7/1/2012 <br />EACH OCCURRENCE $1,000,000 <br />X I OCCUR El CLAIMS MADE <br />AGGREGATE $1,000,000 <br />$ <br />DEDUCTIBLE <br />$ <br />RETENTION $ <br />A <br />WORKERS COMPENSATION AND <br />UB3338T982 <br />10/17/2011 <br />10/17/2012 <br />WC STATU- OTH- <br />X TRY LIMITSER <br />E.L. EACH ACCIDENT $1,000,000 <br />EMPLOYERS' LIABILITY <br />E.L. DISEASE - EA EMPLOYEE $1,000,000 <br />E.L. DISEASE -POLICY LIMIT $1,000,000 <br />B <br />OTHER <br />Professional Liability <br />PECO02932802 <br />10/17/2011 <br />10/17/2012 <br />Per Claim $2,000,000 <br />Annual Aggr. $2,000,000 <br />Claims Made <br />DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br />General Liability policy excludes claims arising out of the performance of professional services. <br />CERTIFICATE HOLDER I I ADDITIONAL INSURED: INSURER LETTER: CANCELLATIONI O n;; -,r Nnti eP fc)r Wnn-Pavmen - <br />ACORD 25-S (7/97) 0 ACORD CORPORATION 1988 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br />BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER <br />FOR PROPOSAL ONLY <br />WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE <br />ERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO <br />O SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND <br />PON THE INSURER, ITS AGENTS OR REPRESENTATIVES. <br />4011 <br />AUTHORIZED REPRESENTAT1111 <br />ACORD 25-S (7/97) 0 ACORD CORPORATION 1988 <br />
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