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Jul OB 03 l~:5Bp Oeor~e Bullock <br /> <br /> · STATE FARM IN~UF~ANCE COMPANIES <br /> state Farm General Ineuranc~ Company <br /> <br /> 31303 Agoura RoaKa~ <br /> Wesll~(e Village,GA 91363-0001 <br /> <br /> V*8637*F412 FU 3 <br /> <br />GOLD CDASTiAP~RA~SALS INC <br />11506 TELEGRAPH RD STE <br />SANTA FE SPGS CA 90670-~100 <br /> <br />Ihl,,Ih,,,ll,,h,,llh,,.ll,,,,lllh,,Ih,,,ll.,h,hl,,ll <br /> <br />Location: <br /> <br />Add Ins-il: <br />Add Ins-Ih <br />Add Ins-Ih <br /> <br />11506 E T~LEGRAPH RD STE 214 <br />SANTA FE SPGS CA <br /> <br /> COMMUNITY DEVELOPMENT AGENCY <br /> <br />COMMUNITY REDEVELOPMENT AGCY <br />CITY oF SANTA ANA HOUSING <br /> <br />Forms, Options, and Endorsements <br />Special Form 3 <br />Personal Injury ExcluSion <br />Debris Removal Endersement <br />Amendatory Endorsement <br />Policy Endorsement <br />Business Policy End(~rsement <br />Hired Auto Liability Ehd <br />Protective Safeguardi <br />Glass Deductible - Section I <br />Additional Insured <br />Additional Insured Er{dorsement <br /> <br />FP-6143 <br />FE-6346 <br />FE-6451 <br />FE-6205 <br />FE-6506.1 <br />FE-6¢64 <br />FE-6311 <br />FE-6303 <br />FE-6538.1 <br />FE-6320 <br />FE-6494 <br /> <br />/~I~PRO VED <br /> <br /> 562-1~51- 10~;8 p.2 <br />RENEWAL CERTIFICATE <br /> P~L;CY NUMBER ~' 92-B0-0091'~ - <br />' 'B'~SIN ESS-OFFIC~ <br /> MAR 05 2003 to MAR 05 2004 <br /> <br /> D&TE DUE "PLEASE P~,Y THIS AMOUNT <br /> M,~R 05 2003 $641.58 <br /> <br />Coverages an{I Limits <br />Section I <br />A Buildings Excluded <br />B Business Personal Property 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 />500 <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 />$1,000,00o <br /> 5,000 <br /> :ooo,ooo <br /> 000,000 <br /> <br />Annual Premium <br />Forms, Opts, & Endrsmnt <br />Bus Liability - Coy L <br />CA Surcharge <br /> Amount Due <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 />Coy. B - Consumer Price: 181.3 <br /> <br />$450.0 <br />159.0 <br />20.0 <br />12.5 <br />$641.5 <br /> <br />AS TO FORM. <br /> <br />r~lephone (5(~2) 943-4343 or (562) 94~-9323 <br /> <br />Prepared DEC 19 ~002 <br /> <br /> ~ 80 ~127 4653 <br />See reverse sid~ for important information. <br />Please keep thil parr for your record. <br /> <br /> <br />