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FIELD DOCUMENTS FILE 2
Environmental Health - Public
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EHD Program Facility Records by Street Name
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D
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DURHAM FERRY
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1600
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3500 - Local Oversight Program
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PR0544624
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FIELD DOCUMENTS FILE 2
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Last modified
7/3/2019 5:58:21 PM
Creation date
7/3/2019 3:31:32 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
FileName_PostFix
FILE 2
RECORD_ID
PR0544624
PE
3526
FACILITY_ID
FA0005206
FACILITY_NAME
GEORGES SERVICE
STREET_NUMBER
1600
Direction
W
STREET_NAME
DURHAM FERRY
STREET_TYPE
RD
City
TRACY
Zip
95376
APN
25510004
CURRENT_STATUS
02
SITE_LOCATION
1600 W DURHAM FERRY RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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RESOINT-01 GATE <br />krise <br /> D� CERTIFICAT OF LIABILITY INSURA L.E °"T211/2008' <br /> (530)668-2777 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> Associates Insurance Services ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> 850501 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR <br /> ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> F.� Box 1270 <br /> Woodland, CA 95776.1270 INSURERS AFFORDING COVERAGE NAIC# <br /> INSURED ResonantSonic International, Inc. INSURERA:Westchester Surplus Line Insurance Com <br /> RSI Drilling INSURERB:ACE American Insurance Company <br /> 220 N. East Street INSURER c:Travelers Insurance Company <br /> Woodland,CA 95776- <br /> INSURER D: <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.NOTWITHSTANDING <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 THE 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 /> INSR D' POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE IMMIDDIM DATE I LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1,000,66 <br /> A X X COMMERCIAL GENERAL LIABILITY 623799807002 1!31/260$ 1/31/2009 PREMISES Eacccmence $. 50,00 <br /> CLAIMS MADE FXI OCCUR MED EXP(Any one person) $ 5,06 <br /> PERSONAL&ADV INJURY $ 1,000,00 <br /> GENERAL AGGREGATE $ 2,006,66 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,06 <br /> T POLICY PRO- F Loc Professional/Pollution 1,000,00 <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,00 <br /> B X ANY AUTO H084155OA002 1/31/2008 1/31/2009 (Eeaccident) <br /> ALL OWNED AUTOS BODILY INJURY <br /> SCHEDULED AUTOS (Per person) $ <br /> HIRED AUTOS 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 EAACC $ <br /> AUTO ONLY: AGG $ <br /> EXCESSNMBRELLA LIABILITY EACH OCCURRENCE $ 4,000,00 <br /> A OCCUR CLAIMS MADE G23799819001 1/31/2008 1/31/2009 AGGREGATE $ 4,000,00 <br /> $ <br /> DEDUCTIBLE $ <br /> X RETENTION $ 10,006 $ <br /> [TR <br /> COMPENSATION AND TWCSTATIU <br /> I TS <br /> R <br /> EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $ <br /> ANY PROPRIETORIPARTNEWEXECUTIVE <br /> OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ <br /> Ryes,describe under E.L.DISEASE-POLICY LIMIT $ <br /> SPECIAL PROVISIONS below <br /> OTHER <br /> C Property QT6605436BO08TIL08 1/31/2008 1/31/2009 Building,$1,000 dedt 650,00 <br /> C Equipment Floater JOT6605436BOOBTILOB 1/31/2008 1/31/2009 Scheduled,$1,000 dedt 1,000,00 <br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS/VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br /> 7777 <br /> ed per attached endorsement. <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> Geological Technics, Inc. DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN <br /> 1101 7th Street <br /> Modesto, CA 98384- NOTICE TO THE CERTIFICATE HOLDER NAMED 10 THE LEFT,BUT FAILURE TO DO SO SHALL <br /> IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR <br /> REPRESENTATIVES. <br /> AUTHORIZED REPRESENTATIVE <br /> ACORD 25(2001/08) ©ACORD CORPORATION 1988 <br />
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