Insurance - Kaplan - 2010-09-26 POLICY NUMBER: A2513988
I: afeco Insurance,
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SAFECO INSURANCE COMPANY OF AMERICA
AUTOMOBILE POLICY DECLARATIONS
(CONTINUED)
NAMED INSURED: RENEWAL
MARK SODEN
FRANCENE KAPLAN POLICY PERIOD FROM: SEPT 26 2010
PO BOX 10263
COSTA MESA CA 92627-0106 TO: MAR 26 2011
at 12:01 A.M. standard time at
the address of the insured as
AGENT stated herein.
CONSOLIDATED OC INS AGENCIES AGENT TELEPHONE:
9070 IRVINE CENTER DR STE 280 (949) 862-4900
IRVINE CA 92618-4692
RATED DRIVERS MARK SODEN FRANCENE KAPLAN
2010 HONDA INSIGHT EX 4 DOOR IDf JHMZE2H72AS015464
2001 FORD F150 4 DOOR PICK-UP IDf 1FTRX18L91NB45694
Insurance is afforded only for the coverages for which limits of liability or
premium charges are indicated
LIABILITY
BODILY INJURY 0500 000 S 73 40 $500,000 S 115 70
Each Person Each Person
$500 000 $500 000
Each Occurrence Each Occurrence
PROPERTY DAMAGE $100 000 52 50 $100,000 72 90
Each Occurrence Each Occurrence
MEDICAL PAYMENTS 52 000 3 50 02,000 4 40
UNINSURED AND UNDERINSURED MOTORISTS
BODILY INJURY 0500 000 43 50 $500,000 51 10
Each Person Each Person
$500 000 5500 000
Each Accident Each Accident
COMPREHENSIVE Actual Cash Value 18 30 Actual Cash Value 17 20
Less $250 Deductible Less $250 Deductible
COLLISION Actual Cash Value 65 50 Actual Cash Value 70 60
Less $1000 Deductible Less $1000 Deductible
WAIVER OF COLLISION DEDUCTIBLE 5 20 5 70
ADDITIONAL COVERAGES
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ANTI FRAUD FEE 90 90
man
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TOTAL $ 262 80 TOTAL 5 338 50
am= TOTAL EACH VEHICLE. 1992 JEEP $ 161 50
mam
1995 JAGU 245 90
2010 HOND 262 80
2001 FORD 338 50
TOTAL 6 MONTH PREMIUM FOR ALL VEHICLES 5 1 008 70
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-CONTINUED-
ma=
P 0 BOX 515097 LOS ANGELES CA 90051
SA-1697/EP 9/90 Pa 2 of 3 DATE PREPARED• ME. 22 2010
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