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W.,M C m Ivt _ry Insurance Page 1 of 2 <br />2ULcom 1 -8W -211 -SAVE PERSONAL AUTO Renewal <br />POLICY DECLARATION EFFECTIVE 06/15/2007 <br />Named Insured and Mailing Address <br />Joe Larose <br />Marie Larose <br />9199 Poinsettia Ave <br />Fountain Valley, CA 92708 <br />IIlIIl1lIlIII I/III)1/Ifillltl/IItHItINI1IUtltitihlifl{i1f I <br />o2O(3 6 - 06/ <br />" <br />�006.00�-0/ <br />Policy No: 3493189 <br />Policy Period: From: 06/15/2007 <br />To: 12/15/2007 12:01 AM Pacific Time <br />Endorsements)/Agroement(s) Applicable: <br />TCU -1 (06104) TCU511 CA (05/05) C <br />Loss Payee (LP), Additional Insured (Al), Evidence of Insurance (EI) Drivers Not Rated <br />Veh 1 EI CITY OF 'SANTA ANA PD <br />Veh 1 EI City of Anaheim PD <br />Veh 2 LP Toyota Motor Credit Corp <br />,t70 z C+ ee N ri�f Y #10.00 Qs— <br />WVHM <br />05/21/2007 <br />$400 ATTACHED TO THE PERSONAL AUTO POLICY, THESE DECLARATIONS COMPLETE THE POLICY AND REPRESENT <br />THE CURRENT STATUS OF YOUR COVERAGES AND LIMITS OF LIABILITY. <br />Visit 21 st.com to make policy changes, pay you' premium, and more. Register online todayl For Customer Care call 1(800)443-3100. <br />KV41CA KSMI 21St Century Insurance Comweriv. 6301 Owennmmith A W— 11 a Lj;' . r- . -- <br />. �"� .(' { <br />pv:i `.yy(��u• <br />i J� .... � . "i°F <br />:. <br />��` k`,�q`FT= <br />. � 4.t �5 �. t <br />1 2W HONDA PUT !x <br />21110F18134H510W <br />w <br />MCD <br />92708 <br />4,aao <br />2 2006 TOYOTA TUNDRA DOU <br />5TBET341 XM52072 <br />w <br />MCD <br />92708 <br />9,000 <br />iJ <br />kk <br />Ne <br />1 Mane nesse <br />39 <br />D <br />GDD <br />2 Jae Lassa <br />41 <br />0 <br />6DO <br />Endorsements)/Agroement(s) Applicable: <br />TCU -1 (06104) TCU511 CA (05/05) C <br />Loss Payee (LP), Additional Insured (Al), Evidence of Insurance (EI) Drivers Not Rated <br />Veh 1 EI CITY OF 'SANTA ANA PD <br />Veh 1 EI City of Anaheim PD <br />Veh 2 LP Toyota Motor Credit Corp <br />,t70 z C+ ee N ri�f Y #10.00 Qs— <br />WVHM <br />05/21/2007 <br />$400 ATTACHED TO THE PERSONAL AUTO POLICY, THESE DECLARATIONS COMPLETE THE POLICY AND REPRESENT <br />THE CURRENT STATUS OF YOUR COVERAGES AND LIMITS OF LIABILITY. <br />Visit 21 st.com to make policy changes, pay you' premium, and more. Register online todayl For Customer Care call 1(800)443-3100. <br />KV41CA KSMI 21St Century Insurance Comweriv. 6301 Owennmmith A W— 11 a Lj;' . r- . -- <br />