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AC CERTIFICANOF LIABILITY INSURANWE OP ID C1DATE <br />IMM,DD,YYYY, <br />SERVI01 <br />06/03/08 <br />PRODUCER <br />George Petersen Isis Agency <br />P. 0. Box 3539 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />627 College Avenue <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Santa Rosa CA 95402 <br />P <br />DATE MM OOM <br />Phone:707-525-4150 Fax:707-525-4175 <br />INSURERS AFFORDING COVERAGE NAIC�k <br />INSURED <br />INSURER A: qMress. 'Insurance CO any <br />INSURER B: <br />Service Station Systems, Inc . <br />680 p�Inn Avenue <br />San Jose CA 95112 <br />INSURER c: <br />INSURER D: <br />INSURER E: <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADE E OCCUR <br />1:61 V CKAU= <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 SUBJECTTO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />ILTR <br />INSRI <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />Ou DA <br />TE MMIDDIYY ' <br />P <br />DATE MM OOM <br />LIMITS <br />GENERAL LIABILITY <br />EACH' OCCURRENCE $ <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADE E OCCUR <br />UPJRAPREM SES (Ea occuranca $ <br />MED EXP (Any one parson) 3 <br />PERSONAL & ADV INJURY S <br />GENERAL AGGREGATE 3 <br />GERL AGGREGATE LIMIT APPLIES PER: <br />POLICY JECT E LOC <br />PRODUCTS-COMPIOP AGG $ <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />COMBINED SINGLE LIMIT $ <br />(Ea accident) <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />BODILY INJURY 3 <br />(Per person) <br />HIRED AUTOS <br />NON OWNED AUTOS <br />BODILY INJURY $ <br />(Per accident) <br />PROPERTY DAMAGE 3 <br />(Per accident} <br />GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT 3 <br />ANY AUTO <br />OTHER THAN EA ACC 3 <br />AUTO ONLY: AGG S <br />EXCESSIUMBRELLA LIABILITY <br />OCCUR CLAIMS MADE <br />EACH OCCURRENCE $ <br />AGGREGATE S <br />$ <br />DEDUCTIBLE <br />$ <br />RETENTION 3 <br />3 <br />A <br />WORKERS COMPENSATION AND <br />EMPLOYERS! LIABILITY <br />ANY PROPRIETORIPARTNP-RIMCU71VE <br />3310020636081 <br />06/04/08 <br />06/04/09 <br />R TORY IM17S ER <br />_ <br />E.LEACH ACCIDENT 31000000 <br />E.L. DISEASE -EA E PLOYEEI S 1000000 <br />OFFICERIMEMBEREXCLUDED? <br />If debe under <br />SPECIAL PROVISIONS below <br />E.LDISEASE -POLICY LIMIT IS 1000000 <br />OTHER <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENTI 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 />Contractors State License Boar <br />PO Box 26000 <br />Sacramento CA 95826 <br />SHOULD ANYOF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO' <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 />IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INBURER, ITS AGENTS OR <br />REPRESENTATIVES. <br />ACORD 25 (2009108) © ACORD CORPORATION 1908 <br />