Laserfiche WebLink
<br />"'" <br /> <br />CERTIFICATE OF INSURANCE ""'" <br /> <br />o <br />t8l <br />o <br />o <br />o STATE FARM LLOYDS, Dallas, Texas <br />insures the following policyholder for the coverages indicated below: <br />Name of policyholder QUINN, SUSAN & GERALD DBA THE <br /> <br />This certifies that <br /> <br />STATE FARM FIRE AND CASUALTY COMPANY, Bloomington, Illinois <br />STATE FARM GENERAL INSURANCE COMPANY, Bloomington, Illinois <br />STATE FARM FIRE AND CASUALTY COMPANY, Scarborough, Ontario <br />STATE FARM FLORIDA INSURANCE COMPANY, Winter Haven, Florida <br /> <br />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 /> <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 Dale (at beginning of policy period) <br />92-S6-8207 2 Comprehensive 01/16/03 01/16/04 BODiLY INJURY AND <br /> Business Liability PROPERTY DAMAGE <br />--------------------_.------- .t:j.pro.duCis.:c:orn.ple;tEld.Oijeraiic;ns.......--------------.----- <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 Date (Combined Single Limit) <br /> o Umbrella , Each Occurrence $ 1000000 <br /> o Other Aggregate $ 2000000 <br /> : Part 1 STATUTORY <br /> Part 2 BODILY INJURY <br /> Workers' Compensation <br /> and Employers Liability Each Accident $ <br /> i 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 /> <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 try to mail a <br />written notice to the certificate holder 30 days before <br />cancellation. If however, we fail to mail such notice, <br />no obligation or liability will be imposed on State <br />Farm or its agehts or fepresentatives. <br /> <br />Y72L~ f/2Ul.1N <br />Signature of Authorized Representative <br />AGENT <br />Title <br />Agenl{iJp MIKE MILLER, Agent <br />Uc. #0360139 <br />A 31882 Camino Caplslrano,Sune 105A <br />AFO ""iIIUNC San Juan Capistrano, CA 92675 <br />Phone: 949-493-3888 <br />Fax: 949-481.1032 <br /> <br />Name and Address of Certificate Holder <br /> <br />THE CITY OF SANTA ANA <br />ITS OFFICERS, EMPLOYEES, <br />ATTN: JIM STIKELEATHER <br />20 CIVIC CENTER PLAZA <br />SANTA ANA, CA 92701-4010 <br /> <br />AGENTS & VOLUNTEERS <br /> <br />558-994 B.3 04-1999 Printed in U.S.A <br /> <br />/U'l'i~OVED AS <br /> <br />~~cA <br />~~~~~(~; :; <br /> <br />DCPLilY Citj o/\I/flrney <br /> <br />lU ["-~,;\...i <br /> <br />3/20/03 <br />Date <br />