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rj Nationwide' Your Policy Declarations Nationwide Auto Policy Pohcj Period Jan 31 2021 - Jan Sl 2022 Po.ic9 ` umber 7204J 241301 Insured Vehicle(s) and Schedule of Coverages (continued) 2002 Toyo Sionli le VIN 4T3ZFtiC82U506983 Coverages Limits of Liability Premium Boon Injury Liability $ 250.000 Each Person $ 500 000 Each Occurrence $ 299 56 Property Damage Liability $ 100 000 Each Occurrence $ 235 50 Medical Payments $ 5.000 Each Person $ 4880 Uninsured Motorists Bodily Injury $ 250000 Each Person N $ 500000 Each Occurrence $ 11304 0 See Endorsement N Damage To Your Auto Actual Cash Value Less $ 500 $ 42,40 a rn CD Other Than Collision lComprehensivej o With Full Safety Glass See Endorsement Col'ision Actual Cash `.value Less $ 500 $ 252 60 0 Waiver Of Collision Deductible $ 626 Custom EGuiPrnCnt $ 3000 Included Total for this Vehicle $ 998 26 2015 Benz E350 VIN WDDHFSKB5EE128136 Coverages M. Fod,l% Liability Prcpert; Damage Liability l,icdical Payments Uninsured Motorists Bodily Injury Damage To i our Auto Limits of Liability $ 25C 000 Ea:.h Person $ 500 000 Each Occurrence $ 100000 Each Occurrence $. 5.000 Each Person $ 250 COO Each Person $ 500000 Each Occurrence See Endorsement Actual Cash Value Less $ Soo Other Than Collision i Comprehersiiel Witn OEM See Endorsement 'Ait, Fuh Safety Glass See Endorsement Collision Actual Cash Value Less $ 500 e4'ith OEM Var.er Of Cethson Deductible Custom Equipment Festal Pc:mbursement Say Endorsement $ 3 000 I 5Q Per Day $ 900 Per Accident See Endorsement Total for this Vehicle Premium $ 245 06 $ 133 96 $ 22 58 $ 9246 $ 10510 $ %24 30 $ 6 25 included $ 2c $ 1,358 48 Risk MmagemmtDiv abri ls' REVI cj S APPROVED BY: n ( p ® Risk Management Malys[