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.: _ Interinsurance Exchange of the Automobile-Club ®: Automobile Insurance Policy Coverages and Limits Renewal Declarations We are pleased to offer you a renewal for your automobile insurance policy. To renew your policy, send at least the minimum payment on or ? before the due date. Insurance is in effect only for the vehicles, coverages, and limits of liability shown on this declarations page and as set $ forth in the insurance policy and endorsements. These declarations, together with the contract and the endorsements in effect, complete your policy. If any chahge to your policy or to the information we have on file results in a premium decreaseduring the policy period, the. a Interinsurance Exchange reserves the right to apply any refund due to your outstanding balance. r g NAMED INSURED (Item 1.) `" AUTO POLICY NUMBER: CAA 062566638 m CHOW, EDWARD S AND LINDA D 2537 UPPER TER GLENDALE CA 9'1214-2245 POLICY EFFECTIVE DATE: POLICY EXPIRATION DATE 01?'I-12 t2:ot A.M. O'1-3'1-'13 ?2:0? A. M. COVERAGES AND LIMITS ANNUAL PREMIUMS Coverage Is not fn eRect unless a premium or the word "included" is shown. COVERAGES LIMITS OF LIABILITY Vehicle 1 Vehicle 2 Vehicle 3 Vehicle Vehicle Liabi/ity Bodily Injury $500,000 each person/ $500,000 each occurrence Property Damage $500,000 each occurrence Medical Physical Damage (Actual Gash Value unless otherwise stated, less deductible) Vehicle 1 Vehicle 2 Vehicle 3 Vehicle Vehicle Comprehensive ACV ACV ACV (Less Deductible) $'100 $100 $L OO Collision ACV ACV ACV (Less Deductible) $500 $500 $500 Car Rental Expense (Per Day) NA NA NA Uninsured Motorist Bodily Injury - $500,000 each person/ $500,000 each accident Uninsuretl & Untlerinsuretl Vehicles Uninsured Deductible Waiver Uninsured Collision Total Premium - PREMIUM DISCOUNTS Please refer to the enclosed document entitled "Premi um Discounts Applied to Your Automobile Policy. "' If at any time you choose to pay less than the full balance outstanding, finance charges of up to 1.5°? per month of the balance outstanding will apply as explained in your billing statements, which are part of these declarations- " To see the annual mileage for your expiring policy, please refer to the "Notice of Annual Mileage" page contained in your renewal package. (l :p lt- IV F --D ??,. ?__ - . E201t Ofi,6 PROCESS DATE '12-26-1 ? PLEASE ATTACH TO YOUR POLICY ,ne„ (SEE REVERSE)