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PROGRESSIVE <br /> WEBB-WILSON COr19MERC/41 <br /> PO BOX 1300 <br /> KLAMATH FALLS,OR 97601 <br /> 1-541-884-4147 <br /> Policy number: 03890437-0 <br /> Underwritten by: <br /> Artisan and Truckers Casualty Co <br /> September 20,2016 <br /> Page 1 of 1 <br /> Certificate of Insurance <br /> Certificate Holder Insured Agent <br /> CITY OF SANTA ANA EVINGER&ASSOCIATES WEBB-WILSON • <br /> 20 CIVIC CENTER PLAZA PO BOX 1 PO BOX 1300 <br /> SANTA ANA,CA 92701 KLAMATH FALLS,OR 97601 KLAMATH FALLS,OR 97601 <br /> This document certifies that insurance policies identified below have been issued by the designated insurer to the insured <br /> named above for the period(s) indicated. This Certificate is issued for information purposes only. It confers no rights upon <br /> the certificate holder and does not change,alter, modify,or extend the coverages afforded by the policies listed below. <br /> The coverages afforded by the policies listed below are subject to all the terms,exclusions, limitations, endorsements,and <br /> conditions of these policies. <br /> Policy Effective Date: Aug 16,2016 Policy Expiration Date: Aug 16,2017 <br /> Insurance coverage(s) Limits <br /> Bodily Injury/Property Damage $1,000,000 Combined Single Limit <br /> Uninsured Motorist Bodily Injury $1,000,000 Combined Single Limit <br /> Description of Location/Vehicles/Special Items <br /> Scheduled autos only <br /> 2001 DODGE GRAND CARAVAN 2B4GP44R31R313753 <br /> Uninsured Motorist Property Damage $20,000 w/$200 Ded($300 if Hit&Run) <br /> Personal Injury Protection $15,000 <br /> Comprehensive $100 Ded <br /> Collision $500 Ded <br /> Rental Reimbursement $30 Per Day($900 Max) <br /> Certificate number <br /> 26416A10437 <br /> Please be advised that the certificate holder will not be notified in the event of a mid-term canceration. <br /> .11 CP <br /> Farm 5241(101021 <br /> a Cr ea. <br />