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X My Auto PolicyDetails <br /> Download <br /> Automobile Insurance Policy Coverages and Limits <br /> Modified Renewal Declarations <br /> We are pleased to offer you a renewal for your automobile insurance policy. To renew your policy.send at Ceast The minimum payment on or <br /> before the due date. Insurance is in effect only for the vehicles.Coverages.and limits of liability shown on this declarations page and as set e <br /> forth in the insurance policy and endorsements. These declarations,together with the contract and the endorsements in effect.complete your <br /> pulley. II any change la your policy or to the information we have on file results in a premium decrease during the policy period.the <br /> Interinsurance Exchange reserves the right to apply any refund due 10 your OLtslanding balance. <br /> NAMED INSURED Iltem 1.) a <br /> AUTO POLTCY NUMBER:CAA 16619760 <br /> KHALILI,EHAR POLICY PERIOD IPACIFiC STANDARD TIME) <br /> 5250 E BERGH DH POLICY EFFECTIVE OATS: 09-03-24 1201 A'A. <br /> ANAHEIM CA 92807-3104 <br /> POLICY EXPIRATION OATS: 09-03-25 12 01 A M <br /> VEHICLES <br /> VEH YEAR 1J:NIE MODEL IDENTIFfCATION VMACLF GARAGE ANNUAL" VERFIED SALVAGE NG, NUMBER, USE ZP CODE NOTES MILEAGE <br /> 2 2u20 CHEV MALIBU 1LT 1GIZD5STXLFU97510 PLEASURE 92607 5,501-7,500 VERIFIFII NO <br /> 3 2017 FARO FOCUSSE 1FADP3K26HL253764 PLEASURE 02607 1,501-2,500 VERIFIED NO <br /> COVERAGES AND LIMITS <br /> Dovem9A 1.not In 0ec1 unWar a Premlumorshawore'IncludW le ah— ANNUAL PREMIUMS <br /> COVERAGES LaeTS OF LIABILITY Vehicle 2 Vehicle 3 Vehicle Vehicle Vehicle <br /> Liahufty <br /> Badly111jury 915,000 each larsonr $30,000 each mourrence 3no $174 <br /> Propany Dmnage 510.000 each xcurronce 3650 $134 <br /> Medical' <br /> No Coverage;No Coverage: <br /> Physical'Damage=acl,.1— <br /> WhId,2 vetxd.3 WWI, vah¢la Vahki, <br /> Comprehalslve No Cumage No Co.era7e ;No Coverage!Na Coverage! <br /> (Less Deducliiblel No Coverage No Caeerage <br /> CWtiston Na Coverage No Corerage �No Coverage:No coverage; <br /> (Less DeductiMa) No Coverage NoC-erage <br /> LR Oenlal Expens <br /> e <br /> ayl No CO Ne No CIwerNe �No Coveraao�Ne Cov a.� <br /> Uninsured MolorPsf er ge' <br /> Bodily Injury- 515.000 aach persary S3aoW each acrid-I $239 $De <br /> Unin wad A Undednewed Vetvctes <br /> Uninsured Ceds waiver <br /> �No Coverage�No Cwaage� <br /> Uninsured Cglliglon iRl No Coverage No COvtt e <br /> Total Premium $1649 S374 <br /> PREMIUM DISCOUNTS 'No Coverage"indicates coverage not purchased. <br /> Please ruler to IiIa enclmed docume'a entitled'PrelMum Discouris Applied to Your Aulmrohde Pocy,' Total Annual Premium' S 2023 <br /> 11 at any time you choose to pay fens than the full balance olttatanding, txxtatles all aLpicaela mamvm:.f <br /> finance charges o1 up to 1.5%per month of The balance outstanding will apply Less Policyholder Savings Dividend S 117 <br /> as explained In your billing statements,which are part of these declarations. Net Premium' S 1906 <br /> To see the annual mlloaga far your expiring policy, please refer to the <br /> "Notice of Annual Miles e" age contained In our renewal package. <br /> tBllally signed <br /> Tu T r a n Ov"T". a APPROVED <br /> Nguyen <br /> Nguyen Dare:202s.o3.n BY To Tran Nguyen at 11:21 am,Mar47,2025 <br /> 11:22:2e-aTOO' <br /> fza" PROCESS DATE 07-31-24 PLEASE ATTACH TO YOUR POLICY (SEE REVERSE) j <br /> Interinsurance Exchange of the Automobile Club <br /> Automobile Insurance Policy Coverages and Limits <br /> Modified Renewal Declaratlons(continued) <br /> AUTO POLICY NUMBER.CAA.168197649 POLICY EFFECTIVE DATE'09�03-2024 <br /> DRIVERSICWera9e may d,ll'e.rvr vaM rarvm.Ylaasa sea eadr secuonMNgar CmrAsclWr cx darnison of Persal5 k+sarrar£f <br /> DRIVER NAME GENDER MARRAL STATUS YEAR FIRST <br /> NUMBER CEr ED <br /> 1 KHALILI,04AB MALE MARRIED 1991 <br /> 2 SHTEwIYEEN,HANIN FEMALE MARRIEO 1994 <br /> a KHALILL TALIA FEMALE SNGLE 2021 <br /> 4 KHALILI.DANA FEMALE SINGLE 2022 <br /> DRIVING RECORD <br /> DRIVER N- <br /> NMBER PRRIC IE PA LLY nO CaNN ERM m* c MS DRrvEP STATUS RATED <br /> VEHICLE <br /> r-MULT AL'.caElrrg VagR OERgUS Nn.wa SEVERE eUSPEn9ax15a'\�`\' NUMBER <br /> Home Insurance Travel Discounts More <br />