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K. LEE GIFTS 4 -2009
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K. LEE GIFTS 4 -2009
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Last modified
5/31/2016 10:20:22 AM
Creation date
7/30/2009 9:39:53 AM
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Template:
Contracts
Company Name
K. LEE GIFTS
Contract #
N-2009-091
Agency
Public Works
Insurance Exp Date
7/20/2016
Destruction Year
0
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89 This Spectrum Policy consists of the Declarations, Coverage Forms, Common Policy Conditions and any <br />72 other Forms and Endorsements issued to be a part of the Policy. This insurance is provided by the stock <br />LQ insurance company of The Hartford Insurance Group shown below. <br />SBA <br />INSURER: HARTFORD CASUALTY INSURANCE COMPANY <br />HARTFORD PLAZA, HARTFORD, CT 06115 <br />COMPANY CODE: 3 <br />Policy Number: 72 SBA LQ7289 DX THE <br />HARTFORD <br />SPECTRUM POLICY DECLARATIONS ORIGINAL <br />N Named Insured and Mailing Address: KWANG LEE DBA K LEE GIFTS <br />rn <br />(No., Street, Town, State, Zip Code) <br />0 P.O. BOX 4384 <br />SANTA ANA CA 92702 <br />Policy Period: From 05/21/12 To 05/21/13 1 YEAR <br />a 12:01 a.m., Standard time at your mailing address shown above. Exception: 12 noon in New Hampshire. <br />co <br />Cq Name of Agent/Broker: BOWERMASTER & ASSC. INS AGNCY/PHS <br />of Code: 181918 <br />N <br />N Previous Policy Number: 72 SBA LQ7289 <br />0 <br />0 <br />H Named Insured is: INDIVIDUAL <br />m <br />Audit Period: NON-AUDITABLE <br />Type of Property Coverage: SPECIAL <br />Insurance Provided: In return for the payment of the premium and subject to all of the terms of this policy, we <br />agree with you to provide insurance as stated in this policy. <br />TOTAL ANNUAL PREMIUM IS: <br />Countersigned by <br />Form SS 00 02 12 06 <br />Process Date: 03/07/12 <br />$917 <br />Authorized Representative <br />INSURED COPY <br />03/07/12 <br />Date <br />Page 001 (CONTINUED ON NEXT PAGE) <br />Policy Expiration Date: 05/21/13 <br />
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