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07/28/2009 16:31 7145278898 STATE FARM <br />PAGE 02 <br />Poifoy Number DECI-ARATIQNS PAGE COVERAGE SUMMARY <br />82-t~A 8133-8 - JUL 213 2009 <br />I~Vp <br />$00 QA D RIVER RD BAK€RSF E LD CA 9S31n1 6000 <br />A STOCK COMPANY W11'H HOME OFFICES iN BLOOMINGTONt ILLINOIS <br />Nan'ted Insured end MAiling Address <br />23-8321-F790 S <br />QEORQE, MARIE <br />D8A ACT ONE ACADEMY QF DANCE <br />1196 N TUSTIN AVt: <br />ORANGE C:A 9286?-8008 <br />BU911dESS POLICY -SPECIAL FORMS Cov A -Inflation Covers a Index; I~I/A . <br />Cov B - Consumer price~ndex~ ?,2f).0 <br />AUTQMATiC REiVEWAL _ If the POLICY PER OD is sho as t2 MbN~S, th s p0 I wlfi b0 ren wed automatical#y <br />s b ect to the ~psremmturns, ruled and farms # e~e~ for eac +~s edlng~ poffay per~nd. I~,ts all ~ i to we wit' <br />g~v~ you and tfle Ntortgagee~/t.lenhotder wniten notice In comp~~ance wltti the policy provis#onspor a r etirre <br />Palley Period: 12 Months The oilc ~ ~~~iy~aw. <br />p y period begins and ends at 1 z:01 am standard time at file <br />Effective Date: .JUN 23 z0o9 premises location, <br />Expiration Cate; JUN 23 2010 <br />Location of Covered Premises: <br />1186 N TUSTiN AVE <br />ORANGE GA 92887.6006 <br />coverages & Property <br />Section I <br />A Buildings <br />C GLOSS Of nCOme n ~f2 rMOp n}djy~ <br />Section 11 <br />t_ Buslne8s Liab11i1y <br />M Medical Payments <br />Products-Completed Oper$tlans <br />(PCO) Aggregate <br />Cameral gggregate (Other <br />Than PCO) <br />corms Options, and Endor: <br />Sp®cie~ Form 3 <br />Amendatory Endorsement <br />Debris Removal Endorsement <br />POi1Cy Er1dOrSem6nt <br />BusMess Policy Endorsement <br />Glass Deductible - S9ctfon f <br />Terrorism Insurance Cov Notice <br />Continued on Reverse Slde of Page <br />Limits of Insuranoe <br />Excluded <br />Actual0~oss <br />$ 2,000,000 <br />FP-6143 <br />FE-6205 <br />FE-6451 <br />FE-8508,2 <br />r=~-6as4 <br />FE-86313. i <br />FE-8999.1 <br />Prepared OTHER LIMIT'S AtdD 1;x <br />JUL p203g0p2008 <br />0~8993'2C CUTQ <br />slid the po cu y to~~nt~ptr~ASB Kt:EP THE E TOOE~TNER, <br />F3equested t3y Additlonel Insured <br />Deductibles - Seotsan r <br />$ 600 Basic <br />in case of loss under flits policy the deductible will be <br />a~ir-pou~nt of tfa olI asp. Otiierdeduotibies maeda~ td f re er to <br />no(Ic:v_ Y Pp Y - <br />Policy Premium <br />Discounts Applied: <br />Renewal Year <br />Years In Business <br />Cfatnt Reoord <br />CLU810N8 MAY APPLY- REi=ER <br />Count stgrred <br />B , <br />CHARLENE f~lA7AKEYAII <br />(714) 527-8897 <br />,oso. <br />POLICY <br />- ~ .fed fi' <br />nt <br />(o SIR 17P.bi <br />