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<br />Auto Club <br /> <br />. . <br /> <br />. <br /> <br />11/9/2007 11:46:09 AM <br /> <br />PAGE <br /> <br />2/005 <br /> <br />Fax Server <br />tJ l-lP 1- rz5' <br /> <br />Interinsurance Exchange of the Automobile Club <br /> <br />Automobile Insurance Policy Coverages and Limits <br />Policy Ching, Declaration. <br /> <br />II <br /> <br />In.uran.. i. in ofIeol only fo, th. vehiol.... oovor.g.... .nd limit. of Iiobility .nown on tni. d.ol.ration. pog. .nd....t forth in <br />tn. Inluranc. pcllcy and andorllm.ntl. Th... d.cl.ratlon., t.gotn., wltn tn. contract .nd tn. .nd....m.nIIln orrlct, c.mpllto <br />you, policy. <br /> <br />NAMED INlUIlED (Ilam 1.) <br /> <br />VERCHES, RAY <br />13ee1 BELLE RIVE <br />SANTA ANA CA 92705-2932 <br /> <br />! AUTO I'OUC't' NLNIl!II: 0 8131801 <br />. POLICVPERIOO (PAC FICSTANDARO TIME) <br />!'OLICY IJllllCTlVI DATI. 10.04.07 12:01 A.M. <br />POLICY EXPIRATION ~TE: 10-ll4-llB 12:01 A.M. <br />!'OLICY CHANG! !'I'I!CT!V! CAT!: 10.211.07 12:01 A.M. <br /> <br />na " NOT A .LL <br />Tni. policy oh.ng. will ino..... your premium by $280. <br /> <br />lLa/ICT OP I'ClLICY CIWIGII <br />MISCEL.ANEOUS CHANGE <br /> <br />VI~' <br />VEHICL.E YEAR MAKE MOC.L IceNTIFlCATION ViH1Ct".E QA~AGE ANNUA.. LEASED FINANOED <br />NUMBER NUMBER USE ZIP OODE MILES <br />1 2002 JEEP GRAND CHEROKEE OVERLAND 1 JeGWtl8Je:2CZ21114 COMMUTE 9270:1 20,001 - ~ooo NO NO <br />3 2006 CHEV CORVETTE 1G1YY24Uil561Dl1lll7 PLEASURE Q27O!i 5,001 .7.500 NO YES <br /> <br />COVlllAOl. AND LIMrrI <br />r:ovlrq.ll not In.rftOt ~In"" I p...rnl~ orth. word "Inoludtcl"" .hoWl'l, <br /> <br />COVERAGES LIMITS OF lIABILITY <br /> <br />LI.bll/ty <br /> <br />ANNUAL PIlEM ILIIII <br />Vlnlell 1 V.hlelo 3 Vlhlell Vlhlcil Vlhlcll <br /> <br />Bodily Injury <br />ProllllrIY CBmoge <br />M.dl..1 <br /> <br />$500,000 IliCh ~rsml $500,000 BiIOh DOOUfl'8l'1D8 <br />8100000 ..oh ""ourrence <br /> <br />, <br />, <br />;.. <br />I <br />11110 <br /> <br />1234 <br />IUO <br /> <br />NA NA <br /> <br />Phr-JC.' D.m.p (ACMI c..~ YI'ue unllll clMrwtlllltlltld, I.. delIUlIllbltl) <br />Vehlclo 1 Vo"clo 3 Vehicle <br />ACo/ ACo/ <br />$2eO $2!iO <br />ACo/ ACo/ <br />$500 S500 <br /> <br />Oomprehenol", <br />("... Doducti~'1 <br />0,11101011 <br />(l.eG8 Deducti~e) <br />CIlr RontIIl Expo_ <br />(Per 00Y; ~ <br />IJnlnoured "'olwfst <br />Bodily I~ury $100,00:: elIeh porlOl'l <br />Unlnlured & Ur,derlrlured Vehleleo <br />Unlroured Ooouotl~e 'Nalv<< <br /> <br />PREMll.IlIlIlCOUNTll . "NA" Indlcat... c.....ra . not <br />Pi.... ,or" toto. onolOlld dooument .nt~od "Prerrlu", Dleoount. A~lodto Y04r A~opi!e Pqll~o". ' Tolal Annyal Pr.mlym' <br />(In,lud.. ~1..,lIcoble dl.coumo.J <br />'II .t .ny t1m. you choOl' to ply In. th.n tho lull balance oUlltandlng, <br />nn.nc. en.run 01 up to 1.15% PI' month 01 tho b.l.nee oulllandlng will .pply <br />at explained In your billing .tatem.nil, which ar. part 01 thet. declardon.. <br />P~'" CATllll-2U7 I'LIAII ATTACH TO YOU" !'OLICY <br /> <br />Totll Premium <br /> <br />11 <br /> <br />Vehicle <br /> <br />Vonlcle <br /> <br />, <br />, <br />I <br />, <br />I <br />: 174 <br /> <br />1417 <br /> <br />"7 <br />.888 <br /> <br />NA <br /> <br />14lI <br /> <br />NA <br /> <br />$:;00.000 oeoh ooeUrrll~ <br /> <br />'0\2 <br /> <br />h,Q~~~ <br />I <br />, <br /> <br />$31 <br /> <br />" l':)'! J\I...:.:") <br /> <br />t.e:' <br /> <br />r '_.', <br />['j <br /> <br />Included <br /> <br /> <br />111123 -" '1178 <br /> <br />urehued. <br /> <br />$2301 <br /> <br />N.t Premium' <br /> <br />. 2301 <br />IIEE REVERIE) <br />