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PAGE 6 <br />UNITED SERVICES AUTOMOBILE ASSOCIATION ADDL INFO ON N XXT EWAL OP�AGE MAfL MCH-M-1 <br />1 i; Q (A RR"- iM'ERNSURAtVCF EXaONCF) <br />tag <br />VA <br />08 09 uh <br />PCI_1C!' N.. BMUSAA <br />9800 Fredericksburg Road - San Antonio, Texas 78288 <br />93 93 X-& <br />00186 66 18U 7101 0 <br />CALIFORNIA AUTO POLICY <br />PC UCYPERIOD. (1201 A.M. standard time) <br />RENEWAL DECLARATIONS <br />EFFECTIVE MAR 20 2021 TO SEP 20 2021 <br />OPERATORS <br />01 MICHAEL EUGENE RANESES <br />ATTACH TO PREVIOUS POLICY) <br />Named Insured and Address <br />03 RUTH L RANESES <br />MICHAEL EUGENE RANESES <br />LTC USA RET <br />2409 MIRA MONTE CT <br />TUSTIN CA 92782-9000 <br />Descrip <br />ion o e IC es <br />VEH USE' <br />'� At- <br />VEH <br />YEAq <br />TRADE NAME <br />Mcce_ <br />60DYTYPE <br />DENTIFCATUNNUMSER <br />SYMWE <br />08 <br />06 <br />TOYOTA <br />HILNDR <br />4D <br />10000 <br />JTEDD21A760154136 <br />P <br />09 <br />17 <br />TOYOTA <br />HIGHLANDER <br />4D <br />12000 <br />5TDKZRFH9HS524448 <br />B <br />The Vehicle(s) described herein is principaliy garaged at the above address unless otherwise stated. r TA -'W-ukjSg - - P41 <br />VEH 08 TUSTIN CA 92782-9000 <br />VEH 09 TUSTIN CA 92782-9000 <br />Is go is rove esthose-cover ages where a premium Is shown below. a limits shown <br />by and be the <br />may e rMced policy provisions may not combined regardless of number of <br />vehicles for which a premium is listed unless specifically authorized els6where in this ROlicv. <br />VEH <br />VEH <br />VEH <br />VEH <br />COVERAGES LIMITS OF LIABILITY <br />08 6—MONTH <br />09 6—MONTH <br />('ACV' MEANS ACTUAL CASH VALUE) <br />D-DFD PREMIUM <br />D-DFD PREMIUM <br />D=DED PREMIUM <br />D-flED PREMIUM <br />MOUNT <br />NMOJNT <br />IWOUNITI $ <br />PART A — LIABILITY <br />BODILY INJURY EA PER $ 100,00 <br />EA ACC $ 300,0092.16 159.16 <br />PROPERTY DAMAGE EA ACC $ 100,000 102.81 160.24 <br />PART B — MEDICAL PAYMENTS <br />EA PER $ 2,000 6.31 9.91 <br />PART C — UNINSURED MOTORISTS <br />BODILY INJURY EA PER $ 100,00 <br />EA ACC $ 300,000 34.81 48.4 <br />PART D — PHYSICAL DAMAGE COVERAGE <br />COMPREHENSIVE LOSS ACV LESS D 50 27.43D 50 67.9 <br />COLLISION LOSS ACV LESS D 50 142.59D 50 483.64 <br />TOWING AND LABOR 6.94 6.94 <br />TOTAL PREMIUM SEE FOLLOWING PAGE(S) <br />DDITIONAL INTEREST — EMPLOYER <br />THE CITY OF SANTA ANA, OFFICER, 5 TA , CA <br />DDITIONAL INTEREST — EMPLOYER <br />TEE CITY COSTA MESA OFFICERS,, COSTA MESA, CA <br />DDITIONAL INTEREST — EMPLOYER <br />THE ROSSMOOR COMMUNITY SERVICE, ROSSMOOR, CA <br />ENDORSEMENTS: ADDED 03-20-21 — NONE <br />MAIN IN EFFECT(REFER TO PREVIOUS POLICY')— A073(05) RSGPCW(01) <br />EXCLUSION OF NAMED DRIVER 5100CA(02) <br />INFORMATION FORMS: NIPFCA(05) 320CA(05) CADS(05) 40CA(01) 13580(03) <br />999CA 19 <br />€` 8 RMF51 00 <br />91 RMM59 <br />00 <br />- <br />In VVI I NLJS WHLHEut-,the bubscnoers at UNI I EU bEKVlUtZb AU I UMUbILt A,6(x;iAT SUN have causedtt <br />their Attorney -in -Fact on this date FEBRUARY 12, 2021 +� <br />Laura <br />President, USAA Re{l;;:� <br />5000 U 07-11 <br />53461-07-11 <br />presents to be signed by <br />?� REVIEWED & APPROVED BY.- <br />\�a <br />Risk Management Analyst <br />