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Client#:f .5 ERVISTAT <br /> AC CERTIFICATE OF LIABILITY INSURANCE 0614/2/006YYY) <br /> PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> Commercial Lines Unit ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> ABD Insurance& Financial Services HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR <br /> ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> 1039-A N. McDowell Blvd <br /> Petaluma,CA 94954-5507 INSURERS AFFORDING COVERAGE NAIC# <br /> INSURED INSURER A: National Liability& Fire Insurance <br /> Service Station Systems,Inc. <br /> INSURER B: <br /> 3224 Regional Parkway <br /> INSURER C: <br /> Santa Rosa,CA 95403 <br /> INSURER D: <br /> INSURER E: <br /> COVERAGES <br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING <br /> ANY REQUREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br /> MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH <br /> POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> TYPE OF INSURANCE P041CY NUMBER. _ POLICY EFFECTIVE POLICY EXPIRATION LIMITS <br /> LTR NSR DATE MM/DD/YY . DATE MM/D <br /> GENERAL LIABILITY EACH OCCURRENCE $ <br /> COMMERCIAL GENERAL LIABILITY DAMAGE TO RSES fE.ENTED $ <br /> REMCLAIMS MADE D OCCUR MED EXP(Any one person) $ <br /> PERSONAL&ADV INJURY $ <br /> GENERAL AGGREGATE $ <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ <br /> POLICY M PRO LOC <br /> JECT <br /> AUTOMOBILE LIABILITY <br /> COMBINED SINGLE LIMIT $ <br /> ANY AUTO (Ea accident) <br /> ALL OWNED AUTOS <br /> BODILY INJURY $ <br /> SCHEDULED AUTOS (Per person) <br /> HIRED AUTOS BODILY INJURY <br /> NON-OWNED AUTOS (Per accident) $ <br /> PROPERTY DAMAGE $ <br /> (Per accident) <br /> GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ <br /> ANY AUTO OTHER THAN EA ACC $ <br /> AUTO ONLY: AGG $ <br /> EXCES.SIUMBRELLA LIABILITY EACH OCCURRENCE $ . <br /> OCCUR FICLAIMS MADE AGGREGATE $ <br /> DEDUCTIBLE $ <br /> RETENTION $ $ <br /> A WORKERS COMPENSATION AND 582138 06/04/06 06/04/07 X WCRYC STATU- OFR <br /> TH- <br /> EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $1,000,000 <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE <br /> OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $1,000,000 <br /> If yes,describe under <br /> SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 <br /> OTHER <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br /> RE: License#485184 <br /> Evidence of Coverage. <br /> CERTIFICATE HOLDER CANCELLATION Ten Day Notice for Non-Payment of Premium <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> Contractors State License Board DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL In DAYS WRITTEN <br /> PO BOX 26000 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL <br /> Sacramento,CA 95826 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR <br /> REPRESENTATIVES. <br /> AUTHORIZED REPRESENTATIVE <br /> ACORD 25(2001/08)1 of 2 #S843594/M843580 SERVISTAT SEW © ACORD CORPORATION 1988 <br />