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STATE NATIONAL INSURANCE COMPANY, INC. <br />(a stock insurance company) <br />1900 L Don Dodson Dr. <br />Bedford, Texas 76021 <br />(800)877.4567 <br />Administered by: <br />Next Insurance, Inc. <br />PO Box 60787 <br />Palo Alto, CA 94306 <br />(855) 222-5919 <br />COMMON POLICY DECLARATIONS <br />POLICY NUMBER:NXT9W7H7fH-00-GL <br />Named Insured and Mailing Address:ivan Marquez <br />Clttyy of Santa Ana risk management Division <br />1570 E Edinger Ave Ste 12 <br />Santa Ana, CA 92705 <br />Policy Period: From:10/07/2022 To: 10/0712023 <br />at 12:01 AM standard time at the mailing address shown above <br />DESCRIPTION OF BUSINESSDJ <br />IN RETURN FOR THE PAYMENT OF PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE <br />AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. <br />OF THE <br />TO <br />BOILER AND MACHINERY COVERAGE PART <br />COMMERCIAL AUTOMOBILE COVERAGE PART <br />COMMERCIAL CRIME COVERAGE PART <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />COMMERCIAL INLAND MARINE COVERAGE PART <br />COMMERCIAL PROPERTY COVERAGE PART <br />EMPLOYMENT -RELATED PRACTICES LIABILITY COVERAGE PART <br />FARM COVERAGE PART <br />LIQUOR LIABILITY COVERAGE PART <br />POLLUTION LIABILITY COVERAGE PART <br />PROFESSIONAL LIABILITY COVERAGE PART <br />COMMERCIAL UMBRELLA/ EXCESS COVERAGE PART <br />$ <br />$ <br />$200.00 <br />$ <br />TOTAL: $200.00 <br />Premium shown Is payable: $ at inception. <br />PREMIUM <br />11n t-wvV orvi ut- vu I iuuuuaa uupynyntau matenal or Insurance Jervices unice, IOC., P <br />with its permission. <br />�¢�•a^•,,t`�� REVIEWED&MPROVEDft <br />�i, � a T,gxwm <br />�cy d�cols <br />RBk Management Analyst <br />