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Policy Number: nmq imEsiqo <br />AGENCY CUSTOMER ID: <br />VEMCLE SCHEDULM E DA(M=DtYYYY) <br />-G- 10/06/2017 <br />AGENCY CARRIER NA1c CODE <br />Interstate Trans Insurance Broker Inc. <br />POUCY NUMBER EFFECIIVC DAIE I NAMED IRR <br />NEW FMSWO TEPIaNAL 106/22/2 INTERNATIONAL BTJS L11,MS INC <br />NIP141r'l iz n1=ArPH3T1nM <br />vrHo <br />YEAR <br />MAKE:VAN HOOL 4"2045 <br />11 .. .. ......... -- <br />ICLE TYPE SYM <br />SYM <br />GE <br />I AGE <br />7A <br />OM <br />of" <br />OTC <br />OTC SM <br />OLL <br />mooLL-UNIT#91 <br />1213712045618 <br />06 <br />2001 <br />SPEC I K'7 <br />_CML <br />'�' I COMI. <br />7- <br />7 - <br />5 YM <br />S <br />7 <br />7- <br />GAHAGIUG S7REET(RaquIwdInKY) <br />CITY <br />— <br />couN <br />STATE <br />STATE <br />ZIP <br />ZIP <br />ADDRESS ri ST <br />S11TO <br />NTURA <br />CA <br />9 6 <br />93706 <br />STATE <br />10.33 <br />TERR <br />I Gcw CLASS <br />1.50, roo <br />sic, <br />FACTOR <br />SEATCP <br />RADIUS <br />FAR-w�—s�-TE=NAL <br />co_N.w <br />COSTNEW <br />A <br />CA <br />0'Vw <br />58 <br />Boo <br />USE <br />COM11IL FOR ��� <br />ES <br />ADD'L NO. <br />FAULT <br />OR <br />MOTOR <br />F <br />RE <br />RENT <br />REI.MB <br />DED BLEs <br />UCTI <br />ACV <br />/?I <br />JC101T' �ISPE,�CL <br />PLEASURE <br />RETAIL <br />MED PAY <br />TOWING <br />& LABOR <br />FT <br />To <br />FG <br />AA L'�SJSTAMT <br />OTC C OF L <br />0 Cc <br />75,000 <br />FARM <br />SERVICE <br />T <br />UNINS <br />mnT.Qa <br />SPEC <br />CoFL <br />-'PV <br />r <br />cl-' <br />5 1 —00 0 COLL <br />DRIVE TO <br />i 1-15M'LES I 1 15 MILEZ+ I <br />LNEjTA!H <br />WORK I SCHOOL <br />TOTALPREM: <br />VEH it <br />I YEAR <br />W <br />VEHICLE E <br />P <br />MAKE:VOLVO VEHICLE TYPE SYMIAGE <br />SYMIAGE <br />Cc <br />COMPI <br />�G"'"P' <br />OTC <br />OTC SYM <br />SyM <br />COLL <br />COLL <br />07 <br />2010 <br />---I <br />MOLIEL.UNIT#515 VIN-3CET2X620A5139735 SPEC R/ <br />C COML <br />COML <br />7- <br />8Y <br />SYM <br />7- <br />CITY <br />COUNTY <br />STATE <br />ZIP <br />ADDRESS <br />157REET(Requ(rodInKY) <br />SA14E <br />STATE <br />TERR <br />GVW I GCw CLASS <br />150,000 <br />sic <br />FACTOR, SEATCp <br />RADIUS <br />FAR'THESTTERMINAL <br />COSTNEW <br />CA 033 <br />Boo <br />B <br />USE HEC <br />HIRE C <br />COVERAGES <br />ADRLTNC� UNDRINS F LSP RENT <br />PAU MOTOR REIMB <br />E DUCTI.LE. M;M SPEC <br />DEDUCTIBLES ACV <br />AS", C'0MM'LHFOR <br />PLEASURE RETAIL LIAR <br />— <br />TOWING P1 <br />FT com <br />MED PAY & LABOR OTC <br />— FG <br />J!!— <br />OTC <br />OTC COFL <br />AA 5 OTC <br />' <br />AA -ST'VAT $5,000 <br />ST"T 000 <br />FARPA SERVICE I <br />UNINS SPEC Frw COLL <br />I <br />s�200,0 <br />00,000. 00 $5, 000 <br />00.00 $5,000 <br />DRIVETO I � 15 MILES 16MILES+ NETVEi <br />COLL <br />COLL <br />WORKISCHOOL ORICR: <br />TOTAL PREM: $ <br />vEH g <br />I YEAR <br />S MNIA <br />�m <br />duuy <br />J)TE! <br />VEHICLE TYPE <br />1AGE M <br />OTC s <br />COLL <br />L-LWIT#8225 <br />V.I,N.:YS2X4X208D1882938 <br />0 8 <br />2013 <br />PP SPEC COML I <br />SYM <br />GARAGING, <br />I STREET (RaqLlmd In KY) <br />CITY <br />COUNTY <br />STATE- <br />ZIP <br />ADDRESS <br />SANE I <br />I <br />LIC <br />STATE <br />1033 <br />TERR <br />GVW I GCW CLASS <br />150,000 1 <br />sic FACTOR <br />-P] <br />1.121ATC RADIUS <br />FARTHESTTEMMINAL <br />— <br />COSTNEW <br />CA <br />1 <br />-900 <br />$ <br />USE <br />IN <br />COMM'L FOR HIRE I <br />--CK <br />CHr F <br />LCOVERAG _S <br />ADDIL <br />FAULT <br />No- <br />UNDRINS <br />MOTOR <br />F <br />q <br />-- <br />LSP <br />RENT <br />DIZ �� �-'Cv <br />— <br />9P SPEC <br />>D—COV, TXICOFL <br />PLEASURE <br />RETAIL <br />LIAB <br />MED <br />PAY <br />FT <br />COMP/ <br />REIMS <br />FG <br />�DAA [�sTAw, <br />OTC <br />OT <br />FARM <br />SERVICE <br />NO <br />;W I <br />UNINS UNINS <br />%An— <br />R <br />SPEC <br />FTW <br />OTC <br />COLL <br />— <br />$200,000 <br />0000 <br />$5000 COLL <br />I <br />DRIVETO NO <br />WORKI pERdTCREH <br />ISCROOL 1415LES 15 MILES i <br />TOTALPREM: 3 <br />VEHO YEAR <br />MAKB:MCj I SCoY]BTTS <br />I <br />VEHICLE TYPE mm7j;ZE <br />-----I-V.I.N.:3BbIXSbdPA12SO80173 <br />T-.0 <br />COMP/ <br />Tc SYM <br />COLL <br />SYM <br />CO 9 2002 <br />MoDEL,-XJN1T#1055 <br />PP E] SPEC P�] COML <br />GARAGING <br />I STREET (Roqulmd In KY) <br />CITY <br />COUNTY <br />--;�F <br />S TA <br />ZIP <br />ADDRESS <br />SAbM <br />STATE <br />1033 <br />TERR 150,000 <br />GVWIGCW CLASS <br />SIC <br />FACTOR <br />SEATCP <br />RADIUS <br />FARTHESTTER <br />COST NEW <br />CuAcE <br />55 <br />00 <br />0 " REEI C <br />A USE C L FOR HIRE CHECK 0. UNDRIN ITI.E. COVERAGES CoLL N MOTOR Cne"ES <br />FAULT LSP IIEDU COTMMCPP11 <br />REIMB �SE <br />ACV CP <br />PLEASURE RETAIL TOWNG cov, COFL <br />LIAR MEDPAY FG <br />I <br />AA &LABOR OTC STAMT $ —0— <br />FAM NO- UNINS SPEC 0 C <br />CAttlYCOLL $-0— <br />DRIVE TO IN + NETVE COLL <br />WORKISCHOOL DRIGR� <br />VEHO YEAR MAKEMCI I BoDY13US TOTAL PREM: S <br />VEHICLE TYPE SYMIAGE L <br />— 1: OTC SYM SYM <br />10 12002 <br />MODEL. LWIT#105 6 7f12111,1:3BMXSbWAX2S080219 PP 7 SPEC cc L 0— 0— <br />GARAGING <br />STREET (Raqulmd In KY) <br />CITY <br />COUNTY <br />ADDRESS <br />I SAJM <br />STATE <br />ZIP <br />LIG <br />STATE <br />1033 <br />TE :RR <br />150 <br />VWOI'Icw CLASS <br />SIC <br />FACTOR <br />SEATCP <br />RADIUS <br />FARTHESTTFRIAINAL <br />COSTNFW <br />CA <br />, OGO <br />55 <br />500 <br />$ <br />USE 111. FOR HIRE I CHECK <br />COM CO ERAGES <br />ACD'L UNDRINS F ENT <br />FAULT MOTOR LSP 111r-Ime <br />DUCTIBLIES COMP! SPEC <br />PLEASURE <br />W11 RFTA' 'L LIAR <br />HFPA <br />_ <br />TOwING FT OTC --G <br />t,4=D P &LABOR <br />AG V OTCL <br />AA <br />SERVICE NO <br />_ <br />UNINS SPEC <br />STA $ <br />DRIVE 7OjS MILES + NETVEH <br />15MILES DRICR: <br />COLL <br />TOTALPREM: <br />U 1 �UJ-4uuu /AkUKU L;UKtUKA I KIN. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />Produced using Forms Boss Plus software. www.FonnsBoss.com: Impressive Publishina 800-208-1977 <br />711 <br />. . . .......... . <br />E U N1 CE HEREDIA <br />- ---- -------- <br />LR�IF�jD Y <br />