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COMPLIANCE INFO_2022
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2300 - Underground Storage Tank Program
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PR0231458
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COMPLIANCE INFO_2022
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Last modified
10/17/2023 4:14:49 PM
Creation date
2/2/2022 11:07:43 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2022
RECORD_ID
PR0231458
PE
2361
FACILITY_ID
FA0001196
FACILITY_NAME
SAVE ON FUEL
STREET_NUMBER
420
Direction
W
STREET_NAME
YOSEMITE
STREET_TYPE
AVE
City
MANTECA
Zip
95337
APN
219-312-06
CURRENT_STATUS
01
SITE_LOCATION
420 W YOSEMITE AVE
P_LOCATION
04
P_DISTRICT
005
QC Status
Approved
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SJGOV\kblackwell
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EHD - Public
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WC 00 00 00 C WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY <br /> ( Ed . 1 - 15) <br /> insurance or self- insurance . Subject to any limits of workers compensation law that apply to : <br /> liability that may apply, all shares will be equal until a . benefits payable by this insurance ; <br /> the loss is paid . If any insurance or self-insurance b . special taxes , payments into security or oth - <br /> is exhausted , the shares of all remaining insurance er special funds , and assessments payable <br /> will be equal until the loss is paid . by us under that law. <br /> 6 . Terms of this insurance that conflict with the <br /> F . Payments You Must Make workers compensation law are changed by this <br /> You are responsible for any payments in excess of statement to conform to that law , <br /> the benefits regularly provided by the workers Nothing in these paragraphs relieves you of your du- <br /> compensation law including those required ties under this policy . <br /> because : <br /> 1 . of your serious and willful misconduct; <br /> 2 . you knowingly employ an employee in violation PART TWO <br /> of law; EMPLOYERS LIABILITY INSURANCE <br /> 3 , you fail to comply with a health or safety law or <br /> regulation ; or A . How This Insurance Applies <br /> 4 . you discharge , coerce or otherwise discriminate This employers liability insurance applies to bodily <br /> against any employee in violation of the workers injury by accident or bodily injury by disease . Bodily <br /> compensation law. injury includes resulting death . <br /> If we make any payments in excess of the benefits 1 . The bodily injury must arise out of and in the <br /> regularly provided by the workers compensation course of the injured employee' s employment by <br /> law on your behalf, you will reimburse us promptly. you . <br /> 2 . The employment must be necessary or inci- <br /> G . Recovery From Others dental to your work in a state or territory listed in <br /> Item 3 . A . of the Information Page . <br /> We have your rights , and the rights of persons entk 3 . Bodily injury by accident must occur during the <br /> tied to the benefits of this insurance , to recover our policy period . <br /> payments from anyone liable for the injury . You will <br /> do everything necessary to protect those rights for 4 . Bodily injury by disease must be caused or ag - <br /> us and to help us enforce them . gravated by the conditions of your employment . <br /> The employee' s last day of last exposure to the <br /> conditions causing or aggravating such bodily in - <br /> H . Statutory Provisions jury by disease must occur during the policy <br /> These statements apply where they are required by period . <br /> law. 5 . If you are sued , the original suit and any related <br /> 1 . As between an injured worker and us , we have legal actions for damages for bodily injury by ac- <br /> notice of the injury when you have notice . cident or by disease must be brought in the <br /> 2 . Your default or the bankruptcy or insolvency of United States of America , its territories or pos- <br /> you or your estate will not relieve us of our du - sessions , or Canada . <br /> ties under this insurance after an injury occurs . <br /> 3 . We are directly and primarily liable to any per- B . We Will Pay <br /> son entitled to the benefits payable by this in . We will pay all sums that you legally must pay as <br /> surance , Those persons may enforce our duties ; damages because of bodily injury to your employ- <br /> so may an agency authorized by law. Enforce- ees , provided the bodily injury is covered by this <br /> ment may be against us or against you and us . Employers Liability Insurance . <br /> 4 . Jurisdiction over you is jurisdiction over us for The damages we will pay , where recovery is permit- <br /> purposes of the workers compensation law. We ted by law, include damages : <br /> are bound by decisions against you under that 1 . For which you are liable to a third party by rea- <br /> law, subject to the provisions of this policy that son of a claim or suit against you by that third <br /> are not in conflict with that law, party to recover the damages claimed against <br /> 5 . This insurance conforms to the parts of the <br /> 2of6 <br /> © Copyright 2013 National Council on Compensation Insurance, Inc. All Rights Reserved . <br /> E <br />
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