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Permits & Development - Encroachment(EP)/Driveway(DW) Permits - 2022_PS-2202501 thru PS-2203000_ - PS-2202852
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Permits & Development - Encroachment(EP)/Driveway(DW) Permits - 2022_PS-2202501 thru PS-2203000_ - PS-2202852
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Last modified
10/13/2022 3:56:32 PM
Creation date
10/13/2022 3:54:52 PM
Metadata
Fields
Template:
Permits_Development
DocName
PS-2202852
Category07
Encroachment(EP)/Driveway(DW) Permits
Year2
2022
Notes2
Peltier Rd. and Des Moines Rd. W/O HWY 99
Address
265 Lincoln Center, Stockton,CA 95207
Application
Anthony Vice
Type
Temp. Road Closure
Supplemental fields
Cross Ref
PWP7110005
Type (2)
Encroachment Permit (EP)
Text box
ID:
1
Creator:
Created:
10/13/2022 3:54 PM
Modified:
10/13/2022 3:54 PM
Text:
mailto:specialevent@hubinternational.com
ID:
2
Creator:
Created:
10/13/2022 3:54 PM
Modified:
10/13/2022 3:54 PM
Text:
mailto:specialevent@hubinternational.com
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Certificate #21503 <br />PH: 925 609 6500 FX: 925 609 6550 <br />TYPE OF EVENT: <br />EVENT DATE(S): <br />INSR LTR Effective Expiration <br />$1,000,000 <br />$2,000,000 <br />$1,000,000 <br />$2,000,000 <br />$1,000,000 <br />$5,000 <br />~ Additional Insureds, next page ~ <br />M2 Vintners, Inc., 2900 E. Peltier Road, Acampo, CA 98220 <br />Products/Completed Operations <br />Aggregate <br />Full Liquor Liability Included when a <br />separate premium has been charged. <br />Occurrence Form (CG 0001) <br />CERTIFICATE OF INSURANCE ENDORSEMENT <br />SPECIAL EVENT LIABILITY GROUP INSURANCE TRUST, A RISK PURCHASING GROUP <br />On behalf of the Risk Purchasing Group and each Member, the Trustee has declined coverage for the Terrorism Risk <br />Insurance Act (TRIA). <br />Host Liquor Liability Included. <br />Specific Events are excluded from coverage. Please see second page for list of excluded events. <br />The coverage afforded by this insurance is primary and non-contributing with any <br />insurance held by the “Additional Insured” as Named Insured, when the “Additional <br />Insured” is shown on this Certificate of Insurance Endorsement as “Additional Insured” <br />or WHEN REQUIRED BY WRITTEN CONTRACT. <br />COVERAGE EXCLUSIONS: (REFER TO POLICY FOR COMPLETE LISTING OF EXCLUSIONS) <br />Type of Insurance <br /> -- Terrorism <br />Policy Limits <br />1/1/2022 <br />EVENT HOLDER - Named Insured: (if multiple, continued on <br />next page)EVENT INFORMATION <br />Each Occurrence <br />Policy Number <br />M2 Winery, 2900 E. Peltier Road, Acampo, CA 98220EVENT LOCATION(S): <br /> COLONY INSURANCE COMPANY <br />FACILITY OWNER - Additional Insured: (if multiple, continued <br />on next page) <br />Arnold, CA 95223 <br />This is to certify that the policies of insurance listed below have been issued to the insured named above for the event date(s) indicated above. Notwithstanding any requirement, term or <br />condition of any contract or other document with respect to which this certificate may be issued or may pertain, the insurance afforded by the policies described herein is subject to all the terms, <br />exclusions and conditions of such policies. <br />CA License #0757776PRODUCER: <br />specialevent@hubinternational.com <br />HUB International Insurance Services Inc. <br />P.O. Box 4047 <br />Concord, CA 94524-4047 <br />Dia de la Muertos & UnCorked Runs <br />5/15 & 10/16/2022 <br /> -- Communicable Diseases <br /> -- Sexual Abuse & Molestation <br />General Aggregate <br />Personal & Advertising Injury <br />P.O. Box 1199 <br />Mark and Kandee Aiton DBA <br />On Your Mark Events <br />INSURER A: <br />Liquor Liability Each Occurrence <br />(Aggregate included in General <br />Liability Aggregate) <br />103 GL 0021111 <br />COVERAGE TERMS: <br />Damage to Premises Rented to You <br />Commercial <br />General Liability 1/1/2023A <br />N/A <br />Medical Payments
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