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hVVae%, vLl\ 1 It 1%-4m i C VI- 1-I1Ai3ILI I Y INti RA' OP ID C1 DATEIMM/DDrrYY) <br />PRODUCER SERVIOI 06 03 08 <br />George Petersen Ins Agency THISSCERTIFICATE UED AS A MATTER "OF INFORMATION <br />P, 0. Box 3539 ONLY AND.CONF.ERS.NO.RIGHTS UPON THE CERTIFICATE <br />HOLDER: THIS'CERTIFICATE.DOES NOT AMEND;EXTEND OR <br />627 College Avenue ALTER=THE COVERAGE-AFFORDED'8Y THE POLICIES BELOW, <br />Santa Rosa CA 95402 <br />Phone:707-525-4150 Fax:707-525-4175 INS LTRERSAFFORDINGCOVERAGE <br />INSURED NAIC <br />INSURER A. res" Insurance Co an <br />INSURERil:. <br />Service Station Systems Inc. INSURERC; <br />680pian Avenue <br />Stul Jose CA 95112 alstlleeRV:., <br />SHOULD.ANY OF -THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE-EXPIRATID <br />DATETHEREOF,THE'ISSUINO INIURER WILL ENDEAVOR TOUAIL 30* DAYS WRITTEN <br />NOTLCETOTHE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 80 SHALL <br />Contractors State License Boas IMPOSENOOBLIOATION ORLIABILITY OF ANY KIND UPON THE INSURER ITS ASENTB OR <br />PO Box 26000 REPRESENTATIVES. <br />Sacramento CA 95826 A EPtiW rNzkyIVE <br />ACORD 25 (2001108) © ACORD CORPORATION 1988 <br />INSURERS: <br />COVERAGES <br />THE <br />ANY <br />POLICIES <br />RECUIREMENT, <br />OF INSURANCE LISTED BELOW HAVE <br />OR <br />BEEN ISSUED TO THE INSURED NAMED <br />ABOVE�FOR4+MIPOLICY3'ERIODINDICATED-NOTWrTHSTANOlt4G <br />MAY <br />PERTAIN; <br />TERM CONDIT40N OF ANY <br />THE INSURANCE AFFORDED BY THE <br />CONTRACT OR OTHER.00CUMENT WITH <br />POLICIES DESCRIBEOMEREIN <br />RESPECT TO,WHICH'THIS <br />CERmICATE MAYEEQSSUED DR <br />POLICIES. <br />AGGREGATE LIMITS SHOWN MAY HAVE <br />IS SUBJECT <br />BEEN REDUCED BY PAID LLAIMS. <br />TO ALL THE?ERMS; <br />EXCLUSIONSIANC) CONDIAONS'flF SUCH <br />Ri <br />LTR <br />DgTµIDO/YY' <br />+ <br />NSRti <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />GENERAL LIABILITY <br />DATE DD/YY LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />EACH41COURRENCIE <br />IWNSES, <br />CLAWS MADE � OCCUR <br />PRE Ea tcuenca S <br />MEL3iEXPa(Anyana��) S <br />PERS ONAL'-&ADVTNJURY S <br />GENERALAGGREGATE S <br />GEML AGGREGATE LIMIT APPLIES PER <br />POLICY jE�o- LOC <br />PRODUCTS = COMP/OP AGG S <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />BODILY INJURY <br />(Par parson) S <br />HIRED AUTOS <br />NDN -OWNED AUTOS <br />BODILY INJURY <br />(Per accident) S <br />PROPERTY DAMAGE <br />(Per ocdclunt) S <br />GARAGE LJABILJTY <br />AUTb ONLY • EA ACCIDENT S <br />ANY AUTO <br />OTHER THAN EA ACC S <br />AUTO ONLY: <br />EXCESSIUMBRELLA LIABILITY <br />AGG <br />S <br />EACH OCCURRENCE S <br />OCCUR f7CLAIMSMADE <br />AGGREGATE S <br />DEDUCTIBLE <br />S <br />RETENTION S <br />S <br />t <br />WORKERS CDMPENSATION AND <br />A <br />EMPLOYERS'UABL'r Y <br />ANY.PROP.RIET.DRRARTNER&XECUTIVE <br />3310020636081 <br />06/04/08 <br />06/04/09 <br />R T RY1. ITS R <br />E.L. <br />OFFICERIMMER •EXCLUDED 7 <br />NT <br />:EACHACCIDES lOOOOOO <br />Kyyee2;daeCrb8AW er <br />E.L.:DISEASE.EA'EMRCOYEE..SIOOOODO <br />SPECIALPROM SIGNS Lalav <br />OTHER <br />ELMISEASE.+'POLICY.LlMR'' S ;iOODDOO <br />DESCRIPTION oFOPERAn0NB 1 LOCATIONS 1 VEHICLES I EXCLUSIONS ADDEDVYENOOILbEMENTISPECU1LMROV1SIONS" <br />Re: License #485184 <br />Evidence of Workers' Compensation Coverage. <br />Ten Day Notice of Cancellation in the event of non-payment of premium, <br />CERTIFICATE HOLDER CANCOA-ATIntJ <br />SHOULD.ANY OF -THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE-EXPIRATID <br />DATETHEREOF,THE'ISSUINO INIURER WILL ENDEAVOR TOUAIL 30* DAYS WRITTEN <br />NOTLCETOTHE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 80 SHALL <br />Contractors State License Boas IMPOSENOOBLIOATION ORLIABILITY OF ANY KIND UPON THE INSURER ITS ASENTB OR <br />PO Box 26000 REPRESENTATIVES. <br />Sacramento CA 95826 A EPtiW rNzkyIVE <br />ACORD 25 (2001108) © ACORD CORPORATION 1988 <br />