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WP0042491
EnvironmentalHealth
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LAMMERS
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4200/4300 - Liquid Waste/Water Well Permits
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WP0042491
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Entry Properties
Last modified
12/9/2021 5:15:47 PM
Creation date
12/9/2021 3:04:27 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0042491
PE
4372
STREET_NUMBER
28281
Direction
S
STREET_NAME
LAMMERS
STREET_TYPE
RD
City
TRACY
Zip
95377-
APN
25105009
ENTERED_DATE
8/27/2021 12:00:00 AM
SITE_LOCATION
28281 S LAMMERS RD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\tsok
Supplemental fields
CYEAR
2021
Tags
EHD - Public
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POLICY NUMBER: U20AC81810-06 COMMERCIAL GENERAL LIABILITY <br /> CG 20 10 07 04 <br /> THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> ADDITIONAL INSURED - OWNERS, LESSEES OR <br /> CONTRACTORS - SCHEDULED PERSON OR <br /> ORGANIZATION <br /> This endorsement modifies insurance provided under the following: <br /> COMMERCIAL GENERAL LIABILITY COVERAGE PART <br /> SCHEDULE <br /> Name Of Additional Insured Person(s) <br /> Or Organization(s): Locations Of Covered Operations <br /> Any person or organization for whom you are performing <br /> operations during the policy period when you and such <br /> person or organization have agreed in writing in a contract <br /> or agreement that such person or organization be added <br /> as an additional insured on your policy. <br /> Information required to complete this Schedule, if not shown above, will be shown in the Declarations. <br /> A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these <br /> include as an additional insured the person(s) or additional insureds, the following additional <br /> organization(s) shown in the Schedule, but only exclusions apply: <br /> with respect to liability for "bodily injury", "property This insurance does not apply to "bodily injury" or <br /> damage" or "personal and advertising injury" "property damage"occurring after: <br /> caused, in whole or in part, by: <br /> 1. All work, including materials, parts or <br /> 1. Your acts or omissions; or equipment furnished in connection with such <br /> 2. The acts or omissions of those acting on your work, on the project (other than service, <br /> behalf; maintenance or repairs) to be performed by or <br /> in the performance of your ongoing operations for on behalf of the additional insured(s) at the <br /> the additional insured(s) at the location(s) location of the covered operations has been <br /> designated above. completed; or <br /> 2. That portion of "your work" out of which the <br /> injury or damage arises has been put to its <br /> intended use by any person or organization <br /> other than another contractor or subcontractor <br /> engaged in performing operations for a <br /> principal as a part of the same project. <br /> CG 20 10 07 04 ©ISO Properties, Inc., 2004 Page 1 of 1 ❑ <br />
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