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AGENCY CUSTOMER ID: 00011400 _ DATE rzo® VEHICLE SCHEDULE (MMIDDNYVY) 07/03/2019 AGENCY - CARRIER - NAIL CODE Crescenta Valley Insurance Cailfornia Auto 38342 POLICY NUMBER EFFECTIVE DATE NAMED INSURED($) 05115/2019 MARK SANDERS VEHICLE DESCRIPTION GARAGING STREET (ROquirod In KY) CITY COUNTY STATE ZIP ADDRESS 4758 Promenade St $Iml Valley.._. 4F USE _--- CA..a ssoss 0411 STATEI TERR GVWIGCW CLASS SIG FACTOR SEATCP RADIUS i FARTHEST TERMINAL COSTNEW SE �Go 10 000 __ �100 $ 48 050 -----T- 7CHECK G ADOL NO UNURINS } : RENT V FlOTGh CO —.MT FORHIRET7 IA DEDUCTIBLES E �Q¢VMtACES_ i FAULT_ MOTOR I.._... �RCIAna ei AC�. jQ T PLEASURE RETAIL 1 t TOWING _I FT GDMPI FG X LIAR MEOPAV BLAEOR XI OTC M S STAMT $ 500 FARM SEHVICL NR f x IlNINS $9FlEC 1 FTW y) COIL GItl� ..—_ fl1Al.�.J. h94T.3±Il... LFAfl. _. ,.., /?� ...,..,. .. ,T .w- .,.� $ 500LOL a 15 MILEs tEMILER NET Du �" — c�.v, ._.... ...... TtlTA P EMz VEHq YEAR 'MAKE: FORD 'TYPE; Pickup VEHICLE TYPE SYMIAGEI CO E'OSYMI 90YL 7 12004 MODEL: F250 SUPER DUTY _ IVIN, 1FTNF20L84EA38319 PP saE �GOML _ — _ _-- T GARAGING I STREET (Roq Trod in KY) CITY COUNTY STATE I ZIP ADDREss 14758 Promenade St l Slm1 Valley CA., 93063 0411 STATE TERR GVWIGCW LLA99 SO i FACTOR SEAT OF RADIUS ( FARTHESTTERMINAL COSTNEW ��__ 10,000 f 1 t 100_ _ $ 18,959 USE LOMM'LT FOR HIREICNECK T Ap(Sl Ntli T❑❑Nt3AiNSt F LSPEN`i GEDUCTIGLEST l ICOMFIt g$PCi hO VKNASE9{.. iH`AMIT }._ ealioi ti HLJMR XFAC4t xj OTC 1erOF LEASURE RETAIL yy } TOWING ') GOMPt 7 LIAR WED PAY 4 81AGOR I, FT A OTC FG 1 M iSTAMT__ yFARM SERVICE mt X ,.1 24 w X cou $ 5000OL DOW vE act Q 1 i6 MILFS { IS MILER �� YA RC 6f $ VEHq YEAR MAKE BOUT VEHICLE TYPE SYMIAGE CpMpl LOLL F15PE;�_.... ___._. .,.,...�.� OTC SYM SYM MODEL _ V LN :. mm PFl41rEC I CCtML _ GARACINGi STREET IR q Y tl KY) �CITY I COUNTY rSTATE ZIP ADDRESS LIG .. 1. .. . _ _ ._.—_ __. .... _._. COST NEW STA HE TERR GVWIGCW CLASS 1 SIC FACTOR SEATCP RADIUS FARTHEST TERMINAL I USE COMM4 j FOR f{IREVE�A{$ES I,, FAULR i MOTORft F '-LSP f qp OEDUCTISLE9 jypVj ',Y"OI TCPr ICPOf {II j TOWING i---i ,�COMPI i i... I f I' LEABURC RETAIL I ��. LIAB P MED PAY 8 LAEOR FT pTC FG M 5T ALIT $ _ FARM bERVICE ND ON 3 SPEC I I F1W 'COIL 5 & COL _, , .XAULT..,X_ MoT RE _- 4 Qr $ _ i- -' -- DRIVE'fit�� --. -- 16 MILES 1E MILE9 + NETFEtt. WORK�9Cj QqL, TWOS TCJAL PREM:S _ VEHN YEAR MAKE IGGUY ) VEHICLE TYPE SYMIAGE C3M T"-9"a`LL fQTC BYM SYM $MODEL. IVIN .. ._._..� IPP SPEC] COML .... .. y..... _ _ ..... .. .... ...._. .... ... GARAGING qu ra In KY STREET 1Re d CITY COUNTY z STATE ZIP ; ) ADDRESS STATE TERR GVWIGCW CLASS SIC FACTOR SEATCP RADIUS FARTHEST TERMINAL COSTNEW _ ( $ USE T COMM'L i FOR HIRE (CHECK T— AW L NOT v UNORINS p �LOp i 11 DEDUCTIBLES ACV} AOMHI SPE@ CQVERAGE9 _ FAULT I, Ya MOTOR REIMU i OTC COi' PLEAGURE RETAIL j r 1 TOWING i- FT £ COMPI FG { i 11 LIAR MEU PAY _ & LABOR OTC ) AA _ a ST AMl $ .. _ FARM SERVICE ryGL UNINS SPEC I #COIL fAU I X; MOTOR . COFL COIL DRIVE TO 1b MILES] {15 MILFS NETVEH PORK 434f1001 I ORtCR' i R ^T LL VEHq YEAR (MAKE TYg- _, _,�„� BODY VEHICLE TV SYMIAGE iv iQ D$YM SYM M PP T SPED COME I �MooeL �YtN . _ ___ .._,....... ... ®�.. .__._ .�,1..COUN_. STATE GARAGING I STREET(Raqutradln FSYj CITY COUNTY STATE ZIP ADDRESS LIC STATE TERR GVWIGCW t CLASS i 91C - FACTOR ;SEAT CP� RADIUS FARTHEST TERMINAL t COSTNEW It y USE COMM'1. i FOR I RE i SPECCK bin NT ICOF PI EASURE RETAIL F 1 i WIffG FT OTC, FG fryR MAE MEO PAY S OCR i OTC ( I M 31 AMi $ FARM y(gV/ NtY r y Y UNINb Iyi C ,i IW COIL a S COL 10 name and logo are registered marks of ACORD Printed by JAB on July 03, 2019 at 01:29PM