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<br />'~ ENCOMPASS_ <br />INSURANCE <br /> <br />USP Elite.. Packa.ge ': <br />~~mended Policy COV. <br />:1 ,",,,,,,,,:,..,..,>. "<"..";;":':.~:;)';';':f:j <br />1I :;":AL'."'" ;'~ /;/;,;,;";.;,,,. . <br /> <br />Policyholder: <br />KRISTIAN KRAUSE <br />21682 VINTAGE WAY <br />LAKE FOREST CA 92630.5759 <br /> <br /> <br />i:i""'" <br /> <br />::'~.:.~',,:::;. <br />'{:f <br /> <br />Agent: <br />WALTER MORTENSEN INS <br />4701 STOCKDALE HWY <br />BAKERSFIELD CA 93309 <br />PHONE: 661.834.6222 240.007770.0000 <br /> <br />Policy Number: <br />.6121189. <br /> <br />Policy Period: <br />03/23/:<1005 to 03/23/2006 12:01 AM Slandard Time <br /> <br />Policyholder Since: <br />03/:<1004 <br /> <br />This Is a replacement of policy 218450853 <br /> <br />Insurance Provided By: <br />Encompass Insurance Company <br />2775 Sanders Rd.; Northbrook, IL 60062.6127 <br /> <br />24 HOUR CLAIM REPORTING 800.588,7400 <br /> <br />YOUR POLICY HAS BEEN CHANGED <br /> <br />A change in name of insured <br /> <br />Chg named insrd to maiden name: Kruase <br /> <br />$ 2,266.00 <br /> <br />Revised Annual Policy Premium <br />No change in premium <br /> <br />TIlls C9v8l'1lge SU/1lmJl",pro,v1d~ <br />I'llPrul!ll~,rQUr~I(~~.,,,", <br /> <br /> <br />MOTOR VEHICLE PROTECTION <br /> <br />(Coverage applies only If a premium or limit Is shown) <br /> <br />Description: <br />VIN: <br />Rated Driver: <br />Use: <br />Class Code: <br />Estimated Annual Mileage: <br /> <br />C()VJ;RA<OJ;s:j)'r0'!l!:j\l,!1'N0i!:i;l',~~~ <br />BODILY INJURY <br />(per person/per accident) <br />PROPERTY DAMAGE <br />(per accident) <br />MEDICAL EXPENSE <br />UNINSURED MOTORISTS - <br />SODIL Y INJURY <br />(per person/per accident) <br />COLLISION DEDUCTIBLE <br />WAIVER <br />(per accident) <br />COMPREHENSIVE (Camp) <br />COLLISION (Call) <br />TOWING <br /> <br />261211892 <br /> <br />~~,~ <br />CII.irmiln gf tM BNnI <br /> <br />KOOOOQCAC603010303110iOOOOO000004002'" <br /> <br />Vehicle 1 <br /> <br />Vehicle <br /> <br />2004 CHEVY TRue TRAILBLAZER <br />lGNDT13S842117211 <br />KRISTIAN KRAUSE <br />Pleasure <br />661100 <br />15000 <br /> <br />iitMd~"!ft,~~~i~m;J~.~ g_MJ)Ui~2 <br />$ 250,000/500,000 $ 451.00 <br /> <br />P1U\MlUM~i!: <br /> <br />$ 25,000 $ <br /> <br />139.00 <br /> <br />$ 5,000 $ <br /> <br />42.00 <br /> <br />$ 250,000/500,000 $ <br /> <br />86.00 <br /> <br />Per Endorsement $ <br /> <br />18.00 <br /> <br />$ 250 Deductible $ <br />$ 500 Deductible $ <br />Reasonable Expense $ <br /> <br />145.00 <br />430.00 <br />Included <br /> <br /> <br />~ <br /> <br />Continued on Next Page <br /> <br />Page 01 of 05 <br />