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��L�nirytnsura��� PERSONAL AUTO Renewal <br />COR1 1-Boo-zTt-SAVE POLICY DECLARATION EFFECTIVE 0611 512 0 08 <br />Named Insured and Mailing Address f y� <br />Joe Larose Qnpy�,Y,pYS7' A-9m-)�-- <br />Marie Lassa <br />9199 Poinsettia Ave <br />Fountain Valley, CA 92708 <br />Policy No: 3493189 <br />Policy Period: From: 0611512008 <br />To: 1211512008 12:01 AM Pacific TOM <br />p 12006 1 TOYOTA TUNDRA DDU <br />Driver <br />1 I Marie Larose <br />2 Jeeumsa <br />COVERAGE IS PROVIDED <br />Coverage <br />A. Bodly injury Liability <br />Motorist <br />Uninsured Motorist <br />J. Additional Equipment <br />The first $1000 is automatically <br />included with coverage E or F. <br />5TuT341X68552072 <br />40 <br />42 <br />- <br />$100, 000 eachpe reon <br />S 100,000 each parson <br />S <br />Included $1, 000 $1, 000 $ <br />Additional $ 0 $ 0 $ <br />If the installment bill plan is used, a service charge may apply' <br />tment(s)IAgreementi Applicable: <br />(06104) TCU511 CA (051051 <br />W MCD <br />W MCD <br />feltsru Ch <br />0 1 Pe <br />9 <br />S <br />$ 40 <br />GOD <br />GDD <br />S <br />9P7Dg 1 41100 <br />92709 1 SAM <br />Loss Payee lLP), Additional Insured (Al), Evidence a Insurance (El) <br />Drivers Not Rated <br />Veh 1 EI CITY OF SANTA ANA PD <br />Veh 1 EI City of Anaheim PD <br />Veit 2 LP Toyota Motor Galt Corp _ n 0 511 612 008 <br />YM Fp1,fpYY/1a FEEtSYMAY APPLY: $10.00. <br />LATE 4$.00 PAYMENT AETt1RNED INSFI: e4.00 President <br />$60.00 WSTALLUANT.IA61 PLAN. v <br />ICIE CKWHEN ATTACHED TO THE CURRENT STATUS OF YOUR COVERAGES AAND LIMITS OF LIATMUTY-uCY AND REPRESENT <br />. and more. Register online todayl For Customer Care call I (E00)443-3100. <br />Visit 21et.com to maks policy changes. pay Vote <br />Tau1G naspal 21s1 Century Insurance Company, 6301 Owensmouth Ave., Woodland Hills, CA 91367 <br />