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<br />cQ. <br /> <br />GuideOne Mutual Insurance Company <br />GuideOne Life Insurance Company <br />GuideOne Elite Insurance Company <br />GuideOne Specialty Mutual Insurance Company <br />GuideOne L10yds Insurance Company <br />GuideOne America Insurance Company <br /> <br />FAMILY JACKET <br />ACCOUNT NUMBER <br />AGENT 04-301 <br />CARL DIEDA <br />DBA: CARL L DIEDA INS AGENCY <br />680 LANGSDORF DR STE 210 <br />FULLERTON, CA 92831 <br />(04 ) (714)870-7752 <br /> <br />001135991 <br />001135991-01 <br /> <br />Insurance <br />1111 Ashworth Road, West Des Moines, Iowa 50265-3538 <br />ADDITIONAL INSURED <br /> <br />CITY OF SANTA ANA ITS OFFICERS <br />EMPLOYEES, AGENTS & REPRESENTV <br />20 CIVIC CENTER PLAZA <br />SANTA ANA CA 92701 <br /> <br />INSURED <br />TEMPLO CALVARIO AND CHURCH OF <br />NO WALLS <br />2617 WEST 5TH STREET <br />SANTA ANA CA 92703 <br /> <br />A - JfXA -I {{;(f7 <br /> <br />NOTICE OF CANCELLATION <br /> <br />COMMERCIAL PACKAGE <br /> <br />Policy Number 1135-991 <br /> <br />Perhaps you have overlooked your recent insurance statement. We appreciate your business and <br />want to continue your coverage. However, because we have not received premium payment, the <br />policy listed above is canceled, effective at 12:01 a.m. standard time on 12/26/04. <br /> <br />To help us avoid this action and continue your coverage without interruption, please submit the <br />minimum premium due before the cancellation date. A late charge will be included in your next <br />billing statement. <br /> <br />If you have already sent your payment, please accept our thanks. If you have any questions <br />about your policy, please contact your agent listed above. Thank you for insuring with <br />GuideOne Insurance. <br /> <br />Policies included within this account are: <br /> <br />1135-991 <br /> <br />MEMORANDUM COpy <br /> <br />120604 <br /> <br />UBCL92 <br />