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CERTIFICATE OF INSURANCE <br />This certifies that ^ STATE FARM FIRE AND CASUALTY COMPANY, Bloomington, Illinois <br />® STATE FARM GENERAL INSURANCE COMPANY, Bloomington, fl6nois <br />^ STATE FARM FSRE AND CASUALTY COMPANY, Scarborough, Ontario <br />{] STATE FARM FLORIDA INSURANCE COMPANY, YVinter Haven, Florida <br />^ STATE FARM LLOYDS, Dallas, Texas <br />insures the following policyholder for the Coverages indicated below. <br />POliryholder ONG, A1,FREDO DBA CHESS PALACE <br />Address of policyholder 12E372 VALLEY VIF'w ST STE 5 <br />Location of operations GARDEN GROVE CA 92895-2518 <br />Description of operations CHESS <br />The polices listed below have been issued to the policyholder far the polity periods shown. The insurance described in these polices is <br />subjed to all the terms exclusions, and conditions of those policies. The limits of liability shown may have been reduced by anY paid claims. <br /> <br />POLICY NUMBER <br />TYPE OF INSURANCE POLICY PERIOD <br />Effective Data ; Date LIMITS Ol= LIABILITY <br />iat beginning of policy psdod) <br />92-D9-0508-1 G Comprehensive 6-i-06 CONTINUOUS BODILY INJURY AND <br /> Business Liability PRO?ERTY DAMAGE <br />This -nsurance indudes• ^ Products -Completed Operations <br /> ^ Contractual LiabiCrty <br /> ^ Underground Hazard Coverage Each Occurrence $ 1, 000, 000 <br /> Q Personal injury <br /> Q Advertising Injury General Aggregate $ 2, 000, 000 <br /> ^ Explosion Hazard Coverage <br /> ^ Cdlapse Hazard Coverage Products -Completed $ 2, 000, 000 <br /> ^ Operations Aggregate <br /> ^ <br /> <br />EXCESS LIABILITY POLICY PER10D <br />Flfective Data ~ Expilalton D~a BODILY INJURY AND PROP>=RTY DAMAGE <br />(Combined Single limit) <br /> ^ Umbrella Each OCCUrrenoe $ <br /> D Other Aggregate s <br /> Part 1 STATUTORY <br /> Part 2 BODILY INJURY <br />NOZrE Workers' Compensation <br /> and Employers Liabr~ity Each Accident $ <br /> Disease -Each Employee $ <br /> Disease -Policy Limit $ <br /> <br /> <br />Pi?LICY NUIl1$£R <br />TYPE OF INSURANCE POLICY PERIOD <br />Etfecfeve Dam ; ration p~ LIMITS OF LIABILITY <br />{at beginning of policy periody <br /> <br /> <br />THE CERTIFICATE OF IN SURANCE lS NOT A CONTRACT OF INSURANCE AND AiEtTH ER e~FiQUerivs•r v Nora uGC:ernn=i v <br />AMENDS, EXTENDS OR ALTERS TlfE COVERAC3E APPROVED BY ANY POLICY DESCRIBED <br />if any of thi <br />ifs exoir~ <br />blame and Address of Certificate Helder <br />ADDITIONAL INSURED: --rn <br />GITY OF SANTA ANA;ZTS OFFICERS, EMPLOYEES, AGENTS,VOLUNTEERS <br />AND REPRESENTATIVES <br />2D CIVIC CENTER PLAZA SANTA ANA, CA. 92701 Signature ~ <br />': . SOHN Ff]b <br />STATE FARM INSURANCE CO' S ~ .Tits <br />JOHN FUT.WILER INSURANCE AGENCY, INC. .~ <br />f714) 895-7882 ~. AgeRYs <br />~i~` <br />G •' v <br />AFO Code <br />policies are ra led before <br />to #e Farm o mail a written <br />rtifi der 30 days before <br />If er, we fail to mail such notice, <br />or liability will be imposed on State <br />its er representatives. <br />Stamp <br />558-9fl4 p.4 11-12-2002 Arinled ei U.SA <br />