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<br />'Jan 09 04 01:56p <br /> <br />T.g1 <br /> <br />. <br /> <br />p.3 <br /> <br />FROM; L.A.CHR MAINTENANCE CO. <br /> <br />FAX NO. ; 18183668403 <br /> <br />Jan. 092004 11:44AM P3 <br /> <br />/ <br /> <br />PlF.ASE' HEAD YOUR POt./!;'!' <br />fhi., d9tI""31ior.s PllQeJAmencf!o De<:lar;,llio <br />p(tviov$ policy no <br /> <br />POLICY NUMBER CA 0-2D-6B-S1Q-1 <br />DO\ge \\I,th Itle pOlicY jackg,t ;Cl~rllilitld l>y Ineo lurm <1M edItion dete Indlr:"led (;~lete,. the ..bov,," rllltn"'b.'9d policy <br />F.'m 1050 Ed 1194 <br /> <br />OECLARA nONS <br />NAMED INSURED <br /> <br />L.A. CHA MAINTENANCE <br />18816 SN FRNNOO MSSN <br />NORTHRIOGE CA 91326 <br /> <br />PAGE 3 OF 3 <br /> <br />A <br />G <br />E <br />.. <br />T <br /> <br />JOHN KIM INS SERV <br />3807 WILSHIRE BVOIIOO <br />LOS ANGELES CA 90010 <br /> <br />PROGI1E.IJIVE~ <br /> <br />POLiCY TERM: SEp 25. 2003 TO MAR 25. 2D04 <br />Tl\f$ DOlity '''C.pl$ the Ialef 01: 1 tht 1i",. the application for in.uraf1ce is execuled or'l <br />the "'$( diY Of the policy period: 01 2. 12;0 I Ii m. on the first day of In. policy !:I.lied. <br />1M$: pallCy S"'II e~r& af 12:0' t.m. On lhO Ia'llt day Of lhe. policy periOd. <br />CA-26390 <br />PROGRESSIVE CASUALTY INS. CO. <br />P.O. BOX 94739. CLEVELAND. OHIO 44101 1-800-444-44B7 <br /> <br />ca.....aw:""1.. ~ IN::~I!: <br /> <br />Thu Igl~"ioCJ cOlIerS09 and "mirs apply 10 the c:rescflbed VOhide as $hQ.,." below CtwP.1~llt .$111 defj'uad in file j)Uhcv imd "'''' SUO,UCIIO ,t1~ terms t1nd r::onditi\)rlt <br />contained in thQ pality. inr:ludmg ;Dmendme<'l(s 8(td end~I@f\IS. No chOlI1QCS wit bll eHecllvQ ptio, 10 I~ ~inl8 ~h~s are tCQue.,led. <br /> <br />SCHEDULE OF COVERED VEHICLES <br /> <br />VEH <br />NO <br />1-01 <br /> <br />OR <br />NO <br /> <br />TRADE <br />YR NAME <br />97 TOYOTA <br /> <br />BODY <br />TYPE <br />PICKUP <br /> <br />SERIAL NO <br />4TANL42NXVZ29BJl2 <br /> <br />VEH TER <br />CLS NO ZIP <br />COS 36 91326 <br /> <br />RAO DSC OSC <br />IUS COD PCT <br />SO 362 <br /> <br />LIABILITY PREMIUK BY VEHICLE <br /> <br />VEH <br />NO <br /> <br />LIAS <br />S 1,141 <br /> <br />MEO <br />PAY <br />S18 <br /> <br />UM/UIK BI <br />$47 <br /> <br />UM/PO <br />$40 <br /> <br />PHYSICAL DAMAGE PREMIUM BY VEHICLE <br /> <br />VEH COMP OR FT/CAC <br />NO TYPE OED <br /> <br />PREM <br /> <br />COLLISION <br />OEO PREM <br /> <br />ON-HOOK <br />LIMIT OED <br /> <br />PREM <br /> <br />VEH <br />TOTAL <br />$ 1,246 <br /> <br />A.PPROVED AS 'ro FORi"," <br /> <br />~~_3i~u_ <br /> <br />Laura StitY9!i,)edy <br />Assistant CiP! Attorn.~\i <br /> <br />11.-- Iou ur\der P"rl II I i8 ps)'fthlo::- i":l" ;ni",res( may I'lPP"l" 10 l'\;Jmad intwed ana $t)(IVC luss Pll'j8l!' <br />....., h _ C;:I$liI No <br />'~"".F'~b BGO 032'i3XXXX B.o CAICS11C <br /> <br />Prog Prt:mllJm Budgel: ( 1 <br />RJfl0203%F.acto. U$';U: 1=1R 062002 <br /> <br />:OIJr'lIC/$1Q/lad. <br /> <br />J11~ (12'92) <br /> <br />I NSUFteO COP), <br /> <br />CVWE0918011217LI11303 <br />