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PROOF OF INSURANCE (2006) CLOSED21st Century Insurance 21st.com 1- 800 - 211 -SAVE Evidence of Insurance and Mailing Address CITY OF EL SEGUNDO 350 MAIN ST EL SEGUNDO, CA 90245 PERSONAL AUTO Amendment POLICY DECLARATION EFFECTIVE 04/29/2006 MEMORANDUM COPY Named Insured and Mailing Address Robert Gall Tina Gall 3945 Hollyline Ave Sherman Oaks, CA 91423 Policy No: 3580142 Policy Period: From: 12/27/2005 To: 06/27/2006 12:01 AM Pacific Time Vehicle(s) and Driver(s) OF LIABILITY ARE SHOWN Veh Year Make /Model Vehicle ID Number Use Vehicle Discounts /Comments Zip I Mileage 1 1997 FORD EXPEDITION 1FMFU18LXVLA39148 2 2000 JEEP GRAND CHER 1J4GW58N7YC305946 Veh 1 Veh 2 3 2001 JEEP GRAND CHER 1J4GX58S11 C603000 4 12008 1 BMW 6501 WBAEH13416CR50049 $ 878 $ 231 Veh Rated Driver B. Property Damage Liability Licensed Tickets Chargeable Accidents Driver Discounts 1 Alexander Gall $ 96 C. Medical Payments $ S,000 each person $ 2 Tina Gall $ 86 $ 59 Uninsured Motorist $ 1S,000 each person 3 Cynthia Paris D. Bodily Injury $ 30,00 each accident 4 Robert Gall 94 $ 33 $ 45 $ 26 DAMAGE TO YOUR VEHICLE COVERAGE IS PROVIDED WHERE A PREMIUM AND A LIMIT OF LIABILITY ARE SHOWN FOR THE COVERAGE. Premium Coverage Limit of Liability Veh 1 Veh 2 Veh 3 Veh 4 A. Bodily Injury Liability $ 100,000 each person Includes $0.90 per vehicle fraud fee $ 300, 000 each accident $ 878 $ 231 $ 285 $ 185 B. Property Damage Liability $ 50, 000 each accident $ 399 $ 130 $ 143 $ 96 C. Medical Payments $ S,000 each person $ 153 $ 59 $ 86 $ 59 Uninsured Motorist $ 1S,000 each person D. Bodily Injury $ 30,00 each accident $ 94 $ 33 $ 45 $ 26 DAMAGE TO YOUR VEHICLE Veh 1 Veh 2 Veh 3 Veh 4 $ 396 $ 78 $ 106 $ 821 Actual Cash Value Less Deductible Ded. Ded. Ded. Ded. E. Comprehensive $ 250 $ 250 $ 250 $ 250 F. Collision $ 300 $ 300 $ 300 $ 300 $ 1,006 $ 278 $ 343 $ 788 Uninsured Motorist D1. Property Damage DED WAIVE I DED WAIVE DED WAIVE DED WAIVE $ 6 $ 4 $ 6 $ 4 G. Towing & Labor $ 5o each disablement Included Included Included Included H. Rental Reimbursement $ 25 per day; $ 750 max $ 32 $ 21 $ $ 21 J. Additional Equipment Included $1,000 $1, 000 $1,000 $1,000 First $1000 is automatically Additional $ 0 $ 0 $ 0 $ 0 included with coverage E or F. Additional coverage is optional. Total $ 1, 000 1, 000 1, 000 $1,000 $ $ Total Premium Per Vehicle $ 2,964 834 1,014 $ 2,000 Total Premium $ 6,812 Endorsements) /Agreements Applicable: Loss Payee (LP), Additional Insured (AI), Evidence of Insurance (Ell Drivers Not Rated Veh 2 El CITY OF EL SEGUNDO ,s51 -4a/ 33 I } Veh 3 LP Chase Manhattan Auto Veh 4 Al Us Banl< N.A. �? f �`i/;/ 3 J $•� For Loss Payee information call 1- 888 - 841 -8233 Address inquiries to 21 st Century Insurance Company 04/28/2006 6301 Owensmouth Ave., Woodland Hills, CA 91367 President WHEN ATTACHED TO THE PERSONAL AUTO POLICY, THESE DECLARATIONS COMPLETE THE POLICY AND REPRESENT THE CURRENT STATUS OF YOUR COVERAGES AND LIMITS OF LIABILITY. TCU4A1cA I01105) 21st Century Insurance Company, 6301 Owensmouth Ave., Woodland Hills, CA 91367 321st Century Insurance -21st.com 1- 800 - 211 -SAVE Evidence of Insurance and Mailing Address CITY OF EL SEGUNDO 350 MAIN ST EL SEGUNDO, CA 90245 Page 1 of 4 PERSONAL AUTO Amendment POLICY DECLARATION EFFECTIVE 08/11/2005 MEMORANDUM COPY Named Insured and Mailing Address Robert Gall 3945 Hollyline Ave Sherman Oaks, CA 91423 Policy No: 3580142 Policy Period: From: 06/27/2005 To: 12/27/2005 12:01 AM Pacific Time Vehicle(s) and Driver(s) Veh Year Model Vehicle ID Number Use Vehicle Discounts /Comments Zip Mileage EXPEDITION GRAND CHEROKEE LIMITED GRAND CHEROKEE LIMITED 1FMFU18LXVLA39148 1J4GW58N7YC305946 1J4G;;58S11C603000 Limit of Liability Veh 1 1 2 3 1997 2000 2001 3 Rated Driver ' A. Liability Bodily Injury Yearn Licensed Tickets Chargeable Accidents Discounts Veh $ Robert Gall Tina Gall Cynthia Paris $ Includes $0.90 per vehicle fraud fee $ 300, 000 each accident 1 2 3 COVERAGE IS PROVIDEL) VVMtnt H rmtiviium r+,w r L.1 -11 1 r.�,� - •– _ • .._ _ _ _ _. Premium Coverage Limit of Liability Veh 1 Veh 2 Veh 3 A. Liability Bodily Injury $ loo, 000 each person $ 239 $ 232 $ 285 $ Includes $0.90 per vehicle fraud fee $ 300, 000 each accident B. Property Damage $ 50,000 each accident $ 115 $ 124 $ 137 $ C. Medical Payments $ S,000 each person $ 50 $ 58 $ 87 $ Uninsured Motorist $ 15, 000 each person 33 $ 45 $ D. Bodily Injury $ 30 000 each accident $ 22 $ DAMAGE TO YOUR VEHICLE Veh 1 Veh 3 $ 87 $ 78 $ 107 $ Actual Cash Value Less Deductible Ded. Ded. Ded. E. Comprehensive $ 250 PDEDWAIVE, $ 250 $ F. Collision $ 300 $ 300 $ $ 174 $ 271 $ 359 $ Uninsured Motorist D1. Property Damage DED WAIVE DED WAIVE $ 4 $ 4 $ 6 $ G. Towing & Labor $ 5o each disablement Included Included Included Included H. Rental Reimbursement $ 25 per day; $ 750 max $ 21 $ _21 $ $ J. Additional Equipment Included $ 1, 000 $1, 000 $1, 000 $ First $1000 is automatically Additional $ 0 $ 0 $ 0 $ included with coverage E or F. Additional coverage is optional. Total 1, 000 $1, 000 $1, 000 $ Total Premium Per Vehicle t 712 821 1,026 Total Premium $ Endorsements) /Agreements Applicable: Loss Payee (LP), Additional Insured (All, tviaence OT insurance 1r-u Veh 1 LP Southland Civic Fcu Veh 1 El CITY OF RANCHO PALOS VERDES Veh 1 El CITY OF BELL For Loss Payee information call 1- 888 - 841 -8233 Address inquiries to 21 st Century Insurance Company 6301 Owensmouth Ave., Woodland Hills, CA 91367 —1 ".1— 33I 4A/ 3r A•/ President 08/10/2005 WHEN ATTACHED TO THE PERSONAL AUTO POLICY, THESE DECLARATIONS COMPLETE THE POLICY AND REPRESENT THE CURRENT STATUS OF YOUR COVERAGES AND LIMITS OF LIABILITY. Tcu4A1cA (01/05) 21st Century Insurance Company, 6301 Owensmouth Ave., Woodland Hills, CA 91367 ,21st Century Insurance PERSONAL AUTO Amendment 21st.com 1 -800- 211 -SAVE POLICY DECLARATION EFFECTIVE 08/11/2005 MEMORANDUM COPY Evidence of Insurance and Mailing Address Named Insured and Mailing Address CITY OF EL SEGUNDO Robert Gall 350 MAIN ST 3945 Hollyline Ave EL SEGUNDO, CA 90245 Sherman Oaks, CA 91423 Page 2 of 4 Policy No: 3580142 Dnfi— Parinrl- Prnm• 06/27/2005 To: 12/27/2005 12:01 AM Pacific Time COVERAGE IS PROVIDED WHERE Coverage A PREMIUM AND A LIMI I Uh LIA1:511-1 T AMC anvvvry Limit of Liability run i nS Premium A. Liability Bodily Injury Includes $0.90 per vehicle fraud fee $ ioo, 000 each person $ 300,000 each accident $ $ $ $ B. Property Damage $ 5o, 000 each accident $ $ $ $ C. Medical Payments $ 5 000 each person $ $ $ $ Uninsured Motorist D. Bodily Injury $ 15,000 each person $ 30,00 each accident $ $ $ $ DAMAGE TO YOUR VEHICLE $ $ $ $ Actual Cash Value Lose Deductible Ded. Ded. Ded. Ded. E. Comprehensive $ $ $ $ F. Collision $ $ $ $ $ $ $ $ Uninsured Motorist D1. Property Dama e $ $ $ $ G. Towing & Labor $ 50 each disablement Included Included Included Included H. Rental Reimbursement $ 25 per day; $ 750 Max $ $ $ $ J. Additional Equipment First $1000 is automatically included with coverage E or F. Additional coverage is optional. Included $ $ $ $ Additional $ $ $ $ Total $ __ $ Total Premium Endorsement(s) /Agreements Applicable: Loss Payee (LP), Additional Insured (AI), Evidence of Insurance (EI) Drivers Not Rated Veh 1 El CITY OF EL SEGUNDO Veh 2 El CITY OF RANCHO PALOS VERDES Veh 2 El CITY OF BELL For Loss Payee information call 1- 888 - 841 -8233 (\ Address inquiries to 21 st Century Insurance Company 08/10/2005 6301 Owensmouth Ave., Woodland Hills, CA 91367 President WHEN ATTACHED TO THE PERSONAL AUTO POLICY, THESE DECLARATIONS COMPLETE THE POLICY AND REPRESENT THE CURRENT STATUS OF YOUR COVERAGES AND LIMITS OF LIABILITY. TCU4AICA (01105) 21st Century Insurance Company, 6301 Owensmouth Ave., Woodland Hills, CA 91367 21st Century Insurance 21st.com 1- 800 - 211 -SAVE Evidence of Insurance and Mailing Address CITY OF EL SEGUNDO 350 MAIN ST EL SEGUNDO, CA 90245 Page 3 of 4 PERSONAL AUTO Amendment POLICY DECLARATION EFFECTIVE 08/11/2005 MEMORANDUM COPY Named Insured and Mailing Address Robert Gall 3945 Hollyline Ave Sherman Oaks, CA 91423 Policy No: 3580142 Policy Period: From: 06/27/2005 To: 12/27/2005 12:01 AM Pacific Time Vehicle(s) and Driver(s) Veh Year Model Vehicle ID Number Use Vehicle Discounts /Comments Zip Mileage Rated Driver . Years License Tickets Chargeable Accidents Discounts Veh COVERAGE IS PROVIDED WHERE A PREMIUM AND A LIMIT OF LIABILITY ARE SHOWN FOR THE COVERAGE. Premium Coverage Limit of Liability A. Liabilit� Bodily Injury Includes $0. 0 per vehicle fraud fee B. Property Dama e $ 10o, 000 each person $ 300, 000 each accident $ 5 o ,000 each accident $ $ $ $ $ $ $ $ C. Medical Payments $ 5, 000 each person $ $ $ $ Uninsured Motorist D. Bodily Injury $ 15, 000 each person $ 30,00 each accident $ $ $ $ DAMAGE TO YOUR VEHICLE $ $ $ $ Actual Cash Value Less Deductible Ded. Ded. Ded. Ded. E. Comprehensive.. $ $ $ $ F. Collision $ $ $ $ $ $ $ $ Uninsured Motorist D1. Property Damage G. Towing & Labor $ 50 each disablement $ Included $ Included $ Included $ Included H. Rental Reimbursement $ 25 per day; $ 750 Max $ $ $ $ J. Additional Equipment Included $ $ $ $ First $1000 is automatically included with coverage E or F. Additional coverage is optional. Additional $ $ $ $ Total $ Total Premium Per Vehicle Total Premium $ Endorsements) /Agreements Applicable: Loss Payee (LP), Additional Insures (All, tviaence of rnburancc tcil Veh 2 El CITY OF EL SEGUNDO Veh 3 LP Chase Manhattan Auto Veh 3 El CITY OF RANCHO PALOS VERDES For Loss Payee information call 1- 888 - 841 -8233 Address inquiries to 21 st Century Insurance Company 6301 Owensmouth Ave., Woodland Hills, CA 91367 Q�— 08/10/2005 President WHEN ATTACHED TO THE PERSONAL AUTO POLICY, THESE DECLARATIONS COMPLETE THE POLICY AND REPRESENT THE CURRENT STATUS OF YOUR COVERAGES AND LIMITS OF LIABILITY. TCU4AICA (01/05) 21st Century Insurance Company, 6301 Owensmouth Ave., Woodland Hills, CA 91367 @Century Insurance -.21st 21st.com 1- 800 - 211 -SAVE Evidence of Insurance and Mailing Address CITY OF EL SEGUNDO 350 MAIN ST EL SEGUNDO, CA 90245 Page 4 of 4 PERSONAL AUTO Amendment POLICY DECLARATION EFFECTIVE 08/11/2005 MEMORANDUM COPY Named Insured and Mailing Address Robert Gall 3945 Hollyline Ave Sherman Oaks, CA 91423 Policy No: 3580142 Pnlicv Period: Frnm- 06/27/2005 To: 12/27/2005 12:01 AM Pacific Time Vehicle(s) and Driver(s) Veh Year Model Vehicle ID Number Use Vehicle Discounts /Comments Zip Mileage $ $ $ $ B. Property Damage $ 50, 000 each accident $ $ Veh Rated Driver Licensed Tickets Chargeable Accidents Discounts $ $ Uninsured Motorist D. Bodily Injury $ 15, 000 each person $ 30,000 each accident $ $ ��nr�rn ��iuror A OOCR All IRA A&If A 1 IRA IT rlG I IAIJII 11 V Awl- R"l IIA /AI l-1 IW 1 Fir 1 11 \ 1 rF[lll �r Coverage Limit of Liability Premium A. Liability Bodily Injury Includes $0.90 er vehicle fraud fee $ 100,000 each person $ 300, 000 each accident $ $ $ $ B. Property Damage $ 50, 000 each accident $ $ $ $ C. Medical Payments $ 5, 000 each person $ $ $ $ Uninsured Motorist D. Bodily Injury $ 15, 000 each person $ 30,000 each accident $ $ $ $ DAMAGE TO YOUR VEHICLE $ $ $ $ Actual Cash Value Less Deductible Ded. Ded. Ded. Ded. E. Comprehensive $ $ $ $ F. Collision $ $ $ $ $ $ $ $ Uninsured Motorist D1. Property Damage $ $ $ $ G. Towing & Labor $ 5o each disablement Included Included Included Included H. Rental Reimbursement $ 25 per day; $ 75o max $ $ $ $ J. Additional Equipment First $1000 is automatically included with coverage E or F. Additional coverage is optional. Included $ $ $ $ Additional $ $ $ $ Total $ Total Premium Per Vehicle Total Premium $ 2,559 Endorsement s► /Agreemants Applicable: Loss Payee (LP), Additional Insured (All, Evidence of Insurance (ti) Veh 3 El CITY OF BELL Veh 3 El CITY OF EL SEGUNDO For Loss Payee information call 1- 888 - 841 -8233 Address inquiries to 21 st Century Insurance Company 6301 Owensmouth Ave., Woodland Hills, CA 91367 UriverS Not matea Q�)--� 08/10/2005 President WHEN ATTACHED TO THE PERSONAL AUTO POLICY, THESE DECLARATIONS COMPLETE THE POLICY AND REPRESENT THE CURRENT STATUS OF YOUR COVERAGES AND LIMITS OF LIABILITY. Tcu4A1cA (01/05) 21st Century Insurance Company, 6301 Owensmouth Ave., Woodland Hills, CA 91367