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<br />H':UM ~IR~ ~Hi.:M IN~. MIKI:: MVi.: <br />\ <br /> <br />~HUNI:: NU. : 114 ~J1 ~~11 ~ <br /> <br />Hpr, l~ ~~~1 ~~:l~~M ~1 <br />~ <br /> <br />CERTIFICATf OF INSURANCE <br /> <br />This certifies that 0 SlATE FARM FIRe; AND CASVAL TY COMPANY, Bloomington, IlIinoi. <br />g] STATE FARM GENERAllNSURANCIO COMPANY, BlllOmmgron, Winl,is <br />o STATE FARM FIRE AND CASUALTY COMPANy, SCarborough, Ontario <br />D STATe; FARM RORIDA INSURANCE COMPANY, Winter Haven, Florida <br />o STATE FARM LLOYDS, Dalla., Texas <br />insur.. the following policyholdl!l' for the coverages indicated below; <br /> <br />Name of policyholder QUINN. SUSAN . GERALD DBA '('HE QUINN COMPANY <br /> <br />Address of policyholder 246 VIA ~!lJ::SA. 5~\I CLEMENTE, CA 926n-9~61 <br /> <br />LOCItion OfOperatigns tawn Bow:..ing C"!nt@T", ~ant~ An... Ca. <br />o..cription of opBrlilions <br /> <br />The policies list'i>d below have b....n issued to the policyholder for the policy periods shown, The insunonee deseribed in lhese policies Is <br />subject to all the terms exdusions, and conditions Of those policies, The limIts of liability ahllWn may have been reduced by any paid <br />daims, <br /> <br /> POLICY PERIOD LIMITS OF LIABILITY <br /> POLICY NIJMBER TYPE OF INSURANCE EtfK1lV$ DiIte : Expirlllion on. (at """inning of policy .-rlad) <br />92-S~-e207-2 Comprehensive 01/16/01 01/1~/02 BODILY INJURY AND <br /> Business liability : PROPERTY OAMAGE <br />---- __0.__._____________ 'D. P.r04iiOiS.=co;.r"pr~'iilj'o;;eraiions""" , "------------------ <br />This insurance includes: <br /> o Contractualliabil~y <br /> o Underground Hazard Co_age Each Oeeurren~ $ <br /> o Perso""llniury <br /> o A"'ertising Inju"Y General Aggmgate $ <br /> o Explosion Hazard Coverage <br /> o Collapse Hazard Coverage Products - C<>mpleted $ <br /> 0 Operation, Aggrt!lgete <br /> 0 <br /> POLICY PERIOD BODI~ Y INJURY AND PROPERTY DAMAGE <br /> EXCESS liABILITY l;tfectiV$ Dale : Expirolion o.te (Combined Single Umit) <br /> o UMl'>reIl. , Each Occurrence $ 1000000 <br /> : <br /> o Other , AOo_ate $ 2000000 <br /> , Part 1 STATUTORY <br /> Part 2 BODI~ Y INJURY <br /> Worker$' Compen.lIlion <br /> and Employers Liabil~y , Eaeh Accident $ <br /> , <br /> , Cis...... Each Employee $ <br /> Dls..... - Policy ~imit $ <br /> ... - POLICY PERIOD LIMITS QF L1ASIUTY <br /> POLICY NUMBER TYPE OF INSURANCE Effective Date : D:Ibt <at beginning of policy period) <br /> : <br /> , <br /> , <br /> <br />THE Cl;IUlI'ICATl; 01' INSURANCE IS NOT A CONTRACT OF INSURANCE AND NEITHER AFFIRMATlvr:l Y NOR NEGATlVEl Y <br />AMI"NDS, ~TENDS OR ALTERS THE COVERAGE APPROVEO BV ANY POUCV OESCRIBED HEREIN. . , <br />If any of the de.cribed poliCies ere ""nceled before <br />ils expiretion date. State Fanm will Iry 10 mail a <br />written notice to the certificate holder 30 days before <br />cane<>lIation, If hOWOMOr, we fail to mail such nctice, <br />...0 obli!1Ation or liability will bfll imposed on Statil <br />F6rm or its agents or repreaenlDlives, <br /> <br />~J_ 7?t-U~.AAj <br />"'~_ ofAulll_ "...__.,. <br />~~~ <br />Tnl <br />AIJOnI"'Code_: iUl'llnCI <br />nrlJIBlVliller -lie, No. 0;60138 <br />:tl B82 Cimino CI,i5lruo #1058 <br />",FO Cod. 80" JUan CaJ)i$trano, lIA' 92675 <br />(949) 4113.388B (949) 83HIIll <br /> <br />Name and Address of Certificate Holder <br /> <br />ae.dl ins ~ <br />THE CITY OF SANTA ANA <br />rTS Orr%eE~S, EMPLOY!ES. <br />" VOLUNTEERS <br />20 Civic Center Plaza <br />Santa ~. c__ 92701 <br /> <br />lV:'EI'T$ <br /> <br />SS8..00h~.3 04-1_ PriI'l1ed in U.:iA <br /> <br />APPROVED AS TO FORM <br /> <br />/~//"( /idl?'d~, <br />L\lura Sheedy , <br />D,eputy City Attorney <br /> <br />4/113/01 <br />Dole <br />