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Policy Number: BA040000048078 <br />Effective Date: 08/2812018 <br />ITEMT"REE, SCHEDULE OFC6VERE0AUTOS YOU OWN <br />Covered <br />Auto No, Description Body Type VIN <br />Garaging <br />Non -Factory Loss Payee <br />Egui ment Limit <br />City <br />Business <br />e <br />1 2008 FORD ECONOLINE E150 Full Size Van IFTNE141-38DBI12 0 <br />Garden Grove <br />CA <br />92844 <br />2 2011 FORD ECONOUNE E250 Full Size Van IFTNE2EWXBDA23510 <br />Garden Grove <br />CIA <br />928444 <br />. .... ...... <br />$97 <br />2 <br />$1,000 <br />$52 <br />-- — -------- <br />Covered Radius (in Miles) <br />Auto No. <br />Vehicle Use <br />Business Use *Stated Amount <br />Non -Factory Loss Payee <br />Egui ment Limit <br />I P to 100 Miles <br />Business <br />Service <br />$0 <br />2 uptoii Mites <br />Business <br />Service <br />$0 <br />$1,000 <br />$48 <br />2 $348 <br />. .... ...... <br />$97 <br />2 <br />$1,000 <br />$52 <br />"Stated Amount coverage lists your vehicle's actual. cash value, including the actual cas h value of any Nan-FaStory Equipment permanently <br />attached to the vehicle that you disclose to LIS, and is the most we will pay for a loss. Non -Factory Eqoiprosnt coverage is subject to a Sub -limit <br />shown on the Declarations. Be sure to check the Stated Amount and Non -Factory Equipment sub -limit at every renewal in order to receive the <br />best value from your Mercury Bus in ass Auto policy. <br />COVERAGES, PREMIUMS, LIMITS, AND DEDUCTIBLES <br />(Absence of a deductible or limit entry in any column below means that the limit or deductible entry in the corresponding ITEM <br />TWO column applies instead,) <br />Cover ed Liability Premium <br />Auto No. <br />Auto Medical <br />Payments <br />Premium <br />UM Bodily Injury <br />Premium <br />UM Property <br />Damage <br />Premium <br />Comprehensive <br />Deductible <br />Premium <br />1 $848 <br />$07 <br />Occurrence <br />$1,000 <br />$48 <br />2 $348 <br />. .... ...... <br />$97 <br />2 <br />$1,000 <br />$52 <br />-- — -------- <br />. ........ . ....... <br />.... <br />Specified Causes Of Loss Collision <br />A <br />Auto Lean/Lease Gap Premum <br />i <br />Roadside Assistance-- <br />Covered mm <br />CDW <br />Limit Per <br />Auto Na, Deductible Premium Deductible Premium <br />Premium <br />Premium <br />$1,104�00 <br />Occurrence <br />1 <br />. .... ...... <br />2 <br />$1,000 <br />$120 <br />-- — -------- <br />Covered __ <br />Rental Reimbursement <br />Maximum Payment <br />Auto No. Each Covered AutoPremium <br />A <br />Auto Lean/Lease Gap Premum <br />i <br />Audio, Visual, & Data Equipment <br />Total Vehicle <br />Premium <br />Limit <br />Premium <br />t. <br />$1,104�00 <br />. .... ...... <br />-- — -------- <br />MCADS030817-CA Page 3 of 4 <br />