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MLIU11Y %.,CK i INUA t UI- LIABILITY INSURA'R PE OP ID Cl DATE(MM/DD/YYYY) <br /> PRODUCER THIS-CERTIFICATE SERVZOl 6 03 08 <br /> 0,SUED AS A MATTER OF INFORMATION <br /> Georca Petersen Ins Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> P. 0. Box 353 9 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR <br /> 627 College Avenue ALTER THE COVERAGE AFFORDED 8Y THE POLICIES BELOW. <br /> Santa Rosa CA 95402 <br /> Phone-. 707-525-4150 Fax:707-525-4175 1NSURERSAFFORDINGCOVERAGE NAICq <br /> INSURED <br /> INSURER A reaa. Insurance Cc an <br /> INSURERR: <br /> Service Station Systems, Inc. INSURER C: <br /> 680 Quian Avenue wBURER'A:. <br /> Sam Jose CA 95112 <br /> INSURERS: <br /> COVERAGES <br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR ITHE'POLICYPERIODtNDICATEO:NOTWITHSTANDING <br /> ANY REQUIREMENT,TERM OR CONDITION DF ANY CONTRACT DR OTHER MOCUMENT WITH RESRECT TO WHICH TAMS OERiIFICATE MAYNIEJSSUEDOR <br /> MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED k1EREIN IS SUBJECT TO ALL THE PERMS;EXCLUSIONS AND CONDITIONSOF SUCH <br /> POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> IN99 <br /> LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE0 u � <br /> GENERAL LIABILITY <br /> EACN.00CURRENCE <br /> COMMERCIAL GENERAL LIABILITY <br /> PREMSES EeoCcumme S <br /> CLAIMS MADE OCCUR MED.EXP(Anyon#Tww) S <br /> PERSONAL d ADV INJURY S <br /> S <br /> GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE <br /> POLICY 7 JEC7 7 LOC PRODUCTS-COMPIOP AGG S <br /> AUTOMOBILE LIABILITY <br /> ANY AUTO COMBINED SINGLE LIMIT <br /> (Ee exldent) <br /> ALL OWNED AUTOS <br /> SCHEDULED AUTOS BODILY INJURY <br /> (Per person) S <br /> HIRED AUTOS <br /> NON-OWNED AUTOS BODILY INJURY <br /> (Per eaident) $ <br /> PROPERTY DAMAGE S <br /> (Per wre dent) <br /> GARAGE LIABILITY <br /> AUTO ONLY-EA ACCIDENT S <br /> ANY ALTO <br /> OTHER THAN EA ACC S <br /> AUTO ONLY: AGG S <br /> EXCESBAJMBRELLA LIABILITY <br /> EACH OCCURRENCE S <br /> OCCUR CLAIMS MADE AGGREGATE <br /> S <br /> DEDUCTIBLE S <br /> RETENTION S S <br /> WORKERS COIAPENSATIDN AND S <br /> EMPVDY.ERS'UUL'ITY R T RY t ITS R <br /> A ANY PROPRIETORJPJIRTNER&XECUTIVE 3310020636081 06/04/08 06/04/09 E.L.EACH ACCIDENT S10004000 <br /> OFFICE RMIEMBER,EXCLUDED7 <br /> Myyeee,d@s**eAffx r E.L.D15EASE•EAEMPt!OYFE S lOODDDO <br /> SPECIAL PROVISIONS below EL DISEASE•PDLICY_LIMTS 1OOOD00 <br /> OTHER <br /> DESCRIPTION OFOPERAT10N8 i LOCATIONS I VEHICLES 18XCLUSIONS ADDED1qY1!ND0R1EM1w 1 tSPECLU 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 /> 11HOULD.ANYOF THE ABOVE DE3CRI9ED POLICIES BE CANCELLED BEFORE THEeXPIRATION <br /> DATE THEREOF,THE'ISSUMIOINSURER-WILLENDEAVORTONMAIL 30* DAYSWWMN <br /> NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILd1RE TO DD SO SHALL <br /> Contractors State License Boal' IMPOBENOCRUGATION OR LIABILITY OF ANY HIND UPON THE INSURER,ITS AGENTS OR <br /> PO Box 26000 REFRESENTATIVES. <br /> Sacramento CA 95826 A T1VE <br /> ACORD 25(2001108) ®ACORD CORPORATION 1986 <br />