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ITEM THREE <br />Schedule Of Covered Autos You Own (Cont'd) <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 <br />in the corresponding Item Two column applies instead.) <br />Coverages <br />Limit <br />Premium <br />Liability <br />$ SEE SCHEDULE ATTACHED <br />$ <br />Personal Injury <br />Stated In Each Personal Injury Protection <br />$ <br />Protection <br />Endorsement Minus <br />$ Deductible <br />Added Personal <br />Stated In Each Added Personal Injury <br />$ <br />Injury Protection <br />Protection Endorsement <br />Property Protection <br />Stated In The Property Protection <br />$ <br />Insurance <br />Insurance Endorsement Minus <br />(Michigan Only) <br />$ Deductible <br />Auto Medical <br />$ <br />$ <br />Payments <br />Medical Expense And <br />Stated In The Medical Expense And Income <br />$ <br />Income Loss Benefits <br />Loss Benefits Endorsement For Each <br />(Virginia Only) <br />Person <br />Comprehensive <br />Stated In Item Two Minus <br />$ <br />$ Deductible <br />Specified Causes <br />Stated In Item Two Minus <br />$ <br />Of Loss <br />$ 25 Deductible <br />Collision <br />Stated In Item Two Minus <br />$ <br />$ Deductible <br />Towing And Labor <br />$ Per Disablement <br />$ <br />Total Premiums SEE SCHEDULE ATTACHED <br />Liability <br />$ <br />Personal Injury Protection <br />$ <br />Added Personal Injury Protection <br />$ <br />Property Protection Insurance (Michigan Only) <br />$ <br />Auto Medical Payments <br />$ <br />Medical Expense And Income Loss Benefits (Virginia Only) <br />$ <br />Comprehensive <br />$ <br />Specified Causes Of Loss <br />$ <br />Collision <br />$ <br />Towing And Labor <br />$ <br />CA DS 03 03 10 © Insurance Services Office, Inc., 2009 <br />oR,N F RiskMougementDMslcrn <br />a� REVIEWED & APPROVED BY. <br />`® tq {iceva�o <br />Risk Management Specialist <br />Page 5 of 13 0 <br />