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NOV 13 '95 11:28AM SAN JOAQUIN PERSONPEL OFC P.2 <br /> culD 'ICATE OF INAAANCE <br /> MIS is to certify that coverages in the name of: 'l' kaM W o <br /> SAN JOAQUIN COUNTY of aoY ao mx a ad=dw a m wxh zc.p�tm <br /> COUNTY COURTHOUSE whim mecmdfi=b�s iniad,6.i &M=ji <br /> STOCKTON, CA 95202 by dv:PSR Lithia m She c�Xwme is Sohl= <br /> are in force at the date hereof, as follows: mnU me wma of web rohniw.' <br /> Coveraqe Cam an Policy Period Limits <br /> C®p C3eeayel A Cay 13-75-ZM as ttiieodcd ffi.lvlll6 $1,000,000 Sie1Fh®mca <br /> Cootsaatuwl Liw60Sq Ham,aadiavaa aoftbw <br /> )a me cyan[of mry nnmeial ehawe in or uneenatitm of--A pa 4u.c4 andoeigmd a=ww v➢t eadea.oe m$i,e v,idm notice m me PW <br /> b vl.,jiw ecrlhiraec is <br /> :+wnod,bat f ibn W air.waft aotlwe Shall MIMM m obli$stim m liOMW SSP=th,mmPanp bryaad am�mw and emd?j.of Zh Polbiu. <br /> DESCRIPTION: Certificate issued in connection with agreement between the <br /> State of California and San Joaquin County Environmental Health Division to <br /> assess and oversee the work site located at 75 E. Alpine, Stockton, for the <br /> purpose of excavation, soil sampling, backfill and compaction from for <br /> 13 through November 17, 1995. <br /> It is hereby agreed that the State of California, Water Resources Control <br /> Board, its officers and employees are named as additional insured as to <br /> activities under this agreement . it is also agreed such insurance or self- <br /> insurance shall be considered to be primary as to similar insurance or self- <br /> insurance carried by same and that thirty (30) days written notice of <br /> cancellation will be provided to certificate holder. <br /> _ _ CQMRanies Affording Covgrages Authorized Ren esen ative <br /> A. San Joaquin County <br /> Safety and Risk Manag r (date) <br /> B. <br /> Diane Edwards, Contract Manager, EAR <br /> State of California, Water Resources Control Board <br /> Clean Water Grogram Divisio <br /> P.O. Box 944212 n, UST Clean-up Fund Program <br /> Sacramento, CA 94244-2120 <br /> G'tri.xaC6a.m sr icamd m me S VSt of me Poem a MaaiE11fM acord as'ffic <br /> e°"wai'.r iaSmd�amatiov.0lmmlm moApnaue oroigmatim,Roc sddmR <br /> elwwn,aatico N ce¢aaw0m Sad,.r:za Pwaalc,ao0ro of mwAg oar of <br /> me dwwaranl pokms.) <br />