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State Farm Mutual Aut~mobiislnsarance Company sss2s-a-rt' ' x~v rL vOL <br />900 Otd River Road dECLARATtQNS PAGE <br />6akersfietd CA 9331 t-0007 <br />NAMEDiNSURED <br />AT2 75-3041-4 N a <br />POLIGY NUMBER V55 4445-601-751 <br />ouzses ___ . __ _..... _ ._ ~ _ __.___. <br />P©LICY PERI00 RUG 11 "2009 to FEB 01 2010 <br />rONZALES, MARY C <br />3b358 CHI7TAM W00l3 Pt. <br />MURRIETA CA 925b2-4395 <br />S"TATE FARM PAYMENT PLAN NUMBER <br /> 0087427812 <br /> 'AGENT <br /> TC1$I'E fLflRES <br /> 983t WALT{ER STREET <br /> CYPRESS, GA 90630 <br /> PHONE: {714}827-5701 or (714}827-5703 <br />DO NOT PAY PREMIUMS SHOWN QN THiS PAGE. <br />SEPARATE STi4TEMEN'T ENCLOSED !F AMOUNT' DUE. <br />YEAfI hSAKE ~ MOt7EL 6C3DY STYkE V>riit~LE ID. Ntt@48E~ ~~ Ci_ASS <br />2402 FORD EXPLORER SPORT WG iFMZU63E22Z682929 &B3HCVtM <br /> <br /> SYMBOLS COVERAGES ----- 'PREp111UMS <br /> 2002 <br /> See policy tar coverage details. FORD <br />A Bodily injurylProj~erty Qamage Lrabdrty $Ib2.15 <br /> Limits of Liability Coverage A-Bodily Injury <br /> Each Parson, Each ArcidenE <br /> $1,000,000 ~1;0G0,000 <br /> Limits of Liabrlity-Coverag~ A-Property Damage <br /> Each Accident <br /> $1,000,0p0 <br />Q500 $500 Deductible Gornprehensive $20.77 <br />G500 $500. Deductible Gtr(lisian $73.08.. <br />R1 CarRental/TravelExpenses $I5.86 <br /> Lirni#s of Liability -Gar Reittat Expense <br /> Each Day Eactl Occurrence <br /> y~~K ~~JV <br />U fr~ninsured Motor Vehicle $14.20 <br /> Limits of Lability-U <br /> Each Person, Each Accident <br /> $so,ooa _ ~so,ooo <br />Ui Uninsr.rred Motor Vehicle Property Damage $1.79 <br /> ,Total remium fat AUG 11 ,2049 to FEB Of 2410, -$287.86 Tbis is ngt a bill. <br />~PGRTAi4'f MESSAGES ~- - - -- - <br />Your policy consists of Phis declarations page, the policy booklet -form 9805A, and anyendorrements 1hatapply, including <br />those rssued to you with any sutxsegi.tent renewal'notice. <br />Replaced polioy number V554445-75H. <br />C Your Total renew}! premium for AUG 01 20fl9 to FEB 01 2010 is $304,83. <br />7 <br />7 <br />EXCEPTIONS AND ENDORSEMENTS {See individual endarsemdnt for details.} <br />' F?NANCED- AMERICANFIRST FCtt PO BOX 11048 ORANG CA 92856-8148. <br />'• 6097J.4 LEASED MOTOR VEHICLES ~ADDiTIONAL ~NSURED~-FORD CREDIT TITLING <br />-.TRUST LEASED UC"ICLES POBO:( 90858, MINNEAPOLIS MN 55439-0858.- <br />- 6091J.1 CERTIFiCAT~ OF GllARANTEED RENEWAL. <br />6127FF AMENDATORY ENDORSEMENT. <br />~ 6893PP AMENDMENT OF CAR RENTAL AND TRAVEL EXPENSES COVERAGES. <br />~ 6945A.1 AMENDMENT OF DEFINED WORDS LIABILITY MEDIGAL PAYMENTS <br />_ UNINSURED MOTOR VEHICLE ANt~ PHYSICAL DAMAGE COVERAGES AIVD <br />- CONDITIONS. <br />~' <br />S <br />~~~ <br />i <br />~ Sint`- S~ '~~otne`j <br />n• <br />~,'.tU1 ~~t,y <br />