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American Family Connect Property and RENEWAL DECLARATION <br /> Casualty Insurance Company <br /> 6000 American Parkway APPROVED <br /> Madison,WI 53783-0001 By Tu Tran Nguyen at 10.:40 am,Apr 21,2026 <br /> CALIFORNIA <br /> POLICY NUMBER: AI02598221 <br /> POLICY PERIOD: 12/13/2025-06/13/2026 <br /> 12:01 AM Standard Time <br /> LAPSE IN COVERAGE: NONE <br /> Bongwon Kim <br /> Susan Kim FOR CLAIMS SERVICE CALL: <br /> 122 SPIRAL 1-888404-5365 <br /> FOR CLIENT SERVICE CALL: <br /> IRVINE, CA 92618-1367 1-888-404-5365 <br /> COVERAGE/LIMIT 6 2024 T'ESLA <br /> MODEL V EV <br /> BODILY INJURY LIABILITY $244.00 <br /> $30,000 EACH PERSON <br /> $60,000 EACH ACCIDENT <br /> n <br /> PROPERTY DAMAGE LIABILITY INCL <br /> $25,000 EACH ACCIDENT <br /> MEDICAL EXPENSE-EXCESS COVERAGE INCL <br /> $5,000 EACH PERSON <br /> UNINSURED MOTORIST BODILY INJURY $60.00 <br /> $30,000 EACH PERSON <br /> $60,000 EACH ACCIDENT <br /> UNINSURED MOTORIST PROPERTY DAMAGE $1.00 <br /> CAR 6-WAIVER OF COLLISION DEDUCTIBLE <br /> COLLISION $313.00 <br /> DEDUCTIBLES CAR 6-$500 <br /> COMPREHENSIVE $127.00 <br /> DEDUCTIBLES CAR 6-$250 <br /> TOWING AND LABOR COSTS $5.00 <br /> $75 PER DISABLEMENT <br /> RENTAL EXPENSE NONELECT <br /> CONSOLIDATED VEHICLE ASSESSMENT FEE $0.87 <br /> TOTAL SEMIANNUAL PREMIUM PER VEHICLE $750.87 <br /> CONVENIENCE FEE*- $10.00 <br /> TOTAL SEMIANNUAL PREMIUM ALL VEHICLES- $760.87 <br /> Coverage is provided only when both a premium and limit are shown. <br /> #Convenience Fee is$5 per monthly installment if payment is made by credit/debit card or$2 per monthly installment for a preauthorized withdrawal method. <br /> adca0la(001) 11/14/2025 <br />