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COMPLIANCE INFO 2008-2012
Environmental Health - Public
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2300 - Underground Storage Tank Program
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PR0231073
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COMPLIANCE INFO 2008-2012
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Last modified
1/19/2024 1:34:02 PM
Creation date
11/2/2018 6:36:22 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2008-2012
RECORD_ID
PR0231073
PE
2361
FACILITY_ID
FA0002064
FACILITY_NAME
7-ELEVEN INC. STORE #14117
STREET_NUMBER
2725
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
CURRENT_STATUS
02
SITE_LOCATION
2725 COUNTRY CLUB BLVD
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
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\MIGRATIONS\C\COUNTRY CLUB\2725\PR0231073\COMPLIANCE INFO 2008-2012.PDF
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EHD - Public
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ACORI] CERTIFICATE OF LIABILITY INSURANCE OP ID S DATE(MMIDDIYYYY, <br /> WALTO-2 09 29/09 <br /> PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> TLB Insurance Services HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR <br /> 3 D 00 Oak Rd. , Suite 210 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Walnut Creek CA 94597 <br /> Phone: 925-395-2600 Fax:925-287-0710 INSURERS AFFORDING COVERAGE NAIC# <br /> INSURED �- INSURER A: 8adurancc American Spec Yno Cc <br /> INSURER 8: Delos Insurance Co. <br /> . <br /> Walton Engineering, Inc. INSURER C: SeaBright Insurance Co <br /> P.O. Box 1025 INSURER D: Hartford Insurance Co 34690 <br /> West Sacramento CA 95691 - <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.NOTWTTHSTANDING <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 TME 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 /> IN POLICY EFFECTIVE POLICY EXPIRATION <br /> LTRINSR TYPE OF INSURANCE POLICY NUMBER DATE MMIDDIYY) DATE MMIDDIYY LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> A . X COMMERCIAL GENERAL LIABILITY ECC101D06001-00 03/06/09 03/06/10 PREMISES(Eaoccvrence) $ 5D,000 <br /> CLAIMS MADE Fx_1 OCCUR MED EXP(Anyone person) $ 51000 <br /> I I PERSONAL&ADV INJURY $ 1,000,000 <br /> GENERAL AGGREGATE $ 2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/CP AGG $2,000,000 <br /> POLICY FX- JECT LOC Emp Ben. 11000,000 <br /> AUTOMOBILE LIAMLITY <br /> I COMBINED SINGLE LIMB $ 1,000,000 <br /> B X ANY AUTO DPAS501792@1 03/06/09 03/06/10 (Ea accident) <br /> ALL OWNED AUTOS <br /> BODILY INJURY 5 <br /> SCHEDULED AUTOS (Per person) <br /> HIREDAUTOS <br /> BODILY INJURY $ <br /> NON-OWNED AUTOS (Per accident) <br /> PROPERTY DAMAGE $ <br /> (Per accident) <br /> GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ <br /> ANY AUTO OTHER THAN EA ACC $ _--�- <br /> AUTO ONLY. ACG $ <br /> EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ 10,000,000 <br /> A X OCCUR CLAIMSMADE EXS101006002-00 03/06/09 03/06/10 AGGREGATE $ 10,000,000 <br /> DEDUCTIBLE $ <br /> RETENTION $ $ <br /> WORKERS COMPENSATION AND X TORY LIMITS ER _ <br /> O EMPLOYERS'LIABILITY BBIG93003 10/01/09 10/01/10 E.L.EACH ACCIDENT $ 1 000,000 <br /> ANY PROP RIETORIPARTNERIEXECUTVE - <br /> OFFICERIMEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 1,000,000 <br /> S yes,CIdescribe under AL PROVISIONS belowE.L.DISEASE-POLICY LIMIT $�1,0Q0,000 <br /> SPE <br /> OTHER <br /> A � Pollution/E&O ECC101006001-00 03/06/09 03/06/10 Poll/E&O 11000,000 <br /> D Installation Fltr 57MSIZ6050 03/06/09 1 03/06/10 Inst Fltr 2,000,000 <br /> DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES!EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br /> *10 days notice applies if cancelled for non-payment of ,premium. <br /> CERTIFICATE HOLDER CANCELLATION <br /> TOWHOMI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30* DAYS WRITT€N <br /> NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL <br /> TO WhOIT1 It May Concern IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR <br /> REPRESENTATIVES. <br /> AUTHORIZED REPRESENTATIVE <br /> Dennis Cote' 166-ea L <br /> ACORD 25(2001108) ©ACO RD CORPORATION 1988 <br />
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