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This SPECIAL MULTI-FLEX POLICY is provided by the stock insurance company(s) of The Hartford Insurance <br /> Group, shown below. <br /> COMMON POLICY DECLARATIONS <br /> POLICY NUMBER: 72 UEC CK8498 THE <br /> H <br /> ARTFORD <br /> Named Insured and Mailing Address: JK MIKLIN INC <br /> (No., Street, Town, State,Zip Code) DBA YAMADA ENTERPRISES <br /> 16552 BURKE LN <br /> HUNTINGTON BEACH , CA 92647 <br /> (ORANGE COUNTY) <br /> Policy Period: From 08/21/24 To 08/21/25 <br /> 12 :01 A.M. , Standard time at your mailing address shown above. <br /> In return for the payment of the premium, and subject to all of the terms of this policy, we agree with you to provide <br /> insurance as stated in this policy. The Coverage Parts that are a part of this policy are listed below. The Advance <br /> Premium shown may be subject to adjustment. <br /> Total Advance Premium: <br /> Coverage Part and Insurance Company Summary Advance Premium <br /> COMMERCIAL AUTO <br /> HARTFORD ACCIDENT AND INDEMNITY COMPANY <br /> ONE HARTFORD PLAZA <br /> HARTFORD, CONNECTICUT 06155 <br /> Form Numbers of Coverage Parts, Forms and Endorsements that are a part of this policy and that are not <br /> listed in the Coverage Parts. <br /> HM0001 HM00100107SD4 IL00171198 IH12050221 IH99400409 IH99410409 <br /> IL00210908 IL02700720 HA00251221 <br /> Agent/Broker Name: CONREY INS BROKERS & RISK MANAGERS <br /> Risk Management Division <br /> '! Ili l�% REVIEWED&APPROVED By: <br /> Countersi ned b �'�" ice` <br /> g y Risk Management Specialist <br /> (Where required by law) Authorized Representative / <br /> Form HM 00 10 01 07 <br />