Laserfiche WebLink
Jul 10 12 01 :29p GARY WENBERG AGENT STAT 408 *374 *2258 p.2 <br />P'ofjcy Number DECLARATIONS PAGE AMENDED JUN 20 20t2 <br />97- BZ- C3i429 -7 <br />STATE FARM GENERAL INSURANCE: COMPANY ••^�� <br />900 OLD RIVER RD., BAKERS FIELD CA 9331 1 -6000 <br />A STOCK COMPANY UVITH HOME OFFICES IN BLOOMINGTON, ILLINOIS <br />Named Insured and Melling Address <br />02- 6912 -F155 R <br />CENTER FOR HEARINQ HEALTH INC <br />2945 SELL RD STE 122 <br />AUBURN CA 95603 -2540 <br />Cov A - Inflation Coverage Index_ NfA <br />BUSINESS POLICY - SPECIAL FORM 3 Cov B - Consumer Price Index: 226.9 <br />AUTOMATIC RENEWAL - If the POLICY PERIOD iS shown as i2 RAONTHS, this olicY will be renewed automaticaliY <br />subject to the premiums; rules and forms in effect for each succeedinct pollc perio+ii If this policy is terminated, we will <br />give you and itte tvtortgagee /Lienholder written notice in compliancewi<h the ypglicy provisions or as required by law. <br />Policy Period: 12 Months The policy period begins and ends at 12:01 am standard time at the <br />Effective Date: DEC 18 2011 premises location. <br />Expiration Date: DEC 18 2012 <br />Location of Covered Premises: <br />7005 LUTHER DR UNIT 3 <br />SACRAMENTO CA 95823 -1828 <br />Coverages 8c Property <br />SeC110R 1 <br />A Buildings <br />B Business Personal Property <br />C Loss of Income - 12 Months <br />Section Il <br />L Business Liability <br />M Medical Payments <br />Products - Completed Operations <br />(PCO) Aggregate <br />Qeneral Agggregate (Other <br />Than PCO) <br />Limits of Insurance <br />Excluded <br />5 400 <br />Actual !'_oss <br />2,oao,aao <br />5,000 <br />4,000,000 <br />$ 4,000,000 <br />Forms Options, -and Endorsements <br />Special Form 3 <br />FQ -6143 <br />`Section II Additional Insured <br />FE -6609 <br />Amendatory Endorsement <br />FE -6205 <br />Tree Debris Removal <br />FE -6451 <br />Policy Endorsement <br />FE- 6506.2 <br />Policy Endorsement - Business <br />FE -6464 <br />Glass Deductible - Section I <br />FE- 6538.1 <br />' New Form Attached <br />Your ppolicy is amended JUN 20 2012 <br />ADDITEONAL INSURED ADDED <br />PREMIUM ADJUSTMENT <br />ENDORSEMENT FE -6609 ADDED <br />ancy: mercan <br />Deductibles - Section 1 <br />$ 500 Basic <br />In case of lass under this policy the deductible will be <br />app[Eed to each occurrence and will be deducted from the <br />amount of the loss. Other deductibles may apply -refer to <br />DOIICV_ <br />Endorsement Premium <br />Increase � 19.84 <br />Discounts Applied: <br />Renewal Year <br />Years in Business <br />Sprinkler <br />Claim Record <br />Continued on Reverse Side of Page <br />Prepared OTHER LIMITS AND EXCLUSIONS MAY <br />JUN 28 2012 ��� <br />FP- 8030.2C AX7Z gY <br />PPLY -REFER TD YOUR PDLICY <br />:.,.,o� `-fir 1n ��n <br />06/1993 GARY WEN33 <br />Your policy consists of this page, any endorsements (409) 374 -3D80 <br />and the policy Form_ PLEASE KEEP THESE TOGETHER. <br />(0 7 i2172b <br />