Laserfiche WebLink
ACORD CERTIFICATE OF LIABILITY INSURAI�'�� OF ID Cl DATE(MMlDD/YYW) <br /> SERV 06/03 08 <br /> PRODUCER THIS CERTIFICATE 15 ISSUED AS TMA 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 Pax:707-525-4175 INSURERS AFFORDING COVERAGE NAICiI <br /> INSURED INSURER A Cypress Insurance Company <br /> INSURER B: <br /> Service Station Systems, Inc. INSURER C: <br /> 680 puinn Avenue INSURER O: <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 /> INSR7 oTIcY FPE><TIV€a6tic <br /> LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MM1DD/YY I DATE MM/DD/YY LIMITS <br /> GENERAL LIABILITY I EACH OCCURRENCE E <br /> COMMERCIAL GENERAL LIABILITY PREMISES Ea o=urence S <br /> CLAIMS MADE F7OCCUR MED EXP(Any one person) 5 <br /> PERSONAL 6 ADV INJURY S <br /> GENERAL AGGREGATE $ <br /> GENL AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/DP AGG S <br /> POLICY jE Q LOC <br /> AUTOMOBILE LIABILITY <br /> COMBINED SINGLE LIMIT S <br /> ANY AUTO (Ea accident) <br /> ALL OWNED AUTOS <br /> SCHEDULED AUTOS BODILY INJURY(Per <br /> (Per person) <br /> HIRED AUTOS <br /> BODILY INJURY 5 <br /> NON-OWNED AUTOS (Per accident) <br /> PROPERTY DAMAGE 5 <br /> (Per accidenl) <br /> GARAGE LIABILITY <br /> AUTO ONLY-EA ACCIDENT 5 <br /> ANY AUTO OTHER THAN EA ACC 5 <br /> AUTO ONLY: AGG S <br /> EXCES5IUMBRELLA LIABILITY EACH OCCURRENCE 5 <br /> OCCUR CLAIMS MADE AGGREGATE S <br /> 5 <br /> DEDUCTIBLE <br /> S <br /> RETENTION 5 <br /> S <br /> WORKERS COMPENSATION AND <br /> A EMPLOYERS'LIABILITY R I TORY LIMIT'S I ER <br /> ANY PROPRIETORIETOR/PARTNER/EXECUTIVE 33100206316081 06/04/08 06/04/09 E.L EACHACCIDENT S1000000 <br /> OFFICERIMEMBER EXCLUDED? <br /> If yes,describe under E.L DISEASE•EA EMPLOYEE S 1000000 <br /> SPECIAL PROVISIONS below E.L.DISEASE•POLICY LIMIT S 1000000 <br /> OTHER <br /> DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES I 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 Soar IMPOSE NO OBLIGATION OR LIABILITY OF ANY HIND UPON THE INSURER,ITS AGENTS OR <br /> PO Box 26000 TIVES. <br /> Sacramento CA 95826 h!T77—L,ACORD 25(2001108) ©ACORD CORPORATION 1988 <br />