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<br />\ 081)0/200' 13:(1' FAX 3108487812
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<br />SNYDD STATE lAR!JI
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<br />CERTIFICATE OF INSURANC~
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<br />0 STATE FARM FIRE AND CASUAL1"\' OOMI'ANY.l!lloomlngtOn. IIllnoltl
<br />¡¡:¡¡ STATE: P'MM G!!NERAL INSURANCE COMPANY, I!lloomlngton, IllInol.
<br />§ STATE FARM FIRE AND CASUALTY COMPANY, StftrborOugh, Oritario
<br />STAT!" FARM FLORIDA INSURANCE COMPANY, Win"" loIav..,. i'IMda
<br />IN!õU.'¡N(~ STATE FARM llOVDS, Dall:fls, TéX3S
<br />, ,¡""u",. "... ,g.IOWi"IJ poUcyMld.r fer 1118 "'V81'89.' Indleatlld below:
<br />Policyholder TKLFORDS ATTN LARSON. IJINDA ({
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<br />Addl'8ssofpo~oyh() der 1255 UTI! ST HERPIOSA BBACI<. CA 902~(-3309
<br />LDcation of op,oratione , SlIMe ,
<br />CeKl'lptlon of I¡pe.lion. 'flt.I'OJIDS
<br />,Th, pollel.. lI,ted bilow h8V8 bu;; isausd !D' 111; POllcyho d~r for 111.. pollc~ ~iod' ,h"';". The insurance duorib8d In the.. pollc;J., I,
<br />i" subjeci 111 all 1118 œmls mcclusfons. and candlllons of 110M paliei... TII, lirnJw of Il8þilily ,l1Qwn may h8ve been ,eduted by any peid clalml.
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<br />", POLICY O@1tJCXI LlMlTI OF LlAIIIUTY
<br />POLICY NUMB!!" TYI'!! OF INSUIlANC!! Eff8ct1Y8 Dale ! E:xpll'lliOn DaIII (at beginning of polley petlodl
<br /> COmpMhanlilll I I!IODIL Y I~UPlY AND
<br />'(' n~Q8-0204-7 G '
<br />."'.~~~~~~ ~!~P)!~.. Umo.. ..~~~.:~~.:~.~..j.. .~.~~:.~;;.:?:'. o. PROPER1'I' DAMAGE
<br />"This iñ:ïürä':'Oiiñèiüd.;" 0 Producls . Compl"ted Opel'lltlon.
<br /> 0 Contrectual liability
<br /> 0 Underground H8rard ClMlreg. Ed OCCUtl'tl\Ct S 1.000,0110
<br /> 0 persanar I~ury
<br /> 0 AdVtI1I8Jng Injury {Jllnllrlll Aggregll9 $ 2. 000, 000
<br /> 0 I;.I<plC8icn H""'lrd CCveI'8Q6
<br /> a COllapse Hazard COverage Products - COmpl81ed $
<br /> 1:1 au.in... prop.r.y $2300 O )8'8Danl Agllrsgal,
<br /> \tedic;.l PbLvmlilntá $5COD
<br /> POLICY PERIOD BODILY INJURY AND PROPERTY DAMAGE
<br /> EXCESS LIABILITY efflc:t1v9 081- : ÐtIl4I'11W4I;11Q (COmOlnld 51""" I.lmlt)
<br /> r;:;¡ Umbrella i ElICh Occurrence $
<br /> , Aaaregate
<br /> 0 Otner i S
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<br /> Part 1 STATUTORY
<br /> , F'art2110DILYINJURY
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<br /> Workers' CompensatIOn '
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<br /> and Emp~ Liability , Elich ~ld'!I\ $
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<br /> . Disease. Each EmployeeS
<br /> , 01...- . Policy Limit $
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<br /> POLICY PERIOD LIMITS OF LIABILITY
<br />POI.ICY NL,lMBIjiR TYPE OF INSURANcE f!ffsçt .. D8I8 : ExpInllan DIII8 tat b""llÍriln" or ~o ç)o IHIrloCl)
<br />094 35H-A29-75 AIJ'l'O C7-~P-DI ' 01-~g.05 JM ¡500 1100
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<br />Name and Add,," of Certificate Holder
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<br />~ t'!'!'Y OF SAN1'A AlIA
<br />20 CIVIC CINTBR ~~~
<br />SANTA ANAl CA 9~701-40S8
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<br />THi! Ce"TI lIc:ATI" '''' IN8UltANCIi! 18 NOT A CONTRACT OF IN8UIW'ICIi AMP NlITWER AFFlRMA~1. Y oIQR N ;qATIVEL Y
<br />AMENDS, EXTEND!: OR AI. TI'" THI C;OYIlltAGI AP I~ IIV ANY POLICY DESCRIBED HeREIN.
<br />~ Iny of I~I d"Cllbtd pollelt. II" QtnC"'d btfare
<br />ils e"Piratlon da. Stall Farm wllltty to m.11 . wrilten
<br />ndlle, 10 tMI Cllrt!ftollll ~D!d\lr 'D dilY" befi¡re
<br />CIIfIcel1,.¡lon. If ho_ver, we fail to mail such notice.
<br />rIO obligation 0' lieblllly will be imposed on 5181.
<br />Fllrm or lis agltl'rts or representatives.
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<br />Signatu
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<br />ADonl'. eodo 81!1mp
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<br />.1/20/0.
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<br />....o.JmrOJ16 SNYDER
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<br />........4 11-11-2002 8r nIç(j IrJ U,:I.A.
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