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GEICO GEICO GENERAL INSURANCE COMPANY (i t <br />Washington 00 VERIFICATION OF COVERAGE <br />(SEE :BELOW UNDER CAUTIONARY NO'PE) <br />INSURED Policy Number: 4214876908 <br />Effective Date: 03 -06 -15 <br />MARIBEL LARIOS Expiration Date: 09 -06 -15 <br />29250 wrangler Or Registered State: CALIFORNIA <br />MHrrieta CA 97563 <br />To whom it may concern: <br />This letter is to verify that we have issued the policyholder coverage under the above policy number for the dates indicated in the effec- <br />tive and expiration date fields for the vehicle listed. This should serve as proof that the below mentioned vehicle meets or exceeds the <br />Financial responsibility requirement for your state. <br />This verification of coverage does not amend, extend or alter the coverage afforded by this policy. <br />Vehicle Year: 2006 <br />Make: BMW <br />Model: 330 <br />VIN:WBAVB33556KS36470 <br />COVERAGES <br />BODILY INJURY LIABILITY <br />PROPERTY DAMAGE LIABILITY <br />UNINSURED &UNDERINSURED MOTORISTS <br />COMPREHENSIVE <br />COLLISION <br />Lienholder <br />Additional Insured <br />CITY OF SANTA ANA <br />ITS EMPLOYEES AND COUNCIL MEMB <br />20 CIVIC CENTER PLAZA <br />SANTA ANA, CA 97701 -0000 <br />Additional Information: <br />LIMITS DEDUCTIBLES <br />$1MIL /$1MIL <br />$10,000 <br />$15,000/$30,000 <br />$1,000 DED <br />$1,000 DED <br />If you have any additional questions, please call 1- 800.841 -3000. <br />X_ Interested Party <br />CAUTIONARY NOTE: THE CURRENT COVERAGES, LE rS, AND DEDUCTMLES MAYDIFFER FROfrI'THE COVERAGES, LIJ IITS,AND DEDUCTIBLES IN EFFECT AT OTHER <br />TEVICS DURHNG'TIM POLICYPERIOD. THIS VERIFICATION OF COVERAGE RETLECTS THE COVERAGES, LIMITS AND DEDUCTIBLES AS OF THE ISSUES) DATE OF THIS <br />DOCUMENT WHICH IS SHOWN UNDER "ADDTTIONAX.INFORM &rXON" OR MAN ISSUED DATE IS NOT SHOWN, THE DATE OF THIS FACSIMILE. <br />U -33 10 -07 yJ <br />�F <br />