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<br />TRANSOLUTIONS <br /> <br />8486426802 <br /> <br />11/~6/02 02;48pm P. 001 <br /> <br />Policy Number <br />92-WK-8292-5 <br /> <br />DECLARATIONS PAGE <br /> <br />~ <br />l=:J <br /> <br />r <br /> <br />STATE FARM GENERAL INSURANCE COMPANY <br />31303 AGOURA RD, WESTLAKE VILLAGE,CA 91363-0001 <br />A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS <br /> <br />. <br /> <br />Named Insured and Mailing Address <br />8468-F415 0 <br /> <br />HIGLEY, CATHERINE <br />DBA TRANSOLUTIONS <br />310 ROBIN HOOD LN <br />COSTA MESA CA 92627-2134 <br /> <br />I~tt <br />N-WO'- ~ <br /> <br />Cov A . Inflation Coverage Index: N/A <br />BUSINESS POLICY. SPECIAL FORM 3 Cov B . Consumer Pricelndex: 181.0 <br />AUTOMATIC RENEWAL - If the POLICY PERIOD is shown as 12 MONTHS, this policy will be renewed automatically <br />subject to the premiums, rules and forms in effect for each succeeding. pOlicy period. If this policy is terminated, we win <br />give you and tile MortgageeILienholder written notice in compliance Wl1I1 the pOlicy provisions or as required by law. <br />Policy Period: t2 Months The policy penod begins and ends at t2:01 am standard time at the <br />Effective Date: OCT 24 2002 premises location. <br />Expiration Date: OCT 24 2003 <br />Named Insured: IndIVidual <br /> <br />Location of Covered Premises: <br />310 ROBIN HOOD LN <br />COSTAMESACA 92627-2134 <br /> <br />Certificate Holder as Additional <br />Insured: <br />City of Santa Ana M-93 <br />20 Civic Center Plaza <br />Santa Ana, CA 92702 <br /> <br />Coverages & Property <br /> <br />Section I <br />A Buildings <br />B Business Personal Property <br />C Loss of Income - 12 Months <br /> <br />Limits of Insurance <br /> <br />ccupancy: <br /> <br />lce <br /> <br />Excluded <br />$ 10 000 <br />$ Actual (oss <br /> <br />Section II <br />L Business Liabilily <br />M Medical Payments <br />Products-Completed Operations <br />(PCO) Aggregate <br />General Aggregate (Other <br />Than PCO) <br /> <br />Deductibles . Section I <br /> <br />1 <br /> <br />1,000,000 <br />5,000 <br />Excluded <br />2,000,000 <br /> <br />$ 500 Basic <br /> <br />$ <br /> <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 />olicy. <br /> <br />POLICY PREMIUM $ 273.00 <br /> <br />Forms] Options, and Endorsements <br />specia Form 3 <br />Policy Endorsement <br />TestinglConsutting E&O Excl <br />Amendatory Endorsement <br />Debris Removal Endorsement <br />Business Policy Endorsement <br />Advertising Injury Excl <br /> <br />FP-6143 <br />FE-6506.1 <br />FE-65tO <br />FE-6205 <br />FE-6451 <br />FE-6464 <br />FE -6345 <br /> <br /> <br />Continued on Reverse Side of Page <br />OTHER LIMITS AND EXCLUSIONS MAY APPLY. REFER TO YOUR POLICY <br />Prepared J . \ ",.., <br />OCT 29 2002 Countersigned -?-. v c-- <br />FP-8030.2C CKKU By (:..== - '- ~ <br />0611993 WAYNE IRELAND <br />Your polley consists of this page, any endorsemenla (949) 85~-B573 <br />and the polley form. PLEASE KEEP THESE TOGETHER. <br /> <br />Agent <br /> <br />(o112172b) <br />