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Z=Aea USAA CASUALTY IN: (ANCE COMPANY <br />NONl (A Slack Insurance Company) <br />USAA® 9800 Fredericksburg Road - San Antonio, Texas 78288 <br />CALIFORNIA AUTO POLICY <br />RENEWAL DECLARATIONS <br />Named Insured and Address <br />CATHY M MOREHEAD <br />2409 N VALENCIA AVE <br />SANTA ANA CA 92706-2063 <br />VEH YEAR I TRADE NAME MODEL BODY <br />04 97 VOLVO 850 WAGON <br />The Vehicle(s) described herein is principally garaged <br />VEH 04 SANTA ANA CA 92706-2063 <br />LAST PAGE 2 <br />MAIL MCH -M -S <br />tete U4veu POLICY NUMBER <br />A + XvXr 00462 63 39C 7101 8 <br />OLICY PERIOD: (12:01 A.M. standard time) <br />EFFECTIVE NOV 04 2000 TO MAY 04 2001 <br />01 CATHY M MOREHEAD <br />VEH USE WORx/$CHOE <br />M,slles Ike <br />IDENTIFICATION NUMBER SYM ea ek <br />This policy provides ONLY those coverages for <br />which a re I'm is shown below. <br />VEH <br />04 6 -MONTH <br />D=DED PREMIUM <br />VEH <br />D=DEDI PREMIUM <br />VEH <br />D=DED PREMIUM <br />VEH <br />D=DED PREMIUM <br />VERAGES LIMITS OF LIABILITY <br />CACV" MEANS ACTUAL CASH VALUE) <br />MOUN $ <br />AMOUNTI $ <br />AMOUNT $ <br />MOUNT $ <br />PART A - LIABILITY <br />BODILY INJURY EA PER $1,000,00 <br />EA ACC $1,000,OOC 236.69 <br />PROPERTY DAMAGE EA ACC $ 100,000 109.22 <br />'PART C - UNINSURED MOTORISTS <br />BODILY INJURY EA PER $ 300,00 <br />EA ACC $ 500,000 59.05 <br />WAIVER OF COLL DEDUCTIBLE 12.54 <br />I <br />ADDITIONAL INTEREST - EMPLOYER <br />EVANS WITHYCOMBE MANAGEMENT„ PHOENIX, Z <br />ADDITIONAL INTEREST - EMPLOYER <br />CITY OF SANTA ANA PUBLIC WRKS, SANTA AN CA <br />ADDITIONAL INTEREST - EMPLOYER <br />CITY OF SANTA ANA, SANTA ANA, CA <br />ADDITIONAL INTEREST - LESSOR AND LOSS PAYEE <br />VEH 04 VOLVO FINANCE NORTH AMERICA, SPRINGFIELD OH <br />ENDORSEMENTS: ADDED 11-04-00 - NONE <br />REMAIN IN EFFECT(REFER TO PREVIOUS POLICY)- A137(01) 5100CA(01) A072(03) <br />A073(03) *** 13580(02) <br />In WITNESS WHEREOF, we have caused this policy to he signed by our Fresldent and Secretary at pan Antonio, texas, <br />on this date SEPTET, 2000^ ��'�/•/ <br />Bra ford W. Rich Henry Icellict, Jr. w <br />5000 C _ Secretary President <br />