Policy Number
|
policy period |
Produceer Name and Code |
AC 11025027 |
From 12.01AM 05/23/2007
|
To 12:01 AM 05/23/2008 |
HEBARD INS. AGCY.. INC. 2646
|
Named Insured:
DAVID L SAULQUE
|
| DBA: A1 AIR VENT |
| Description of Vehicles |
|
|
|
| Veh # |
Yr |
Make |
Body Type / Tonnage |
Model |
GvW |
Serial Number
|
Cost or Value
|
Purch Date
|
New/Used
|
| 1< |
1995 |
FORD |
3/4 T VAN |
|
L |
1FTME24H2SHB96401 |
17 .514 |
01/1997 |
U |
| 2
|
1998 |
CHEVROLET |
1/2 T VAN |
|
L |
1GCOM19W7WB103805 |
21 .494 |
04/1998 |
N |
| 3 |
2001 |
FORD |
1/2 T PICKUP |
|
L |
1FTZF17261NA76023 |
20 .768 |
05/2001 |
N |
| 4 |
2003 |
ISUZU |
1 1/2 T FLATBED |
|
M |
JALC4J14537011935 |
39.965 |
01/2004 |
N |
| 5 |
2006 |
ISUZU |
1 1/2T TRUCK |
|
M |
JALC4B16967016874 |
55,640 |
11/2006 |
N |
| |
|
| Veh #
|
Garaging Address ("Same" means kept at mailing address)
|
| 1 |
1717 ENGLISH COLONY |
PENRYN |
CA 95663 |
| 2 |
1717 ENGLISH COLONY |
PENRYN |
CA 95663 |
| 3 |
1717 ENGLISH COLONY |
PENRYN |
CA 95663 |
| 4 |
1717 ENGLISH COLONY |
PENRYN |
CA 95663 |
| 5 |
717 ENGLISH COLONY |
PENRYN |
CA 95663 |
| |
| Veh
#. |
LP/AI |
Names and Addresses of Loss Payees(LP), Additional Interests(AI) and Registered Owners(RO)
|
| 4 |
LP/'A] |
GMAC |
PO BOX 8102 |
COCKEYVILLE |
MD 21030 |
|
LP |
GMAC |
PO BOX 5378 |
TIMONIUM |
MD 21094 |
|
|
|
|
COVERAGES |
PREMIUMS |
Liability
|
,000 |
each person |
$ |
.000 each accident |
$ 1.000 ,000 Combined Single Limit
|
Veh # 1 |
Veh # 2 |
Veh # 3 |
Veh # 4 |
Veh # 5 |
Veh # |
| Bl $ |
| PD $ |
,000 |
each accident or |
|
|
| |
$1,000.000 Combined Single Limit |
| |
|
|
|
479 |
436 |
436 |
523 |
458 |
|
| Uninsured Motorist - Bl $ ,000 Combined Single Lir
$ 30 ,000 each person $ 60,000 each accide |
|
12 |
12 |
12 |
12 |
12 |
|
| Uninsured Motorist - PD
$ 3500 Maximum |
|
5 |
5 |
|
|
|
|
| ion Deductible Waiver |
|
|
|
3 |
3 |
3 |
|
| Excess Medical Expense Providing For Reimbursement to Company
$ 5000 each person ;: No Excess, No Reimbursement |
|
18
|
18
|
18
|
18
|
18
|
|
Comprehensive - Deductible(s)
|
|
|
|
51
|
130
|
235
|
|
| Veh $ |
Veh $ |
Veh 3 $100.00 |
Veh 4 $500.00 |
Veh 5 $100.00 |
|
Comprehensive - Deductible(s)
|
|
|
|
179
|
474
|
537
|
|
| Veh $ |
Veh $ |
Veh 3 $500.00 |
Veh 4 $500.00 |
Veh 5 $500.00 |
|
|
|
179
|
474
|
537
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Premiums Per Vehicle
|
|
514
|
471
|
699
|
1160
|
1263
|
|
|
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|