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HomeMy WebLinkAboutSANDOVAL, EDITH INSURANCL ON FILE N-2025-076 WORK MAY PROCEED UNTIL INJ (NC�XP)RFS CITY CIR DATE;Aq JF''F( 0 9 2025 COUNCIL AIDE PROFESSIONAL SERVICES AGREEMENT p; GMT THIS AGREEMENT is made and entered into on this 27`h day of March, 2025 by and between J11 rip VA�Utz Edith Sandoval ("Consultant"), and the City of Santa Ana, a charter city and municipal corporation 00 organized and existing under the Constitution and laws of the State of California("City"). RECITALS A. The City desires to obtain the services of a Consultant to provide administrative, constituent, and legislative support for a member of the Santa Ana City Council. B. Consultant represents that Consultant is qualified to perform these services. C. In undertaking the performance of this Agreement, Consultant represents that Consultant is knowledgeable in its field and that any services performed by Consultant under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional in the field. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions hereinafter set forth, the parties agree as follows: 1. SCOPE OF SERVICES a. Consultant shall perform during the term of this Agreement,the tasks and obligations including all labor, materials, tools, equipment, and incidental customary work required to fully and adequately provide administrative, constituent, and legislative support services for Councilmember Jessie Lopez ("Councilmember") as provided in this Agreement and in the Scope of Services as described in subsection b below. b. At the direction of Councilmember, Consultant shall perform a variety of administrative, constituent, and legislative functions and tasks, including but not limited to, conducting complex administrative studies, researching and responding to constituents' inquiries, drafting written communications involving strategy,policies,and/or procedures,coordinating assigned project activities,preparing creative projects, and serving as a liaison,where necessary. c. As may be required for services performed while at City Hall, the City may provide access to the Councilmember's office space — consistent with City procedures — should Consultant require limited access to perform services required by the Councilmember. Consultant shall maintain a business location separate from City and Consultant understands that such access to office space is not required by the City but provided to the Consultant on an as-needed basis and should only be used when City Hall is open to the public or while the Councilmember is present. 2. COMPENSATION a. City agrees to pay, and Consultant agrees to accept as total payment for its services for City, the hourly pay rate of$35.00, for services rendered pursuant to this Agreement. Page 1 of 12 Consultant agrees and understands that no changes to this pay rate shall be made during the term of this Agreement and that monthly billing pursuant to this Agreement, shall not exceed a total slwa of two thousand five hundred dollars ($2,500.00)per month. The total sum to be expended under this Agreement shall not exceed ten thousand dollars($10,000,00) during the term of this Agreement. b. Consultant agrees and understands that the not-to-exceed amount, provided above, includes reimbursement for all out-of-pocket expenses, including but not limited to, mileage, copying costs,and mail services authorized at the sole direction of the Councilmember in connection with the performance of duties under this Agreement. The City shall not make any separate payments for any of the above expenses. c. Consultant shall submit monthly invoices to City for work performed during the billing period. Payment by City shall be made within thirty (30) days following receipt of proper invoice evidencing work performed, subject to City accounting procedures. Monthly invoices shall be in substantially the form attached hereto as.Exhibit"A." 3. TERM This Agreement shall commence on March 27, 2025 and terminate on June 30, 2025, unless terminated earlier in accordance with Section 19, below. City shall recognize and compensate Consultant for any services performed beginning March 17, 2025. 4. INDEPENDENT CONTRACTOR Consultant shall, during the entire term of this Agreement, be construed to be an independent contractor and not an employee of the City. This Agreement is not intended nor shall it be construed to create an employer-employee relationship, a joint venture relationship, or to allow the City to exercise discretion or control over the professional manner in which Consultant performs the services which are the subject matter of this Agreement;however,the services to be provided by Consultant shall be provided in a manner consistent with all applicable standards and regulations governing such services. Consultant shall pay all salaries and wages, benefits, employer's social security taxes, unemployment insurance, and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. S. POLITICAL CAMPAIGN ACTIVITIES a. Consultant is prohibited from the following political campaign activities while this Agreement is in place: 1) Acting as campaign treasurer/manager or a campaign consultant for any can. for Santa.Ana City Council or Mayor; 2) Campaigning for any candidate for Santa Ana City Council or Mayor and at the same time,working pursuant to this agreement and/or charging the City for the time spent campaigning pursuant to this agreement; 3) Using City equipment, supplies or resources to campaign for tiny candidate for Santa Ana City Council or Mayor; Page 2 of 12 d) Accepting any campaign contributions on behalf of any candidate for Santa Ana City Council of Mayor; 5) Campaigning while wearing any attire or logo that identities you as a Consultant for the City of Santa Ana; 6) Campaigning while using any City room, building, or location that has not been specifically designated for political speech; 7) Receiving any payment or reimbursement from a campaign candidate for Santa Ana City Council or Mayor or their campaign account; and/or 8) Opening a campaign committee or pulling nomination papers to run as a candidate for Santa Ana City Council or Mayor. b. Consultant will sign the declaration attached hereto as Exhibit B acknowledging said prohibitions. 6. PROHIBITION AGAINST APPOINTMENT TO CITY BOARD OR COMMISSION Consultant is prohibited from accepting appointment or continuing with any prior appointment to any City Board or City Commission set forth in Chapter 2 of the Santa Ana Municipal Code while this Agreement is effective. 7. BACKGROUND CHECK Consultant agrees to submit to a background check including, but not limited to, a live scan and records check to City's satisfaction. Failure to do so is grounds for termination of this Agreement. S. OWNERSHIP Or MATERIALS This Agreement creates a non-exclusive and perpetual license for City to copy,use,modify,reuse, or sublicense any and all copyrights, designs, and other intellectual property embodied in plans, specifications, studies, drawings, estimates, and other documents or works of authorship fixed in any tangible medium of expression, including but not limited to, physical drawings or data magnetically or otherwise recorded on computer diskettes, which are prepared or caused to be prepared by Consultant under this Agreement (".Documents & Data"). Consultant shall require all subcontractors to agree in writing that City is granted. a non-exclusive and perpetual license for any Documents & Data the subcontractor prepares under this Agreement. Consultant represents and warrants that Consultant has the legal right to license any and all Documents & Data. Consultant snakes no such representation and warranty in regard to Documents & Data which were provided to Consultant by the City. City shall not be limited in any way in its use of the Documents and Data at any time, provided that any such use not within the purposes intended by this Agreement shall be at City's sole risk. 9. INSURANCE Prior to undertaking performance of work under this Agreement, Consultant shall maintain and shall require any subcontractors to obtain and maintain insurance as described below for the entire Term of this Agreement against claims for injuries to persons or damage to property which may arise from or in connection with services,products and materials supplied to City. Total cost of such insurance shall be borne by Consultant. Page 3 of 12 Minimum Scope and Limit of Insurance. • Automobile Liability: Insurance Services Office Form CA 00 01 covering Code 1 (any auto), with limits no less than$1,000,000 combined single limits. In the event Consultant does not maintain commercial automobile liability insurance, City will accept evidence of personal automobile insurance, • Workers' Compensation: as required by the State of California, with Statutory Limits, and Employer's Liability Insurance with limit of no less than $1,000,000 per accident, policy or employee, for bodily injury or disease. Coverage is not required if Consultant has no employees and signs request to waive such insurance. • If Consultant maintains broader coverage and/or higher limits than the minimum requirements for each line of coverage shown above, City requires and shall be entitled to the broader coverage and/or the higher limits maintained by Consultant. Any available insurance proceeds in excess of the specified minimum limits of insurance and coverage shall be available to City. Other Insurance Provisions. The above required insurance policies are to contain or be endorsed to contain the following provisions: • City, its City Council, its officers, officials, employees, agents, and volunteers are to be covered as additional insureds, under Consultant's COL, Professional Liability, and Automobile Liability policies,with respect to any liability arising out of work or operations performed by or on behalf of the Instructor including materials, parts, equipment, and personnel furnished in connection with such work or operations. • Consultant's Insurance company(ies)agrees to waive all rights of subrogation against City, its City Council, its officers, officials, employees, agents, and volunteers for losses paid under the terms of any policy which arise from work performed by Consultant under this Agreement. • For any claims related to this contract, Consultant's insurance coverage shall be primary and any insurance maintained by City, its City Council, its officers, officials, employees, agents, or volunteers shall not contribute with it. • A severability of interest provision must apply for all the additional insureds, ensuring that Consu Itant's insurance shall apply separately to each insured against whom a claim is made or suit is brought, except with.respect to the insurer's limits of liability. • Insurance policies required herein shall provide that coverage shall not be canceled, suspended, voided, reduced in coverage or in limits, non-renewed by the carrier, or materially changed except after thirty(30)days prior written notice has been given to City. Ten.(10) days prior written notice shall be provided to City for policy cancellation or non- ren.ewal due to non-payment of premium. • Certificate .Holder on each Evidence of Insurance certificate shall be: City of Santa Ana, Attention: City Manager's Office,20 Civic Center Plaza M-31, Santa Ana, CA 92701.The name and location of project must be included in the Description of Operations section of each certificate. Page 4 of 12 Self-Insured Retentions. Self-insured retentions must be declared to and approved by the City. The City may require the Consultant to purchase coverage with a lower retention or provide proof of ability to pay losses and related investigations, claim administration, and defense expenses within the retention. Acceptability of Insurers. Insurance is to be placed with insurers authorized to conduct business in the State of California with a current A.M.Best rating of no less than A:VII,unless otherwise acceptable to City. Verification of Coverage. Consultant shall furnish City with original Certificates of Insurance including all required amendatory endorsements (or copies of the applicable policy language effecting coverage required by this clause)and a copy of the Declarations and Endorsement Page of the CGL policy listing all policy endorsements before work begins. However, failure to obtain the required documents prior to the work beginning shall not waive Consultant's obligation to provide them. City reserves the right to require complete, certified copies of all required insurance policies, including endorsements required by these specifications, at any time. Special Events Coverage. Special events coverage is available and can be purchased by Consultant. Use this link to learn more: httl2s://2sparta.com/selip application.phu. Special Risks or Circumstances. City reserves the right to modify these requirements,including limits, based on the nature of the risk,prior experience, insurer, coverage, or other special circumstances. 10. INDEMNIFICATION Consultant agrees to defend, and shall indemnify and hold harmless the City, its officers, agents, employees, contractors, special counsel, and representatives from liability: (1) for personal injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims for personal injury, including death, and claims for property damage, which may arise from the negligent operations of the Consultant,its subcontractors, agents,employees,or other persons acting on its behalf which relates to the services described in section 1 of this Agreement; and (2) from any claim that personal injury, damages,just compensation, restitution,judicial or equitable relief is due by reason of the terms of or effects arising from this Agreement. This indemnity and hold harmless agreement applies to all claims for damages, just compensation, restitution, judicial or equitable relief suffered, or alleged to have been suffered,by reason of the events referred to in this Section or by reason of the terms of,or effects, arising from this Agreement. The Consultant further agrees to indemnify,hold harmless,and pay all costs for the defense of the City, including fees and costs for special counsel to be selected by the City, regarding any action by a third party challenging the validity of this Agreement, or asserting that personal injury, damages,just compensation,restitution,judicial or equitable relief due to personal or property rights arises by reason of the terns of, or effects arising from this Agreement. City may make all reasonable decisions with respect to its representation in any legal proceeding. 11. INTELLECTUAL PROPERTY INDEMNIFICATION Consultant shall defend and indemnify the City,its officers,agents,representatives,and employees against any and all liability, including costs, for infringement of any United States' letters patent, trademark, or copyright infringement, including costs, contained in the work product or documents provided by Consultant to the City pursuant to this Agreement. Page 5 of 12 12. RECORDS Consultant shall keep records and invoices in connection with the work to be performed under this Agreement. Consultant shall maintain complete and accurate records with respect to the costs incurred under this Agreement and any services, expenditures, and disbursements charged to the City for a minimum period of three(3)years,or for any longer period required by law,from the date of final payment to Consultant under this Agreement. Alt such records and invoices shall be clearly identifiable. Consultant shall allow a representative of the City to examine, audit, and make transcripts or copies of such records and any other documents created pursuant to this Agreement during regular business hours. Consultant shall allow inspection of all work, data, documents, proceedings, and activities related to this Agreement for a period of three (3) years from the date of final payment to Consultant under this Agreement. 13. CONFIDENTIALITY If Consultant receives from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Consultant agrees that it shall not use or disclose such information except in the performance of this Agreement, and further agrees to exercise the same degree of care it uses to protect its own information of like importance, but in no event less than reasonable care. "Confidential Information" shall include all nonpublic information. Confidential information includes not only written information, but also information transferred orally, visually, electronically, or by other means. Confidential information disclosed to either party by any subsidiary and/or agent of the other party is covered by this Agreement. The foregoing obligations of non-use and nondisclosure shall not apply to any information that(a)has been disclosed in publicly available sources; (b) is, through no fault of the Consultant disclosed in a publicly available source; (e) is in rightful possession of the Consultant without an obligation of confidentiality; (d) is required to be.disclosed by operation of law; or (e) is independently developed by the Consultant without reference to information disclosed by the City. 14. CONFLICT OF INTEREST CLAUSE a. Consultant represents that neither it nor any of its officers,partners or employees has a financial interest, as defined in Section 87103 of the Government Code, in the subject matter of this Agreement other than the right to receive payment from City for services rendered. b. Consultant agrees that it shall not make,participate in making, or in any way attempt to use its position as consultant to influence any decision of City in which Consultant knows, or has reason to know,that any of its officers,partners or employees has a financial interest as defined in Section 87103 of the Government Code. c. Consultant warrants that neither Consultant nor any of its officers,partners or employees, has any financial interest in any real property,building or structure within 2,500 feet of the location of any project or assignment to which this Agreement may apply in the City of Santa Ana. Consultant agrees to disclose to City any financial interest in such property as may be acquired by its officers,partners or employees during the term of this Agreement. Page 6 of 12 d. In accordance with the City's Conflict of Interest Code, if determined by the City Manager to be a designated position, Consultant shall file a Statement of Economic Interests (Form 700) with the Fair Political Practices Commission, 15. NON-EXCLUSIVE Consultant understands and agrees that this is a non-exclusive Agreement and City may enter into other agreements with other consultants and may use any of the contractors with whom City has contracts and, therefore, the City cannot estimate nor guarantee the volume or amount of work to be received by Consultant under this Agreement. 16. NON-DISCRIMINATION Consultant shall not discriminate because of race, color, creed,religion, sex,marital status, sexual orientation, gender identity, gender expression, gender, medical conditions, genetic information, or military and veteran status, age, national origin, ancestry, or disability, as defined and prohibited by applicable law, in any services provided under this Agreement. Consultant affirms that it is an equal opportunity employer and shall comply with a]1 applicable federal, state and local laws and regulations. 17. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Consultant, and supersedes any and all other agreements, oral or written,between the parties. In the event of a conflict between the terms of this Agreement and any attachments hereto,the terms of this Agreement shall prevail. This Agreement may not be modified except by written instrument signed by the City and by an authorized representative of Consultant. The parties agree that any terms or conditions of any purchase order or other instrument that are inconsistent with, or in addition to, the terms and conditions hereof, shall not bind or obligate Consultant or the City. Each party to this Agreement acknowledges that no representations, inducements,promises or agreements,orally or otherwise,have been made by any party, or anyone acting on behalf of any party,which is not embodied herein. 18. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Consultant, Consultant may not assign, transfer, delegate, or subcontract any interest herein without the prior written consent of the City and any such assignment, transfer, delegation or subcontract without the City's prior written consent shall be considered null and void. Nothing in this Agreement shall be construed to limit the City's ability to have any of the services which are the subject to this Agreement performed by City personnel or by other Consultants retained by City. 1.9. TERMINATION This Agreement may be terminated by the City upon thirty(30)days written notice of termination. In such event, Consultant shall be entitled to receive and the City shall pay Consultant compensation for all services performed by Consultant prior to receipt of such notice of termination,subject to the following conditions: Page 7 of 12 a. As a condition of such payment, Consultant may be required to deliver to the City all work product(s) completed as of such date, and in such case such work product shall be the property of the City unless prohibited by law, and Consultant consents to the City's use thereof for such purposes as the City deems appropriate. b. Payment need not be made for work which fails to meet the standard of performance specified in the Recitals of this Agreement. Consultant's term shall automatically terminate immediately if, at any time, the Councilmember is no longer an elected member or Mayor of the Santa Ana City Council. 20. WAIVER No waiver of breach, failure of any condition, or any right or remedy contained in or granted by the provisions of this Agreement shall be effective unless it is in writing and signed by the party waiving the breach, failure,right or remedy. No waiver of any breach, failure or right, or remedy shall be deemed a waiver of any other breach, failure, right or remedy, whether or not similar, nor shall any waiver constitute a continuing waiver unless the writing so specifies. 21. JURISDICTION-VENUE This Agreement has been executed and delivered in the State of California and the validity, interpretation,performance, and enforcement of any of the clauses of this Agreement shall be determined and governed by the laws of the State of California. Both parties further agree that Orange County, California, shall be the venue for any action or proceeding that may be brought or arise out of, in connection with or by reason of this Agreement. 22. PROFESSIONAL LICENSES Consultant shall, throughout the term of this Agreement,maintain all necessary licenses,permits, approvals, waivers, and exemptions necessary for the provision of the services hereunder and required by the laws and. regulations of the United States, the State of California, the City of Santa Ana and all other governmental agencies. Consultant shall notify the City immediately and in writing of its inability to obtain or maintain such permits, licenses, approvals, waivers, and exemptions. Said inability shall be cause for termination of this Agreement. 23. NOTICE Any notice, tender,demand, delivery, or other communication pursuant to this Agreement shall be in writing and shall be deemed to be properly given if delivered in person or mailed by first class or certified mail,postage prepaid,or sent by fax or other telegraphic communication in the manner provided in this Section,to the following persons: To City: City Clerk City of Santa Ana Page 8 of 12 20 Civic Center Plaza(M-30) P.O.Box 1988 Santa Ana, CA 92702-1988 With courtesy copies to: City Manager City of Santa Ana 20 Civic Center Plaza(M-31) P.O. Box 1988 Santa Ana, CA 92702 To Consultant: Edith Sandoval A party may change its address by giving notice in writing to the other party. Thereafter, any communication shall be addressed and transmitted to the new address. If sent by mail, communication shall be effective or deemed to have been given three (3) days after it has been deposited in the United States mail, duly registered or certified, with postage prepaid, and addressed as set forth above. If sent by fax, communication shall be effective or deemed to have been given twenty-four(24)hours after the time set forth on the transmission report issued by the transmitting facsimile machine, addressed as set forth above. For purposes of calculating these time frames, weekends, federal, state, County or City holidays shall be excluded. 24, MISCELLANEOUS PROVISIONS a. Each undersigned represents and warrants that its signature herein below has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify City filly, including reasonable costs and attorney's fees, for any injuries or dantages to City in the event that such authority or power is not, in fact, held by the signatory or is withdrawn, b. All.Exhibits referenced herein, if any, and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. [signatures appear on following page] Page 9 of 12 SIGNATURE PAGE TO COUNCIL AIDE PROFESSIONAL SERVICES AGREEMENT IN WITNESS WHEREOF,the parties hereto have executed this Agreement the date and year first above written. ATTEST CI OF S NTA el f L 1 Alvaro Nunez C' k City Manager APPROVED AS TO FORM CONSULTANT SONIA R. CARVALHO City Attorney By: Jonathan T. Martine Edith Sandoval Assistant City Attorney Page 10 of 12 EXHIBIT A Month and Year Invoice Your Name Street Address Invoice#: City, ST Zip Code Agreement #: Phone Date: Bill To: City of Santa Ana 20 Civic Center Plaza Hourly Rate: Santa Ana, CA 92701 Total Billable Hours: Amount Due: Date Start Time Time Out Description of Work Billable Hours Performed 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Page 11 of 12 EXHIBIT B Acknowledgment Regarding Political Activities Prohibitions I, Edith Sandoval ,am an independent contractor working as a Council Aide pursuant to this Agreement. 1. I acknowledge and agree that during the term of this Agreement, I will not participate or conduct the following political activities: a) Acting as campaign treasurer/manager or a campaign consultant for any candidate for Santa Ana City Council or Mayor; b) Campaigning for any candidate for Santa Ana City Council or Mayor and at the same time,working pursuant to this agreement and/or charging the City for the time spent campaigning pursuant to this agreement; c) Using City equipment, supplies or resources to campaign for any candidate for Santa Asia City Council or Mayor; d) Accepting any campaign contributions on behalf of any candidate for Santa Ana City Council of Mayor; e) Campaigning while wearing any attire or logo that identifies you as a Consultant for the City of Santa Ana; f) Campaigning while using any City room,building, or location that has not been specifically designated for political speech; g) Receiving any payment or reimbursement from a campaign candidate for Santa Ana City Council or Mayor or their campaign account; and/or h) Opening a campaign committee or pulling nomination papers to run as a candidate for Santa Ana City Council or Mayor. 2. I acknowledge and understand that failure to abide by any of the above prohibitions are grounds for immediate termination of this Agreement. Signed this 31 day of March , 20 25. Edith Sandoval (Name of Consultant) (Signature of Consultant) March 31 , 2025 Date (Name of Witness) (Signature of Witness) Page 12 of 12 CITY OF SANTA ANA XFON Risk Management a division of Human Resources Managing Risk through Awareness and Action 4�i.r,I AFFIDAVIT OF EXEMPTION FOR WORKERS' COMPENSATION INSURANCE I, t J� ' • v��� "� ("Representative"),attest that I am an authorized (Name and Title of Vendor Representative) representative of - & S()V,d o" ("Company"),and (Consululnt/Company Name) possess the authority to legally bind Company. In my capacity as Representative of Company,I represent and confirm the following,as relates to the agreement between Company and City of Santa Ana,agreement number ("Agreement")to provide CO VK W. ("Services"): (Services to be provided under agreement/wntract) During the course and scope of Company's agreement with the City of Santa Ana, Company will not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that if Company should become subject to the workers' compensation provisions of Section 3700 of the Labor Code,Company shall forthwith comply with the provisions and provide proof of workers' compensation coverage immediately. If at any time it is found that Company is not adhering to any and/or all of the statements in this Tu Tran 6y Digitallyrn 7rao signed document and does not maintain the minimum professional liability insurance coverage as Nguyen Nguyen 6053z o°oo' required in the Agreement, it will be considered a breach of Agreement rendering the Agreement null and void and Company will be fully liable for any and all damages. APPROVED By Tu Tran Nguyen at 4:05 pm,Apr 01,2025 3 �� 242s Signature Doc -AA Print Name Lovi-(A6A la O&AVIC11 s'he Title Contact Information,i.e.,Telephone Number and/or Email Address WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSANT DOLLARS($100,000).IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST,AND ATTORNEY'S FEES. Affidavit of Exemption for Workers'Compensation Insurance 11.12.2024 Automobile Club of Southern California P.O. Box 25001, Santa Ana CA 92799-5001 AAA.com (877)422-2100 October 24, 2024 9 AUTO INSURANCE RENEWAL OFFER N Policy Number: ; ALVARADO, VICENTE Thank you for your 15 years of membership with the Auto Club YOUR POLICYHOLDER SAVINGS and for trusting us with your insurance needs. We greatly DIVIDEND IS: appreciate your business and look forward to continuing your $371 insurance coverage for another year. We are also pleased to announce that valued policyholders YOUR DISCOUNTS like you will again receive a return of premium through a Policyholder Savings Dividend. This is one of the The following discounts have been advantages of having auto insurance through the Auto Club. applied to your auto policy premium: Multi-Vehicle As a convenience, we have applied your $371 Policyholder . Loyalty Savings Dividend to your renewal premium to reduce your . Good Driver premium balance. • Verified Mileage Please take a moment to review the enclosed declarations and make sure the coverages and limits for your renewal continue YOUR RENEWAL PREMIUM to meet your current insurance needs. Your renewal premium includes an additional premium charge as a Thank you again for choosing us. result of: • an accident Sincerely, that occurred during the last year. Please refer to the reverse of your enclosed declarations page for a list of driving record activity for Greg L. Backley each operator on your policy. President and CEO POLICYHOLDER SAVINGS DIVIDEND STATEMENT on reverse Z Click AAA.com/myaccount to access your I Visit or call your local Auto Club branch I Call (877)422-2100 caaaiezn policy and pay your bill online AAA.com/branches 1024240 Insurance provided to qualified Auto Club members by the Interinsurance Exchange of the Automobile Club. AUTO POLICY NUMBER: POLICYHOLDER SAVINGS DIVIDEND STATEMENT We are pleased to announce that our auto policyholders will once again receive money back through the payment of a POLICYHOLDER SAVINGS DIVIDEND. While auto dividends are not guaranteed, qualifying auto policyholders have received a Policyholder Savings Dividend in each year since 1990 and now you have the opportunity to get money back just for insuring your car with us. For years our auto policyholders have enjoyed the benefit of quality insurance, caring customer service, great discounts and also the opportunity to receive money back through a Policyholder Savings Dividend. Not all insurance companies can say that. Giving money back to our auto policyholders through dividends is another way we're always with you. The amount of the Policyholder Savings Dividend that you will receive upon completion of your current policy period is displayed below. Your dividend amount is based on your current policy premium. Since dividends are paid at the end of your current policy term, the good news is we have applied your dividend to your renewal premium to reduce your premium balance and your minimum due. This means less money coming out of your pocket to renew your policy. YOUR SAVINGS? YOUR POLICYHOLDER SAVINGS DIVIDEND THIS YEAR 41 Policyholder Savings Dividend Amount; $371 Dividend applied to renewal premium for auto policy period: 12-01-24 to 12-01-25 (Refer to the enclosed Renewal Billing.Statement for your premium balance) YOUR POLICYHOLDER SAVINGS DIVIDEND HISTORY Total savings received from dividends within the last five years: $2,535.51 This total includes the Policyholder Savings Dividends that were provided to you as financial relief due to COV1D-19. Call (877) 422-2100 I Click AAA.comlmyaccount to access your Visit or call your local Auto Club branch policy and pay your bill online AAA.comlbranches cAaosps�za 102A2 �a Insurance provided to qualified Auto Club members by the lnterinsurance Exchange of the Automobile Club. Interinsurance Exchange of the Automobile Club P.O.Box 25448,Santa Ana,CA 92799-5448 AAA.com/billpay 1-877-422-2100 AUTOMOBILE RENEWAL BILLING STATEMENT THIS BILLING STATEMENT AND THE INFORMATION IT CONTAINS ARE PART OF YOUR INSURANCE POLICY DECLARATIONS INSURANCE BILLING STATEMENT POLICY NUMBER: ALVARADO, VICENTE N BILLING DATE: 10-23-2024 DUE DATE: 12-01-2024 1. RENEWAL PREMIUM: $5,268.00 2. LESS PRIOR PAYMENT: $0.00 cr Your Policyholder Savings Dividend has been used to reduce 3. PREVIOUS BALANCE: $0.00 the minimum due necessary to renew your policy: 4. AMOUNT FINANCED: $5,268.00 Minimum Amount Due: $585.28 5. LESS POLICYHOLDER SAVINGS DIVIDEND: $371.00 cr Less Policyholder Savings Dividend: $371.00 cr 6. TOTAL BALANCE: $4,897.00 Minimum Due Required to Renew: $214.28 Future payments will vary from $594.12 to $637.17 if there are no changes in premium and installments are paid as billed.' To renew your policy, please pay either the Total Balance $4,897.00 or the Minimum Due $214.28 on or before the Due Date 12-01-2024 "After the initial renewal installment,each subsequent installment will include a finance charge. -see reverse for details- SAVE TIME WITH OUR OTHER PAYMENT OPTIONS CLICK AAA.com/billpay VISIT AAA.com/branches to find an office near you CALL 1-877-422-2100 When you sign up for AAA Auto Pay, installment payments can be withdrawn directly from your financial institution. You no longer have to worry about missing a payment, writing checks or paying for postage. To learn more about our flexible payment options please visit us at AAA.com/autopay. CAA0780A y TO ENSURE PROPER HANDLING,INCLUDE STATEMENT WITH PAYMENT. y E20200908 102424 DETACH HERE. n g AUTOMOBILE RENEWAL BILLING STATEMENT VICENTE ALVARADO p Please Verify) Billing Date: 10-23-2024 s CHANGE CONTACT INFO BELOW/UPDATE EMAIL AT AAA.com/UpdateEmail Please write policy number on check. TO PAY IN FULL ( ) Include alpha and numeric characters. PAY THIS AMOUNT STREET PHONE Policy Number: BALANCE CITY STATE ZIP Make Checks Payable to: $4,897.00 ACSC EMAIL Or Pay Online at AAA.com/billpay AMOUNT PAID P.O.BOX 25448 DUE DATE MINIMUM DUE SANTA ANA,CA 92799-5448 12-01-24 $214.28 10902 078164496 120124 00021428000215000DO22000 004897007 SEND ANY QUESTIONS REGARDING THIS BILL TO: ACSC Attn: CORPORATE RECEIVABLES A313 P,O, Box 25001, Santa Ana, CA 92799-5001 Phone: 1-877-422-2100 Truth in Lending Information for Policy: Number of Payments First Payment Due Date First Payment Amount Other Payments are due each Other Payments will vary succooding month on this date from $594. 12 09 12-1--24 $214.28 1ST to $637. 17 ANNUAL PERCENTAGE FINANCE CHARGE Amount Financed Total of Payments Total Sale Price RATE The cost of your credit as a The dollar amount the The amount of credit provided to The amount you will have paid The total cost of your yearly rate. credit will cost you. you or on your behalf, after you have made all purchase on credit. payments as scheduled, 14.95% $248.65 $5,268.00 $5,516.65 $5,516.65 There is no prepayment penalty. The full balance or at least the Minimum Due is payable by the due date. You must pay the outstanding balance in full to avoid paying any finance charges. After the first renewal payment, each subsequent billing will include a finance charge. Payments received will be applied first to any fees or charges due. The remainder of your payment will be applied to the premium due. All returned payments, whether by check, electronic transaction, or other form of payment, may be re-presented electronically for payment. Each late payment Is subject to a $7 fee and each returned payment is subject to a $15 fee. Installment payment plans and all fees are subject to change without notice. An adverse payment record (such as a late payment, a returned payment, or a nonpayment) may reduce the number of remaining installments and increase the minimum due, or result in a request to pay the entire balance of the policy bill in full, Whenever a payment is returned by your financial institution, we may, at our option, notify you In writing that the entire outstanding premium balance is Immediately due and payable in cash or by cashier's check or bank money order at one of the Auto Club's district offices. In addition, the payment record during the current policy period will determine the payment terms offered at the next policy renewal. The finance charge periodic rate will be 1% per month (12% ANNUAL PERCENTAGE RATE)on that portion of the Balance exceeding $1,000 and 1.5% (18%ANNUAL PERCENTAGE RATE)on that portion of the Balance that is$1,000 or less. CM07803 E20 10423 102 24 Interinsurance Exchange of the Automobile Club Automobile Insurance Policy Coverages and Limits Renewal Declarations We are pleased to offer you a renewal for your automobile insurance policy. To renew your policy, send at least the minimum payment on or 5 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 forth in the insurance policy and endorsements. These declarations, together with the contract and the endorsements in effect, complete your policy. If any change to your policy or to the information we have on file results in a premium decrease during the policy period, the Interinsurance Exchange reserves the right to apply any refund due to your outstanding balance. w NAMED INSURED(Item 1.) AUTO POLICY NUMBER: ALVARADO, VICENTE POLICY PERIOD(PACIFIC STANDARD TIME) ° POLICY EXPIRATION DATE: 12-01-25 12:01 A.M. VEHICLES VEH, YEAR MAKE MODEL IDENTIFICATION VEHICLE GARAGE ANNUAL** VERIFIED SALVAGE NO. NUMBER USE ZIP CODE MILES MILEAGE 6 1995 GMC T151SONOMA PLEASURE 92706 3,501- 4,500 VERIFIED NO COVERAGES AND LIMITS ANNUAL PREMIUMS Coverage Is not in effect unless a premium or the word"Included"is shown. COVERAGES LIMITS OF LIABILITY Vehicle 6 Vehicle 7 Vehicle 8 Vehicle 9 Vehicle 11 Liability ' Bodily Injury $30,000 each person! $60,000 each occurrence $190 ; $323 $474 $254 $199 Property Damage $60,000 each occurrence $142 ; $233 $402 $169 ; $146 Medical 1 No Coverage;No Coverage;No Coverage;No Coverage;No Coverage Physical Damage (Actual Cash Value unless otherwise stated,less deductible) Vehicle B Vehicle 7 Vehicle 8 Vehicle 9 Vehicle 11 Comprehensive No Coverage ACV ACV ACV ACV No Coverage: $88 $90 $173 $150 (Less Deductible) No Coverage $500 $500 $500 $250 ; Collision No Coverage ACV ACV ACV ACV No Coverage: $420 $699 $161 $243 (Less Deductible) No Coverage $500 $500 $500 $500 Car Rental Expense (Per Da No Coverage No Coverage No Coverage $35 No Coverage:No Coverages No Coverage!No Coveraga: $27 No Coverage Uninsured Motorist j Bodily Injury- $30,000 each person/ $60,000 each accident $80 $206 $155 $135 $102 Uninsured&Underinsured Vehicles Uninsured Deductible Waiver ;No Coverage: Included Included j Included j Included Uninsured Collision $7 No Coverage;No Coverage;No Coverage'No Coverage Total Premium $419 $1270 ; $1820 $919 ; $840 PREMIUM DISCOUNTS "No Coverage" indicates coverage not purchased. Please refer to the enclosed document entitled"Premium Discounts Applied to Your Automobile Policy." Total Annual Premium* $5268 * If at any time you choose to pay less than the full balance outstanding, (Includes allepplicablediscounts.) finance charges of up to 1.6% per month of the balance outstanding will apply Less Policyholder Savings Dividend $371 as explained in your billing statements,which are part of these declarations. Net Premium* $4897 ** To see the annual mileage for your expiring policy, please refer to the "Notice of Annual Mileage" page contained in your renewal package. cnAa2na� PROCESS DATE 10-23-24 PLEASE ATTACH TO YOUR POLICY (SEE REVERSE) E2U21030 102424 Interinsurance Exchange of the Automobile Club Automobile Insurance Policy Coverages and Limits Renewal Declarations (continued) AUTO POLICY NUMBER: POLICY EFFECTIVE DATE: 12-01-2024 DRIVERS(Coverage may differ for each driver. Please see each section of the policy contract for the definition of"Persons Insured".) ❑RIVER NAME GENDER MARITAL STATUS YEAR FIRST NUMBER LICENSED 1 ALVARADO,VICENTE MALE MARRIED 1974 2 ALVARADO,VICKY FEMALE SINGLE 1999 3 ALVARADO,ROSA -EXCLUDED* FEMALE MARRIED 4 GUZMAN,JERRY -EXCLUDED* MALE SINGLE 5 SANDOVAL,EDITH FEMALE MARRIED 2006 6 ALVARADO,JUAN MALE MARRIED 2003 IMPORTANT:NO COVERAGE IS PROVIDED BY THIS POLICY WHILE ANY VEHICLE 15 BEING OPERATED BY AN EXCLUDED DRIVER, PLEASE READ THE"EXCLUSION OF DESIGNATED PERSON ENDORSEMENT"AGREEMENT PREVIOUSLY PROVIDED TO YOU. (Endorsement No.2184.) DRIVING RECORD DRIVER NUMBER OF NUMBER OF TRAFFIO CONVICTIONS RA ED NUMBER PRINCIPALLY DRIVER STATUS AT-FAULT ACCIDENTS MINOR SERIOUS MAJOR SEVERE SUSPENSIONS NUMBER 1 1 PRIMARY 8 2 ADDITIONAL 3 EXCLUDED 4 EXCLUDED 5 PRIMARY 9 6 PRIMARY 7 ENDORSEMENTS AND CERTIFICATES SPECIAL EQUIPMENT** SOUND EQUIPMENT** NUMBER TITLE VEH. CAMPERI OTHER P-wAY TELE- R4U10 OTHER 2011 MEMBER'S AUTOMOBILE POLICY—POLICY NUMBER CHANGE No. VAN coNv. RADIO PHONE 2184 EXCLUSION OF DESIGNATED PERSON 6 2367 AMENDATORY ENDORSEMENT 7 8 9 11 'Coverage is indleated by a"YES"in the appropriate equipment column.Coverage limitations apply unless coverage was purchased specifically for certain equipment. ANY PHYSICAL DAMAGE LOSS MAY BE MADE PAYABLE TO YOU AND ANY INTEREST LISTED BELOW: PERSON DESIGNATED TO RECEIVE NONPAYMENT OF PREMIUM NOTICES: An individual designated by 6 policyholder to receive notice of topse,termination, expiration, nonrenewal, or cancellation of the policy for nonpayment of premium does not have any rights, whether as an additional Insured or otherwise, to any benefits under the policy,otherthan the right to receive notice. EzMo-a N rosa�a Click AAA.comlmyaccount to access your policy information online, pay your bill or print additional proof of insurance cards Interinsurance Exchange of the .Automobile Club Premium Discounts Applied to Your Automobile Policy Auto Policy Number: The following automobile premium discounts are available from the Interinsurance Exchange. If you meet the discount requirements, an "X" will appear in the box next to the discount name and you will receive a premium reduction on all coverages that qualify for the discount. MULTI-POLICY []X MULTI-VEHICLE ® SELECT PROFESSIONALS&GROUPS LOYALTY ri DRIVING COURSE ri MATURE DRIVER STUDENT AWAY GOOD STUDENT GOOD DRIVER ALVARADO,VICENTE ALVARADO,VICKY SANDOVAL,EDITH ALVARADO,JUAN VERIFIED MILEAGE 1995 GMC T15ISONOMA 2019 SUBA XV CROSSTREK 2012 TYTA CAMRY STDlLEIXLEISE 2001 GMC YUKON 2011 JEEP COMPASS If you need additional information about any of the above discounts, please refer to the Available Automobile Premium Discounts insert included with your renewal offer (or the insert provided with your application). If you have additional questions about premium discounts or your auto policy, please call us at 1-877-422-2100. aff?�a08 0 az11 Ed.62 Interinsurance Exchange of the Automobile Club Policy Number: NOTICE OF ANNUAL MILEAGE Pursuant to section 2632.5 (c) of the California Insurance Code of Regulations, we are providing you with the annual mileage figures for your vehicle(s). Vehicle Vehicle Vehicle Vehicle Annual Miles No. Year Make Identification No. Expiring Policy 6 1995 GMC 2,501 - 3,500 E20110A23 8217 1, , Ed.09-2008 Interinsurance Exchange of the Automobile Club What You Need to Know About Your Auto Policy Renewal N RATE REVISION � While we maintain ongoing efforts to keep insurance costs as low as possible, inflation has been rising N faster than usual impacting all of us with higher prices. This trend has also affected the insurance industry, making it necessary to increase our rates, on an overall basis, to keep pace with inflation. Today, many insurance companies are having to adjust their rates to keep up with increased costs. We are confident that even with this increase, our prices coupled with the opportunity to receive money back through a Policyholder Savings Dividend, continue to make our auto insurance among the most competitive to meet your insurance needs. Premium adjustments as a result of this rate revision will vary by policy depending on individual policy rating factors such as the number of vehicles insured, years of driving experience, total annual miles driven for each vehicle, driving record, qualifying discounts, and other rating factors. Your premium may also be impacted by any changes that have been made to your policy since last year. Please refer to the enclosed declarations page to see how these changes affect your policy premium. ANNUAL MILEAGE INFORMATION If the annual mileage of a vehicle has changed or if it significantly changes during the next policy period, you may request an adjustment to the annual mileage of that vehicle. If you are requesting a change to the annual mileage of a vehicle receiving the Verified Mileage Discount, the adjustment to the policy will be effective after the verification of odometer readings provided by you. We may also require an inspection of the vehicle odometer or use third party sources to verify, update, or determine the annual mileage. MONTHLY(12-PAY) PAYMENT PLAN OPTION We are pleased to offer a Monthly Payment Plan that allows you to pay your annual renewal premium in twelve (12) monthly installments. The initial installment of 10% of the total renewal premium will be due on the renewal effective date and no finance charge will apply to this initial installment. The balance of your total renewal premium will be spread into eleven (11) equal monthly installments beginning approximately 30 days after the renewal effective date. Each of these installments will Include a finance charge. To qualify for this Monthly Payment Plan, you must be enrolled in our AAA Auto Pay plan. This convenient plan allows your monthly premium payments to be withdrawn automatically from your bank account. An installment schedule displaying your payments for the policy period will be sent to you. Please contact us if you are interested in switching to this new payment plan. PREMIUM PAYMENT OPTIONS AND FEES Qualifying insureds may pay the annual premium in full or in installments. After the initial renewal installment, each subsequent installment will include a finance charge. The periodic rate is 1% per month (12% ANNUAL PERCENTAGE RATE) on that portion of the balance exceeding $1,000 and 1.5% per month (18% ANNUAL PERCENTAGE RATE) on that portion of the balance that is $1,000 or less. There is no prepayment penalty. The total amount of the finance charge is included in the information mailed with the initial renewal installment billing. Each late payment is subject to a $7 fee and each returned payment is subject to a $15 fee. Installment payment plans and all fees are subject to change without notice. An adverse payment record (such as a late payment, a returned payment, or a nonpayment) may reduce the number of remaining installments and increase the minimum due or result in a request to pay the entire balance of the policy bill in full. In certain situations we may not offer the installment plan. 40416 CA Auto 6-1-24 YOUR RIGHT TO SELECT ANOTHER PERSON TO RECEIVE NOTICES OF NONPAYMENT OF PREMIUM California State law allows you the option to designate one additional person to receive notices of lapse, termination, expiration, non-renewal, or cancellation of your insurance policy for nonpayment of premium. If you choose to designate another person to receive notices of nonpayment of premium, this person will appear as the "Person Designated to Receive Nonpayment of Premium Notices" on your Declarations page. Nonpayment of premium notices sent to the person you designate will be in addition to the notices mailed to you, the policyholder. Adding a designated person to your policy is optional and you may change or remove a designated person at any time. Adding, changing, or removing a designated person has no effect on your policy coverages or premium. An individual designated by you, the policyholder, will not have any rights, whether as an additional insured or otherwise,to any benefits under the policy, other than the right to receive notice of lapse, termination, expiration, nonrenewal, or cancellation of the policy for nonpayment of premium. If you are interested in designating another person to receive nonpayment of premium notices, please contact us at 800-924-6141 or stop by your local Auto Club to obtain a "Notice of Nonpayment of Premium—Designee Selection Form." OTHER IMPORTANT INFORMATION Minimum Financial Responsibility Limits Available for Liability Coverages In compliance with Insurance Code Section 1861.15, we will, upon request, furnish Bodily Injury Liability coverage and Property Damage Liability coverage in the minimum financial responsibility amounts of $15,000 for bodily injury to or death of one person, $30,000 for bodily injury to or death of two or more persons, and $5,000 for damage to property of others in any one accident. Premium Increase for Accidents or Traffic Convictions You have the right to be informed, upon request, of any increase in your premium because of accidents or convictions for traffic violations. CWB0IB 1024 24 2 CA Auto 6-1-24 Interinsurance Exchange of the Automobile Club AVAILABLE AUTOMOBILE PREMIUM DISCOUNTS The following automobile insurance premium discounts are offered to qualifying policyholders. Good Driver Discount Drivers are eligible for a 20%premium discount on the vehicles they principally operate if during the last 10 years, they have not been convicted of an alcohol or drug-related offense; and during the last 3 years, they: m • were continuously licensed to drive a motor vehicle. • had no suspension, cancellation or revocation of their driving license. • had no principally(51% or more)at-fault accidents which resulted in bodily injury or death of any person. • had no traffic convictions which are assessed two violation points(i.e., reckless driving, speed contest or hit-and-run). • had no more than: one (minor)traffic conviction which is assessed one violation point(such as speeding or running a red light); OR one principally (51% or more) at-fault accident which resulted only in damage to property(no bodily injury or death), and the total loss or damage caused by the accident exceeded$1,000. Loyalty Discount A discount of up to 5.60/6*will automatically apply to qualifying policyholders who have had continuous automobile liability insurance with the Exchange for at least one year. Multi-Vehicle Discount A discount of up to 27.30/*will apply on most policies insuring two or more qualifying vehicles for Bodily Injury Coverage. Qualifying vehicles include private passenger autos, SUV's, most pick-ups and vans, motor homes, dune buggies and classic cars. (This discount does not apply to classic cars insured under a Collector Car policy). Multi-Policy Discount This discount will automatically apply to qualified auto policies if the named insured (or resident spouse/registered domestic partner)also insures their home or watercraft with the Interinsurance Exchange or has a qualifying AAA Life Insurance Policy. Auto policyholders can save the following on their auto premium: • up to 15.70/o*wlth a qualifying homeowners policy; or up to 11.2%*with a qualifying condo policy, or up to 3.7%* with a qualifying renters policy. • up to 2.80/0 with a qualifying watercraft policy. • up to 4.70le with a qualifying AAA Life policy. Verified Mileage Discount A discount ranging from approximately 1.1°/6* up to 19.10/o*is available on an individual vehicle basis when selected by the named Insured. To qualify, the named insured must provide us, when requested, with the current odometer reading as verification of the number of miles driven annually for that vehicle. If we do not receive a vehicle's current odometer reading when requested, the vehicle will not qualify for the Verified Mileage Discount.We may use odometer readings obtained from government agencies and other sources to determine or verify the vehicle's annual mileage. For vehicles owned less than 90 days, we may use a default annual mileage. This discount Is applied prospectively at new business, renewal, and upon certain policy amendments. If the annual miles of a vehicle significantly change during the policy year, you may request an adjustment to the verified annual mileage of that vehicle. The adjustment to the policy will be effective after the verification of odometer readings provided by you or the vehicle is inspected by us. Good Student Discount Full-time high school, college or university students with less than nine years of driving experience and a current or cumulative grade point average(GPA)of at least 3.0, are eligible for a discount of up to 14.31/o*on the vehicle(s) they principally operate. Acceptable certification of full-time status and GPA is required before the discount can be applied. Re-certification is required annually and must be received prior to policy renewal. *Discount amounts are approximate and will vary by policy. CAA08 A 1-1-21 E20201012 10242-0 Student Away Discount Students with less than nine years of driving experience who are attending a school at least 100 miles away for the majority of the year without the physical possession of a vehicle may qualify for a discount ranging from approximately 28%* up to 46.7%* (depending on whether the driver is rated as a primary or an additional operator on the policy). Acceptable certification of student status and school location is required before the discount can be applied. Re-certification is required annually and must be received prior to policy renewal. Select Professionals and Groups Discount Program A discount ranging from approximately 1.4%*up to 7.4%*will apply if the named insured (or resident spouse/registered domestic partner) meets the qualifying criteria for at least one of the professional groups listed below. Acceptable documentation verifying the criteria is required before the discount can be applied. • Engineer-must have at least a Bachelor's degree in or be a licensed engineer in one of the following fields of engineering: Aeronautical, Aerospace, Architectural, Biomedical, Chemical, Civil, Computer Science, Electrical, Electronics, Environmental, Gas, Health & Safety, Industrial, Marine, Materials, Mechanical, Mining & Geological, Nuclear, Petroleum or Structural. • Scientist;-must have at least a Bachelor's degree in one of the following fields of science: Applied Mathematics, Astronomy, Biochemistry, Biology, Chemistry, Computer Science, Cybernetics, Ecology, Environmental Science, Genetics, Geology, Geochemistry, Geophysics, information Systems, Kinesioiogy, Marine Biology, Mathematics, Meteorology, Microbiology, Molecular Biology, Neuroscience, Oceanography, Physics, Physiology, Planetary Systems or Statistics. • Educators**-must be credentialed as a teacher or educational administrator by the State of California Commission on Teacher Credentials with a "Clear,""Professional Clear,""Life" or"Preliminary"designation; OR employed as a full-time college or university teacher or professor. • Medical Professionals**- must be currently licensed or have current membership with an approved state or national organization in one of the following occupations: Doctor, Physician's Assistant, Registered Nurse or Nurse Practitioner, Dentist, Veterinarian, Pharmacist, Physical or Occupational Therapist, Optometrist or Ophthalmologist, Psychiatrist, Speech Pathologist. • Lawyers--State Bar Of California Members**- must be an active member of the State Bar of California, or a member of the State Bar of California with an inactive status due to judicial duties. • Certified Public Accountants**- must be currently licensed in or have current membership with an approved state or national CPA organization. • Alumni Association Member"- must be an active member of the alumni association of the four-year college or . university from which they graduated. Mature Driver Discount Drivers who are 55 or over may be eligible for a discount of up to 1.9%*on the vehicles they principally operate if they successfully complete a Mature Driver improvement Course (approved by the California Department of Motor Vehicles)during the past three years and have not had any traffic conviction or at-fault accident since the course completion date. Drivers must provide us with the completion certificate before the discount can be applied. The discount may apply for up to three consecutive policy periods—after which a new certificate will be required to continue receiving the discount. Driving Course Discount Qualifying drivers who successfully complete a driver training course pre-approved by the Interinsurance Exchange are eligible for a discount of up to 4.711e for all coverages on the vehicles they principally operate. Currently, the Auto Club Driving School's"Licensed to Learn" program, designated for novice drivers, is the only course approved for this discount. For information about the Licensed to Learn program, please call (877)428-2277. Drivers must have no more than one good driver point during the three years prior to the Driving Course Discount being added to the policy, and have no principally at-fault accidents or traffic convictions after completing the course. " Discount amounts are approximate and will vary by policy. " The use of the name of any state or private organization for identification purposes in connection with the Program does not imply any endorsement by or affiliation with such organization. caAoa�se 1az�°n24 2 1-1-21 Evidence of Liability Insurance California Evidence of LiabilityInsurance VEHICLES ON POLICY YEAR MAKE VEH I.D.# Interinsurance Exchange of the Automobile Club 1995 GMC of Named Insured Policy Number: ALVARADO,VICENTE o DRIVERS ON POLICY ALVARADO,VICENTE ALVARADO,VICKY Effective Date:12-01-24 Expiration Date: 12-01-25 SANDOVAL,EDITH ALVARADO,JUAN This policy complies with Sections 16056 or 16500.5 of the California Vehicle Code. Coverage subject to policy terms and limits. VEHICLES ON POLICY California Evidence of Liability Insurance YEAR MAKE VEH I.D.# Interinsurance Exchange of the Automobile Club 1995 GMC Named Insured Policy Number: ALVARADO,VICENTE o DRIVERS ON POLICY ALVARADO,VICENTE ALVARADO,VICKY Effective Date:12-01-24 Expiration Date: 12-01-25 SANDOVAL,EDITH ALVARADO,JUAN This policy complies with Sections 16056 or 16500.5 of the California Vehicle Code. Coverage subject to policy terms and limits. Get your digital proof of insurance & membership card !��:� >>Download the app. Click AAA.com/app75 wKm Electronic proof of insurance may not be valid as proof in all states.Please keep your hard copy version on hand.Must be a current AAA member and insured through AAA to use this feature.Available for iPhoneg,and smanphones for Android"".Message,data and morning roles may apply. California Evidence of LiabilityInsurance VEHICLES ON POLICY YEAR MAKE VEH I.D.# Interinsurance Exchange of the Automobile Club 1995 GMC Named Insured Policy Number: uJ ALVARADO,VICENTE Lu _ o DRIVERS ON POLICY p ALVARADO,VICENTE u- ALVARADO,VICKY Effective Date:12-01-24 Expiration Date: 12-01-25 SANDOVAL,EDITH ALVARADO,JUAN This policy complies with Sections 16056 or 16500.5 of the California Vehicle Code. Coverage subject to policy terms and limits. California Evidence of LiabilityInsurance VEHICLES ON POLICY YEAR MAKE VEH I.D.# - Interinsurance Exchange of the Automobile Club 1995 GMC Named Insured Policy Number: W x ALVARADO,VICENTE o DRIVERS ON POLICY L ALVARADO,VICENTE ALVARADO,VICKY Effective Date:12-01-24 Expiration Date: 12-01-25 SANDOVAL,EDITH ALVARADO,JUAN This policy complies with Sections 16056 or 16500.5 of the California Vehicle Code. Coverage subject to policy terms and limits. 56408 10124 CAA0850A E20240919 102424 1F YOU HAVE AN ACCIDENT CALL OUR 2417 AAA CLAIMS HOTLINE 1-800-672-5246 After an accident, exchange Information with the other party and follow these 5 easy steps: Step 1: Pull vehicle over to a safe place. Get the names, Step 4: Take photos of the vehicles involved,damages and addresses,and phone numbers of all persons involved in the surrounding area of the accident,if it is safe to do so. accident, e.g.,pedestrians,witnesses,other passengers,etc. Step 5: Call our AAA Claims Hotline at 800-672-5246 to Step 2: Take photos of or write down the other person's report the loss. If necessary,we will arrange to have your vehicle driver's license information and other vehicle's license plate towed. Our provider's tow trucks always display the AAA number,including states of registration. emblem. Step 3: Take photos of or write down the other person's Do not admit responsibility for or discuss the circumstances of the accident Insurance card information, with anyone other than the police or an authorized Auto Club claims representative. Do not disclose your policy limits to anyone. For questions or changes to your policy,call 1-877-422-2100,Monday through Friday from 7 a.m.to 9 p.m.or Saturday from 8 a.m.to 5 p.m. IF YOU HAVE AN ACCIDENT CALL OUR 2417 AAA CLAIMS HOTLINE 1-800.672.5246 After an accident,exchange information with the other party and follow these 5 easy steps: Step 1: Pull vehicle over to a safe place. Get the names, Step 4: Take photos of the vehicles involved,damages and addresses,and phone numbers of all persons involved in the surrounding area of the accident,if it is safe to do so. accident,e.g.,pedestrians,witnesses,other passengers,etc. Step 5: Call our AAA Claims hotline at 800-672-5246 to Step 2: Take photos of or write down the other person's report the lass. If necessary,we will arrange to have your vehicle driver's license information and other vehicle's license plate towed. Our provider's tow trucks always display the AAA number,including states of registration. emblem. Step 3: Take photos of or write down the other person's Do not admit responsibility for or discuss the circumstances of the accident with anyone other than the police or an authorized Auto Club claims Insurance card Information. representative. Do not disclose your policy limits to anyone. For questions or changes to your policy,call 1-877-422-2100,Monday through Friday from 7 a.m,to 8 p.m.or Saturday from 8 a.m.to 5 p.m. Evidence of financial responsibility shall at all times be carried in the vehicle. In addition, we suggest that each listed driver carry a card.Under California law,drivers and owners of a motor vehicle must be able to show proof of financial responsibillty at all times. Insurance information Call our AAA Claims has already been submitted directly to the DMV electronically, submit this document to DMV Hotline at 1-800-672-5246 only if specifically requested by DMV.These cards became invalid and should be destroyed on the expiration or termination date of the policy. IF YOU HAVE AN ACCIDENT CALL OUR 2 I7 AAA CLAIMS HOTLINE 1-800-672-5246 After an accident,exchange information with the other party and follow these 5 easy steps: Step 1: Pull vehicle over to a safe place. Get the names, Step 4: Take photos of the vehicles involved,damages and addresses,and phone numbers of all persons involved in the surrounding area of the accident, if it is safe to do so. accident,e.g.,pedestrians,witnesses,other passengers,etc. Step 5: Call our AAA Claims Hotline at 800-672-5246 to Step 2: Take photos of or write down the other person's report the loss. If necessary,we will arrange to have your vehicle driver's license information and other vehicle's license plate towed. Our provider's tow trucks always display the AAA number, including states of registration. emblem. Step 3: Take photos of or write down the other person's Do not admit responsibility for or discuss the circumstances of the accident with anyone other than the police or an authorized Auto Club claims insurance card information. representative. Do not disclose your policy limits to anyone. For questions or changes to your policy,cal€1-877-422-2100,Monday through Friday from 7 a.m,tog p.m.or Saturday from 8 a.m.to 5 P.M. IF YOU HAVE AN ACCIDENT CALL OUR 2 17 AAA CLAIMS HOTLINE 1-800-672-5246 After an accident,exchange information with the other party and follow these 5 easy steps: Step 1: Pull vehicle over to a safe place. Get the names, Step 4: Take photos of the vehicles involved,damages and addresses,and phone numbers of all persons involved in the surrounding area of the accident,if it is safe to do so. accident,e.g.,pedestrians,witnesses,other passengers,etc. Step 5: Call our AAA Claims Hotline at 800-672-5246 to Step 2. Take photos of or write down the other person's report the loss.If necessary,we will arrange to have your vehicle driver's license information and other vehicle's license plate towed. Our provider's tow trucks always display the AAA number,including states of registration. emblem. Step 3 Take photos of or write down the other person's Do not admit responsibility for or discuss the circumstances of the accident with anyone other than the police ur an authorized Auto Glub claims Insurance card Information. representative, Do not disclose your policy limits to anyone. For questions or changes to your policy,call 1-877-422-2100,Mondayi through Friday from 7 a.m.to 9 p.m.or Saturday from 8 a.m.to 5 p.m. 56408 10124 Evidence of Liability Insurance �G California Evidence of LiabilityInsurance VEHICLES ON POLICY YEAR MAKE VEH I.D.# Interinsurance Exchange of the Automobile Club 1995 GMC Named Insured Policy Number: ALVARADO,VICENTE 9 o DRIVERS ON POLICY ALVARADO,VICENTE y, ALVARADO,VICKY Effective Date:12-01-24 Expiration Date: 12-01-25 SANDOVAL,EDITH g ALVARADO,JUAN This policy complies with Sections 16056 or 16500.5 of the California Vehicle Code. Coverage subject to policy terms and limits. VEHICLES ON POLICY California Evidence of Liability Insurance YEAR MAKE VEH I.D.# Interinsurance Exchange of the Automobile Club 1995 GMC It Named Insured Policy Number: ui ALVARADO,VICENTE o DRIVERS ON POLICY ALVARADO,VICENTE ALVARADO.VICKY Effective Date:12-01-24 Expiration Date: 12-01-25 SANDOVAL,EDITH ALVARADO,JUAN This policy complies with Sections 16056 or 16500.5 of the California Vehicle Code. Coverage subject to policy terms and limits. Get your digital proof of insurance & membership card »>Download the app. Click AAA.com/app75 r� Electronic proof of insurance may not be valid as proof in all states,Please keep your hard copy version on hand.Must be a current AAA member ��// and insured through AAA to use Iris feature.Available for!Phone@ and smanphcnes for Android'v.Message.data and rooming rotes may apply. X California Evidence of LiabilityInsurance VEHICLES ON POLICY YEAR MAKE VEH I.D.# Interinsurance Exchange of the Automobile Club 1995 GMC Named Insured Policy Number: W ALVARADO,VICENTE _ o DRIVERS ON POLICY o ALVARADO,VICENTE ALVARADO,VICKY Effective Date:12-01-24 Expiration Date: 12-01-25 SANDOVAL,EDITH ALVARADO,JUAN This policy complies with Sections 16056 or 16500.5 of the California Vehicle Code. Coverage subject to policy terms and limits. California Evidence of LiabilityInsurance VEHICLES ON POLICY YEAR MAKE VEH I.D.# Interinsurance Exchange of the Automobile Club 1995 GMC w Named Insured Policy Number: w x ALVARADO,VICENTE DRIVERS ON POLICY 0 ALVARADO,VICENTE ALVARADO,VICKY Effective Date:12-01-24 Expiration Date: 12-01-25 SANDOVAL,EDITH ALVARADO,JUAN This policy complies with Sections 16056 or 16500.5 of the California Vehicle Code. Coverage subject to policy terms and limits. 56408 10/24 CAA0550A E20240919 102424 IF YOU HAVE AN ACCIDENT CALL OUR 2 17 AAA CLAIMS HOTLINE 1-800-672.5246 After an accident,exchange information with the other party and follow these 5 easy steps: Step 1: Pull vehicle over to a safe place. Get the names, Step 4: Take photos of the vehicles involved,damages and addresses,and phone numbers of all persons involved in the surrounding area of the accident,if it is safe to do so, accident,e.g.,pedestrians,witnesses,other passengers,etc. Step 5: Call our AAA Claims Hotline at 800-672-5246 to Step 2: Take photos of or write dawn the other person's report the loss. If necessary,we will arrange to have your vehicle driver's license information and other vehicle's license plate towed. Our provider's tow trucks always display the AAA number,including states of registration. emblem. Step 8. Take photos of or write down the other person's Do not admit responsibility for or discuss the circumstances of the accident with anyone other then the police or an authorized Auto Club claims insurance card information, representative. Do not disclose your policy limits to anyone. For questions or changes to your policy,tali 1.877-422-2100,Monday through Friday from 7 a.m,to 9 p.m.or Saturday from 8 a.m,to 5 p.m, IF YOU HAVE AN ACCIDENT CALL OUR 2 17 AAA CLAIMS HOTLINE 1-800-672-5246 After an accident,exchange information with the other party and follow these 5 easy steps: Step 1: Pull vehicle over to a safe place. Get the names, Step 4: Take photos of the vehicles involved,damages and addresses,and phone numbers of all persons involved in the surrounding area of the accident,if it is safe to do so. accident,e,g.,pedestrians,witnesses,other passengers,etc. Step 5: Call our AAA Claims Hotline at 800-672-5246 to Step 2: Take photos of or write down the other person's report the loss. If necessary,we will arrange to have your vehicle driver's license information and other vehicle's license plate towed. Our provider's tow trucks always display the AAA number,including states of registration. emblem. Do not admit responsibility for or discuss the circumstances of the accident Step 3: Take photos of or write down the other person's with anyone other than the police or an authorized Auto Club claims insurance card information. representative. Do not disclose your policy limits to anyone. For questions or changes to your poiicy,call 1-877-422-2100,Monday through Friday from 7 a.m.to 9 p.m.or Saturday from 8 a.m.to Evidence of financial responsibility shall at all times be carried In the vehicle. In addition, we suggest that each listed driver carry a card, Under California law,drivers and owners of a motor vehicle must be able to show proof of financial responsibility at all times, Insurance information Call our AAA Claims has already been submitted directly to the DMV electronically, submit this document to DMV Hotline of l-$r�0-G72-5246 only if specifically requested by DMV,These cards become invalid and should be destroyed on the expiration or termination date of the policy. IF YOU HAVE AN ACCIDENT CALL OUR 2417 AAA CLAIMS HOTLINE 1-800-672-5246 After an accident,exchange information with the other party and follow these 5 easy steps: Step 1: Pull vehicle over to a safe place. Get the names, Step 4: Take photos of the vehicles involved,damages and addresses,and phone numbers of all persons involved in the surrounding area of the accident,if it is safe to do so. accident,e.g.,pedestrians,witnesses,other passengers,etc. Step 5. Call our AAA Claims Hotline at 800-672-5246 to Step 2: Take photos of or write down the other person's report the loss. If necessary,we will arrange to have your vehicle driver's license information and other vehicle's license plate towed. Our provider's tow trucks always display the AAA number,including states of registration, emblem. Step 3: Take photos of or write down the other person's Do not admit responsibility furor discuss the circumstances of the accident with anyone other than the police Oran authorized Auto Club claims insurance card Information. representative. Do not disclose your policy limits to anyone. For questions or changes to your policy,call 1.677-422-2100,Monday through Friday from 7 a.m,to 9 p.m.or Saturday from 8 a.m.to 5 p.m. IF YOU HAVE,AN ACCIDENT CALL OUR 2 J7 AAA CLAIMS HOTLINE 1-800-672-5246 After an accident,exchange information with the other party and fallow these 5 easy steps: Step 1: Pull vehicle over to a safe place. Got the names, Step 4: Take photos of the vehicles involved,damages and addresses,and phone numbers of all persons involved in the surrounding area of the accident,If it is safe to do so, accident,e.g.,pedestrians,witnesses,other passengers, etc. Step 5: Call our AAA Claims Hotline at 800-672-5246 to Step 2: Take photos of or write down the other person's report the loss.If necessary,we will arrange to have your vehicle driver's license information and other vehicle's license plate towed. Our provider's tow trucks always display the AAA number,including states of registration, emblem, Do not admit responslbitily for or discuss the circumstances of the accident Step 3: Take photos of or write down the other person's with anyone other than the police or an authorized Auto Club claims Insurance card Information, representative. Do not disclose your policy limits to anyone. For questions or changes to your policy,call 1-877-422-2100,Mandayfhrough Friday from 7 a,m.to 9 p.m.or Saturday from 8 a.m.to 5 p.m. 56408 10124 Evidence of Liability Insurance California Evidence of LiabilityInsurance VEHICLES ON POLICY YEAR MAKE VEH I.D.# Interinsurance Exchange of the Automobile Club 1995 GMC Named Insured Policy Number: = g ALVARADO,VICENTE ° o DRIVERS ON POLICY LL ALVARADO,VICENTE w ALVARADO,VICKY Effective Date:12-01-24 Expiration Date: 12-01-25 SANDOVAL,EDITH ALVARADO,JUAN This policy complies with Sections 16056 or 16500.5 of the California Vehicle Code. Coverage subject to policy terms and limits. T California Evidence of LiabilityInsurance VEHICLES ON POLICY YEAR MAKE VEH LD.# Interinsurance Exchange of the Automobile Club 1995 GMC of Named Insured Policy Number: ALVARADO,VICENTE 9 o DRIVERS ON POLICY ALVARADO,VICENTE ALVARADO,VICKY Effective Date: 12-01-24 Expiration Date: 12-01-25 SANDOVAL,EDITH ALVARADO,JUAN This policy complies with Sections 16056 or 16500.5 of the California Vehicle Code. Coverage subject to policy terms and limits. Get your digital proof of insurance & membership card maw >>Download the app. Click AAA.com/app75 r® Electronic proof of insurance may not be valid as proof in all states.Please keep your hard copy version on hand.Must be a current AAA member �J and insured through AAA to use this feature.Available for!Phone®and smadphcnes for Android'.Message.data and rooming tales may apply. O� California Evidence of LiabilityInsurance VEHICLES ON POLICY YEAR MAKE VEH I.D.# Interinsurance Exchange of the Automobile Club 1995 GMC Named Insured Policy Number: W of ALVARADO,VICENTE _ ❑ DRIVERS ON POLICY o ALVARADO,VICENTE LL ALVARADO,VICKY Effective Date:12-01-24 Expiration Date: 12-01-25 SANDOVAL,EDITH ALVARADO,JUAN This policy complies with Sections 16056 or 16500.5 of the California Vehicle Code. Coverage subject to policy terms and limits. California Evidence of LiabilityInsurance VEHICLES ON POLICY YEAR MAKE VEH I.D.# Interinsurance Exchange of the Automobile Club 1995 GMC W Named Insured Policy Number: W ALVARADO,VICENTE o o DRIVERS ON POLICY r` ALVARADO,VICENTE ALVARADO,VICKY Effective Date:12-01-24 Expiration Date: 12-01-25 SANDOVAL,EDITH ALVARADO,JUAN This policy complies with Sections 16056 or 16500.5 of the California Vehicle Code. Coverage subject to policy terms and limits. 56408 10124 CAA0850A E20240919 102424 IF YOU HAVE AN ACCIDENT CALL OUR 2 17 AAA CLAIMS HOTLINE 1-800-672-5246 After an accident,exchange information with the other party and follow these 5 easy steps: Step 1: Pull vehicle over to a safe place. Get the names, Step 4: Take photos of the vehicles involved,damages and addresses,and phone numbers of all persons Involved in the surrounding area of the accident,if it is safe to do so. accident,e.g., pedestrians,witnesses,other passengers,etc. Step 5: Call our AAA Claims Hotline at 800-672-5246 to Step 2: Take photos of or write down the other person's report the loss, If necessary,we will arrange to have your vehicle driver's license information and other vehicle's license plate towed. Our provider's tow trucks always display the AAA number,including states of registration. emblem. Step 3: Take photos of or write down the other person's Do not admit responsibility for or discuss the circumstances of the accident insurance card information. with anyone other than the police or an authorized Auto Club claims representative. Do not disclose your policy limits to anyone. For questions or changes to your policy,call 1-877-422-2100,Monday through Friday from 7 a.m,tog p.m.or Saturday from a a.m.to 5 p.m. IF YOU HAVE AN ACCIDENT CALL OUR 2417 AAA CLAIMS HOTLINE 1-800-672-5246 After an accident,exchange information with the other party and follow these 5 easy steps: Step 1: Pull vehicle over to a safe place. Get the names, Step 4: Take photos of the vehicles involved.,damages and addresses,and phone numbers of all persons involved in the surrounding area of the accident,if it is safe to do so. accident,e.g.,pedestrians,witnesses,other passengers,etc. Step 5: Call our AAA Claims Hotline at 800-672-5246 to Step 2. Take photos of or write dawn the other person's report the loss.if necessary,we will arrange to have your vehicle driver's license information and other vehicle's license plate towed. Our provider's tow trucks always display the AAA number,including states of registration. emblem. Step 3 Take photos of or write down the other person's Do not admit responsibility for or discuss the circumstances of the accident with anyone other than the police or an authorized Auto Club claims Insurance card information. representative, Do not disclose your policy limits to anyone. For questions or changes to your policy,calf 1-877-422-2100,Monday through Friday from 7 a.m.to 9 p.m.or Saturday from a a.m.to 5 p.m. Evidence of financial responsibility shall at all times be carried in the vehicle. In addition, we suggest that each listed driver carry a card. Under California law,drivers and owners of a motor vehicle must be able to show proof of financial responsibility at all times. Insurance information Call our AAA Claims has already been submitted directly to the DMV electronically, submit this document to DMV Hotline at 1-800-672-5246 only if specifically requested by DMV.These cards become Invalid and should be destroyed on the expiration or termination date of the policy. IF YOU HAVE AN ACCIDENT CALL OUR 2417 AAA CLAIMS HOTLINE 1-800-672-5246 After an accident,exchange information with the other party and follow these 5 easy steps: Step 1: Pull vehicle over to a safe place. Get the names, Step 4: Take photos of the vehicles involved, damages and addresses,and phone numbers of all persons involved in the surrounding area of the accident,if it is safe to do so. accident,e.g.,pedestrians,witnesses, other passengers,etc. Step 5: Call our AAA Claims Hotline at 800-672-5246 to Step 2: Take photos of or write down the other person's report the loss. If necessary,we will arrange to have your vehicle driver's license information and other vehicle's license plate towed. Our provider's tow trucks always display the AAA number,including states of registration. emblem. Do not admit responsibility for or discuss the circumstances of the accident Step 3' Take photos of or write dawn the other person's with anyone other than the police or an authorized Auto Club claims insurance card Information. representative. Do not disclose your policy limits to anyone. For questions or changes to your policy,cail 1-877.422-2100jand rough Friday from 7 a.m.to 9 p.m,or Saturday from 8 a.m.to 5 p.m. IF YOU HAVE AN ACCIDENT CALL 17 AAA CLAIMS HOTLINE 1-800-672-5246 After an accident,exchange information with the other par follow these 5 easy steps: Step 1: Pull vehicle over to a safe place. Get the names, Step 4: Take photos of the vehicles involved,damages and addresses,and phone numbers of all persons involved in the surrounding area of the accident,if it is safe to do so. accident,e.g.,pedestrians,witnesses,other passengers,etc. Step 5: Gall our AAA Claims Hotline at 800-672-5246 to Step 2: Take photos of or write down the other person's report the loss. If necessary,we will arrange to have your vehicle driver's license information and other vehicle's license plate towed. Our provider's tow trucks always display the AAA number,including states of registration. emblem. Step 3: Take photos of or write dawn the other person's Do not admit responsibility for or discuss the circumstances of the accident with anyone other than the.police or an authorized Auto Club claims Insurance card Information. representative. Do not disclose your policy limits to anyone. For questions or changes to your policy,call 1-877-422-2100,Monday through Friday from 7 a.m.to 9 p.m.or Saturday from 8 a.m.fo 5 p,m. 56406 10124 ♦ 1: PRIVACY NOTICE This Privacy Notice describes how we handle your personal information as an insurance carrier and agent and the steps taken to protect your privacy. We send a privacy notice annually, as required by law. We reserve the right to g modify this Notice at any time. A separate privacy notice would apply to information collected through other means including from the use of our website,AAA mobile applications, AAA membership, AAA OnBoard telematic services, P and affiliate partner products and services. You should consult those notices if necessary. g Information We Collect. We collect,from you and from other sources,your personal information during the entire insurance life cycle from solicitation, application, underwriting, policy purchase and change, policy maintenance, claims submission and handling, renewal and termination. This includes information such as your name, home and email address, driver's license number and telephone number. Personal information does not include(i) privileged information or(ii)any information that is publicly available. We also collect information about your transactions with us, our affiliates and others, such as insurance policy information, premiums, and payment history. We may also collect information, such as your driving record, claims history, medical information and credit information. As allowed by law,we may ask for consumer reports concerning your application or any renewal of your insurance. Information given to us by an insurance support organization, including consumer reporting agency, may be retained by them and disclosed to other persons. Information We Share. We may share your personal information with our affiliates and non-affiliates. We do not disclose your information unless allowed by law. To limit your sharing, please visit AAA.com/Privacy-Rights, and follow its instructions, OR alternatively complete the enclosed IMPORTANT PRIVACY CHOICES FOR CONSUMERS form and return it to us using any of the three listed methods. We may share the following categories of your information without your consent: 1. To a person other than an insurance institution (hereinafter referred to as"insurer"), agent or insurance-support organization (ISO) if needed to: a. Perform a business, professional, or insurance function; b. Determine your eligibility for an insurance benefit or payment; c. Detect or prevent crime,fraud, material misrepresentation or material nondisclosure with an insurance transaction. 2. To an insurer, agent, ISO, or self-insurer to: a. Detect or prevent crime,fraud, material misrepresentation or nondisclosure with an insurance transaction; b. Perform an insurance transaction involving you. 3. To any medical care institution or medical professional to: a. Verify insurance coverage or benefits; b. Inform you of a medical problem you may not be aware of; c. Conduct an operations or services audit. 4. To an insurance regulatory authority(e.g., Department of Insurance). 5. To law enforcement or other government authority. 6. In response to an order(including a search warrant or subpoena) or as otherwise required by law. 7. For actuarial or research studies if: a. Your identity is not given in any reports that may be produced; b. Materials that can identify you are returned or destroyed when they are no longer needed; c. The group conducting the study agrees not to disclose it further unless permitted by law. 8. To someone who only uses your information in the marketing of a product or service if you have been given the opportunity for your information to not be shared and the person receiving it agrees to use it only for marketing. We will not disclose: a. Medical record information; b. Privileged information; c. Personal information relating to your character, personal habits, mode of living, or general reputation; d. Any classification derived from such information. CA GLBA 8 IIPPA Privacy Notice Revised 09/2024 SEE REVERSE PAC0001A E20240822 102424 9. To an affiliate who uses your information only in connection with an audit of our operations or for the marketing of insurance products or services if they agree not to disclose your information further. 10. To a group policyholder to report claims experience or to conduct an audit of our operations. Your right to access your information. You have the right to inspect your Information if we can reasonably locate and retrieve it.Your right to access extends to that information which has been collected and maintained by us in connection with your Insurance transactions. Your access rights do not extend to your 4 information that was collected in reasonable anticipation of a claim or civil or criminal proceeding in which you are N Involved. Your request must be in writing, Please send your request to: V Interinsurance Exchange of the Automobile Club P.O. Box 25001 Santa Ana, CA 92799-5001 Attention: Underwriting Projects You must provide your name, address, phone number, policy number, and a description of your recorded information that you wish to access. We will reply within 30 business days of receipt. Our reply will: • Inform you of the nature and substance of your information collected; • Offer the choice to either see or copy your information or receive a copy of it by mail (we may charge a reasonable fee); • Provide a plain language explanation if your information is in code; • Provide the identity of persons to whom we disclosed your information over the prior 2 years, or if the identity was not recorded, we will provide the names of insurers, agents, ISOs or others to whom we normally disclose your information; • Provide a summary of the process to request to correct, amend, or delete your recorded information. If your information is from an institutional source or is medical record information from a medical care institution or a medical professional, we will state who provided it. Your rights to correct, amend, or delete information. Once you inspect your recorded information, you can request that we correct, amend, or delete it. Your right applies to information regarding your insurance transactions. Your request must be in writing. We will respond within 30 business days of receipt and will either agree or refuse your request, If we correct, amend, or delete the portion of your recorded Information in dispute,we will notify you in writing and furnish the change to: • Those you designate who may have received your information within the past 2 years; • Any ISO whose primary source of information is from insurers(subject to certain conditions), if the ISO regularly received your information and maintains it; • Any ISO that gave your recorded information to us. If we refuse your request,we will tell you why, If you disagree, you can file a concise consumer statement of: • What you think Is the correct, relevant, or fair information, and • The reasons you disagree with our refusal. Your consumer statement will be filed with your disputed information. We will clearly identify the matter in dispute, and: • Ensure those reviewing your disputed information are aware of and have access to your statement; • Provide your statement whenever we subsequently disclose your disputed information; • Furnish your statement to the same persons or groups that would receive a correction, amendment, or deletion, Information Protection. We maintain physical, electronic and procedural safeguards to protect your information. We require employees and vendors to keep your personal information confidential. Access to such information is provided to those who need it for their duties. We review the information security practices of vendors with whom we share personal information, This Notice is provided on behalf of: Automobile Club of Southern California, ACSC Management Services Inc., and Interinsurance Exchange of the Automobile Club. 2 CA Gt_BA&IIPPA Privacy Notice Revised 0912024 PAG0881a E2"'9822 10242 Important Privacy Choices for Consumers You have the right to control whether we share some of your personal information. X Please read the following information carefully before you make your choices below. Your Rights You have the following rights to restrict the sharing of personal and financial information with our affiliates (companies we own or control) and outside companies that we do business with. Nothing in this form prohibits the sharing of information necessary for us to follow the law, as permitted by law, or to give you the best service on your accounts with us. This includes sending you information about some other products or services. Your Choices Restrict Information Sharing With Companies We Own or Control (Affiliates): Unless you say "No," we may share personal and financial information about you with our affiliated companies. ❑ NO, please do not share personal and financial information with your affiliated companies. Restrict Information Sharing With Companies We Do Business With To Provide Financial Products And Services: Unless you say "No," we may share your personal and financial information about you with outside companies we contract with to provide financial products and services to you. ❑ NO, please do not share personal and financial information with outside companies you contract with to provide financial products and services. Time Sensitive Reply You may make your privacy choice(s) at any time. Your choice(s) marked here will remain unless you state otherwise. However, if we do not hear from you we may share some of your information with affiliated companies and other companies with whom we have contracts to provide products and services. Name: Membership or Policy Number(s): To exercise your choices do one of the following: 1. Please visit AAA.com/Privacy-Rights and follow its instructions to opt-out of sharing; 2. Complete this form and email us at aaa-privacy@ace.aaa.com to request a prepaid mail our completed form to us; or you so that you can , envelope which will be sent toy y y p 3. Reply electronically by scanning the form and emailing to us at aaa-privacy@ace.aaa.com 3 CA GLBA&IIPPA Privacy Notice Revised 09/2024 PAC0101C 102424818 AAA Auto Pay Plan Terms and Conditions The Authorization Agreement at the bottom of this page is valid only for insurance policies written by the Interinsurance Exchange of the Automobile Club("Exchange")and for your AAA membership.* Automatic debits from your checking account for insurance policies will begin with the first AAA Auto Pay Plan payment billed after the Authorization Agreement is received and processed. (Please allow 15 days for processing.) Until then,your insurance premium payment is still due on the date shown on your most recent billing statement and should be returned to us in the white envelope provided. Outstanding membership dues amounts will begin to be debited after the Authorization Agreement has been processed. AAA Auto Pay automatic payments are subject to all applicable finance charges,installment and other fees. Insurance only: We gave you notice of the amount of all applicable finance charges and fees at the time you applied for the insurance policy(ies)below and upon renewals of your policy(ies). Installment payment plans and all fees are subject to change without notice. Policyholders and members who have payments returned unpaid from their financial institution may have the AAA Auto Pay Plan authorization revoked as to all insurance policies by the Exchange and as to AAA membership by Automobile Club of Southern California("AAA"). In the event that this occurs,you will be notified by mail and a return payment fee and late fee may be added to your bill(or to a second attempted debit to your account). If AAA Auto Pay is revoked, g installments remaining for the current insurance policy period will be billed on your regular payment plan with statements mailed to you and outstanding membership dues and fees will be billed with statements mailed to you periodically. If an error is made,the Exchange or AAA,as applicable,can correct it by initiating debits or credits. You may revoke enrollment in the AAA Auto Pay Plan,as to any one or more insurance policies and/or your membership,at any time by signing and dating a written request and mailing it to: AAA/Interinsurance Exchange of the Automobile Club,P.O. Box 25006,Santa Ana,CA 92799-5006. While not required,a revocation form is available for your use at AAA.com/form or upon request by contacting us at 1.800.924.6141 or your local AAA branch. * If you enroll in AAA Auto Pay for more than one insurance policy and/or membership,the processing bank will determine the order of processing debits (I.e.,the order of payment)for each policy and/or membership. If you would like to make payments out of more than one checking account,you will need to complete one Authorization Agreement for each checking account. If you would like to enroll more than three insurance policies in AAA Auto Pay,please use one Authorization Agreement for every three policies. Your current payment is still due on the date shown on your most recent billing statement and should be returned to us in the envelope provided. nor S SMITH ; IANE M S,M1111 MtU00 LOS PLACE ST SAMPLE ���—IIXI'IVUTON BEACH CA 92647 Date Mail completed forms with a voided check (optionap — _ Or r�,nr_• C I�L� i. in the envelope provided, or return to: _. Doll.- AAA/Interinsurance Exchange of the Automobile Club �vz H�„ti costa M—.CA 926IN' P.O. Box 25006 Santa Ana, CA 92799-5006 • 215 111 1! 21S 0 Important: This form cannot be faxed or electronically mailed to us. We must have an original signature to complete this transaction. Please keep a copy of this form for your records. ACH0809A.E211201208 PX4 1112424 JVI Please detach at line. AUTHORIZATION AGREEMENT FOR INSURANCE AND MEMBERSHIP DIRECT PAYMENTS(ACH DEBITS)—AAA Auto Pay Plan • To use AAA Auto Pay for your membership, enter your Club Code and Membership Number in the boxes below. • Please enter the number of each insurance policy you want billed through AAA Auto Pay. Club Code First A Di;ts of Membershi Number Lefler Prefz up to 3 MEMBER# ❑�_�❑�❑❑� POLICY# ©�� oo®a©®®a© Letter Prefix(up l03 ❑❑❑❑❑❑❑�❑ POLICY# L❑etter Preto upt� ❑❑❑❑❑❑❑❑❑ POLICY# I(we)hereby authorize the Interinsurance Exchange of the Automobile Club("Exchange')and Automobile Club of Southern California("AAA'),to initiate debit and credit entries to my(our): CHECKING ACCOUNT indicated below at the financial institution named below("Institution'),for(i)all amounts that become due by me(us)to the Exchange,including,without limitation,insurance premium,finance charges,installment,return payment,late payment and other fees("Fees'), (ii)all membership dues that become due by me(us)to AAA and all related Fees,and to debit that same to such account. I(we)acknowledge that the origination of ACH transactions to my(our)account must comply with the provisions of U.S.Law and is governed by the Terms and Conditions that accompanied this Agreement. INSTITUTION NAME Must be exactly 9 digits Up to 17 digits ROUTING#[]❑❑❑[:]❑❑❑❑ACCOUNT#[:]❑❑❑❑��E❑❑[—]❑F]❑ E][7] This authorization is to remain in full force and effect until terminated by the Exchange or AAA or until the Exchange or AAA has received written notification from me(or either of us)of its termination in such time and in such manner as to afford,the Exchange or AAA,as applicable,and Institution,a reasonable opportunity to act on it. NANIE(S)OF ACCOUNT IIOLDER(S) DATE SIGNATURE(S)OF ACCOUNT HOLDER(S) AAA Employee#(ifappucable) Branch/Sec It Membership# Alerober Name 8417(3t13)