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Insured Name MARIANN LONG Policy Number RB 752730 <br />VEHICLE COVERAGE INFORMATION <br />No. Year Make Model Vehicle Identification No <br />1 2007 LEXUS RX 400 AWD JTJHW31U972021753 <br />$ 92.00 <br />Auto Assessment for Consumer Services $ <br />$ 1.74 <br />Personal Catastrophe Liability Premium <br />$ 1777.00 <br />TOTAL AUTOMOBILE PREMIUM <br />$ 1,074.74 <br />Vehicle 1 Current Term Annual Mileage 14400 Prior Term Annual Mileaae 144on <br />V14HI1. EIaORSEMr~�tT(S)....::.. <br />09-14 UNINSURED MOTORISTS COVERAGE - CA ....... <br />PP1301 12-99 COV FOR DAMAGE TO YOUR AUTO EXCLUSION <br />AU741 02-07 LIMITED MEXICO COVERAGE <br />Vr AK3714 07-05 PERSONAL CATASTROPHE LIABILITY <br />VV LIMIT OF LIABILITY COV A $1,000,000 <br />TERR: 1, AUTOS 1, HOMES 1 <br />AK3664 09-04 PCL AMENDMENT-DWELLING/APARTMENT RENTAL <br />ADDRESS 5 NORTHGROVE <br />ADDRESS <br />CITY: IRVINE ST: CA ZIP: 92604 <br />ADDRESS 17 BRIDGEWOOD <br />ADDRESS <br />CITY: IRVINE ST: CA ZIP: 92604 <br />ADDRESS 48 LARKSPUR LANE <br />ADDRESS <br />CITY: MAMMOTH LAKES ST: CA ZIP: 93546 <br />AU971 11-13 AUTO CHANGES TO YOUR POLICY <br />WAIVER OF COLL DEDUCTIBLE DOES NOT APPLY <br />REVIF=UVEI) BY: <br />*Indicates a change was made to your policy. <br />AIS 5034 (08 00) CONTINUED <br />1 <br />$ 177.00 <br />EUNKIIE HEREDIA (PG 9 OF 4/) <br />023163 11 0000548 <br />Liability <br />Premium <br />Operator 1 Information <br />A. Liability <br />MARIANN LONG <br />Driver St/License Number <br />Bodily Injury - Each Person <br />$ <br />250, 0 0 0 <br />Bodily Injury - Each Accident <br />$ <br />500,000 <br />$ 278. 0 0 <br />Date of Birth Sex Marital Status <br />Property Damage <br />r Married <br />Each Accident <br />$ <br />100,000 <br />$ 144. 00 <br />Operator 2 Information <br />B. Medical Payment <br />JOHN HAYNES <br />Each Person <br />Driver St/License Number <br />C. Uninsured Motorists <br />Bodily Injury- Each Person <br />$ <br />25,000 <br />Date of Birth Sex Marital Status <br />Bodily Injury - Each Accident <br />$ <br />50,000 <br />$ 50. 00 <br />M Married <br />Property Damage <br />Each Accident <br />D, Damage To Your Auto <br />Actual Cash Value (ACV) minus <br />deductible shown <br />Collision Loss <br />$ <br />1, 0 0 0 <br />$ 306. 0 0 <br />Comprehensive Loss <br />$ <br />1,000 <br />$ 114. 00 <br />Towing and Labor Cost <br />Per Disablement <br />Total Premium for Vehicle <br />Endorsements Listed Below <br />TOTAL VEHICLE PREMIUM <br />$ 892.00 <br />ECt;FTB APS LPET TD 7NE. Vft IIL <br />Multi -Car <br />Multi -Policy <br />Good <br />Driver Plus <br />Anti Theft Devices <br />V14HI1. EIaORSEMr~�tT(S)....::.. <br />09-14 UNINSURED MOTORISTS COVERAGE - CA ....... <br />PP1301 12-99 COV FOR DAMAGE TO YOUR AUTO EXCLUSION <br />AU741 02-07 LIMITED MEXICO COVERAGE <br />Vr AK3714 07-05 PERSONAL CATASTROPHE LIABILITY <br />VV LIMIT OF LIABILITY COV A $1,000,000 <br />TERR: 1, AUTOS 1, HOMES 1 <br />AK3664 09-04 PCL AMENDMENT-DWELLING/APARTMENT RENTAL <br />ADDRESS 5 NORTHGROVE <br />ADDRESS <br />CITY: IRVINE ST: CA ZIP: 92604 <br />ADDRESS 17 BRIDGEWOOD <br />ADDRESS <br />CITY: IRVINE ST: CA ZIP: 92604 <br />ADDRESS 48 LARKSPUR LANE <br />ADDRESS <br />CITY: MAMMOTH LAKES ST: CA ZIP: 93546 <br />AU971 11-13 AUTO CHANGES TO YOUR POLICY <br />WAIVER OF COLL DEDUCTIBLE DOES NOT APPLY <br />REVIF=UVEI) BY: <br />*Indicates a change was made to your policy. <br />AIS 5034 (08 00) CONTINUED <br />1 <br />$ 177.00 <br />EUNKIIE HEREDIA (PG 9 OF 4/) <br />023163 11 0000548 <br />