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Jul OB 03 12:SBp George Bullock <br /> <br /> · STATE FAR~ gN~U~ANCE COMPANIF$ <br /> State Farm General lneuranoe Compalty <br /> <br /> 31303 Agoura Road <br /> Westltlke Villa~ge,CA 9t 363-0001 <br /> <br /> V, 8637-F412 FU 3 <br /> <br /> GOLD COASTi APPRAISALS <br /> 11506 TELEGRAPH RD STE <br /> SANTA f'E SPGS CA 90670-~100 <br /> <br />Ihh,lh,,dl,,h,,llh,,,dh,,,lllh,,Ih,,,ll.,h,hh,il <br /> <br />Location: 11506 E 'I'VE. LEGRAPH RD STE 214 <br /> ~ SANTA FE SPGS CA <br /> <br />Add Ins-Ih COMM JNITY DEVELOPMENT AGENCY <br /> <br />Add Ins-Il: <br />Add Ins-Il: <br /> <br />COMMUNITY REDEVELOPMENT AGCY <br />CITY oF SANTA ANA HOUSING <br /> <br />Forms, Options, an~ Endorsements <br />Special Form 3 <br />Personal Injury Exclu~sion <br />Debris Removal EndGrsement <br />Amendatory Endorsement <br />Policy Endorsement <br />Business Policy EndGrsement <br />Hired Auto Liability End <br />Protective Safeguard~ <br />Glass Deductible - Section I <br />Additional Insured <br />Additional Insured E~dorsement <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 /> 5B2-B5 1 -IOBB p. 2 <br />REklE~AL CERTIFICATE <br /> P~LICY NUMBER 92-B0-0091-~ <br />- BL~SIN ESS-OFFICI~ <br /> MAR 05 2003 to MAR 05 2004 <br /> <br /> DATE DUE "PLEASE P~Y THIS AMOUNT <br /> MAR 05 2003 $641.58 <br /> <br />Agent DREW MARTIN <br />Telephone (582) 943-4343 or (562) 943-9323 <br /> <br />(~overages ami Limits <br />Section I <br />A Buildings Excluded <br />B Business Personal Properly 54,400 <br />C Loss of Income Actual Loss <br /> <br />Deductibles - Section I <br /> Basic <br /> Other deductibles may <br /> apply - refer to policy <br /> <br />Section II <br />L Business Liability <br />M Medical Payments <br /> Gen Aggregate (Other than PC;O) <br /> Products-Completed Operations <br /> (PLO Aggregate) <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 />$1,000,000 <br /> 5,000 <br /> 2,000,000 <br /> 2,000,000 <br /> <br />A~:'PROVED AS 'FO FORM <br /> <br />Prepared DEC 19 ~002 <br /> <br />$450.0 <br />159.0 <br />20.0 <br />12.5 <br />$641.5 <br /> <br /> ~ 80 3127 4653 <br />See reverse sid~ for important information. <br />Please keep ~hie part for yoUr record. <br /> <br /> <br />