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ACORD CERTIFICA"rc- OF LIABILITY INSURA, OP ID Cl DATEI"ID"YW) <br /> PRODUCrR SERI 06 03 08 <br /> George Petersen Ins Agency THIS CERTIFICATEIM, SUED AS A MATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> P. 0. Box 3539 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR <br /> 627 College Avenue ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Santa Rosa CA 95402 <br /> Phone: 7D7-525-4150 Fax:707-525-4175 INSURERS AFFORDING COVERAGE NAIC# <br /> INSURED INSURER A teas Insurance Co an <br /> INSURER13: <br /> Service Station Systems, Inc. INSURER C: <br /> 680 Quinn Avenue INSIIRER�. <br /> San Jose CA 95112 <br /> INSURER E: <br /> COVERAGES <br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE- OLICYPERIOD INDICATED.NOTWITHSTANDING <br /> ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THISCERnFICATE MAYBE 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 /> INSIr <br /> LTR NSR1 TYPE OF INSURANCE POLICY NUMBER <br /> DATEtMMIDDIYYI0 LIMITS <br /> GENERAL LIABILITY <br /> EACMOCCURRENCE S <br /> COMMERCIAL GENERAL LIABILITY <br /> PREMISES Esomunncs $ <br /> CLAIMS MADE �OCCUR MEDEXPIAnyonewson) $ <br /> PERSONAL 6 AOV INJURY S <br /> GENERAL AGGREGATE S <br /> GENL AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOP AGG S <br /> POLICY IEo- LOC <br /> AUTOMOBILE LIABILITY <br /> COMBINED SINGLE LIMIT S <br /> ANY AUTO (Ea eccldenl) <br /> ALL OWNED AUTOS <br /> SCHEDULED AUTOS BODILY INJURY S <br /> (Per person) <br /> HIRED AUTOS <br /> NDN-OWNED AUTOS BODILY INJURY S <br /> (Per exidenq <br /> PROPERTY DAMAGE S <br /> (Per strident) <br /> GARAGE LIABILITY <br /> AUTO ONLY-EA ACCIDENT S <br /> ANY AUTO <br /> OTHER THAN EA ACC S <br /> AUTO ONLY; AGG S <br /> EXCESSI)MBRELLA LIABILITY EACH OCCURRENCE $ <br /> OCCUR CLAIMS MADE AGGREGATE S <br /> S <br /> DEDUCTIBLE <br /> S <br /> RETENTION S <br /> S <br /> WORKERS COMPENSATION AND <br /> R TRY LI 178 ER <br /> A EMP LOYERS'LIABIUTY 3310020635081 <br /> ANY PROPRIETORRARTNER/EXECUTIVE 06/04/06 06/04/09 E.L EACH ACCIDENT 51000,000 <br /> OFFICERIMEMBER EXCLUDED? <br /> Hyysss,describe urxW E.L.DISEASE•EA EMPLOYEE S 1000000 <br /> SPECIAL PROVISIONS below EL DISEASE-POLICY.LIMIT 5 1000000 <br /> OTHER <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED'BYENDORSIEMRMTI 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 /> SHOULD ANYOF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THEt)(PIRATION <br /> DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30* DAYSWRITTEN <br /> NOTICE TO THE CERTIFICATE HOLDER NAMED)TO THE LEFT,BUT FAILURE TO DO EO SHALL <br /> Contractors State License Boar IMPOSE NOOPUOATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR <br /> PO Box 26000 REPRESENTATIVES. <br /> Sacramento CA 95826 A �HsTNE <br /> ACORD 25(2007108) �--� ©ACORD CORPORATION 1988 <br />