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a <br /> s ® a <br /> 304 E Weber Avenue FAX : (209) 464-0138 <br /> 3rd Floor, Stockton, CA 95202 <br /> Phone: (209)468-3420 (209) 468-8392 <br /> ✓ (209) 468-3433 <br /> Date: 08/09/2006- Time: 1L:31 pin <br /> # of Pages (including this sheet): <br /> To: Michael Dominguez FAX (209)941-0412 <br /> Of: Fremont Shell <br /> From: Toua Yang, EHS Voice Phone : (209)468-3459 <br /> Re: Certificate of FinancialResponsibility& Certificate of Insurance from Zurich <br /> Urgent ✓ For Review ✓ Please Reply Please Recycle <br /> Comments: <br /> According to the State Water Resource Control Board,the State UST Fund can only be use to satisfy <br /> financial responsibility if used in conjunction with a letter from Chief Financial Officer or a Certificate <br /> of Deposit that demonstrates financial responsibility of at least$5,000 exclusive of the State fund. I <br /> understand that your facility is covered by insurance'through Zurich. If you can provide EHD with a <br /> copy of the current Certificate of Insurance or Endorsement from Zurich that demonstrates financial <br /> "responsibility of at least 1 million dollars per occurrence and 1 million dollars annual aggregate then <br /> your financial responsibility will be satisfied. The Certificate of Insurance or Endorsement from Zurich <br /> should be similar in literature to the attached Models of"Certificate of Insurance" or"'Endorsement." <br /> Also attached is a blank copy of the Certificate of Financial Responsibility for your use. Make <br /> corrections to the Certificate of Financial Responsibility because you do not need the State Fund if <br /> Zurich can provide you the insurance. I've already spoken with Lori on;this matter. If you have any <br /> questions, feel free to contact me. <br /> STATEMENT OF CONFIDENTIALITY: The information in this facsimile is legally privileged and confidential information intended only for the use of the addressee <br /> listed on this cover sheet. If the reader of this message is not the intended recipient,or the employee or agent responsible to deliver it to the intended recipient, <br /> you are hereby notified that any dissemination,distribution or copying of this telecopy is strictly prohibited. If you have received this facsimile in error,please <br /> immediately notify us by telephone at the number listed on this cover sheet and return the original message to us at the above address via United States Postal <br /> Service. We will reimburse your costs in notifying us and returning the message to us. Thank You. <br /> EHD 48-01-012 FAX COVER SHEET <br /> REVISED 6-14-02 <br />