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Elite - Package 1 'Af ENCOMPASS - <br />I N $ U F3 A N C E <br />Policyholder: Agent: <br />KRISTIAN KRAUSE WALTER MORTENSEN INS <br />21682 VINTAGE WAY 4701 STOCKDALE HWY <br />LAKE FOREST CA 92630-5759 BAKERSFIELD CA 93309 <br />PHONE: 661-834-6222 <br />Policy Number: Policy Period: <br />261211892 03/23/2005 to 03/23/2006 12:01 AM Standard Time <br />This is a replacement of policy 218450853 <br />Insurance Provided BY: <br />Encompass Insurance Company <br />2775 sanders Rd.; Northbrook, IL 60062-6127 <br />YOUR POLICY HAS BEEN CHANGED <br />A change in name of insured <br />Chg named insrd to maiden name: Kruase <br />Revised Annual Policy Premium <br />No change in premium <br />240-007770-00-'0 <br />Policyholder Since: <br />03/2004 <br />24 HOUR CLAIM REPORTING 800-588-7400 <br />$ 2,266.00 <br />MOTOR VEHICLE PROTECTION (Coverage applies only if a premium or limit is shown) <br />261211892 <br />146� <br />.1 tM <br />0 <br />Continued on Next Page Page 01 of 05 <br />Vehicle I <br />Vehicle <br />Description: <br />2004 CHEVY TRUC TRAILBLAZER <br />VIN: <br />IGNDT13SB42117211 <br />Rated Driver: <br />KRISTIAN KRAUSE <br />Use: <br />Pleasure <br />Class Code: <br />661100 <br />Estimated Annual Mileage: <br />15000 <br />COVERAGES, gQ4., <br />z <br />BODILY INJURY <br />250,000/500,000 <br />$ 451.00 <br />(per person/per accident) <br />PROPERTY DAMAGE <br />$ 25, 000 <br />$ 139.00 <br />(per accident) <br />MEDICAL EXPENSE <br />$ 5,000 <br />$ 42.00 <br />UNINSURED MOTORISTS - <br />BODILY INJURY <br />$ 250,000/500,000 <br />$ 86.00 <br />(per person/per accident) <br />COLLISION DEDUCTIBLE <br />Per Endorsement <br />$ 18.00 <br />WAIVER <br />(per accident) <br />COMPREHENSIVE (Comp) <br />$ 250 Deductible <br />$ 145.00 <br />COLLISION (Coll) <br />$ 500 Deductible <br />$ 430.00 <br />TOWING <br />Reasonable Expense <br />$ Included <br />261211892 <br />146� <br />.1 tM <br />0 <br />Continued on Next Page Page 01 of 05 <br />