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RENEWAL DECLARATIONS (CONTINUED) <br />Medical Office Policy for CITY OF SANTA ANA <br />Policy Number 90-E3-K874-5 <br />SECTION I - PROPERTY SCHEDULE <br />Location <br />Location of <br />Limit of Insurance* <br />Limit of Insurance* <br />Seasonal <br />Number <br />Described <br />Increase - <br />Premises <br />Coverage A - <br />Coverage B - <br />Business <br />Buildings <br />Business Personal <br />Personal <br />Property <br />Property. <br />001 <br />6867 GOLFCREST DR APT 51 <br />No Coverage <br />$ 2,600 <br />25% <br />SAN DIEGO CA 92119-2444 <br />r As of the effective date of this policy, the Limit of Insurance as shown includes any increase in the limit due to'Inflation Coverage. <br />SECTION I - INFLATION COVERAGE INDEX(ES) _ _ - <br />Cov A - inflation Coverage Index: NIA <br />Cov B - Consumer Price Index: 314.2 <br />SECTION I - DEDUCTIBLES <br />Basic Deductible $1,000 <br />Special Deductibles: <br />Money and Securities $250 Employee Dishonesty $250 <br />Equipment Breakdown $1,000 <br />Other deductibles may apply - refer to policy. <br />Prepared <br />AUG 02 2024 O Copyright, State Farm Mutual Automobile Insurance Company, 2008 <br />CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. <br />006408 Continued on Next Page Page 2 of 7 <br />