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<br />.~-", ,.. <br /> <br />10/17/202& 11:59 <br /> <br />7145278898 <br /> <br />STATE FARM <br /> <br />PAGE 82 <br /> <br />CERTIFICATE OF INSURANCE <br />o STATE fARM FIRE AND CASUALTY COMPANY, Bloominglon, IlIinoi. <br />181 STATE FARM GENERAL INSURANCE COMPANY, Bloomington, Illinois <br />o STATE FARM FIRE AND CASUALTY COMP~NY, Aurora, 001";0 <br />o STATE FARM FLORIDA INSURANCE COMPANY. WInter H........ Fiori.. <br />o STATE FARM LLOYDS. DelloI.. T.... <br />;"s_ tfte foJ1owing pnlicyholder fOf ,he co__ Indicated below. <br />p~ Marie Georq~ DBA: AC~ Or.. Ac.demy of 03~C~ <br /> <br />~ <br /> <br />This certifies that <br /> <br />_"'policyholder <br />L_"'aperetOno <br />~.of operation. <br /> <br />lla6 Tustin Ave, OranqQ, C~ 92867 <br />1166 Tustin Av~. Orang., CA g2867 <br /> <br />O.,nce School <br /> <br />- _ - below h8v8 been _ 10 tfte polioyhoIder b' tile policy poriode _. Tho ins""""", deoc:roOed in theoe ~ io oubjecI <br />to oIlhe _ e><cluslo<1s ""d condttions of _ pofocie. The limits of_lily.hOwn mey haw been Ieduc:ed by any pa;d clolms. <br /> <br /> POLICY PERIOD ~S OF l.IA8/LlTY <br />I'OIJCY NUM8I!R TYPE OF INSURANCE Effec:_ Date : ~ Dolo (.t beginning or policy period) <br />92-GA-8133-8 G Compt'ehenslve 6/23/06 : 6/23/07 BODILY INJURY AND <br /> Business Liability ; PROPERTY DAMAGE <br />"u. .. m. ........... ........... ..L......... h..... h h -----...._--... <br />.iiiiS~iftCiUde.: 181 Products. Completed Operations <br /> 181 Contractual Uobility EocI1 Occurrence $1.000,000 <br /> o Personal Injury <br /> o Advertising Injury General Aggregate $ 2, OCO. COD <br /> 0 <br /> 0 ProdUCU - Compl_ $ 2. oo~, 000 <br /> 0 O.....otion. <br /> POLICY PERIOD BODILY INJURY AND PROPERTY DAMAGE <br /> EXCESS LIABILITY Elfecllve DMe : &pioation Dole (Combined Single Um;t) <br /> o Umb"'U" : Each Occurrence S <br /> DOt..... "'reoak- S <br /> POUCY PERIOD Part 1- Wortcers Compensation - Sl8tutory <br /> Effreetlve o.te : 1!!' . . lJiaa 0-. <br /> Workers' CCHnpensIItjon Part 11- EmpIo~ L_y <br /> and Employers liability Each Aocldent S <br /> Dj_.-E_~ $ <br /> Dioaae - Policy Umlt S <br /> POLICY Pl!RlOO LIMITS OF LlA8llITY <br />POLICY lIl*9ell TYPE OF INSURANCE EfFectiw Dale : Dale (1l4 beginning or polity period) <br /> : <br /> : <br /> <br />THE CERllFlC,tUl: OF INSURANCE IS NOT A CONTRACT OF INSURANCE AND NEITHER AFARMATlVELY NOR NEGATIVELY <br />AMENDs, EXTaIDS OR AL TE"S THE COVERAGE APPROVED 8Y ~NY POLICY DESCRIBED HEREIN. <br /> <br />Name and Addr... of Certifitale Holder <br />CI7Y OF SANTA ANA <br />THEIR O~FrCERS AND EHPLOY~ES <br />9S8 W SANTA ANA BlND STE 200 <br />SaD.~. ADa, CA '2701 <br /> <br />~ any Of tna ~ poIic:ie$ are canceled before <br />lIleIrexpiration dale. Slate Fa"" willtry to ITlIII a <br />written notice to tile _ holder deys before <br />canc8Uation. If however, we (iitil to m811 such nottce, <br />no ObIigalion Of r_iIy IWI be imposed on State Fann <br />or' agents or reprece ivee. <br /> <br /> <br />lOIl7/0; <br />Oat. <br /> <br />S5~4a.e Pr.ntN;" U,S,A. ~C\I 05-0'-2001 <br /> <br />. '-f;.~3;t~7}.e- .rLz_ <br />h . . <br />" '-.i..'.'.}l"o:;Y <br /> <br />SIg"atllre Of AutnoriHd RepA!Hnt <br />"-g-cnt <br />Tit.. <br />Ch~r1ene Hatak~y^m~ <br />AgentNMte <br />Tefephone NUfTl~r 714 527 8S91 <br />I Agont'. Code stomp <br />A;ent Code 75 <br />AFOCOde aell <br /> <br />Ck. <br /> <br />