BARRERA, DEBBIE L.-2010 - Laserfiche WebLink

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.:an '15 10 OZ-:25p CERTIFICATE OF INSURANCE n. „,... This certifies that ® STATE FARM FIRE AND CASUALTY COMPANY, Bloomington,, Illinois ❑ STATE FARM GENERAL INSURANCE COMPANY, Bloom'ngton, lihnois ,,,,... «L ❑ STATE FARM FIRE AND CASUALTY COMPANY, Scarborough, Ontaric ❑ STATE FARM FLORIDA INSJRANCE COMPANY, Winter Haven, Florida ❑ STATE FARM LLOYDS, Da!las, Texas insures the following policyholder for the coverages indicated below Policyholder Aadara Address of policyholder Location of operations Description of operations 2215 N MAIN ST, SANTA ANA, Cr? 92 7 C 6 2216 N; MAIN ST, SANTA ANA, CA 927C-6 YOGA ST-M-10 p.2 The policies listed below have been issued to the policyholder for the policy periods shown. The insurance described in these policies is subiect :o all the terms, exclusions, and condit'ons of those policies. The limits of liability shown may have been reduced by any paid claims- THE CERTIFICATE OF INSURANCE IS NOT A CONTRACT OF INSURANCE AND NEITHER AFFIRMATIVELY NOR NEGATIVELY AMENDS, EXTENDS OR ALTERS THE COVERAGE APPROVED BY ANY POLICY DESCRIBED HEREIN. Name and Address of Certificate Holder City of Santa Ana / City Attorney Iten Reviewed Approved: Date; 55 -994 a 5 Rev 11 -C8 -2004 Printed n L.S.A. If any of the described policies are canceled before their expiration date, State Farm will try to mail a written notice to the certificate holder 30 days before cancellation. If however, we fail to mail such notice, no obligation or liability will be imposed on State Farm or its agents or representatives. Signature of Authorized Representative O1- "_5 -1G T Ile Date ERIC LENAE AN Agent Name Telephone Number 562.553.2488 Agent's Code Stamp Agent Code 75 -3190 AFO Code F415 POLICY PERIOD LIMITS OF LIABILITY POLICY NUMBER TYPE OF INSURANCE Effective Date Expiration Date (at beginning of policy period) Comprehensive BODILY INJURY AND 92- BR- U 751-0 G Business Liability C9 -10-C _ 9 -i0 -i0 PROPERTY DAMAGE ----------------------- - - - - -- This insurance includes: --------------------------------------------------------- - -- - 2g Products - Completed Operations ® Contractual Liability Each Occurrence $ 1, OvO, Goo ® Personal Injury ® Advertising Injjry General Aggregate S 2, 0 0, 300 ❑ Products - Completed $ 1, 300, 00C ❑ Ouerations Aggregate EXCESS LILABILITY POLICY PERIOD Effective Date ; Expiration Date BODILY INJURY AND PROPERTY DAMAGE (Combined Single Limit) ❑ Umbrella i Each Occurrence $ ❑ Other Aggregate S POLICY PERIOD Part I - Workers Compensation - Statutory Effective Date Expiration Date Workers' Compensation Part !I - Employers Liability and Employers Liability Each Accident $ Disease - Each Employee $ Disease - Policy Limit $ POLICY PERIOD LIMITS OF LIABILITY POLICY NUMBER TYPE OF INSURANCE Effective Date ; Expiration Date (at beginning of policy period) THE CERTIFICATE OF INSURANCE IS NOT A CONTRACT OF INSURANCE AND NEITHER AFFIRMATIVELY NOR NEGATIVELY AMENDS, EXTENDS OR ALTERS THE COVERAGE APPROVED BY ANY POLICY DESCRIBED HEREIN. Name and Address of Certificate Holder City of Santa Ana / City Attorney Iten Reviewed Approved: Date; 55 -994 a 5 Rev 11 -C8 -2004 Printed n L.S.A. If any of the described policies are canceled before their expiration date, State Farm will try to mail a written notice to the certificate holder 30 days before cancellation. If however, we fail to mail such notice, no obligation or liability will be imposed on State Farm or its agents or representatives. Signature of Authorized Representative O1- "_5 -1G T Ile Date ERIC LENAE AN Agent Name Telephone Number 562.553.2488 Agent's Code Stamp Agent Code 75 -3190 AFO Code F415