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STRTE FRRH I~$ <br /> <br />AUTO POLICY ST <br /> <br />I21RSON,LINnA K & <br />AKELEY, THOMAS E <br />1255 19TH ST <br />~ERMOSA BEACH CA <br /> <br />90254-3309 <br /> <br />MUTL 03 <br />2000 <br /> <br />STATUS:PAID <br />AMT DUE: <br /> <br /> DUE DATE: <br />0.00 OXD:JUN-05-01 <br /> <br />JUNE t7, 2003 <br /> <br /> rUS <br /> H PHONE: (310) 3'72-1538 <br /> 6102-~'05-75A IRG: 20 <br /> ZIP: 90254 <br /> 323I CLASS: 6B30At12 <br /> WAG ACC FREE: JUN-05-01 <br />AAR3346YJM01825 BIRTH: JUL-28-54 <br /> <br />RM DATE: <br />OV DATE:DEC-05-01 <br /> <br />A /IMM / 301.36 R1 80% 500 16.80 <br />C5000 ]7.76 U 100 /300 42.22 <br />DS0 66.40 U1 1.76 <br />6250 190.80 <br />~ 2.40 <br /> <br />/ <br />AMT PAID: 639.50 DATE PAID: JUN-06-03 <br />COR 1 491.40, MCD 124.37, CGDD 159.88 <br />VSD 40% 11.84, ODM 12000 06-0~, MLD 68 <br /> <br />TOT PREM: 639.50 <br />PREV pREM: 610.07 <br /> <br />NAME: LARSON,LiNDA K & <br /> <br />REPLACED POLICY: 0376102-75 <br /> <br />EXCEP. & END: ADD'L INSURED - THE CITY <br /> AGENTS, AND VOLUNTEERS 20 CIVIC CE5 <br />DRVR DT OF LIC RL NXT RL-DT <br />LINDA 07/28/1970 1 SR-06/05/2004 <br /> <br /> H PHONE: {310) 372-1538 <br /> POLICY FOP. M: 9905A <br /> <br /> F SANTA ANA ITS OFFICERS, EMPLOYEES, <br /> FLA~A SANTA ANA CA 92701. <br />CC/CONV DATE INFORMATION <br /> <br />REC CMG: <br /> <br />COV. S & Z NAMES S AM'I~ Z <br /> <br /> <br />