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COMPLIANCE INFO_2009-2011
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2300 - Underground Storage Tank Program
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PR0231923
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COMPLIANCE INFO_2009-2011
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Last modified
2/1/2024 2:05:50 PM
Creation date
6/23/2020 6:54:02 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2009-2011
RECORD_ID
PR0231923
PE
2361
FACILITY_ID
FA0003606
FACILITY_NAME
ARCO 05450
STREET_NUMBER
1617
Direction
W
STREET_NAME
FREMONT
STREET_TYPE
ST
City
STOCKTON
Zip
95203
APN
13511015
CURRENT_STATUS
01
SITE_LOCATION
1617 W FREMONT ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0231923_1617 W FREMONT_2009-2011.tif
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EHD - Public
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ACQRD Y,) <br /> ,e, 03/23/10 <br /> PRODUCER LIC #oB29370 1-925-244-7700 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> Edgewood Partners Insurance Centers (EP{C) ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> [San Ramon Branch] HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> P. O. Boot 5003 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> San Ramon, CA 94583 <br /> 2PICcerto@adgewoodins.com INSURERS AFFORDING COVERAGE I NAIC# <br /> INSURED INSURER A:WESTCHESTER SURPLUS LINES INS CO 10172 <br /> Gettlez-Ryan, Ine. <br /> INSURER B:PEERLESS INS CO 124190 <br /> 6747 Sierra Court, Suite J INSURER C:TRAVELERS PROPERTY CAS CO OF AMEN 125674 <br /> Dublin, CA 94568 INSURER D: <br /> INSURER E: <br /> COVERAGES <br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING <br /> ANY REQUIREMENT,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 POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH <br /> POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> BISR ADO'LPOLICY NUMBER POLJCY EFFECTIVE (POLICY EXPIRATION LIMITS <br /> 2► GENERALLL48RM 624014484003 04/01/10 04/01/11 EACH OCCURRENCE $1,000,000 <br /> _ <br /> X COMMERCIAL GENERAL LIABILITY PREMISES EaoC�flcrence $50,000 <br /> CLAIM MADE X OCCUR MED EXP(Anyone person) $5,000 <br /> PERSONAL&ADV INJURY $1,000,000 <br /> GENERALAGGREGATE 52.000.000 <br /> 'GENLAGGREGATEUMITAPPUESPER: ( PRODUCTS-COMPIOPAGG $2,000,000 <br /> - POLICY E PRO- 77 LOC <br /> B AUTOMOBILE LIABILITY BA8404396 04/01/10 04/01/11 , <br /> COMBINED SINGLE LIMIT $1,000,000 <br /> X ANY AUTO I(Eescofdent) <br /> X ALL OWNED AUTOS BODILY INJURY $ <br /> X SCHEDULEDAUTOS (Peron) <br /> X HIREDAUTOS <br /> BODILY INJURY $ <br /> X NON-OWNEDAUTOS I (Pereaadent) <br /> -. ......�... .,�.m.. ®. PROPERTY DAMAGE $ <br /> ... accident) <br /> GN AGE LIABILITY AUTO ONLY-EA ACCIDENT $ <br /> ANYAUTO OTHERTHAN P.AACC $ <br /> AUTO ONLY: AGG $ <br /> A EXCESSNMBRELLALL48RM 024014502003 04/01/10 04/01/11 EACH OCCURRENCE $4.000,000 <br /> X I OCCUR CLAIMS MADE AGGREGATE _ $4,000,000 <br /> - <br /> DEDUCTIBLE $ <br /> RETENTION S $ <br /> C WORKERS COMPENSATION AND DTJUB7827P41510 04/01/10 ( 04/01/11 X I <br /> WCSTAMT OCL <br /> EMPLOYERS' ORIPARIABILITY E.L.EACHACCIDENT $1,000,000 <br /> ANY PROPRIETORIPARTNEREXECUTIVE <br /> OFFICERMEMBEREXCLUDED9 E.L.DISEASE-EAEMPLOYEE $1,000,000 <br /> Kdesoibe under <br /> SPECIALPROVISIONS below I E.L.DISEASE-POLICY LIMIT $1,000,000 <br /> A Pollution 624014484003 04/01/10 04/01/11 Iger Occurrence 1,000,000 <br /> A ;Professional Liability 624014484003 04/01/10 04/01/11 IPer Claim 1,000,000 <br /> B Rented/Leased Equipment CBP0404796 04/01/10 04/01/11 For Item 100,000 <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br /> CERTIFICATE HOLDER CANCELLATION Ten Day Notice for Non-Payment of Premium <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES 13E CANCELLED BEFORE THE EXPIRATION <br /> *EVIDENCE OF COVERAGE DATE THEREOF.THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN <br /> NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO 90 SHALL <br /> IMPOSE NO OBLIGATION OR UABILJTY OF ANY KDIO UPON THE INSURER,ITS AGENTS OR <br /> REPRESENTATIVES. <br /> AUTHORED REPRESENTATIVE <br /> ACORD 25(2001/08)atalebsadah 0ACORD CORPORATION 1988 <br /> 14876120 <br />
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