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Insurance - Kaplan - 2013-01-28 RECEIVED SUMMARY OF INSURANCE JAN292013 THE • bu IN IYttm JwVfIARY DISTRICT HARTFORD FOR: FRANCENE KAPLAN DBA KAPLAN CONSULTING Prepared: 01-28-2013 PO BOX 10263 COSTA MESA CA 92627 Phone: FAX: BY: HOME OFFICE BIN INSURANCE HOLDINGS LLC/PHS 505500 PO BOX 33015 SAN ANTONIO TX 78265 Phone: (866)467-8730 FAX: (877)905-0457 ACCOUNT POLICY RECAP Polic Number Eff Date Ex• Date Premium . Spectrum 46 SBM BP1544 02082013 02082014 $425.00 Sentinel Ins Co LTD POLICY DETAIL Policy . Spectrum Property Coverages - Form Limit Deductible Location 001 Building 001 254 CECIL PL COSTA MESA, CA 92627 Comm'l Liability Coverages - Applicable to all policy locations Each Occurrence $1,000, 000 Damage to Premises Rented to You $1, 000, 000 Medical Expense (Any One Person) $10,000 Personal & Advertising Injury $1,000, 000 General Aggregate $2,000,000 Product/Complet Operation Aggregate $2, 000,000 • CYBERFLEX COVERAGE TERRORISM Class Description Detail Code Premium Basis Location 001 Public Speaker 10531 $3,075 This Summary and its attachments provides a high level overview of policy coverages and does not include all conditions, limitations or exclusions. Please refer to the actual policy forms for detailed coverages, limits and deductibles. \\,, • ° POLICY NUMBER.—46' SBM: BP1544 THIS'ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY ADDITIONAL:. INSURED PERSON ORGANIZATION ° TA MESA<SANITARY DISTRICT -� 62$ W; 19TH>STREET o COSTA MESA CA 92627. c+ 0 a •Fii.'-'.-;''':''-._'--:.,;:',,,;'--‘'.''.:;:-.‘:.-:`---,-:.-:-:t:-.:.::-i--.:.--.-'::..„.-':--:Form IH:.1:-.2 00;11 851 :-..-i.--.'1 NO. 001 Printed in=USA• Page ':0=01 1 - Process Date.;`. 11/2E/12 - Expiration'Date: 02/08. 1 INSURED 'COPY