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Safeco - .: _ POLICY NUMBER: P5683475 <br /> SAFECO INSURANCE COMPANY OF OREGON <br /> AUTOMOBILE POLICY DECLARATIONS <br /> (CONTINUED) <br /> NAD INSURED: <br /> FREDERICK ELLIS <br /> CATHERINE ELLIS POLICY PERIOD FROM: APR. 20 2017 <br /> 702 JUNE DR TO: APR. 20 2018 <br /> MOLALLA OR 97038-8843 <br /> at 12:01 A.M. standard time at <br /> the address of the insured as <br /> AGENT: stated herein. <br /> ABC AGENCY INC AGENT TELEPHONE: <br /> 3720 SW 141ST AVE STE 211 (503) 597-5009 <br /> BEAVERTON OR 97005-2349 <br /> RATED DRIVERS FREDERICK ELLIS, CATHERINE ELLIS, LUCAS F ELLIS, THOMAS H ELLIS <br /> 2012 VOLKSWAGEN GOLF 2 DOOR IDI WVWMM7AJ4CW244242 <br /> Insurance is afforded only for the coverages for which limits of liability or <br /> premium charges are indicated. <br /> COMBINED SINGLE LIMIT: <br /> BODILY INJURY AND $500,000 $ 600.90 <br /> PROPERTY DAMAGE Each Occurrence <br /> LIABILITY <br /> PERSONAL INJURY 77.00 <br /> PROTECTION <br /> UNINSURED/UNDERINSURED MOTORISTS: <br /> COMBINED $500,000 73.50 <br /> BI & PD LIABILITY Each Accident <br /> SEE YOUR POLICY <br /> co <br /> m COMPREHENSIVE Actual Cash Value 77.10 <br /> cco <br /> o Less $100 Deductible <br /> 0 <br /> rnCOLLISION Actual Cash Value 238.10 <br /> I; Less $1000 Deductible <br /> v <br /> oADDITIONAL COVERAGES: 7 20 <br /> c, ROADSIDE ASSISTANCE PACKAGE <br /> o <br /> 0 TOTAL $ 1,073.80 <br /> 0 <br /> 0 <br /> o TOTAL EACH VEHICLE: 2014 VOLK $ 1,122.10 <br /> o 2004 VOLK 850.40 <br /> 0 2012 VOLK 1,073.80 <br /> o _ <br /> 0 <br /> 0 $SUMMARY $ 3PRE6 UM <br /> o VEHICLE COVERAGES <br /> o 30 <br /> DISCOUNTS & SAFECO SAFETY REWARDS You saved $1,952.50 Included <br /> TOTAL 12 MONTH PREMIUM FOR ALL VEHICLES $ 3,046.30 <br /> You may pay your premium in full or in installments. There is no installment fee <br /> for the following billing plans: Full Pay. Installment fees for all other billing <br /> plans are listed below. If more than one policy is billed on the installment bill, <br /> only the highest fee is charged. The fee is: <br /> � � $2.00 per installment for recurring automatic deduction (EFT) <br /> $5.00 per installment for recurring credit card or debit card <br /> $5.00 per installment for all other payment methods <br /> -CONTINUED- <br /> P 0 BOX 515097, LOS ANGELES, CA 90051 <br /> SA-1F397/FP 9/90oft..e , „f ; DATE PREPARED: APR. 19 2017 <br />