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FONTANA
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2130
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3500 - Local Oversight Program
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PR0545053
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Entry Properties
Last modified
12/11/2019 10:33:20 AM
Creation date
12/11/2019 9:37:06 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
WORK PLANS
RECORD_ID
PR0545053
PE
3528
FACILITY_ID
FA0005720
FACILITY_NAME
SMITH CANAL PUMP STATION
STREET_NUMBER
2130
STREET_NAME
FONTANA
STREET_TYPE
DR
City
STOCKTON
Zip
95204
CURRENT_STATUS
02
SITE_LOCATION
2130 FONTANA DR
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
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EHD - Public
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INSURED: <br /> u • � S- 1 <br /> POLICY NUMBER: T <br /> COMMERCIAL GENERAL LIABILITY t <br /> THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAR,EFULLY.. =� <br /> ADDITIONAL INSURED-6WNERS, LESSEE OR <br /> f CONTRACTORS (FORM B) <br /> This endorsement modifies insurance provided under the following: � I <br /> COMMERCIAL GENERAL LIABILITY COVERAGE PART. <br /> SCHEDULE <br /> Name of Person or Organization: ? <br /> CITY OF STOCKTON, ITS OFFICERS, AGENTS AND E425 N. MPLOYEES <br /> STO <br /> ti <br /> EL DORADO STREET <br /> STOCKTON, CA 95202 <br /> (If no entry appears above, information required <br /> tions as applicable to co this a orsement <br /> to this to <br /> will be shown in the Declaa- <br /> n I <br /> WHO IS AN INSURED (Section II) is amendenclude as a\�ured son or organization shown I` <br /> in the Schedule, but only with respect to liabiOo l Y arising out of "you work" for that insured by or for you. f <br /> r.� 1111 <br /> S' ature . } <br /> \ Author zed Representative <br /> I <br /> L. <br /> I <br /> a : <br /> CG 20 10 11 85 Copyright, Insurance Services Office, Inc, 1984 i <br /> r <br /> 0 1 <br /> t <br />
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