|
xx-x xxxx .xx r,.xx x,xx
<br /> mm
<br /> t Date
<br /> ( )
<br /> YY
<br /> r�y#x
<br /> E�I11
<br /> COR x ..x . I: EU . C #:r .::::. n R ::::##;.A##.:::::::: ::::.:
<br /> xx
<br /> MEMO,x �xxxxxxxAAxx �xx #:x:#
<br /> :AAA:` AAAAAAAAAAA _
<br /> :.#CA AAAA ::i � #:### 2/14 2008
<br /> Producer Arica Serpa THIS CERTIFICATExVISµISSUED....AS A MATTER OF INFORMATION
<br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.
<br /> Owen-Dunn Insurance Services THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE
<br /> 2831 G Street COVERAGE AFFORDED BY THE POLICIES BELOW.
<br /> Sacramento CA 95816 INSURERS AFFORDING
<br /> 916.443.0200 INSURER Peerless Inc. Co
<br /> www.owendunn.com A NAIC#24198 A.M. Best:A XV
<br /> 0670167 INSURER Oak River Ins. Co.
<br /> NAIC#34630 A.M. Best: A++XIII
<br /> Insured INSURER
<br /> BZ Service Station Maintenance, Inc.
<br /> INSURER
<br /> P.O. Box 933
<br /> West Sacramento CA 95691 INSURER
<br /> E
<br /> ..................:.x...,....,..,.=xx,:„.x.xxx..xx=;.;.xxxxxxx;xxxxxxx xxx:xxx,xxxxx=,..xx.„=.x=.,.,k.xx..:...,, . AA.,x.AAxx,.xx,..,.,...x....x AAAAA#::#:#:#.###
<br /> .=Cx.C..xxxx,.C.=.xxxxxx.xxxx x xxxA,xxx x. ..,A,.=,.x........................x .:.C..........xx. ,...A.......,...xx.0
<br /> AA.A
<br /> .,A. :•#C: CSC:( CCCCC#CGCG
<br /> C:CA"#AA:A:::CCC:CE.....C......AAACCA
<br /> xCAC'CACACAAAA..=...::CC::C:.,.,C.E.;.A.xx
<br /> ...I ,..#(...xxxx
<br /> ..C.xx.,...>.,..x,
<br /> A....CSI:: ...
<br /> .C C:I::::CAx xx#,x :AAA( :,C,
<br /> E :;!#.. x.Cxx
<br /> Axe.
<br /> x xICCCCCC:A:ACCC:x,x...xxx....==..x
<br /> ::CAC :CCC# :CCC
<br /> ::CGCG:((( ::CCC
<br /> "CCCCC:CCCCC CxCxx.x,....,._..
<br /> C=. :C6:: ::6C”
<br /> THE YxPOLICIESxMOFv INSURANCE xLISTED BELOW HAVE BEEN ISSUED TO THE NINSUREDxNAMED eABOVE%FOR THEY POLICY PERIOD INDICATED.
<br /> NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR 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
<br /> TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br /> POLICY POLICY
<br /> NSR EFFECTIVE EXPIRATION
<br /> LTR TYPE OF INSURANCE POLICY NUMBER MNDATE Y MNDATE Y LIMITS
<br /> ENERAL LIABILITY EACH OCCURRENCE $
<br /> A COMMERCIAL GENERAL LIAB CBP9555195 2/15/2008 2/15/2009 FIRE DAMAGE(Any one fire) $ 100,00(
<br /> CLAIMS MADE OCCUR MED EXP(An one person) $ 0
<br /> PERSONAL&ADV INJURY $ 1,000,00(
<br /> GENERAL AGGREGATE $ 2.000.00(
<br /> GEN'L AGG LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ O
<br /> POLICY ROJECT LOC $
<br /> AUTOMOBILE LIABILITY CBP955195 2/15/2008 2/15/2009 COMBINED SINGLE LIMIT $ 1,000,00(
<br /> A ANY AUTO
<br /> ALL OWNED AUTOS BODILY INJURY
<br /> SCHEDULED AUTOS (Per person) $
<br /> HIRED AUTOS BODILY INJURY
<br /> NON-OWNED AUTOS (Per accident) $
<br /> PROPERTY DAMAGE
<br /> (Per accident) $
<br /> GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
<br /> ANY AUTO OTHER THAN EA ACC$
<br /> AUTO ONLY: AGG$
<br /> EXCESS LIABILITY EACH OCCURRENCE $
<br /> OCCUR F�CLAIMS MADE AGGREGATE $
<br /> S
<br /> DEDUCTIBLE $
<br /> RETENTION$ $
<br /> WORKERS'COMPENSATION& 5raruroeY UNITI lOTHERii.gAA) ..g:E ..I
<br /> B EMPLOYERS'LIABILITY 2210000180071 10/27/2007 10/27/2008 EL EACH ACCIDENT $
<br /> EL DISEASE-EA EMPLOYEE $
<br /> EL DISEASE-POLICY LIMIT S
<br /> License#433159
<br /> ..I :s: :
<br /> xxxA.xx.x
<br /> .G..xx.,xxxx.xxxx, ii€R„ _
<br /> xxxx;,,.=xx,xxx x .,.#..#xAGA,x,x...=.
<br /> #AG„AAAAAA:GG�:G:GAxxx. :GxIA:.AAAx
<br /> x,=AAx.xx
<br /> ::s�::��• :,x x x xA.x.l 1 xxxAxxxxxxixx :� i .,.=.xAA:G:,G
<br /> ;�=x•;�; #���� � '#AA#•;AAI:::AAAI,:„�::AA;##;#A####GA:A:#:GAA:A#::#AAA:###GA:#AAA#:Gxxxxxxx„,,,x���L�i�: ;�1��\I: #'A:A##�„; x
<br /> License#433159 SHOULD ANY OF THE ABOVE DESCRIBED+POLICIES BE CANCELLED BEFORE THE
<br /> Contractors State License Board EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
<br /> 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
<br /> LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION
<br /> OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRE-
<br /> SENTATIVES. `10 Days for Non-Payment of Premium
<br /> P.O. Box 26000
<br /> Sacramento CA 95826 AUTHORIZED
<br /> REPRESENTATIVE
<br /> Q�k(XQ/
<br /> Candace Alicea
<br /> kRR ldkCA!CRRRSRtltldpRRppR9RBtl!tltlptlktltlptltltltlRi R I RRR4COGBIFCYI4CiC?iA:tlCdGGGCGOCC.CpOdCGap`q...:55......5'Ap x pp xxl:C AAA..A•.•%A AAGA"x'x=x'xx AGGAAGGG•x.GA AAACAAA##"xGAAGII
<br /> kR.Rkxlllllll13RA IAxllf ilei? xxxlllxxxllllllx!xAlAC:CiFp�G qq��II kyr.:
<br /> }� [� AAitAAkAAAAkAAARRkAAAAAgAk5AA55A5A5C555A5A555k AA#5tl555:.":SS%#:;:xCAxx� x E17#':"AAAAAAAAAARAAAARRARRkAkRkkkA43!%= +=�'ysI '�-^'_'*
<br /> CC#AACCC#CC##ACAA#A:#C#AACA.".CCCC-C##ACA(##CCCx`ACC##CCCCC�CA.+#C C# CCCCCx:::IQAfiACA M.i.[IC.CAkR C1AIN%�GOCC5x...1CC�555G5tlC��xl93�zux:vuS::sx
<br />
|