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Jul OB 03 12:SBp George Bullock <br /> i' <br /> · STATE[ FARM IN~UF~ANCE COMPANIES <br /> State Farm General Insurance Compalty <br /> <br /> 31303 Agoura Road <br /> WeWll~(e rills;ge,CA 91363-0001 <br /> <br /> ~ V. 8637-F412 FU 3 <br /> <br /> GOLD COASTi APRRAISALS :[NC <br /> 11506 TELESRA~H RD STE Zl& <br /> SANTA FE SpGS CA 90670-::$1.00 <br /> <br /> Ihh,lh,,,!h,h,,llh,,.Ih,,,lllh,,Ih,,,ll.,h,hh,II <br /> <br />Location: 11506 E TELEGRAPH RD STE 214 <br /> ~ SANTA FE SPGS CA <br /> <br />Add Ins-Ih <br />Add Ins-Il: <br />Add Ins-ih <br /> <br />COMM~ JNITY DEVELOPMENT AGENCY <br /> <br />COMMUNITY REDEVELOPMENT AGCY <br /> <br />CITY oF SANTA ANA HOUSING <br /> <br />Forms, Options, and Endorsements <br />Special Form 3 <br />Personal Injury Exclubion <br />Debris Removal End(~rsement <br />Amendatory Endorsement <br />Policy Endorsement <br />Business Policy EndOrsement <br />Hired Auto Liability End <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 />Agent DREW MARTIN <br />r~lepho,.~e (5iS2) 943-4343 or (562) 94¢-9323 <br /> <br /> .i <br /> <br /> 5B2-E;51-1OE;B p. 2 <br /> RENEWAL CERTIFICATE <br />· P~LICY NUMBER ~ 92-B0-0091-~ - <br /> BI]SIN ESS-OFFICI~ <br /> MAR 05 2003 to MAR 05 2004 <br /> <br /> D&TE DUE ~PLEASE P~Y THIS AMOUNT <br /> <br />MAR 05 2003 <br /> <br /> Coverages an{I Limits <br /> Section I <br /> A Buildings <br /> B Business Personal Properl7 <br /> C Loss of Income <br /> <br />$641.58 <br /> <br /> Excluded <br /> 54,400 <br />Actual Loss <br /> <br />Deductibles - Section I <br /> Basic <br /> Other deductibles may <br /> apply - refer to policy <br /> <br />500 <br /> <br />Section Il <br />L Business Liability <br />M Medical Payments <br /> Gen Aggregate (Other than PCO) <br /> Products-Completed Operations <br /> (PCO Aggregate) <br /> <br />$1,000,000 <br /> 5,000 <br /> ,000,000 <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 />Cov. B - Consumer Price: 181.3 <br /> <br />$450.0 <br />159.0 <br />20.0 <br />12.5 <br />$641.5 <br /> <br />A?PROVED AS I'O FORM. <br /> <br />Prepared DEC 19 ~002 <br /> <br /> ~ 80 3.127 4653 <br />See reverse sid~ for importllnt information. <br />Please keep thie part for your record. <br /> <br /> <br />