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J----t ... --- . . .. — . . — v a . 81I& OI 06/10/09 <br /> PRODUCER THIS CERTIFICATE RMUED AS A MATTER OF INFORMATION <br /> George Petersen Ins Agency ONLY AND CONFOUM RIGHTS UPON THE CERTIFICATE <br /> P. O. Box 3539 HOLDER.THIS CERTIMATE 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 Sax:707-525-4175 INSURERS AFFORDING COVERAGE NAIC# <br /> KNSUR.o INSURERA. Cypress Insurance Co an <br /> INSURER B: <br /> SRu1vice Station System, Inc. INSURER C: <br /> inn <br /> anogs t A 95112 IN D: <br /> INSURER E: <br /> COVERAGES <br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE:INSUREO NAMED ABOVE FOR THE POLICY PERIOD SATED.NOTWITHSTANDING <br /> ANY REOUMEMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENt WITH RESPECTTO 1MHSCH THIS CERTIFICATE MAY BE ISSUED OR <br /> MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH <br /> POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAC CLAIMS. <br /> LTR ffSRC TYPE OF INSURANCE POLICY NUMBER ERR.PWXMW LIMITS <br /> GENERAL,LIABRAY EACH OCCURRENCE S <br /> COMMERCIAL GENERAL LIABILITY =90=.1. S <br /> CLAIMS MAGE ®OCCUR MED EXP(Any aro pwm) S <br /> PERSONAL a ADV INKY S <br /> GENERAL TE S <br /> GM AGGREGATE LIMIT APPLES PER: PRODUCTS.COMPIOP AGO S <br /> POLICY LOC <br /> AUTOMOBILE LIABILITY <br /> COMBINED SINGLE LIMIT S <br /> ANY AUTO (Es sd nq <br /> ALL OWNED AUTOS <br /> BODILY INJURY S <br /> SCHEDULED AUTOS (Perp—) <br /> WIRED AUTOS BODILY INJURY <br /> NON47WNEO AUTOS (Per 80*w) S <br /> PROPERTY DAMAGE a <br /> GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S <br /> ANY AUTO OTHER THAN EA ACC i <br /> AUTO ONLY: AGG S <br /> EXCSSWUMBRELLA LWBILITY EACH OCCURRENCE S <br /> OCCUR ®CLAIMS MADE AGGREGATE a <br /> S <br /> DEDUCTIBLE $ <br /> RETENTION S a <br /> VIIORKERS COMPENSATION AND B TORY LIMITS I I ER- <br /> A EMP 3310020636091 06/04/09 06/04/10 E.L.EACH ACCIDENT $1000000 <br /> O �PRO��BERUEXCLNERIE CUTIVE <br /> py�u E.L.DISEASE-EA EMPLOYE S 1000000 <br /> sFEsGtA6 aM O bol. E.L.DISEASE-POLMYLIMIT S 1000000 <br /> anlE <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUBIONB ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br /> Proof of 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 THmmor,THIN IBSUIN0 mmeR YWLL ENDEAVOR To MAIL 30* DAYs WRITTEN <br /> NOT=TO THE CERTIKCATE HOLDER NAMED TO THE LEFT,BUT MURK TO DO 60 SHALL <br /> Proof of Coverage IMPOSE NO OBLIGATION OR LIAR M OF ANY KIND UPON THE INSURER,ITS AGENTS OR <br /> REPRESENTATIVES. <br /> A THE <br /> ACORD 26(2001/08) ®ACORD CORPORATION 1988 <br />