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<br />!!!!!! <br />- <br />- <br />- <br />.... <br />III <br />== <br />EIi!l <br />- <br /> <br />== <br />-= <br />=== <br />- <br />Iii <br />I <br /> <br />-= <br />- <br />- <br />- <br />E <br />.. <br />~ <br />- <br />- <br />- <br />.. <br />=- <br /> <br />- <br />=- <br />lIIii <br />-- <br />- <br />- <br /> <br />Ii <br /> <br />02/28/2005 12:30 <br /> <br />5192397105 <br /> <br />NEW CITY AMERICA <br /> <br />PAGE 05 <br /> <br />ce-"'-,CIA.l. AU11:HIOIIIIJE <br />COVERAGE PARr - DEC:L\RATIOM8 <br />IURlliIf AII1'O COVt=.RAGE FOIIII (CeItlLlul) <br /> <br />POLICY"~ 72 tl2Ie J:l:dIl1l1l3 <br /> <br />n1!II'IWO. SCIIIiDULE OF COVIlI'iAU8 AIID ca.__ AU'1QS (CenlhIId) <br /> <br />,., <br />'"' <br />... <br />... <br />"" <br /> <br /> LbIt <br />~-. Cc.1._" ". .... W. WI! Par.... AIPJ GIJ. Ad...- ~ '''''' <br /> AuIlM AcdJ .'lII'~ <br />PH't'S1CAL DAMAGE See ITEM FOUR far hhd or bonllW8d ..lillii'". <br />COMPREHENSIVE 02 ...... Cash Va/U8, c..t of ~, <<111. SIIIIlId $ 86.00 <br />COVEIW3E ArnclWIt 8haWn in m:w 1JoIREE, whJc:I.-ls <br /> -Ihst. minus U1Y dedr.L.1ll1alm in ffi:M <br /> '111FlEE far ellCh lXIWIlIICI"ilUlIl". <br />SPEClF1ED CAlJ8ES OF AcllulIJ C8IIl Vahle, Colt 1JI AIlpair', or" 8ated <br />lOSS OOVERAC!I:! Amount~ in 1TEMlKlEE. ~ Is <br /> __ mill... IlecIucti bill for <br /> 8IICh .....1IlICl..1J\O" lor "laos" caUMd Il!I mI""'*" <br /> orvandlll8m. <br />cou.lSION COVERAGE 02 AGIUaI CIlIh YeIue, c:c.t of 1WpU', CII''' S111t8d $ 199.00 <br /> A/IIlIUIII.tIown in ITEM l1iFlEE, ~r II <br /> __, INl\uS 8IIY dIdIntbIe s'-' In rrEM <br /> THI'IEE lor tJIlIlh -.cI"aUto". <br />'tOWINB AND LAIJOA . or lhe UllDUIll....... ..... far IIIllh <br /> "8IIID" kI m!M 1HAEE, whIcIIIliMr III ...' far <br /> .-GtIllu ~"""hl <br /> <br />... <br />.. <br />... <br />.. <br />,., <br />'" <br />~ <br />... <br />... <br />.. <br />"" <br /><> <br />In <br />... <br />* <br /> <br />El<it mil..... <br />(Nol1rlGlUcl8d aboVe) <br /> <br />TDTAI. ADVANCE pp...... <br /> <br />$ <br /> <br />1,866.00 <br /> <br />Forlll HA GO".. <br /> <br />.... a of.. <br /> <br />'9 :l'JOil'd <br /> <br />.l.ZCI I ,','l\:I.lt 3"1lln <br /> <br />'lqRO...."'.TQ <br /> <br />7C"DT ~nn~i~7'~- <br />