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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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Entry Properties
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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EHD - Public
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WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 00 00 C <br /> ( Ed . 1 - 15) <br /> papers related to the injury, claim , proceeding D . Premium Payments <br /> or suit . You will pay all premium when due . You will pay the <br /> 4 . Cooperate with us and assist us , as we may re- premium even if part or all of a workers compensa- <br /> quest , in the investigation , settlement or defense tion law is not valid . <br /> of any claim , proceeding or suit . <br /> 5 . Do nothing after an injury occurs that would in - E . Final Premium <br /> terfere with our right to recover from others . The premium shown on the Information Page , <br /> 6 . Do not voluntarily make payments , assume obli- schedules , and endorsements is an estimate . The <br /> gations or incur expenses , except at your own final premium will be determined after this policy <br /> cost, ends by using the actual , not the estimated , premi- <br /> um basis and the proper classifications and rates <br /> PART FIVE that lawfully apply to the business and work covered <br /> by this policy. If the final premium is more than the <br /> PREMIUM premium you paid to us , you must pay us the bal- <br /> ance . If it is less , we will refund the balance to you . <br /> A . Our Manuals The final premium will not be less than the highest <br /> All premium for this policy will be determined by our minimum premium for the classifications covered by <br /> manuals of rules , rates , rating plans and classifica- this policy . <br /> tions . We may change our manuals and apply the If this policy is canceled , final premium will be de- <br /> changes to this policy if authorized by law or a gov. termined in the following way unless our manuals <br /> ernmental agency regulating this insurance . provide otherwise : <br /> 1 . If we cancel , final premium will be calculated pro <br /> B . Classifications rata based on the time this policy was in force . <br /> Item 4 of the Information Page shows the rate and Final premium will not be less than the pro rata <br /> premium basis for certain business or work classifi- share of the minimum premium . <br /> cations . These classifications were assigned based 24 If you cancel , final premium will be more than <br /> on an estimate of the exposures you would have pro rata ; it will be based on the time this policy <br /> during the policy period . If your actual exposures are was in force , and increased by our short-rate <br /> not properly described by those classifications , we cancelation table and procedure . Final premium <br /> will assign proper classifications , rates and premium will not be less than the minimum premium . <br /> basis by endorsement to this policy . <br /> F . Records <br /> C . Remuneration You will keep records of information needed to com - <br /> Premium for each work classification is determined pute premium . You will provide us with copies of <br /> by multiplying a rate times a premium basis . Remu- those records when we ask for them . <br /> neration is the most common premium basis . This <br /> premium basis includes payroll and all other remu - G . Audit <br /> neration paid or payable during the policy period for <br /> the services of: You will let us examine and audit all your records <br /> 1 . all your officers and employees engaged in work that relate to this policy. These records include ledg- <br /> covered by this policy; and ers , journals , registers , vouchers , contracts , tax re- <br /> ports , payroll and disbursement records , and pro- <br /> 2 . all other persons engaged in work that could grams for storing and retrieving data . We may con- <br /> make us liable under Part One (Workers Com - duct the audits during regular business hours during <br /> pensation Insurance) of this policy . If you do not the policy period and within three years after the pol- <br /> i have payroll records for these persons , the con - icy period ends . Information developed by audit will <br /> tract price for their services and materials may be used to determine final premium . Insurance rate <br /> be used as the premium basis . This paragraph 2 service organizations have the same rights we have <br /> will not apply if you give us proof that the em- under this provision , <br /> ployers of these persons lawfully secured their <br /> workers compensation obligations . <br /> 5 of 6 <br /> © Copyright 2013 National Council on Compensation Insurance, Inc . All Rights Reserved . <br />
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