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Polio? Number Frolfo Period <br />n� n� T A <br />Producer Nome and Code <br />4 <br />04�� I99Ei 64't l 3� AIM /Ns sat- sANTA14UNTUA 39 <br />emaJTaurer?: <br />ENVIRO.MENTAL DELIVERY SERVICES INC <br />D000rl,tlor,of VehIctae <br />h <br />1' <br />2 <br />Yr <br />1 <br />4. <br />PAeks <br />TIT <br />m, _r.— ._._—T. <br />Trik <br />v..t. <br />Sod 7 a 1 7orin e s <br />Model <br />Number <br />C0-� <br />7 <br />r e 19r <br />1 <br />1 7 PICKUP 4W <br />7 TIMP <br />L <br />c <br />1 <br />000 <br />4W0 <br />T�TCkTTP �b+, r <br />1 Y F T s <br />c 3N3RJ717117 <br />2W7 <br />3 <br />e 4' <br />2GTHK39N2L1564111 <br />1 r r <br />"I VA <br />/199, <br />4 <br />MC <br />L <br />1 $7TH <br />1355 <br />Gara Address Sarno means kept et mailing address) W <br />y <br />DRY CREEK RO <br />HEALDSBURG CA 85448 <br />2 <br />901 GLENDALE BLVD GLENDALE CA 91208 <br />t <br />355 DRY CREEK RD HEALDSSURt3 CA 95448 <br />T <br />355 DRY CREEK RO HEALDSBURG CA 95448 <br />4 <br />2 <br />LPrAI <br />1�P <br />Vnmoa (Ind Addresses of Loco PayoeetLP), Additional Intereete(Al) and Registered Owners(90) <br />G PO BOX 2525 HUDSON Ott 4.23E <br />I <br />COVERAGES <br />PREMIUMS <br />llubU•i <br />8t 9 250 ,000 each peroon 500,000 each ace dent <br />PD 100 ,000 each accident or <br />,000 Cornbleted She imit <br />Veh p s <br />Veh a 2 <br />Veil a 3 <br />Veh a 4 1 Veh a Ver <br />992 <br />1787 <br />992 <br />992 <br />Vruvured Motarlet Bi tr.4ox. 100/300 <br />8 30 X 000 eoct•1?eruon 5 80,000 each accident <br />23 <br />34 <br />23 <br />l 23 <br />UnInwred Motorist PO <br />8 Mex.rnum <br />Collision Oeduttinto Waiver <br />4 <br />6 <br />4 <br />24 <br />156 <br />4 <br />24 <br />206 <br />Excess Medical E>,pereo Providing For Reimburao;nont to Company <br />5000 An oh parson i No Exoeee. No Roimbursernent <br />24 <br />206 <br />43 <br />482 <br />Rents; Car Benefit <br />each day 8 Maximum <br />Comprehensive Oeducubtetel <br />Vol) Veh Valt Veh Veh Von <br />a 500 __A 500_ 50O a e 500 p s <br />CoMeon Uaduceblotal <br />,he, 500 Voh 59Q Voh 50 Von Veh V <br />t...2._ 2 _L___ t 500 _3._ <br />282 <br />620 <br />221 <br />282 <br />Premiums Par Veh cfe <br />1631 <br />2972 <br />1420 1531 <br />Vehicle Schedule <br />I'�I MER,JRY CASUALTY COWAN' <br />