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Jul 08 03 12:58p George Bullock <br /> <br /> · STATE FAR~ a~SU~ANCE COI~PAN~ES <br /> ~ta~ Farm ~ener~ ln~uran~ Co~y <br /> <br /> 31303 Agour~ <br /> We~e ~II~e,CA 9t 363-0001 <br /> V,~637-F412 FU 3 <br /> <br />GOLD COASTiAP~RAISALS INC <br />11506 TELE6RA~H RD STE Zl& <br />SANTA FE SPGS CA 90670-~100 <br /> <br />Ihh,lh,,dl,,h,,llh,,,;Ih,,,llll,,,Ih,,,ll.,h,hh,II <br /> <br />Location: <br /> <br />Add Ins-Il: <br />Add Ins-Il: <br />Add Ins-Il: <br /> <br />11506 E T~. LEGRAPH RD STE 214 <br />SANTA FE SPGS CA <br /> <br /> COMM JNITY DEVELOPMENT AGENCY <br /> COMMUNITY REDEVELOPMENT AGCY <br /> <br />CITY OF SANTA ANA HOUSING <br /> <br />Forms, Options, and Endorsements <br />Special Form 3 <br />Personal Injury ExcluSion <br />Debris RemovaJ EndOrsement <br />Amendatory Endorsement <br />Policy Endorsement i <br />Business Policy EndOrsement <br />Hired Auto Liability Ebd <br />Protective Safeguardi <br />Glass Deductible - Section I <br />Additional Insured <br />Additional Insured Eddorsement <br /> <br />FP-6143 <br />FE-6346 <br />FE-6451 <br />FE-6205 <br />FE-6506.1 <br />FE-6464 <br />FE-6311 <br />FE-6303 <br />FE-6538.1 <br />FE-6320 <br />FE-6494 <br /> <br /> DREW MARTIN <br />T;lephone (5~2) 943-4343 or (562) 94¢-9323 <br /> <br /> 51~2-651 -1068 <br /> RENEWAL CERTIRCATE <br />' ' P~LICY NUMBER 92-B0-0091~ <br /> BII~sIN ESS-OFFIC ~ <br /> MAR 05 2003 to MAR 05 2004 <br /> <br />DATE DUE <br /> <br />MAR O5 2003 <br /> <br />Coverages an~ Limits <br /> Section I <br /> A Buildings <br /> B Business Personal Property <br /> C Loss of Income <br /> <br />Deductibles - Section I <br /> Basic <br /> Other deductibles may <br /> apply - refer to policy <br /> <br />p.2 <br /> <br />-PLEASE P~Y THIS AMOUNT <br /> <br />$641.58 <br /> <br />Section II <br />L Business Liability <br />M Medical Payments <br /> Gen Aggregate (Other than PCO) <br /> Products-Completed Operations <br /> (PCO Aggregate) <br /> <br /> Excluded <br /> 54,400 <br />^¢tual Loss <br /> <br />Annual Premium <br />Forms, Opts, & Endrsmnt <br />Bus Liability - Coy L <br />CA Surcharge <br /> Amount Due <br /> <br />500 <br /> <br />Premium Reductions <br />Your premium has already been reduced <br />by the following: <br /> Renewal Year Discount <br /> Yrs in Business Discount <br /> Claim Record Discount <br /> Prot. Devices Discount <br />Cov. A - Inflation Index: N/A <br />Cov. B - Consumer Price: 181.3 <br /> <br />$1,00~,000 <br /> ,000 <br /> :ooo,ooo <br /> 000,000 <br /> <br />/~i~PROVED .AS I~0 FORM. <br /> <br />Prepared DEC 19 !7002 <br /> <br />$450.0 <br />159.0 <br />20.0 <br />12.5 <br />$641.5 <br /> <br /> ~ 80 ~127 4653 <br />See reverse sidf~ for irnportttnt information. <br />Please keep Yni~ par~ for your record. <br /> <br /> <br />