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Policy Number <br />92-92-2579-2 <br />DECLARATIONS PAGE AMENDED Nov 1 2006 <br />STATE FARM GENERAL INSURANCE COMPANY "'"O'er <br />900 OLD RIVER RD, BAKERSFIELD CA 93311-6000 <br />A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS <br />Agent Copy <br />Named Insured and Mailing Address <br />23-1308-F412 U <br />CLIFFORD, SUSAN SAXE DR <br />A PROFESSIONAL CORPORATION <br />16530 VENTURA BLVD STE 203 <br />ENCINO CA 91436-4535 <br />BUSINESS POLICY -SPECIAL FORM 3 <br />1,0oo,o0a <br />5,000 <br />2,000,000 <br />AUTOMATIC RENEWAL - If the POLICY PERIOD is shown as 12 MONTHS, this policy will be renewed automatically <br />subject to the Aremiums, rules and forms in effect for each succeedingq policy period. If this policy is terminated, we will <br />give you and tfle Mortgagee/Lienholder written notice in compliance wllh the policy provisions or as required by law. <br />Policy Period: 12 Months The policy period begins and ends at 12:01 am standard time at the <br />Effective Date: APR 18 2006 premises location. <br />Expiration Date: APR 18 2007 <br />Location of Covered Premises: <br />16530 VENTURA BLVD STE 203 <br />ENCINO CA 91436-4535 <br />Coverages & Property <br />Section I <br />A Buildings <br />B Business Personal Property <br />C Loss of Income - 12 Months <br />Section II <br />L Business Liability <br />M Medical Payments <br />Products-Completed Operations <br />(PCO) Aggregate <br />General Aggregate (Other <br />Than PC ) <br />2,000,000 <br />Cov A -Inflation Coveragge Index: N/A <br />Cov B -Consumer Pricelndex: 199-2 <br />Your policy is amended NOV 1 2006 <br />NUMBER OF ADDL INTERESTS CHANGED <br />ENDORSEMENT FE-6609 ADDED <br />upancy: <br />Deductibles -Section I <br />$ 500 Basic <br />In case of loss under this policy, the deductible will be <br />applied to each occurrence and will be deducted from the <br />amount of the loss. Other deductibles may apply -refer to <br />Forms, Options, and Endol <br />Special Form 3 <br />'Section II Additional Insured <br />Physicians and Surgeons <br />Debris Removal Endorsement <br />Amendatory Endorsement <br />Policy Endorsement <br />Business Policy Endorsement <br />' New Form Attached <br />Continued on Reverse Side of Page <br />Limits of Insurance <br />$ E128u900 <br />$ Actual Loss <br />FP-6143 <br />FE-6609 <br />FE-6407 <br />FE-6451 <br />FE-6205 <br />FE-6506.2 <br />FE-6464 <br />Prepared OTHER LIMBS AND EX <br />NOV 02 2006 <br />FP-8030.2C AFCB <br />06/1993 <br />Your policy consists of this page, any endorsements <br />and the policy form. PLEASE KEEP THESE TOGETHER <br />Endorsement Premium <br />Increase <br />Discounts Applied: <br />Renewal Year <br />Years in Business <br />Enclosed Building <br />Protective Devices <br />Sprinkler <br />Continued an Reverse <br />ELUSIONS MAY APPLY <br />Countersi c <br />By <br />EROL A N <br />(310)5 79 <br />TO <br />)~, <br />$ 18.40 <br />POLICY <br />Agent <br />(oif2172b) <br /> <br />