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State farm Mutual Automobile Insurance Company
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State farm Mutual Automobile Insurance Company
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i I <br /> 15DW1 05-11-1999 DECLARATIONS PAGE — 3 OF 3 MATCH 00110 <br /> 15TM: <br /> CD STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY <br /> INSURANCE 31303 AGOURA ROAD WESTLAKE VILLAGE CA 91363 <br /> 12 <br /> 11 XAX KEXIf CV OM POLICY NUMBER W27 8388—A24-75L <br /> 9 00110 75-8533- 116E7 <br /> *** THE CITY OF SANTA ANA & THE POLICYPERIOcMAY 03 1999TOJUL 24 1999 56 <br /> *C* SANTA ANA FINANCING AUTHORITY <br /> *0* THEIR OFFICERS , AGENTS & 4 <br /> *Y* 20P CIVIC SCENTERNPLAZA STEJEFFVM28 2 <br /> NS <br /> *** SANTA ANA CA 92701-4010 <br /> _ DO NOT PAY PREMIUMS SHOWN ON THIS PAGE. <br /> SEPARATE STATEMENT ENCLOSED IF AMOUNT DUE.-- <br /> DESCRIBED YEAR MAKE MODEL BODY STYLE VEHICLE IDENTIFICATION NUMBER CLASS <br /> VEHICLE 1997 FORD F350 PICKUP 1FTJW36G3VEA67677 1HOH0210 <br /> COVERAGES(AS DEFINED IN POLICY) <br /> SYMBOL-PREMIUM-COVERAGE NAME LIMITS OF LIABILITY SEE ilEVERSE SIDE FOR IMPORTANT MESSAGE <br /> NAMED INSURED_ ACTIVE PARTITIONS INSTAI CATIONS INC 541 N MAIN ST STE 104-3n1 <br /> CORONA CA 91720-2055 <br /> THIS IS DECLARATIONS PAGE. AGENT :PLEASE ATTACH ITOUR TO YOUR AUTO POLICY BOOKLET. PHONE : (6 2 6)0 915—' ILL <br /> 6 6 <br /> YOUR POLICY CONSISTS OF THIS PAGE,ANY ENDORSEMENTS,AND THE POLICY BOOKLET. FORM 8533-414 <br /> REPLACED POLICY W278388-75K 9805 . 5 PLEASE KEEP TOGETHER <br /> M U T L V O L 155-4976 CA.3 <br />
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