Please select one option below. If you are submitting an update, please note all updates must be submitted within 15 days of change.
Proof of general liability insurance with a minimum limit of liability per occurrence of $1,000,000 for bodily injury and property damage. This insurance shall indicate on the certificate of insurance the following coverage and indicate the policy aggregate limit applying to: premises and operations; broad form contractual; independent consultants and subcontractors; products and completed operations as applicable.
Describe and provide drawings of intended location.
For example, cart (3' wide by 4' height)
Please check both in acceptance of this acknowledgement.
Please sign application.
To turn in this application, please print, sign, date and bring this form to 1010 Tenth Street Suite 3100, Modesto, California 95354.
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