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American Family Connect Property and <br /> Casualty Insurance Company <br /> 3500 Packerland Drive <br /> De Pere,WI 54 1 1 5-9070 <br /> CALIFORNIA <br /> POLICY NUMBER: AI03233853 <br /> POLICY PERIOD: 01/15/2024-07/15/2024 <br /> 12:01 AM Standard Time <br /> LAPSE IN COVERAGE: NONE <br /> Matthew Wallman <br /> Rachael Wallman FOR CLAIMS SERVICE CALL: <br /> 2848 N PRESTON ST 1-888-404-5365 <br /> FOR CLIENT SERVICE CALL: <br /> ORANGE, CA 92867-2257 1-888-404-5365 <br /> COVERAGE/LIMIT 4 2018 TSLA 5 2021 TSLA <br /> MODEL 3 MODEL Y STA <br /> BODILY INJURY LIABILITY $242.00 $207.00 <br /> $250,000 EACH PERSON <br /> $500,000 EACH ACCIDENT <br /> rN <br /> PROPERTY DAMAGE LIABILITY INCL INCL <br /> $100,000 EACH ACCIDENT <br /> MEDICAL EXPENSE-EXCESS COVERAGE INCL INCL <br /> $5,000 EACH PERSON <br /> UNINSURED MOTORIST BODILY INJURY $108.00 $91.00 <br /> $250,000 EACH PERSON <br /> $500,000 EACH ACCIDENT <br /> UNINSURED MOTORIST PROPERTY DAMAGE $1.00 $1.00 <br /> CAR 4-WAIVER OF COLLISION DEDUCTIBLE <br /> CAR 5-WAIVER OF COLLISION DEDUCTIBLE <br /> COLLISION $208.00 $197.00 <br /> DEDUCTIBLES CAR 4-$500 5-$500 <br /> COMPREHENSIVE $41.00 $66.00 <br /> DEDUCTIBLES CAR 4-$250 5-$250 <br /> TOWING AND LABOR COSTS INCL INCL <br /> $75 PER DISABLEMENT <br /> RENTAL EXPENSE $29.00 $27.00 <br /> $50 PER DAY/$1500 PER OCCURRENCE <br /> CONSOLIDATED VEHICLE ASSESSMENT FEE $0.87 $0.87 <br /> TOTAL SEMIANNUAL PREMIUM PER VEHICLE $629.87 $589.87 <br /> TOTAL SEMIANNUAL PREMIUM ALL VEHICLES- k <br /> $1,219.74 <br /> Risk <br /> I <br /> Maragematt Division <br /> REVIEWED&APPROVED BY: <br /> o+ <br /> Coverage is provided only when both a premium and limit are shown. `'1 t� ' A Acw <br /> Risk Management Specialist <br /> adca0la(001) 12/18/2023 <br />