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FROM : L. A. CHA MAINTENANCE CO. <br />INSURANCE LAND INS <br />4032 WILSHIRE BL #309 <br />IDS ANGELES, CA goo 10 <br />Named insured <br />L.A. CHA MAINTENANCE <br />18816 SN FRNNOD MS5N <br />NORTrfRiDGE, CA 91326 <br />FAX NO. : 18183668403 <br />000040 <br />Commercial Auto <br />Insurance Coverage Summary <br />This is your revised Renewal <br />Declarations Page <br />( Apr. 28 2009 12:35PM P2 <br />/�/QD,Cs/Qf,.ft/Uf <br />Policy dumber: 02068519.8 <br />Underwritten by: <br />Uni U Financial Casualty company <br />May h 23. 2009 <br />Polk / Period: Mar 25, 20o9 -Sep 25, 2009 <br />Pagt I of 2 <br />p rogressiveagent.com <br />Online Service <br />Maki• payments, check biding activity, print <br />polio: documents, or check the status of a <br />clairr <br />213.388.5505 <br />INSURANCE LANs) INS <br />01119Ct your brakarfor personalised service. <br />800-444-4497 <br />For C ISIOmer service If your broker is <br />unavailable or to report a claim. <br />Your caverage begins on March 25, 2009 at 12:01 a.m. This policy expires on September 25, 2009 at 12:01 a.m. <br />This coverage summary replaces your prior one. Your insurance policy and any policy endorsements contain a full explanation of <br />your coverage. The policy limits shown far an auto may not be combined with the limits for the same coverage on another auto, <br />unless the policy contract allows the stacking of limits. The policy contract is form 6912 (03105). The contract is modified by forms <br />Z435 (12/06), 475gCA (09/06), 2852CA (09/06), 4757 (03/05), 4852CA (10/04), 4881CA (12104) and Z228 (07105), <br />The Warned insured organization type is a corporation. <br />but(ine of caverage <br />[te;criQ[ibn Units <br />Oeducobte <br />Liabllfty 7a Others .......... <br />Bodily Injury and Property Damage Liability <br />................. . ......... <br />$1,000,000 combined single limit <br />Uninsured/Underinsurecl Motorist <br />.................................................. <br />Uninsured Motorist Pro rT Da <br />...,., J? y.... "?age... <br />each S15,000each rson <br />....,.�... /$30,000 each accidµnt <br />$3,500 each acddent................................. <br />"' 50 e <br />............................................ <br />Medical Payments <br />...... <br />81,000 each person ...... <br />Subtata! policy premium <br />Calfomia Vehicle Assessment fee................................................................................ <br />........ <br />l. <br />ll <br />Tata) 6 month pollcyIpremlum........... ..... ................. <br />............ I... .......... ......"....I".... ........ <br />Rated driver <br />Premiuri� <br />$539 <br />R <br />°......................... 9 <br />$624.00 <br />....1. <br />0.90 <br />$.624.90 <br />1. riw>;il�cNa............................................. �PPROVE13..AS"TO.FORM ......... ,....................... ........... <br />.. <br />Auto coverage schedule <br />1 1997 Toyota Pickup LauSheedy <br />VIN: 4TANL42NXVZ298312 A,ssistapr�f nittjYZip �Qcie `yg1325 <br />Radius; 50 <br />Liability ..ability U ..... 8t UM PO Me Pay <br />Premium$539 ..,..,.....$39 ................. ............ ................................................ „.,.,..............,................ <br />$37" g Auto Total <br />$624 <br />Premium discounts <br />poliq <br />..............I ...... <br />Paid in Full and Renewal <br />FWM64a9 CA(I;JI06) `+i <br />Continued <br />'it i:11 lvllil l7i'1/ �'r 31V"t�. <br />