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UNITED SERVICES AUTOMOBILE ASSOCIATION <br />(A RECIPROCAL INTERINSURANCE EXCHANGE) <br />us�1' 9890 Fredericksburg Road - San Antonio, Texas 78288 <br />CALIFORNIA AUTO POLICY <br />AMENDED DECLARATIONS <br />(ATTACH TO PREVIOUS POLICY) <br />smed Insured and Address <br />MICHAEL EUGENE RANESES <br />LTC USA RET <br />2409 MIRA MONTE CT <br />TUSTIN CA 92782-9000 <br />:H IYEARI TRADE NAME I MODEL I BODY TYPE <br />a <br />Stete ven POLICY NUMBER <br />�`�1FdE 00186 66 18U 7101 0 <br />This policy ,prove es those. coverages where a premium_ Is shown Oelow. Tfie limits shown <br />mny un raaucaa vy PUnaymium Plvveasv s <br />vehloles for which a reIs lista unless <br />ano may nor oe cvmolnea regaraless oT Ina <br />specifloaliv authorized elsewhere In this Dlay. <br />numner or <br />COVERAGES LIMITS OF LIABILITY <br />VEK <br />VEH <br />V: <br />CACV" MEANS ACTUAL CASH VALUE) <br />D=DED PREMIUM <br />D=PED PREMIUM <br />[0v=t:DtEED PREMIUM <br />D=DED PREMIUM <br />MQUN a <br />MDUN $ <br />MDUN a <br />MDUN a <br />:HICLE TOTAL PREMIUM <br />392.72 <br />1486.04 <br />. -----------------------------ADJUSTMENT <br />REASO <br />--------------------------__---- <br />1RT A - BI LIAR LIMIT CHANGED VEH <br />08 09 PART <br />C - <br />JM BI LIMIT <br />CHANGEC <br />REVISED 6 MONTH PREMIU <br />...$ 1878,76 <br />6 <br />NTH DECREASE <br />... $ <br />183.10 <br />PREMIUM DUE AT INCEPTION. THIS I <br />NOT A BILL, <br />STATEMENT <br />TO <br />FOLLOW. <br />iE FOLLOWING COVERAGE(S) DEFINED IN <br />THIS POLICY <br />ARE <br />NOT PROVIDED <br />FOR; <br />VEH 08 - EXTENDED BENEFITS COVER <br />GE, RENTAL REIMBURSEMENT <br />VEH 09 - EXTENDED BENEFITS COVER <br />GE, RENTAL REIMBURSEMENT <br />n WITNESS WHEREUF, the Subscril <br />heir Attomey-in-Fact on this date <br />2/2 <br />Laura HIS <br />President USAA Reciprocal <br />)00 U 07-11 1,0468ZP.000717.ODDD.0002.O.ODOOOO.7 <br />1461-07-11 <br />