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COMPLIANCE INFO_2006-2011
Environmental Health - Public
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EHD Program Facility Records by Street Name
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LOUISE
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2300 - Underground Storage Tank Program
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PR0231430
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COMPLIANCE INFO_2006-2011
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Last modified
1/30/2024 11:04:03 AM
Creation date
6/23/2020 6:48:36 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2006-2011
RECORD_ID
PR0231430
PE
2361
FACILITY_ID
FA0000848
FACILITY_NAME
QUIK STOP MARKET #2121
STREET_NUMBER
1196
Direction
W
STREET_NAME
LOUISE
STREET_TYPE
AVE
City
MANTECA
Zip
95336
APN
217-410-43
CURRENT_STATUS
01
SITE_LOCATION
1196 W LOUISE AVE
P_LOCATION
04
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0231430_1196 W LOUISE_2006-2011.tif
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EHD - Public
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COVERAGES <br />POLICIES <br />OF INSURANCE LISTED BELOW HAVE <br />BEEN ISSUED TO THE INSURED NAMED <br />ABOVE FOR THE POLICY <br />PERIOD INDICATED. <br />NOTWITHSTANDING <br />THE <br />ANY <br />REQUIREMENT, <br />TERM OR CONDITION OF ANY <br />CONTRACT OR OTHER DOCUMENT WITH <br />HEREIN IS SUBJECT <br />RESPECT TO WHICH <br />TO ALL THE TERMS, <br />THIS CERTIFICATE MAY <br />EXCLUSIONS AND CONDITIONS <br />BE ISSUED OR <br />OF SUCH <br />MAY <br />PERTAIN, <br />THE INSURANCE AFFORDED BY THE <br />POLICIES DESCRIBED <br />POLICIES. <br />AGGREGATE LIMITS SHOWN MAY HAVE <br />BEEN REDUCED BY PAID CLAIMS. <br />FRSW <br />LTR <br />NSR <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />DATE MMIDD <br />PDATE �roDM N <br />LIMITS <br />EACH OCCURRENCE <br />$1,000,000 <br />A <br />PREMISES(Eaoccurence) <br />$ 501000 <br />GENERAL LIABILITY <br />X COMMERCIAL GENERAL LIABILITY <br />07PKG01395 <br />03/06/07 <br />03/06/08 <br />MED EXP (Any one person) <br />$ 5,000 <br />CLAIMS MADE X] OCCUR <br />PERSONAL &ADV INJURY <br />$1,000,000 <br />X $5, 000 Ded <br />GENERAL AGGREGATE <br />$2,000,000 <br />PRODUCTS - COMP/OP AGG <br />$2,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />BID. Ben. <br />11 000, 000 <br />POLICY JEC LOC <br />AUTOMOBILELU181LITY <br />03/06/07 <br />03/06/08 <br />COMBINED SINGLE LIMIT <br />(Ea accident)ALL <br />$10000,000 <br />BJXANY <br />AUTO <br />8001121446 <br />OWNED AUTOS <br />BODILY INJURY <br />(Per person) <br />$ <br />SCHEDULED AUTOS <br />HIRED AUTOS <br />BODILY INJURY <br />(Per accident)NON-OWNED <br />$ <br />AUTOS <br />PROPERTY DAMAGE <br />$ <br />(Per accident) <br />AUTO ONLY - EA ACCIDENT <br />$ <br />GARAGE LIABILITY <br />EA ACC <br />$ <br />ANY AUTO <br />OTHER THAN <br />AUTO ONLY: AGG <br />$ <br />EACH OCCURRENCE <br />$4,000,000 <br />EXCESS/UMBRELLA LIABILITY <br />CLAIMSMADE 07EFX00007 <br />03/06/07 03/06/08 AGGREGATE <br />$4,000,000 <br />A OCCUR <br />S <br />DEDUCTIBLE <br />$ <br />RETENTION $ <br />X TORY LIMITS ER <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY 713000492706 <br />10/01/06 10/01/07 E.L. EACH ACCIDENT <br />$ 1,000,000 <br />C <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />E.L. DISEASE - EA EMPLOYEE $1,000,000 <br />OFFICERIMEMBER EXCLUDED? <br />If yes, describe under <br />E.L. DISEASE - POLICY LIMIT <br />$ 1, 0 0 0 , 0 0 0 <br />SPECIAL PROVISIONS below <br />OTHER <br />07PKG01395 <br />03/06/07 03/06/08 Poll/B&O <br />$1,000,000 <br />A Pollution/B&0 <br />D Fltr 57MSIZ6050 <br />03/06/07 03/06/08 Inst Fltr <br />$110001000 <br />Installation <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY <br />ENDORSEMENT 1 SPECIAL PROVISIONS <br />*10 days notice applies if cancelled for <br />i <br />i <br />I <br />non-payment of premium. <br />x <br />j <br />CANCELLATION <br />CERTIFICATE HOLDER <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO1 <br />TOWHOMI <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL <br />30* DAYS WWRI7TEN <br />i <br />NOTICE TO THE CERTIFICATE HOLDER NAMED 70 THE LEFT, BUT <br />FAILURE TO DO SO SHALL <br />To Whom it May Concern <br />IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />REPRESENTATIVES. . <br />AUTHORIZED REPRESENTATIVE <br />I <br />i <br />Dennis Cote' <br />© ACORD CORPORATION 198 <br />ACORD 25 (2001/08) <br />
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