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"(SEP-22-2005 13:11 From: <br />OC IONS, + EFF DT. 09/2: i 130UNO: Y HOUSEHOLD#. <br />t�.p <br />R M INSMARK R LA BQNTE - nFNNESSEV17962 WESTON, PL TUSTTN <br />+ ? (x,00) 0001— 0000 DIFF MAIL. N C;AR. N N IYi/CiTS/IIA, 175950207 SOK ' 165829624 SOK <br />P�PSC#/AGNT SB 97-44-31L SB 7-41-31/4/VU/DC/L F SP YL '08 Y F SC 5 <br />IEN-DT/TY/RS 1/21/05 + + 12/11/QS + + <br />q.jYR/MDL/VS/SY 9 SILHOUET 01 + 5 01 TM - T-- <br />O1 + X <br />�j !N-SER#/C-P 16 DX03E5XD26D2 9 N 1GNEC13TX1R227290 N <br />IIIDSC-SUR-ADDL AS S PR MA DP Y AR GD PR MA Z9 N <br />i',j!DVR/EXP/P-AF JO 5 H 0 000 SHARON ✓ 29 000 <br />(COVERAGES L.IM I TS— )F.000TIBLES <br />BIPD 250 00 00 + 250/5100/100 I <br />1 UM BI 250/ + 250/500 + <br />I <br />1 1ZH PD W/O COLL + + <br />I11M PD W/COLL X + X + <br />'TINED COVERACE 5000 + 5000 + <br />',✓'COMPREHENSIVE 50 + 240 + <br />.COLLISION 5 I 500 `+ <br />i; RE SELECT D MORE AVAILABLE <br />To:71.4 647 5635 <br />01012535E 1,503 91@9 <br />HMOWNERN: <br />CA 9L780 <br />UMB#/TY: 014981877 U <br />=HELP F2=EX HELP F3=EXIT F4—PROMPT F5 -REFRESH F6=5CR1, VWD F9=DETAILS <br />i—SUMMARY �1a POGCI,N.! F2,0 -VOID F21=SUSPEND F22-U/W(RESP) F23=a/W(END) <br />P.2/3 <br />NARMSINSORANCE AGENCY <br />1431 E. CHAPMAN AVE <br />ORANGE, CA 92866 <br />LIC.# 0568564 <br />j <br />013 <br />(714) 744N m 2516 <br />nsuranss <br />443 5 <br />7 c <br />L <br />11,a l <br />1 <br />I <br />APPROVED AS TO FORM <br />rel <br />i <br />Laura Stitt Sheedy <br />j ; I <br />Assistant City Attorney <br />Ii <br />„I <br />P.2/3 <br />