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Jul 562-S51 - IO6B p. 4 <br />'coPY' DI~CLARATIONS AGE 'COlbY <br /> <br />OB Q3 12:59p. George Bullock <br />b~ata Farn~ Mutual Autoll~obile Insurance qompany <br />ve$130~ .Ago, bra Road <br /> ~ke Village CA 913~3 <br /> ~ 75-863]bl u <br />REBECCA ~AUCEDA <br />i57 T.E~'LEY ST AP 4 <br />HAC~NDA;HGTS CA t~45-4574 <br /> <br />NAMED INSURED: GOL~ COAST APPRAISALS INC <br /> <br />POLICY NUI~BER 81 2431-F_~8-75 - <br /> <br />POLICY PERIOD MAY 28 2003 to NOV28 200 <br /> <br />AGENT <br />DREW MARTIN <br />11119 SAk]TA GERTRUDES AVENUE <br />WHITTIER, CA 90604-3350 <br /> <br /> DO 18CT PAY PREMIUI~ SHOWN ON THI~ PAGE. PHONE: (~162)943-4343 or (~62)943-9323 <br /> SEPARATE STATEMENT ~ICLOSED IF AMOUNT DUE. <br /> <br />1997 TOYOTA CAMRY 4DR JT2BG22K4VQ088050 · 6H00A1 ~ 0 <br /> <br /> 1997 <br />See policy for coverage details. TOYOTA <br /> <br /> Limi~ of Liabil~-Ooverage A-Bodily Iniu~ <br /> <br />Each Acoident <br />$500 ~ductible ~mpre?n~ve $49.95 <br />Emergency Road So.icc $2 88 <br />Lim~ of Li~ili~ - C~ Rental E~nse <br /> <br /> $50 $1,200 <br /> <br /> $~ 00,000 $300,000 <br /> <br />r IMPOFITA...NT MD[.S.SA.GES, ,,.. ,. ~. .. : . . ~ ...... ". '. ~,..'~ ;~ ,*:~"~<~,.~,~"~,.:,,.~..~143~..-; ....~.~-..~,',:'. <br />....... ~.~ .. ... .... .,x.~.. ' .... - ...... ' ........... :" ..... '-" ..::.;..~.2Z:z." ' , .... <br />Your policy consists of this deolarations page, the policy booklet - form 9805A, and any endorsements that apply, including <br />those, issued to yo~u~ with any subsequent renewal notice. <br /> <br /> ....... ---~----~ ..... .---~- - · ' .-..~ ....-'.~t_..,. "_ _" .-' ....... ':~__.'.__ ""__'_ <br /> 6028AU ADDITIONAL INSURED-REBECCA SAUCEDA, 15746 TETLEY ST APT#I4, HACIENDA <br /> HOTS CA 91745+4574 <br /> 6030S BU$INES~ NAMED INSURED ENDORSEMENT <br /> 6893PP AMENDMENT OF CAR RENTAL AND TRAVEL'EXPENSES COVERAGES <br /> 6gOSA AMENDMENT OF DEFINED WORDS, LIABILITY, MEDICAL PAYMENTS, <br /> UN,INSURED MOTOR VEHICLE AND PHYSICAL DAMAGE COVERAGES. <br />Named Insured- GOLD COAST APPRAISALS INC 11506 TELEGFLAPH RD STE 214 SANTA FE SPGS CA <br />90670-31 O0 <br /> <br />FORM <br /> <br />Agent: !~REW MARTIN <br /> <br /> <br />