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SERVISTAT <br /> ACO D- CERTIFICATE F L I ILA I DATE II� <br /> 6!/5/2005/200YYY7 <br /> -IODUCER Commercial Lines Unit(707)769-2900 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> ABD Insurance&Financial Services HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR <br /> 1039-A N.McDowell Blvd ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Petaluma,CA 94954-5507 INSURERS AFFORDING COVERAGE NAIL# <br /> INSURED Service Station Systems,Inc. INSURER A: Oak River Insurance Company 34630 <br /> 3224 Regional Parkway INSURER B: <br /> INSURER C: <br /> INSURER D: <br /> Santa Rosa,CA 95403 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 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 /> IL Ng TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ <br /> COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ <br /> PREMISES IE,o=Urm <br /> CLAIMS MADE ❑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 PRO-- LOC <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> ANY AUTO (Ea accident) <br /> ALL OWNED AUTOS <br /> BODILY INJURY $ <br /> SCHEDULED AUTOS (Per person) <br /> HIREDAUTOS BODILY INJURY <br /> NON-OWNED AUTOS (Per accident) $ <br /> I <br /> PROPERTY DAMAGE $ <br /> (Per accident) <br /> GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ <br /> ANY AUTO EA ACC $ <br /> OTHER THAN <br /> AUTO ONLY: AGG $ <br /> EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ <br /> OCCUR FICLAIMS MADE AGGREGATE $ <br /> DEDUCTIBLE <br /> b <br /> RETENTION $ $ <br /> A EMPLOYERS'LIABILITY WORKERS COMPENSATION AND 2210020636071 6/4/2007 6/4/2006 X WC sTATUORY UMIT oTH- <br /> ANY PROPRIETORIPARTNER/EXECUTIVE <br /> E.L.EACH ACCIDENT $ 1,000,000 <br /> OFFICERIMEMBER EXCLUDED? <br /> E.L.DISEASE-EA EMPLOYEEI$ 1,000,000 <br /> If yes,describe under <br /> SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT 1$ 11000,000 <br /> OTHER <br /> DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br /> Evidence of Coverage. <br /> CERTIFICATE HOLDER CANCELLATION Ten Day Notice for Non-Payment <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> ChevronDATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN <br /> Box 2 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL <br /> C/O IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR <br /> PO BOX 2020 REPRESENTATIVES. <br /> Conway AR 72033 ApTH1,0RIZED s A E <br /> ACORD 25(2001108) 46341 0 ACORD CORPORATION 1988 <br />