My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
COMPLIANCE INFO_2022
Environmental Health - Public
>
EHD Program Facility Records by Street Name
>
N
>
99 (STATE ROUTE 99)
>
4855
>
2300 - Underground Storage Tank Program
>
PR0506650
>
COMPLIANCE INFO_2022
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
11/19/2024 1:51:20 PM
Creation date
1/24/2022 11:22:22 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2022
RECORD_ID
PR0506650
PE
2361
FACILITY_ID
FA0007571
FACILITY_NAME
ARCH ARCO AM PM*
STREET_NUMBER
4855
Direction
S
STREET_NAME
STATE ROUTE 99
City
STOCKTON
Zip
95215
APN
17926051
CURRENT_STATUS
01
SITE_LOCATION
4855 S HWY 99
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
SJGOV\kblackwell
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
51
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
AC40R � CERTIFICATE OF LIABILITY INSURANCE DATE20/20 / 1 <br /> � AccHt: 2526821 9/20/2021 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br /> BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER . <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy( ies) must be endorsed. If SUBROGATION IS WAIVED, subject to <br /> the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br /> certificate holder in lieu of such endorsement(s). <br /> CONTACT <br /> PRODUCER NAME: <br /> Lockton CompaniesPHONE 844-290-4908 AX No <br /> 444 W 47th Street, Suite 900 EMAIL <br /> Kansas City, MO 64112- 1906 ADDRESS: BBSicerts@locktonaffinity.com <br /> INSURER(S) AFFORDING COVERAGE NAIC N <br /> INSURER A : Ace American Insurance Co. 22667 <br /> INSURED INSURER 6 : <br /> Barrett Business Services, Inc. <br /> UC/F LARRY & CLIFF ENTERPRISES, INC. DBA: LC SERVICES INSURER C : <br /> 3887 N VALENTINE INSURER D : <br /> FRESNO, CA 93722 <br /> INSURER E <br /> INSURER F : <br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES , LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, <br /> INSR I TYPE OF INSURANCE KD`OL S BR POLICY NUMBER POLICY <br /> YIYYYY MMfDDY� LIMITS <br /> LTR <br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ <br /> DAMAGE TO E TED <br /> CLAIMS-MADE OCCUR PREMISES Ea occurrence <br /> MED EXP (Anyone person) <br /> PERSONAL & ADV INJURY S <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ <br /> POLICY ❑ PROJECT ❑ LOC PRODUCTS • COMPIOP AGG $ <br /> S <br /> OTHER: <br /> OAUTOMOBILE LIABILITY <br /> CND SINGLE LIMIT $ <br /> ANY AUTO BODILY INJURY (Per person) S <br /> ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ <br /> AUTOS AUTOS NO OWNED PROPERTY DAMAGE $ <br /> HIRED AUTOS AUTOS Per accident <br /> $ <br /> UMBRELLA LIAB H OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE S <br /> DED RETENTION $ $ <br /> WORKERS COMPENSATION X STATUTE ER <br /> H <br /> AND EMPLOYERS' LIABILITY Y / N <br /> ANY PROPRIETORIPARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 2,000,000 <br /> A OFFICERIMEMBEREXCLUDED? NIA 069980430 11 !1 /2021 11 /1 /2022 <br /> (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE S 2,000,000 <br /> Its, describe under E.L. DISEASE - POLICY LIMIT $ 2,000,000 <br /> DESCRIPTION OF OPERATIONS below <br /> DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101 , Additional Remarks Schedule, maybe attached If more space is required) <br /> Policy Slate = CA <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Proof THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED <br /> Fresno, CA IN ACCORDANCE WITH THE POLICY PROVISIONS. <br /> AUTHORIZED REPRESENTATIVE <br /> M v <br /> © 1988-2014 ACORD CORPORATION . All rights reserved . <br /> ACORD 25 (2014/01 ) The ACORD name and logo are registered marks of ACORD <br />
The URL can be used to link to this page
Your browser does not support the video tag.