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MAY -03-2001 14:00 FROM:ERIC W GRUVERPH D 71454449% TO:714 245 0094 P.003,003 <br />DECLARATIONS B TRUCK INSURANCE EXCMAHCi. XO FARMERS iNSURAfICF EXCHANGE SPECIAL Q FIRE INSURANCE EXCHANGE <br />SENTINEL MEMBERS oI FARM RS INSURANCE GROUP QF COMPANIES <br />PACKAGE HOME OFFICE: 4680 WILSHme BLVD., LOS ANGELES, CALIFORNIA 90010 <br />SUPER <br />1. Named . ERIC GRUVER Pte. <br />Insured Count <br />Mailing :17772 SEVENTEENTH STREET Premauc Acct No. <br />Address . SUITE 106 97-15-P26 01504-40-07 <br />TUSTIN CA 92780 Agent Policy Number <br />The named insured is an individual unless otherwise slated:Type of <br />C1 Partnerslli O Corp. Business PSYCHOLOGY OFFICE <br />❑ <br />2Policy Period from 08i25i00 Joint Ventura Organization (Other than ParMership or Joint Venture) <br />. p� <br />to 08i25i0 t not ror to bore applied lor) <br />If this policy replaces ocher coveragwill co li that end al croon standard time on the same day this ptlley begins, this policy will Trot take effect until the other <br />coverage ends. This pdw l will premium for sueeea:two policy pettiods as follows: II we efectt to continue this Insurance, we wiu renew this poiley it <br />You WY the repaired renewal premium for each successive policy period subject to our premiuny rules and forms Nen In effect <br />3. Insured location same as mailing address unless otherwise stated: 17772 SEVENTEENTH STREET <br />SUITE 106 <br />A. Mortgage Holders TUSTIN CA 92760 <br />Loan # <br />Loan # <br />5. Premium E 500.00 13 -X' N Mortgage Holder Pays <br />6. Policy Ferns and Endorsements attached at inception: 25-2614 25-2880 25-2191 59043 -EDI <br />E6036 -EDI E4168 -EDI E4004 -EDI 04216 -EDI E3026-ED1 E41103-ED2 <br />7. WeemvMeinsmane►�.h,r�.t�..,..- ._ __ <br />SECTION 1 I B Business Personal Properlysbo applies <br />unrea• argr <br />22,000 0n inereateoQy an® <br />P��r <br />-- __.•""""•" ��"'°"'O <br />OPTIONAL COVERAG <br />Nat LOSS SUSTAINED <br />NONE <br />and <br />Swimming PoollFerroesand Walkways <br />Loss of <br />Building Glass(Bionket) <br />ADAM avow <br />Income <br />Outdoor Sign Covera a <br />EPLACHIIENT COS <br />ON$ sppusr <br />Vdluable Pa Pers (In addition to Sl 00 included.) <br />S <br />Yn w ww <br />0000 IhdF <br />❑ EarUWuake Damage <br />` <br />SECTION II <br />4Buainess (lability - Including Products and Completed <br />S <br />Operations- (Annual a00re0ate appWes for all occumerrces <br />IMITS LIABIL <br />dudn the 'od. <br />Annual ate <br />Liability <br />E -Fire Legal Liabtlily 575,000 Included unless other option Indicated by an 13 <br />1 0l 000 <br />and <br />Medicals <br />❑SIOU-000 $150.000 eachoccuneMNI ISub'ecttdtheannual in ate Sit <br />for Cev.D <br />F•Medical Payments 110 Ottrers (Subject to the annuaf agglegate <br />drown for COwerne D.) <br />5,000 each person <br />SECTION III <br />Crime <br />IV40havI VniliOttaf <br />Deputy City Atunrnev <br />