COMPLIANCE INFO_2025 - Laserfiche WebLink

Home Browse Search

�DATE(MMIDDIYYYY) ACORV CERTIFICATE OF LIABILITY INSURANCE 2/25/2025 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT -- - _ NAME_ Certificate Team___ �F Inszone Insurance Services, LLC PHONE 877-308-9663 16 C,No):916-400-2625 2721 Citrus Road, Suite A E MAC'IL� xuIL Rancho Cordova, CA 95742 ADDRESS: certs@inszonains.com INSURED BZ Service Station Maintenance, Inc. P.O. Box 933 West Sacramento, CA 95691 COVERAGES CERTIFICA 2043447343 Su REVISION NUMBER: 0172 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ... 1. F ADDL S-fJBR —_____ ------ POLICY EFF POLICY EXP —�- ISR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MMIDD/YYYY LIMITS i A X COMMERCIAL GENERAL LIABILITY G4896722A 001 211612025 2/15/2026 EACH OCCURRENCE $110001000 I ---- DA GE TO R-EN'rED CLAIMS4ADE OCCUR PREMISES (Ea occurrence) $100,000 MED EXP (Any one person) $10,000 PERSONAL &ADV INJURY $1,0000000 GE_N'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s2,000,000 PRC - X POLICY El n JECT LOC PRODUCTS - COMP/OP AGG $ 2,000,000 t _...J OTHER: $ 8 AUTOMOBILE LIABILITY 50013611401 8/19/2024 8/19/2026 COMBINED SINGLE LIMIT $1,000,000 Ea accident X ANY AUTO BODILY INJURY (Per person) S OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY —. AUTOS — HIRED NOWOWNED PROPERTY DAMAGE $ _ —AUTOS ONLY __ AUTOS ONLY Per accident _ UMBRELLA LIAR - OCCUR EACH OCCURRENCE $ I EXCESS LIAB CLAIMS•MADE AGGREGATE $ DED RETENTION S $ C WORKERS COMPENSATION i ONCC17012248.01 10/2712024 10/27/2025X STATUTE ERH j AND EMPLOYERS' LIABILITY — ANYPROPRIETOR/PARTNERIEXECUTIVE Ya NIA E.L. EACH ACCIDENT _ _ $1,000,000 'OFFICER/MEMBEREXCLUDED7 (Mandatory In NH) E.L. DISEASE • EA EMPLOYEE $1,000,000 it yes. describeunder DESCRIPTION OF OPERATIONS below E,L. DISEASE - POLICY LIMIT $1,000,000 I ; Pio(essional Liability G4 896722A 001 I 2/15/2025 2/15/2026 Aggregate $2j000oD00 A : Professional Liability G4896722A 001 2/15!2025 2/15/2026 Each Claim $1,000,000 DESCRIPTION OF OPERATIONS f LOCATIONS /VEHICLES (ACORD 101, Addltlonai Remarks Schedule, maybe ellached If more apace Is required) Pollution Liability -Policy Number: G4896722A 001 -Policy Effective Date: 2115/2025 -Policy Expiration Date: 2/1512026 -Aggregate: $2,000,000 - Occurrence: $1,000,000 -Insurer A: Westchester Surplus Lines Insurance Co, -NAIC #10172 Equipment Floater - Policy Number: 67MSBA0829 - Policy Effective Date: 2/15/2025 - Policy Expiration Date: 2/15/2026 - Leased Rented Equipment: $100,000 - Deductible: $5,000 - Insurer D: Hartford Fire Insurance Company - NAIC #19682 Verification Of Insurance CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE HE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, Verification Of Insurance AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD