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QUINN, SUSAN 2 - 2001
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QUINN, SUSAN 2 - 2001
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Last modified
1/3/2012 2:13:53 PM
Creation date
3/6/2006 2:43:02 PM
Metadata
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Template:
Contracts
Company Name
Susan Quinn
Contract #
N-2001-013
Agency
Personnel Services
Expiration Date
6/30/2002
Insurance Exp Date
1/16/2002
Destruction Year
2010
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<br />CERTIFICATE OF INSURANCE __ <br /> <br />This certifies that 0 STATE FARM~E AND CASUALTY COMPANY, Bloomingto~inois <br />I&J STATE FARM GENERAL INSURANCE COMPANY, Bloomington, Illinois <br />o STATE FARM FIRE AND CASUALTY COMPANY, Scarborough, Ontario <br />o STATE FARM FLORIDA INSURANCE COMPANY, Winter Haven, Florida <br />o STATE FARM LLOYDS, Dallas, Texas <br />insures the following pOlicyholder for the coverages indicated below <br /> <br />Name of policyholder QUINN, SUSAN & GERALD DBA THE QUINN COMPANY <br /> <br />Address of policyholder 246 VIA PRESA, SAN CLEMENTE, CA 92672-9461 <br /> <br />Location of operations <br />Description of operations <br />The policies listed below have been issued to the policyholder for the policy periods shown. The insurance described in these policies is <br />subject to all the terms exclusions, and conditions of those policies. The limits of liability shown may have been reduced by any paid <br />claims. <br /> <br /> POLICY PERIOD LIMITS OF LIABILITY <br /> POLICY NUMBER TYPE OF INSURANCE Effective Date : Expiration Date (at beginning of policy period) <br />92 S6 8207 2 Comprehensive 01/16/01 01/16/02 BODILY INJURY AND <br /> Business Liability : PROPERTY DAMAGE <br />----------------------------- .0 .?",eiu"i..~ C"iTipleted Operation.................. --------- <br />This insurance includes: <br /> o Contractual Liability <br /> o Underground Hazard Coverage Each Occurrence $ <br /> o Personal Injury <br /> o Advertising Injury General Aggregate $ <br /> o Explosion Hazard Coverage <br /> o Collapse Hazard Coverage Products - Completed $ <br /> 0 Operations Aggregate <br /> 0 <br /> POLICY PERIOD BODILY INJURY AND PROPERTY DAMAGE <br /> EXCESS LIABILITY Effective Date : Expiration Dale (Combined Single Limit) <br /> o Umbrella Each Occurrence $ 1000000 <br /> o other : Aggregate $ 2000000 <br /> Part 1 STATUTORY <br /> Part 2 BODILY INJURY <br /> Wor1<ers' Compensation <br /> and Employers Liability Each Accident $ <br /> Disease Each Employee $ <br /> Disease - Policy Limit $ <br /> POLICY PERIOD LIMITS OF LIABILITY <br /> POLICY NUMBER TYPE OF INSURANCE Effective Date : Expiration Date (at beginning of policy period) <br /> <br />AODL. INSURED <br />THE CITY OF SANTA ANA <br />ITS OFFICERS, EMPLOYEES, <br />ATTN: JIM STIKELEATHER <br />20 CIVIC CENTER PLZ <br />SANTA ANA, CA 92701-4010 <br /> <br />THE CERTIFICATE OF INSURANCE IS NOT A CONTRACT OF INSURANCE AND NEITHER AFFIRMATIVELY NOR NEGATIVELY <br />AMENDS, EXTENDS OR ALTERS THE COVERAGE APPROVED BY ANY POLICY DESCRIBED HEREIN. <br />If any of the described policies are canceled before <br />its expiration date, State Farm will O'I!€kocmail a <br />written notice to the certificate holder 30 days before <br />cancellation. XlXmllllllllJll),{lW: :faiIxacmxikilUlClxllotiE:El( <br />Jm~!)ffiwx!ildiliJi1x>ll'fijklloc:irn:Aoll'ldxovx~ <br />~1IrntlI: :lIl!!lllllI$JOlCceJ[nlgelltll<<v:et:: <br /> <br />VIL.'I, ~ <br />S~~7-hofized Representative z/..z.z,k I <br />Hie Date <br />Agent's Code Stallfike Miller. Lie. No. 0360139 <br />31882 Camino Capistrano, #1058 <br />AFO Code San Juan Capistrano, CA 92675 <br />(949)493-3888 (949)831-9811 <br /> <br />Name and Address of Certificate Holder <br /> <br />AGENTS & VOLUNTEERS <br /> <br />558-994 a.3 Q.4-1999 Printed in U.SA <br /> <br />APPROVED AS TO FORM <br /> <br />~AA/l hu///y <br /> <br />ilira Sheedy <br />Deputy City Attorney <br /> <br />.. <br />
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