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WP0041565
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4200/4300 - Liquid Waste/Water Well Permits
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WP0041565
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Last modified
6/7/2021 2:55:23 PM
Creation date
6/7/2021 2:53:07 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0041565
PE
4372
STREET_NUMBER
16775
Direction
S
STREET_NAME
HOWLAND
STREET_TYPE
RD
City
LATHROP
Zip
95330-
APN
19814004
ENTERED_DATE
12/29/2020 12:00:00 AM
SITE_LOCATION
16775 S HOWLAND RD
P_LOCATION
07
P_DISTRICT
003
QC Status
Approved
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EHD - Public
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Additional Insured —Owners, Lessees Or Contractors <br />Scheduled Person Or Organization <br />ZURICHm <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />Policy No. GL00184640-05 Effective Date: 10/01/2020 <br />This endorsement modifies insurance provided under the: <br />Commercial General Liability Coverage Part <br />SCHEDULE <br />Name Of Additional Insured Persons) <br />Or Organization(s): <br />Locations) Of Covered Operations <br />ny person or organiza ion, o er an an arc i ec ,engineer <br />or surveyor, whom you are required to add as an additional <br />Any Location or Project <br />agreement executed prior to loss, except where such requirement <br />is rohibited b law. <br />A. Section II —Who Is An Insured is amended to include as an additional insured the persons) or organizations) <br />shown in the Schedule of this endorsement, but only with respect to liability for "bodily injury", "property damage" or <br />"personal and advertising injury" caused, in whole or in part, by: <br />1. Your acts or omissions; or <br />2. The acts or omissions of those acting on your behalf; <br />in the performance of your ongoing operations for the additional insureds) at the locations) designated in such <br />Schedule. <br />B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: <br />This insurance does not apply to "bodily injury" or "property damage" occurring after: <br />1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than <br />service, maintenance or repairs) to be performed by or on behalf of the additional insureds) at the location of the <br />covered operations has been completed; or <br />2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any <br />person or organization other than another contractor or subcontractor engaged in performing operations for a <br />principal as a part of the same project. <br />All other terms, conditions, provisions and exclusions of this policy remain the same. <br />U -GL -2169-A CW (02/19) <br />Page 1 of 1 <br />Includes copyrighted material of Insurance Services office, Inc., with its permission. <br />c <br />
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