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A` O�jy <br />INSURANCE BINDER <br />DATF 1uun,r%^f%,.. <br />R !S A TEMPORARY INSURANCE CONTRACT - - - ,mw -�.... I ; _, <br />AGENCY SUBJECT TO THE CONDITIONS 8/1J2013 <br />SHOD ON THE REVERSE SIDE OF THIS Darr Insurance Services Inc . COMPANY '�—°_ _=— _ SIDE -O _ _ FORM <br />License # OD 3 68 7 3 MsrcurY Insurance Company BINDER N <br />9899 Indiana Avenue � Ste 101 DATE EFFECTIVE 5138101352 <br />Riverside TIME EXPIRATION `- <br />CA 92503 <br />16—C O Ext : (951) 509-0509 �4 OS 01 2013 12:01 AM <br />- . 51)509-0515 � _ ' <br />.. A1C Na . - / 013 <br />04694 PM <br />*Ad-E-NQUY THIS BINDER IS ISSUED TO EXTEND COVERAGE IN THE ABOVE NOON <br />0 0 0 0 814 5 �- . SuB CODE�� �__ -_ PER EXPIRING POLICY *. NAMED COMPANY DESCRIPTION QF oPERAT1pN 0 4 O 102 0 02 2 4 8 504 <br />ED SIVEHICLEWpROPERTY Inclu <br />PHILLIP M PITCHFORD 2005 HONDA ACCORD EX VIN I1SGCI�i55Bq Lv�tlony <br />2417 ELSINORE ROAD 85A065239 <br />RIVERSIDE CA 92506 <br />COVERAGES <br />PROPERTY E OF INSURANCE _ �... _ ,�..__ -___ COVE LIMITS <br />ITS <br />CAUSES OF LOSS `'- DEDUCTIBLE <br />COINS X <br />BASIC BROAD 1_ SPEC `« - AMOUNT <br />--��� <br />GENERAL LIABILITY <br />COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE <br />$ <br />r- <br />CLAIMS MADE � � OCCUR ED PA - <br />ISE $ <br />ME EXP Any one Person <br />8 ADV INJURY � <br />RETRO DATE FOR CLAIMS MADE: GENERAL AGGREGATE S <br />VEHICLE LWBILITY <br />ANY AUTO PRODUCTS - COMPIOP AGG S <br />ALL OWNED AUTOS r : -. �,,.r .,�- �:��-� COMBINED SINGLE LIMIT _ $ <br />ti BODILY INJURY Per rson $ 100 D D D <br />SCHEDULEO AUTOS ' <br />DBODILY INJURY (Per accident S 300- DDO 'r <br />HIRED AUTOS tj �'J � PROPERTY DAMgGE 5 Q <br />FED S .DDO <br />NON -OWNED AUTOS � MEDICAL PAYMENTS <br />X PRIVATE PASSENGER <br />._. <br />-• - ""�'-�-. PERSONAL IN <br />AUTOMOBILE rir --.... _ _ � JURY PROT $ <br />2 0 05 HONDA /ACCORD Ex 1HGCM5 .�_R ~_.�.�_ <br />VEHICLE PHYSICAL DAMAGE UNINSURED MOTORIST S <br />�g85A065239 <br />DED ALL VEHICLES ~� S <br />X COLLISION: 5 SCHEDULED VEHICLES <br />ACTUAL CASH VALUE <br />X OTHER THAN COL: 250 STATED AMOUNT $ <br />GARAGE LIABILITY <br />ANY AUTO AUTO ONLY - EA ACCIDENT S <br />OTHER THAN AUTO ONLY:4- _ _ ��......._._..... . <br />EXCESS IABILITY _ - <br />EACH ACCIDENT <br />AGGREGATE S . _ ..".....`� --_ ... <br />ELLA FORM EACH OCCURRENCE R THAN UMBRELLA FORM RETRO DATE FOR CLAIMS MADE: AGGREGATE <br />i <br />SELF - INSURED RETENTION S <br />WORKER'S COMPENSATION <br />AND WC STATUTORY LIMITS <br />EMPLOYERS LIABILITY E. L. EACH ACCIDENT <br />_ ..� $ <br />E -L. DISEASE - EA EMPLOYEE $ <br />SPECIAL <br />CONDITIONS PROOF OF INSURANCE ONLY E.L. DISEASE - POLICY LIMIT : <br />1 <br />OTHER FEES x <br />COVERAGES -- <br />TAXES $ <br />NAME & ADDRESS ESTIMATED TOTAL PREMIUM <br />$ <br />MORTGAGEE X ADDITIONAL INSURED <br />CITY OF RIVERSIDE LOSS PAYEE <br />ITS OFFICERS, EMPLOYEES AGENTS LOAN # • PAYEE y `_ <br />3600 MAIN STREET <br />RIVERSIDE CA 92501 PROOF aF INSURANCE ONLY <br />AUTHORIZED REPRESENTATIVE <br />ACORD 75 (2010104) <br />INS075 (201004).02 Page 1 of 2 0 1993 -2010 ACORD CORPORATIO <br />The ACORD name and logo are registered marks of AC ORD N. All rights reserved. <br />