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Client#: 2079581 ABLEMAI1 <br /> TM CERTIFICATE <br /> F LIABILITY I DATE 10/ 1/2001/20/Y5 <br /> 25 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. <br /> If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br /> this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s). <br /> PRODUCER CONTACT <br /> NAME: Rhonda Scialpi <br /> USI Insurance Services NW CL1 PHONE 503 224-8390 F°X 610 362-8130 <br /> AIC,No,Ext : AIC,No <br /> 825 NE Multnomah, Suite 1500 ADDRESS: rhonda.scialpi@usi.com <br /> Portland, OR 97232 INSURER(S)AFFORDING COVERAGE NAIC# <br /> 503 224-8390 Zurich American Insurance Company INSURER A : p y 16535 <br /> INSURED INSURER B : <br /> Able Maintenance, Inc. INSURERC : <br /> 3224 Regional Parkway <br /> Santa Rosa, CA 95403 INSURER D : <br /> INSURER E: <br /> INSURER F <br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> LTRR ADDLSUBR TYPE OF INSURANCE NSR WVD POLICY NUMBER MM/DD�Y MMIDIDNYYY LIMITS <br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ <br /> CLAIMS-MADE 0 OCCUR PREMISE OR occur ence $ <br /> MED EXP(Any one person) $ <br /> PERSONAL&ADV INJURY $ <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ <br /> PRO- <br /> POLICY JECT LOC PRODUCTS-COMP/OP AGG $ <br /> OTHER: $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> Ea accident $ <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED BODILY INJURY Per accident $ <br /> AUTOS ONLY AUTOS ( ) _ <br /> HIRED NON-OWNED PROPERTY DAMAGE <br /> AUTOS ONLY AUTOS ONLY Per accident $ <br /> $ <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB HCLAIMS-MADE AGGREGATE $ <br /> DED I I RETENTION$ $ <br /> A WORKERS COMPENSATION 8897913 10/01/2025 10/01/202 X PER OTH- <br /> AND EMPLOYERS'LIABILITY Y/N ST TUTS E <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $1,000,000 <br /> OFFICER/MEMBER EXCLUDED? F­N] N/A <br /> (Mandatory in NH) E.L. DISEASE-EA EMPLOYEE $1,000,000 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L. DISEASE-POLICY LIMIT $1,000,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule, may be attached if more space is required) <br /> RE: Work performed by the Named Insured on behalf of the Certificate Holder <br /> Service Station Systems, Inc. is named as an Additional Insured in respects to General Liability. <br /> CERTIFICATE HOLDER CANCELLATION <br /> Service Station Systems, Inc. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> 680 Quinn Ave. ACCORDANCE WITH THE POLICY PROVISIONS. <br /> San Jose, CA 95112 <br /> AUTHORIZED REPRESENTATIVE <br /> © 1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25 (2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD <br /> #S51100005/M51070548 PDNZP <br />