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AGENCY CUSTOMERID; 00011400 <br />coR®® VEHICLE SCHEDULE - - DATE(MMIDDNYYY) <br />07/03/2019 <br />AGENCY CARRIER NAIC CODE <br />Crescenta Valley Insurance California Auto 38342 <br />POLICY NUMBER EFFECTIVE DATE NAMED IN6UHEDI61 <br />MAKE VIVA. _ 1yPg,van VEHICLE TYP�^E--� -SYMI AGE 6 OTC SYM SYM j 2002 MODEL DENALI XL K15pp M N: 1 GKFK66U 12J 102989 1 PP SPEC I COML <br />GARAGING STREET (Roqulrodl KY) CITY COUNTY STATE ZIP <br />ADDRESS 4758 Promenade St _ _ S_ml Valley _ CA jj 93063 0411 <br />_.__.. ppp._� LK ..... ED PAY I_. (FT 1 1 pp µ.y FRENT I UE OCT-E i $ coMPl BIPED <br />STATE TERR GVWIGCW CLASP SIC FACTOR SEATCP RADIUS FARTHEST TERMINAL } COST NEW <br />USE U GOMM'L l FOR HIRE CHECK � FAULAD&T <br />NO. 11NURIN3 FTW COLL CYM9 X� I _j tl Cp jCOf, <br />MejVERACE& _ FAVI T (j(j MOTOR !� $ J ACV $ .AeyGULI <br />PLFASURE �IiETAIL I TOWING (OMPI �' <br />a SLADOR X OTC M 6TAMT 8 500 <br />FARM SERVICE I N(}- UNINS SPHC <br />DRIVE-fP _ .._ ... hi.tl.0 .X PA4?FS113�_ C,0E-L .1_..,t,_,. ..XI. __ <br />j <15 MILEG I15 MILESa NETV6N - <br />Di�hh TOTA4 PHEM: i <br />VIED ; YEAR MAKE FORD BODY CpMp rm�oLr <br />TYPE P CI(UP VEHICLE TYPE SYM I AGE OTC BYM SYM <br />7 2004 MODEL F250 SUPER DUTY VIN 1 FTNF20L84EA38319 PP [ SPEC cCML <br />_- -- _ __ <br />GARAGING STREET (R,u rod n KY) CITY COUNTY l STATE ZIP <br />ADDRESS 4758 Promenade St j Sim[ Valley I l CA 193063-0411 <br />LIT I TERR GVWIGCW CLASS 310 FACTOR BEAT CP RADIUS FARTHESTTERMINAL COST NEW <br />STATE <br />1p,Op0 T100 RCIMB i 18tC9OM59 <br />F<}VERAGES pAF OEUUCTIDLEXUSE ORHIRECHECK ANLNCj P ACVI J OTCPh COA PLEASURE RETAIL 1 X LIAR ME PAY rOWINO PT yy PpOMP! F' 1 <br />1 a_. it _ G IAROR ,� M I_ 1 T AMT S 500 <br />FARM ERVICE i11 p�� li X VNINS 1 Sf+FG X <br />tr.. .__ J. AQ1.1: MQtW3. J_ gQFi..._.. _ Fnv GULL $ S_ 6000ou <br />GR�NE , c tS MILES 1E MILE6 a DFUCIe '" - "' <br />R A la <br />VE11N YEAR MAKE DORY VEHICLE TYPE .MMIAGE COMP11 eoLL <br />_. iYp :.� OTCSYMI sYM <br />{PP F.aria <br />GARAOING i STREET (R g Irntl In KY) CITY COUNTY STATE 21P <br />ADDRESS <br />{ <br />_i. ._.. _�. .. .._ ..._.... <br />STATE TERR GVWIGCW i CLASS SIC FACTOR SRATC1 RADUS 1 FARTHESTTERMINAL COST NEW <br />_ _ t $ <br />USE COMM FOR HIRE BECK AnIJI NC5 UMt RIN6 1 LSP RCN7u UEUUCTIeLEe 7-`OL�MP/ Arm <br />I{I ,¢ 4ttAtSE3 FAULT -XI MOTOR I F NEWS _ f AGV OTC {.OF L <br />1 PLEASURE REtAIL LIAG MED PAY LAUGH 1 _1 Fr COMPI FG <br />IftWING —1 LOgO M Si <br />FARM SERVICE NO-V ppNINS SPE[. I 1 FIW ' OroLL <br />�yEAUi7 ,fx htGFW! <._ ..C9t6 COLL <br />ORIVE'fIP T<i6 MILF9 1S MILES NETVEN�� <br />W K t 1 TAL PRBMi <br />VEHO 1 YEAR MAKE; BODY VEHICLE TYPE SYM 11AGE UUMP TSYM <br />jMUDEL IN, �PP �_ SPEC- CGML ! <br />GARAGING ; STREET(Rnqu lmtl In KY) ! CITY COUNTY £STATE' ZIP <br />ADDRESS t <br />L— .. _— _ _..,..,_. —_ ------- <br />STATE TERR GVWIGCW CLASS i SIC FACTOR TSEpT CPS RADIUS FARTHEST TERMINAL COSTNEW <br />_. <br />CHEC <br />Use )COMML FDHHIHE IQw, A004 NO MOTORN1 F LGP FE p OEOUCTIDLES ACV �COMI 761'NG <br />&pVERAGEE�_ rAUIT ._�, OTC ICGFL <br />PLEASURE RETAIL JILIAB MED PAY 1 ALABOR FT OiC P!�FG AA STAMT I$_. _..._ <br />p FARM SERVICE IIIYtk UNINS SPEC I FTVJ COLL tY <br />4 __ I (FAULT �.X. MOTOR I .COPE t - $ 1S LOLL <br />WRIT. D . 15 MILES 15 MILES !!!!!!I kY VEH 7 AL RM: <br />VENp YEAR MAKE U. VEHICLE TYPE SYM IAGE UMP C� <br />.. _.-1--1:-_ ......_.__...(Y-`! ,GTCSVM SYM <br />MODEL V.1 N.� PP L__J SPFC COWL <br />! <br />.�_.....� _._..i <br />......... <br />GARAGING ! 9MLHT (RogNitadiP l4TI CITY COUNTY I STATE ZIP <br />ADDRESS <br />—_ <br />STATE TERR BMW I DCW CLASS SIC FACTOR 1mATCPI RADIUS 11 FARTHEST TERMINAL COST NEW <br />FAriMGURE �SEHAV/641( ._._I IbV NOOFSAl <br />;.v DECPAYiFAULT��51 aDROR i!OrMPIR MTB. * M ... SIAMrACV <br />LOTC COFL. <br />USE GOMM'l. FQR9 iE F LSP DEDUCTIBLES COMP( -SPEC <br />ni <br />�yjikAQORD name and logo are registered marks of ACORD <br />1{�' Printed by JAB on July 03, 2019 at 01:29PM <br />Risk enfi Dtuisk� t <br />