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r/ ENCOMPASS_ <br />I N S U R 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 240-007770-0000 <br />Policy Number: Policy Period: Policyholder Since: <br />261211892 03/23/2005 to 03/23/2006 12:01 AM Standard Time 03/2004 <br />This Is a replacement of policy 218450853 <br />Insurance Provided By: <br />Encompass Insurance Company 24 HOUR CLAIM REPORTING 800-588-7400 <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 $ 2,266.00 <br />No change in premium <br />This Cgyerage Summpri Arov das Yo!t witty 16* "® t�tpnPy it l f tatl9g, 7trdu (i #h� Y4 change and <br />MOTOR VEHICLE PROTECTION (Coverage applies only K a premium or limit is shown) <br />Vehicle 1 Vehicle <br />Description: <br />2004 CHEVY TRUC TRAILBLAZER <br />VIN: <br />1GNDT13S842117211 <br />Rated Driver: <br />KRISTIAN KRAUSE <br />Use: <br />Pleasure <br />Class Code: <br />661100 <br />Estimated Annual Mileage: <br />15000 <br />COVERAGES, <br />BODILY INJURY <br />$ 250,000/500,000 <br />$ <br />451.00 <br />(per person/per accident) <br />PROPERTY DAMAGE <br />$ 25,000 <br />$ <br />139.00 <br />(per accident) <br />MEDICAL EXPENSE <br />$ 5,000 <br />$ <br />42.00 <br />UNINSURED MOTORISTS - <br />BODILY INJURY <br />$ 250,000/500,000 <br />$ <br />86.00 <br />(per person/per accident) <br />COLLISION DEDUCTIBLE <br />Per Endorsement <br />$ <br />18.00 <br />WAIVER <br />(per accident) <br />COMPREHENSIVE (Comp) <br />$ 250 Deductible <br />$ <br />145.00 <br />COLLISION (Coll) <br />$ 500 Deductible <br />$ <br />430.00 <br />TOWING <br />Reasonable Expense <br />$ <br />Included <br />261211892 <br />Charman oltlr so.rd <br />Continued on <br />Next <br />Page Page 01 of 05 <br />'OooO(1CAo6o]010)0910eoo0Woo000100Y <br />