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ACORD. CERTIFICAk OF LIABILITY I N' , OP ID Cl DATE,NM,DDIrM) <br /> SERVX01 06 03 08 <br /> PRocuCr� THIS CER71FfPAT SUED AS A MATTE:RDF INFORMATION <br /> George Petersen Iris Agency ONLY AND.:CONF.ERSNOA1GHTSUPON THEaCERTINCATE <br /> P. 0. Box 3539 HOLLER. T#1iS.CEIM,FICATE DOES 10T AMEND;EXTEND OR <br /> 627 College Avenue ALTER NE COI�ERA•GEAFFORDEDmy THE POLICIES BELOW. <br /> Santa Rosa CA 95402 <br /> Phone: 7D7-525-4150 - Fax:707-525-4175 INSURERSAFFORDINGZOVERAGE NAIC>k <br /> INSURED INSURER,A•, <br /> xesa:.•.InsurNsttsce Co an <br /> INSURER33r: <br /> Service Station Systems, Inc. INSURE&.- <br /> 680 Quinn Avenue eNstR�: <br /> San Jose CA 95112 <br /> INst9RER E: <br /> COVERAGES <br /> THE POLICIES OF INSURANCE USTEDMEL40W HAVE-BEEN ISSUEOTO THE aNSURED"NAM€D ABOVE*,ORAMiP.AL4CYf PERt®D IDICATED-NOTWFT49STAy01NG <br /> ANY REQUIREMENT,TERM OR CONDIT40NMF ANY CONTRACT OROTHER'DOCU HENT WITH RESREC7T0,WHICH-*Tf*$vCfR ICATE•MAYSEESSIR DoR <br /> MAY PERTAIN.1HEINSURANCEAFFORDED;BY•THEPOLICIES''.DESCRIBEDHEREWISSUBJECTTOALLTHE7ERMSVEXCLUSIONS AND CONDIl70NSd3FSUCH <br /> POLICIES.AGGREGATE'LIMITSSHOWNI,AAYHAVE BEEN REDUCED,BYPAID:CLAIMS. <br /> 1N <br /> LTR"NSR TYPE OFINSURANCE POLICY NUMBER pAhVDO DATie�NIMIDDIYY'" UMITS <br /> GENERALJAMLITY <br /> EACHXIEGU>}RfNCE: f <br /> COMMERCIAL GENERAL LIABILITY PAE*9E' Ea oecwenca S <br /> CLAIMS MADE ❑OCCUR MEIfXI' AnYonaM> on) S <br /> PERS�Nr L f AOV4NaURY Y. S <br /> GENL'RpL;:AGGREGATE <br /> GEN'L AGGREGATE LIAITAPPLES PER <br /> POLICY SM LOC PRI3D1)CTS COMP/OPAGG f <br /> AUTOMOBILE LIABILITY <br /> ANY AUTO <br /> COMBINED SINGLE LIMIT f <br /> (Ea want) <br /> ALL OWNED AUTOS <br /> SCHEDULED AUTOS BODILY INJURY S <br /> (Perpetsan) <br /> HIRED AUTOS <br /> NON-OWNED AUTOS (PerOaa"URI S <br /> ) <br /> PROPERTY DAMAGE f <br /> (Par tOidenl) <br /> GARAGE LIABILTIY <br /> ANY AUTO AUTO ONLY-EA ACCIDENT S <br /> OT"ER.THAN EA ACC S <br /> AUTO ONLY: AGG s <br /> EXCESSARABRELLA LIABILITY <br /> EACH OCCURRENCE f <br /> OCCUR ❑CLAIMS MADE AGGREGATE <br /> S <br /> DEDUCTIBLE f <br /> RETENTION f f <br /> f <br /> WORKERS COIF"NTION AND <br /> EMPwRERS'fJABS.MTY X <br /> A ANY.PRORRIEtORRRARTNEROMCUTIVE 3310020636081 06/04/08- 06/04/09 EL 140HAdalbw S.10000`00 <br /> OFFICE .'EXCLWO? <br /> Iy.et aNaeaaar. EL,D)EilsE.:EAgAuoY� sn0p '0. <br /> OTHCIAL'PROV1810NSER OMow E.LMISEASE:+'POLICY,LTMIT' S 100OD.00 <br /> OTHER <br /> DESCRIPTION 0FOPERATIONS I-LOCATiONB'I VEHICLES I EXCLUSIONS°ADDEDV YENDORSMIMRWj SPEGALMROVISIONS"'" <br /> Re: License #465184 <br /> Evidence of Workers' Compensation Coverage. <br /> Ten Day Notice of Cancellation in the event of non-payment of-premium. <br /> CERTIFICATE HOLDER CANQELdA.Tm <br /> SHGULD.ANYOF-THEABOVE DESERAISEDpOLICKS:HE CANCELLED.BEFORE rHE+EXPIRATION <br /> DATE'THEREDFiTHWMSUTAG'INSURER,MLLZNDBAVORTO-MAIL 30*' DAYS WRITTEN <br /> NOTXCETD TNE-CERTLaICATE 1NOLDER'NAMED TO THE LEFT,BUT FAILURE TODD ID'SHALL <br /> Contractors State License Boar IMPDSENO*IIUGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR <br /> PO Sox 26000 REPRESENTATIVES. <br /> Sacramento CA 95826 A T1VE <br /> ACORD 25(2001/08) ®ACORD CORPORATION 1988 <br />