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<br />'. <br /> <br />., .... <br />1~A..W.a'l'AtCloAJ'lOTltIII: <br />06/01/02 06/01/03 <br />""'" '" <br /> <br /> <br />~-* INSURED COPY ~~~ <br /> <br />RENEWAL DECLARATION OFFER <br />EFFECTIVE 06/01/02 <br /> <br />IN THE EVENT PAYMENT IS NOT RECEIVED <br />BY THE DUE DATE NOTED BELOW IN THE <br />STATEMENT OF ACCOUNT, YOUR POLICY <br />BECOMES NULL AND VOID. <br /> <br />ErI21stCENTURY INSURANCE <br />m i21.com 1-800-211-SAVE <br />UMBRELLA POLICY DECLARATION PAGE <br />WHEN ATTACHED TO THE ~RSOHAL UMBREU..A POlICy, TtIESE DECl.AAATlON& COMPLfT! 1lIE POUCV AND REP1IIUENT <br />THE ~ STATUS OF ~ c:oveRAGES AN) LMTS OF UAElU1Y ACCXJA:)fG' TO OUR PJECCA)8. <br /> <br />PEP 9024260 <br /> <br />ROBERT J ASH <br />GERRI ASH <br />13361 PROSPECT AVE <br />SANTA ANA CA 92105 <br /> <br />... . . . <br />LIMITS OF LIABILITY <br />L. ..... S <br />EACH OCCURRENCE EACH OCCURRENCE <br />S 1,000,000 250.00 <br /> <br />. . <br /> <br />. . . <br /> <br />YP <br />AIlOI1\OHAL CHARGES <br />20.00 <br /> <br /> <br />BASIC POUCV PREMIUM' <br />160.00 <br /> <br />YOU AGREE THAT PRIMARY INSURANCE IS IN FORCE AND Will CONTINUE TO BE IN FORCE FOR ALL EXPOSURES <br />COVERED BY THIS POLICY FOR AT LEAST THE LIMITS SHOWN BELOW. <br /> <br />, . <br /> <br />. . .., .., <br /> <br />BODILY INJURY - <br /> <br />PROPERTY DAMAGE- <br />BODILY INJURY AND PROPERTY <br />DAMAGE COMBINED <br /> <br />$ 100,000 EACH PERSON <br />$ 300,000 EACH OCCURRENCE <br />$ 50,000 EACH OCCURRENCE <br />$ 100,000 EACH OCCURRENCE <br /> <br />AUTOMOBILE LIABILITY <br />RECREATIONAL VEHICLE LIABILITY <br /> <br />COMPREHENSIVE PERSONAL LIABILITY <br /> <br />________ ADDITIONAL CHARGES -------- <br />AUTOMOBILES 2 10.00 <br />RESIDENCES 1 INCLUDED <br />1-4 FAMILY RENTALS .00 <br />RECREATIONAL VEHICLES 1 10.00 <br />YOUTHFUL OPERATORS .00 <br /> <br />~~~ REMINDER. All PRIMARY LIMITS MUST BE <br />IN FORCE AS NOTED ABOVE ~~~ <br /> <br /> <br />l.....>~ <br /> <br />05/02102 <br /> <br />A <br /> <br />FOR CUSTOMER CARE CALL 1-800-443-3100 <br /> <br />Cl~IMS SERVICE PHONE. 1-800-322-8200. <br /> <br />_ STATEMENT OF ACCOUNT FOR POLICY 9024260 <br />TOTAL PREMIUM ................ . 180.00 <br />AMOUNT DUE 06/01/02 ........ . 180.00 <br />