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oeo 19 OS 11:25a Santa Rna Zoo 7149537401 di <br />I; t Interinsurance Exchange of the Automobile Club <br />• Automobile Insurance Policy Coverages and Limits <br />Renewal Declarations <br />4e arn cieBsed to offer you a renewal for your automobile insurance. policy. To renew your POICY,l send t least the onmu <br />y -. ;:1. en. or before the due date . Insurance is in effect oldy for the vehiClrs, Coverages, . Y s <br />leclalationz page and as set forth in the insurance policy and endorsements. These declarations', together With thP. contract and <br />he endursements in effect, complete Your policy. If any change to your policy or to the information we haverid due to you[ its In a <br />)remlum decrease during the policy period, the Intennsurance I xchange reserves the right to apply • y <br />lutstapdmg halanrr. <br />NAMED INSURED (Item 1.) ' <br />AUTO POLICY NUMBER: G 6162649 <br />130'_DRICK. LORRIE <br />238? N FLANDERS ST <br />ORANGE CA 92865 -2836 <br />YEAR MAKE MODEL <br />•aVr✓BEC _ <br />n 1990 FORD EXPLORER^ <br />POLICY PERIOD (PAC61C STANDARD TIME) <br />EFFECTIVE DATE: 5 -5 -06 i7 of A.M. <br />EXPIRATION DATE: 5 -5 -07 12:01 A.M. <br />IDENTIFICATION yr HICL@ GARAGE ANNUAL LEAiCD FINANCE <br />Ni USE Zln CODE wt .ES <br />IFMZl132E0WZ8i3595 PL FA SmVRE 92ali 1.501- 1D,DOD NO NO <br />COVERAGES AND LIMITS <br />Coverage Ie not m edecl unlesx a Premium W the warn "Indutled' Iz shown. <br />cUVCRAGCC LIMITS OF LIABILITY ,^ <br />Liability <br />aodM "jury $1,000,000 each person! $1,000,000 oath occurrence <br />Property Damdgc $50,000 each orcurremc <br />MedYa! <br />Excess Medical Payments $`.000 each person <br />Physical Damogc Iii G Ml vow. union a—.. "en, iW, mwmekl <br />Vehlrh, 4 Vuhldc Veh¢Iu <br />ConoreheridAe ACV <br />(L<-s Deductible) $100 <br />Collision ACV <br />(Less Deduetible) $250 <br />Car 4e�ta1 [)¢true <br />NA <br />ANNUAL PREMIUMS <br />Vehicle Vehicle Vehicle Vehicle Vehirle <br />' S 352 <br />5 179 <br />Vnmdc VOI <br />$ 38 <br />$ 245 <br />NA <br />3od'.,'njory $15008 wchpersoW S:a0.000 L*Whoccu"-e o <br />Ln "T.Tfid & Uvdarinsured Vehicles <br />Lrvnsured Deductible Waiver <br />Total <br />PREMIUM DISCOUNTS <br />Please refer to the er1el0.5ed document entitled <br />'Premmm Disedi Applied to Yow Automobile Policy." <br />3 24 <br />Included <br />$856 _ _^ <br />"NA" Indicates coverage riot purr -ad. <br />Total Annual Prefnlum' S85( Less Policyholder's Dividend S 1 t' <br />Net Premium $ 74' <br />'Inchules ell applic:exo dlw.nunts <br />PROCESS DATE 1-31,06 PLEASE ATTACH TO YOUR POLICY (SEE REVERSE <br />