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<br />CERTIFICATE OF INSURANCE <br /> <br />o STATE FARM FIRE AND CASUALTY COMPANY. Bloomington. Illinois <br />o STATE FARM GENERAL INSURANCE COMPANY, Bloomington. Illinois <br />o STATE FARM FIRE AND. CASUALTY COMPANY, Scarborough. Ontario <br />o STATE FARM FLORIDA INSURANCE COMPANY, Winter Haven. Florida <br />I.'U".", . 0 STATE FARM LLOYOS. Dallas. Texas <br />insures the following policyholder for the coverages indicated below: <br />Name of policyholder FRIESS COMPANY BOILDERS, Il/C. <br /> <br />Address of policyholder 31658 RANCHO VlEJO ROllO, SUITE B, SlIN JUlUf elIPISTRANO, ell 92675 <br />Location of operations " <br />Description of operations <br />The policies listed below have been issued to the policyholder for the policy periods shown. The insurance desa-ibed in these policies Is <br />subject to all the terms exclusions, and conditions of those policies. The limits of liability shown may have been reduc;ed by any paid <br />claims. <br /> <br />THE CERTIFICATE OF INSURANCE IS NOT A CONTRACT OF INSURANCE AND NEITHER AFFIRMAl1YEL Y NOR MEGATlVEL Y <br />AMENDS, EXTENDS OR ALTERS THE COVERAGE APPROVED BY ANY POUCY DESCRIBED HEREIN. <br />If any of the desa-ibed policies are canceled before <br />its expiration date. State Farm will try to mall a <br />written notice to the certificate holder days <br />before. cancellation. If however. we fail to mail such <br />notice, . no obligation or liability will be imposed on <br />State F or lIS agen esentatives. <br /> <br /> <br />, ot....., .rr"l' IIOVU,," .L~. <,101 1'n.A P"'~'iotJ..:I"""'U <br /> <br />NUI>~~ <br /> <br />I: Sl4a,..,.r/,.,.U <br /> <br />A <br /> <br />POUCY NUMBER <br /> <br />POUCY PERIOD <br />TYPE OF INSURANCE Effective Date i DaIII <br />Comprehensive . <br />.~~~~~ "~L~~ll!o/... ......." ... ........."...." L. ..". ........... <br />o Products. Completed Operations <br />o Contraatual Liability <br />o Unclerground Hazard Coverage <br />o Personal Injury <br />o Advertlaing Injury <br />o Explosion Hazard Coverage <br />o Collapsa Hazard Coveraga <br />o <br />o <br /> <br />"iiiIs'iiiSuri.iici, friCiudes:" <br /> <br />. <br /> <br />EXCESS LIABILITY <br />o Umbrella <br />o Other <br /> <br />POUCY PERIOD <br />Effective DatIl : Emiralion Dale <br /> <br />Worlcen;' Compensation <br />and Em players Liability <br /> <br /> POLICY PERIOD <br />POLICY NUMBER TYPE OF INSURANCE Effec;tive Date ! . Dale <br />C99 7l85-C25-15A AUTO 09/25/02 , 03/25/03 <br />: <br />P43 8007-D14-1Sc IIUTO 10/14/02 . 04/14/03 <br />. <br />. <br />012 8435-029-1511 AUTO 10/29/02 : 04/29/03 <br />, <br /> . <br /> <br />Name and Address of Certificate Holder <br /> <br />THE COMMUNITY REDVELOPNENT <br />lIGENCt OF THE CITY OF SlINTA ANA <br />ANO THE CITY OF SIIl/TA ANA <br />ITS OFFE~ICERS ANO EMPLOYEES <br />AS ADDITIONAL INSUREO <br />20 CIVIC CENTER PLIIZA-H26 <br />SANTA ANA ClI 92706 <br /> <br />.",-'\,,'\'" <br />tOt';>... . <br />fa . . <br /> <br />55a.994 a.3 (W.1i99 Printed in U.SA. <br /> <br />:lORe\<. <br />\sf' S. S f'\\O(\\e': <br />\... \CI\~ 'J <br />p..sS\s\a.\\ y <br /> <br />cS ~ <br /> <br />1ilJ005 <br /> <br />LIMITS OF UABlLITY <br />(at beginning of policy period) . <br />BODILY INJURY AND <br />PROPERTY DAMAGE <br /> <br />ElICh Occurrence $ <br /> <br />General Aggregate S <br /> <br />Products - Cem pleted S <br />Operatlons Aggregate <br /> <br />BODILY INJURY AND PROPERTY DAMAGE <br />(Combined Single Limit) <br />Each Occurrence S <br />Aggregate $ <br />Part 1 STATUTORY <br />Part 2 BODILY INJURY <br /> <br />Each Accident S <br />Disease Each Employee $ <br />Disease. Policy Limit $ <br /> <br />LIMITS OF UABlUTY <br />(at beginning tJI policy period) <br />1,000,000 <br /> <br />1,000,000 <br /> <br />1,000,000 <br /> <br />Date <br /> <br />AFO Code <br /> <br />1'416 <br /> <br />JOHN~ <br />MISSION VIEJO <br /> <br />8323 <br />f41ti <br />