Laserfiche WebLink
NOU-28-2001 15:32 TLB INSURANCE AGENCY P.02i02 <br /> � �I3 <br /> I C tfilglfU W t f I <br /> 0 TI I T F LIA ILI t Y I t; �AD SH UM 11/28/01 <br /> PR - -- THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> TTiAB Insurance services HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR <br /> 1000 Bro'away Suite 289 ALTER THE COVERAGE AFFORDED BY THE POUCIES ISELOW. <br /> Oakland 94607-4090 <br /> Phone: 51 -626-9100 Fax:510-628-9115 INSURERS AFFORDING COVERAGE <br /> IN�uRgD INSURER A: Ra al Su lus Lines Insurance <br /> INSURERS. Golden Eagle Insurance <br /> n <br /> Sava a Construction Inc. INSURER C: Spate Co sation Insurance <br /> 401 sona Court INSURER D: North American Special Ins <br /> alace=villo CA 95667-9788 <br /> INSURER E: <br /> COVERAGES <br /> THE POLICIE0 OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWTT`HSTANDNIG <br /> ANY RECIUIRPAENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br /> MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH <br /> PQUCMS.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAR CLAM. <br /> LTINSR TYPE OF IWAM"CH POLICY NUMBER DATE 1MMID DATE .POLICY EFFECT TION LIMITS <br /> GENERAL LMOLITY EACH OCCURRENCE $ 1,000,000 <br /> A X COMMERCIALGENERALLIMILITY y,=530499 08/22/01 OB/22/02 FIRE DAMAGE(Any am firb) S50,000 <br /> {1 Aws MADE ®OCCUR MED EXP(Any one pmsan) S S,000 <br /> PERSONAL s ADV INJURY $ 1,000,000 <br /> - GENERAL AGGREGATE s2,000,000 <br /> GWI.AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGO $ 1,000,000 <br /> POLICY JJpE T LOG <br /> AUTOMOOI R LIANUTY COMBINED SINGLE LIMIT $1,000,000 <br /> R X ANY AUTO BA9494328 06/04/01 06/04/02 tra`m"O <br /> ALL OWNED AUTOS HODILY INJURY S <br /> (Per Poeson) <br /> SCHEDULED AUTOS <br /> FARED AUTOS BOptLY INJURY $ <br /> (Per accident) <br /> NON OWNSO AUTOS <br /> CC . $500 Deduct PROPERTY DAMAGE y <br /> Co 1. $500 Deduct (Peraccide <br /> GARAGE L` BIL m AUTO ONLY-EA AccID04' <br /> ANY 4UTO OTHER THAN EA ACG $ <br /> AUTO ONLY.' AGO $ <br /> EXCESS LIABILITY EACH OCCURRENCE $ <br /> OCCUR CLAIMS MARE AGGREGATE $ <br /> $ <br /> DEDUcn8LE $ --- <br /> RETENTION $ $ <br /> WORKERS COMPENSATION AND <br /> X TORY UMRS ER <br /> C EMPLCYOS'UASIUTY 403273 10/01/00 10/01/02 EL-EACHACCOENT $1,000,000 <br /> E.L.INSEAM-EA EhWUPYGE $1,000,000 <br /> EL.DISEASE.POLICY LIMIT $1 000 000 <br /> OTHER <br /> D Equi.parlent Floater ESNOOOOO15 10/29/00 10/29/01 <br /> DI:sCRIPt(oN OF OPMUTIONSILGCATIONSIV WIM-EWE=LUSW4 ADDED BY ENOORSEMeffISPEC"PROVISIONS <br /> *10 day$ notice of cancellation for nonpayment of premium* <br /> RE: Chevron, 1103 South Main St. , Manteca, CA. Certificate Holder is named <br /> as Additional Insured if required by written contract, but only with respect <br /> to liability arising out of the named insured's work for the certificate <br /> holder by or on behalf of the named insured. <br /> CERTIFICA*HOLDER----al ADDMONAI INSURED:INSURER LETTER A CANCELLATION <br /> SIANJOAC SHOULD ANY of THE ABOVE DESCRIBED PoLIVES ElI.'CANCELLED SWORE THE EXPIRATIC <br /> San Joaquin County GATE THEREOF,THE ISSUING INSURER WILL ENOFAVOR TO MAIL *30 oars WRITTeN <br /> Public Health Services NOTICE To THE cERTIF=TE HOLDER NAMED TO THE LEFT,BUT FAILURE TO to SO SFIAU- <br /> �:nviron=ntal Health Dept. IMPOSE NO OBLIGATION OR LIABILITY OF ANY MIND UPON THE INSURER,ITs AGENTS oR <br /> 1304 E. Weber Avenueo 3rd Floor <br /> REPRESENTATIVES. <br /> :Stockton, CA 95202-2777 <br /> [Bill L--A / J <br /> ACORD 26-S(7197) 0ACORC CORPORATION 19913 <br /> TOTAL P.02 <br />