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ACORD CERTIFICAT-- OF LIABILITY INSURAN, OF ID Cl DATE JM""""Y' <br /> SERVI01 06/03/08 <br /> PRODUCER THIS CERTIFICATE 1S ISSUED AS A MATTER OF INFORMATION <br /> George Petersen Ins Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> P. 0. Box 3539 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR <br /> 627 College Avenue ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Santa Rosa CA 95402 <br /> Phone: 707-525-4150 Fax:707-525-4175 INSURERS AFFORDING COVERAGE NAIC# <br /> INSURED INSURER fA ress Insurance Ca any <br /> INSURER B: <br /> Service Station Systems, Inc. INSURER C: <br /> 680 Quinn Avenue INSURER D: <br /> San Jose CA 95112 <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 REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECTTO 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 /> INS Il' POTICCvtFF G7IIE`PO[TC T O <br /> LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MMlDDiYY I DATE (MM/DD/YY LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ <br /> COMMERCIAL GENERAL LIABILITY PREMISES jEa Dccurence) S <br /> CLAIMS MADE F7 OCCUR MED EXP(Any one person) S <br /> PERSONAL d ADV INJURY S <br /> GENERAL AGGREGATE S <br /> GENL AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOP AGG 5 <br /> POLICY PROJEC,-- LOC <br /> AUTOMOBILE LIABILITY <br /> COMBINED SINGLE LIMIT 5 <br /> ANY AUTO (Ee accident) <br /> ALL OWNED AUTOS <br /> BODILY INJURY S <br /> SCHEDULED AUTOS (Per person) <br /> HIRED AUTOS <br /> BODILY INJURY S <br /> NON-OWNED AUTOS (Per accident) <br /> PROPERTY DAMAGE S <br /> (Per Occident) <br /> GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ <br /> ANY AUTO EA ACC S <br /> OTHER THAN <br /> AUTO ONLY: AGG S <br /> EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE S <br /> OCCUR CLAIMS MADE AGGREGATE S <br /> 5 <br /> DEDUCTIBLE <br /> S <br /> RETENTION S <br /> S <br /> WORKERS COMPENSATION AND R I TORY LIMITS ER <br /> EMP LOYERS'LIABILITY <br /> A ANY PROPRIETOR/PARTNER/EXECUTIVE 3310020636081 06/04/08 06/04/09 E,L EACHACCIDENi IS1000000 <br /> OFFICERIMEMBEREXCLUDED? E.L DISEASE•EA EMPLOYEE S 1000000 <br /> H yes,describe under <br /> SPECIAL PROVISIONS below EL DISE I SE-POLICY LIMIT I$1000000 <br /> OTHER <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <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 CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30* DAYS WRITTEN <br /> NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL <br /> Contractors State License Boar IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR <br /> PO BOX 2 6 D OO REPRESENTATIVES. <br /> Sacramento CA 95826 AREI TJ <br /> ACORD 25(2001/08) ©ACORD CORPORATION 1988 <br />