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Insured Name MARIANN LONG Policy Number RB 752730 <br />VEHICLE COVERAGE INFORMATION <br />SECTION III <br />No. Year Make Model Vehicle Identification No <br />1 2007 LE'XUS RX 400 AWD JTJHW31IJ972021753 $ 882.00 <br />Auto Assessment for Consumer Services 1.74 <br />Personal Catastrophe Liability Premium 177.00 <br />TOTAL, AUTOMOBILE PREMIUM 1,060.74 <br />Vehicle 1 Current Terrn Annual Mileage 14400 Prior Term Annual Mileaer4a 1 AAnn <br />DOM.... ..... <br />Liability <br />Premium <br />Operator I Information <br />A. Liability <br />COV FOR DAMAGE TO YOUR AUTO EXCLUSION <br />AU741 <br />02-07 <br />MARIANN LONG <br />AX3714 <br />07-05 <br />PERSONAL CATASTROPHE LIABILITY 177 00 <br />Driver StILicense mber <br />Nu <br />Bodily Injury - Each Person <br />250 0 00 <br />TERR: 1, AUTOS 1, (TOMES I <br />AK3664 <br />Bodily Injury - Each Accident <br />5 0: 0 0 0 a <br />216.00 <br />Date of Birth Sex Marital Status <br />Property Damage <br />ADDRESS <br />Each Accident <br />B. Medical Payment <br />$ 100, 000 <br />$ <br />142. 00 <br />Operator 2 Information <br />ADDRESS <br />CITY: IRVINE ST: CA ZIP: 92604 <br />JUN HAYNAs <br />Each Person <br />ADDRESS 48 LARKSPUR LANE <br />Driver StiLicense Number <br />C. Uninsured Motorists <br />CITY: MAMMOTH LAKES ST: CA ZIP: 93.546 <br />*AU971 <br />11-13 <br />Bodily Injury - Each Person <br />$ 25,000 <br />WAIVER OF COOL DEDUCTIBLE DOES NOT APPLY <br />Date of Birth Sex Marital Status, <br />Bodily Injury - Each Accident <br />$ 50, 000 <br />$ <br />49 , 00 <br />M Married <br />Property Damage <br />Each Aoddent <br />D. Damage To Your Auto <br />Actual Cash Value (ACV) minus <br />deductible shown <br />Collision Loss <br />$ 1, 000 <br />$ <br />302. 00 <br />Comprehensive Loss <br />$ 1,000 <br />$ <br />113.0 0 <br />Towing and Labor Cost <br />Per Disablement <br />Total Premium for Vehicle <br />Endorsements Listed Below <br />VITAL VEHICLEPREMIUM <br />882.00 <br />% A.BYiE <br />777777777Z� <br />Multi-Car <br />Multi-Policy <br />Good Driver Plus <br />Anti-Theft Devices <br />DOM.... ..... <br />MARlANN LONG AN ASS,O <br />7,�FES: AGREEMENT # A-2013-171 <br />W <br />REVIEED BY: EUNICE ERED A (PG. 3 of 4) <br />"Indicates a change was made to your policy, <br />AK 5034 (08 00), CONTINUED 030791, 12 caoccsq <br />09-14 <br />UNINSURED MOTORISTS 'ddVkkXGE- L... dA .... ... <br />PPI301 <br />12-,99 <br />COV FOR DAMAGE TO YOUR AUTO EXCLUSION <br />AU741 <br />02-07 <br />11MITED MEXICO COVERAGE <br />AX3714 <br />07-05 <br />PERSONAL CATASTROPHE LIABILITY 177 00 <br />LIMIT OF LIABILITY COV A $1,000,000 <br />TERR: 1, AUTOS 1, (TOMES I <br />AK3664 <br />09-04 <br />PCL AMENDMENT - DWELLING /APARTMENT RENTAL <br />ADDRESS 5 NORTEGROVE <br />ADDRESS <br />CITY: IRVINE ST: CA ZIP: 92604 <br />ADDRESS 17 BRIDGEWOOD <br />ADDRESS <br />CITY: IRVINE ST: CA ZIP: 92604 <br />ADDRESS 48 LARKSPUR LANE <br />ADDRESS <br />CITY: MAMMOTH LAKES ST: CA ZIP: 93.546 <br />*AU971 <br />11-13 <br />AUTO CHANGES TO YOUR POLICY <br />WAIVER OF COOL DEDUCTIBLE DOES NOT APPLY <br />MARlANN LONG AN ASS,O <br />7,�FES: AGREEMENT # A-2013-171 <br />W <br />REVIEED BY: EUNICE ERED A (PG. 3 of 4) <br />"Indicates a change was made to your policy, <br />AK 5034 (08 00), CONTINUED 030791, 12 caoccsq <br />