EFTA01077973.pdf

WensFargo Insurance Services USA, Inc. SWELLS 330 Madison Avenue FARG 0 7th Floor New York NY 10017-5001 July 25, 2013 RE: Automobile Insurance Dear Leon: Enclosed please fmd Fireman's Fund Insurance Company policy_ renewing your automobile insurance for a further period of one year from July 26, 2013. Also attached is our invoice in the amount of $21,075 representing the annual premium. The policy covers on eleven vehicles which are as follows: 1989 Mercedes Benz 560 SL 2009 Honda Pilot 2004 Mercedes Benz S600 2011 Chevrolet K1500 Silverado 2004 Toyota Highlander 2012 Mercedes Benz 8350 2004 Acura TL 2012 Chevrolet Tahoe LT 2007 Bentley 2013 Mercedes Benz S600 2008 Jeep Patriot All of these vehicles are garaged in Bedford Hills, New York. There is $1,000 deductible comprehensive fire, theft and collision coverages. Liability protection is afforded with a limit of $500,000 bodily injury/property damage. You have excess umbrella liability covering over and above this primary insurance. I trust you will fmd all in order and remain Sincerely, Jeffrey A. Haber JAH:ya Encl. Together we'll go far G trice Am41‘1744, Las L Drbid.Atmowc RencwalLea do: EFTA01077973  Declarations Personal Auto Po!ley Policy Number Fireman's Fond Insurance Companies Coverage is provided in the following cotnpany, Policyl iod: From 07/26/2013 To 07/26/2014 a stock company (120) Tie* a the AMISS eflerezet secedes acedHas) 13 - Associated Indemnity Corporation insured's Name and Mailing Address I Auto(s) principally garaged at mailing address unless Zip Code Leon D Black otherwise stated_ # 200 The Narrows Bedford Hills, NY 10506 MIN lLon Payee Per Auto TAX TERRITORY: 05704 DESCRIPTION OF AUTO(5) OR TRAIL AM° Model ass- No. kJ Aim Class /Tier Year Trade Name, Model, Body Type Identification Number Tea. = 1 2011 Chevrolet K1500 Silvered° 1GCNKPEA8BZ116619 A 2011 883120H 65 2 1989 Mercedes Benz 56051. WDBBA48D3KA100433 A 1989 89112214 65 3 2012 Chevroke Tahoe LT 1GNSKBEO5CR302060 E • 2012 8831204 .. 65 15% Coverage Is Provided Where A Premium And Limit Of Liability Are Shown For The Coverage . Coverages Limit of Liability Fall Term Premium S AM I S Adel S PO63 A. liabftity (Single Limit) S 500,000 Each Accident 406 804 406 A. Liability (Split Limits) Boa bitty 5,000 Each Pawn S .000 Each Accident Property Damage S ,000 Each Accident B. Medical Payments S 100.000 Each Person 9 10 9 C ()uins-urecVLIndminsured Motorists (Sisk& Limit) S 500,000 Each Accident —170 "170 "170 C. Uninsured Bodily Injury S ,000 Each Pawn Motorists S ,000 Each Accident (Split Limits) Properly Damage 5 .000 Each Accident D. Damage Collision Loss (ACV Means Actual Cah Value) To Auto I: ACV Minus 51000 Deductible 341 457 389 Your Auto 2: ACV Minus 51000 Deductible Auto Auto 3: ACV Nimus 51000 Deductible Ober Than Auto : 5 ACV Minus 5 wenuate Collision Loss Auto 1: S Minus S1010 oceeuake 93 291 98 Auto 2: S Minus $1000 Mambo Auto 3:3 Minus SI003 Cedtcale Towing and Labor Costs- Each Disablement 'Ind 'Ind incl Rental Rein:lbws:anent or Eat Tousponstioa See Eadersemem 'Ind and inel 'Personal Injury Protection see attached See Endorsement 76 189 76 NY Motor VeNcle Enforcement Fee 10 10 10 'Prestige Auto 'incl and lid "Supplemental Endorsement (SUM) Endorsements Attached Total Premium Per Auto 1105 1901 1138 PP0001 PP0179 PP0346 PP0364 PP0409 PP0476 Eadorsement Premium s '257 PP0587 PP0588 PP0593 PP1301 102164 102173 102192 Total Policy Premium Sams pg.4 Discounts: See attached Data ofIssue Countasignatina of Authorized Agenr 7/18/13 CEB 5965.%95 This Declarations Page Is Issued in Coop:nom With And Is Part Of The Pascual Auto Policy INSURED COPY Page 1of 4 EFTA01077974  Declaration Personal Auto Policy Policy NumberIMM Fireman's Fund Insurance Companies Coverage is provided in the following company, Potty Period: From 07/26/2013 To 07/26/2014 a stock company (12.0=t Staird Trees Oil Attu ofNmet hb000f AO 510(4 Hem,) 13 - Associated Indemnity Corporation Insured's Name and Mailing Address Auto(s) principally garaged at mailing address unless Zip Code Leon D Black otherwise stated. Debra R Black 64-6 200 The Narrows Bedford Hills, NY 10506 Loss Payee Per Auto TAX TERRITORY 05704 DESCRIPTION OF AUTO OR TRAILERS Aug Model see No. Year Trade Name, Model, Body Type klenrifIcatica Number tot Age Class / Tier TeTea. Mat 4 2012 Chevrolet Silverado K2500H0 1GC1KX038CF189577 .1 2012 815120H 65 15% 5 2004 Mercedes Benz 5600 WDENG76J74A3.99157 Y 2004 883120H 65 15% 6 2004 Toyota Highlander _JTEEP21A840031177 A 2004 883121H 65 15% Coverage Is Provided Where A Premium And Limit Of Liability Are Shown For The Coverage Coverages Limn of Liability Fall Term Premium s Asa S Asa 3 Ause6 A. Liability (Single Limit) S 500,000 Each Accident 452 416 406 A. Liability (Split Limits) Bodily Injury S ,000 Each Person 5,000 Each Accident Property Damage S NO Each Accident B. Medical Payments S 100,000 Each Person 9 9 9 C UninsmerlfUnderinsured Motorists (Sink Limit) S 500,000 Each Accident "170 "170 "170 C. Uninsured Bodily Injury S ,000 Each Person Motorists S .000 Each Accident (Split Limits) Property Damage $ ,000 Each Accident D. Damage Collision Loss (ACV Means Actual Cash Value) To Auto 4: ACV Minus $1000 Deductible 537 769 228 Your Auto 5: ACV Minus $1000 Deductible Auto Auto 6: ACV Minus $1000 Deductible Other Than Auto :5 ACV Minus S osaaahic Collision Loss Auto 4:5 Minus 51000 Dolvenble 159 401 68 Auto 5: 5 Minus $1000 Doltcak Auto 6: $ Minus 51000 Dedorobk Towing and Labor Costs Each Disablement 'Ind rind Ind Rental Reimbursement or Ext. Transportation Soo Endorsement Ind Ind 'Ind Personal Injury Protection sec attached See Endorsement 83 79 76 NY Motor Vehicle Enforcement Fee 10 10 10 'Prestige Auto Ind Ind 'Intl "Supplemental Endorsement (SUM) Endorsements Attached Total Premium Per Auto 1420 1854 967 Endorsement Premium Stine' Teal Policy Premium S see ps4 Discounts: see attached Daze of blue Countersignature of Authorized Agent 7/18/'13 CEB 5965.5-95 This Declarations Page is Issued In Conjunction With And Is Pan Of The Personal Auto Policy INSURED COPY Page 2 of 4 EFTA01077975 Declarations Personal Auto Policy Policy Number Fireman's Fund Insurance Companies Coverage is provided in the Mains company, Poligleriod: From 07/26/2013 To 07/26/2014 a stock company maim Sudard Thant itc Addnu orSamcd eased as Voce Hay) 13 - Associated Indemnity Corporation Insured's Name and Mailing Address Auto(s) principally garaged at mailing address unless Zip Code Leon D Black otherwise stated. #7-9 200 The Narrows Bedford Hills, NY 10506 Loss Payee Per Auto TAX TERRITORY. 05704 DESCRIPTION OF AUTOS) OR TRAILEFt(S) Aate Model Syr ta NO Year Trade Name, Model Body Type identifiatice Number Age Class I Tier Ten. M. 7 2007 Bentley Continental GTC SCBDR33W17C046196 Y 2007 816120H 65 15% 8 2008 Jeep Patriot Limited 1J8FT48W08D700745 E 2008 883120H 65 15% 9 2009 Honda Piot 5FNYF48269B053993 E 2009 815120H 65 15% Coverage Is Provided Where A Premium And Limit OfLiabilitYAre Shown For The Coverage Coverages Limit of Liability Fall Term Premium S Awes S AM 8 5 Aurae A. liability (Single limit) $ 500,000 Each Accident 452 416 464 A. Liability (Split Limits) Bodily Injury $ ,000 Each Pence S ,000 Each Accident Propaty Damage 5.000 Each Accident B. Medical Payments S 180,000 Each Person 9 9 9 C Uninsuredflindainsured Motorists (Single Limit) S 500,000 Each Accident "170 "170 *-170 C. Vain:lad Bodily Injury $ ,000 Each Perna Motoras $ ,000 Each Accident (Split Limits) Property Damage 5,000 Each Accident D. Damage Collision Loss (ACV Meats Actual Cub Value) To Auto 7: ACV Minus $1000 Deductible 1657 315 382 Your Auto 8: ACV Maus SI000 Deductible Auto Auto 9: ACV Minus S WOO Deductible Other Than Auto : $ ACV Maus S Oinvento Caftan Lass Ante 7:3 Maus 51000 Mantic 1215 85 108 Auto 8: $ Minus $1000 Deter& Auto 9:$ Minus 51000 Delta* Towing and Labor Coss Each Disablement *Ind *kid *kid Rental Reimbursement or Ext. Transportation Sec Endorsement Ind mid *Ind Personal Injmy Macedon see attached See Endorsement 8.3 79 86 NY Motor Vehicle EnforcerneM Fee 10 10 10 *Prestige Auto 'Ind Ind Ind ''Supplemental Endorsement (SUM) Endorsements Attached Total Premium Per Auto 3596 1084 1229 Endorsement Premium S Ind Total Policy Premium S see pg 4 Discounts: see attached Date of Issue Counteralmatum of Authorized Agent 7/18/13 CEB 5965.5-95 This Declarations Page Is I sued In Conjunction With And Is Pit Of The Personal Auto Policy INSURED COPY Page 3 of 4 EFTA01077976 Declarations Personal Auto Policy Policy Number AAE 12263565 Fireman's Fund Insurance Companies Coverage is provided in the following company, Poligferiod: From 07/26/2013 To 07/26/2014 a stock company (12:01M Sumbld Ties *I ere Mins of Nimbi inns' a Slats Herrn) 13 - Associated Indemnity Corporation Insured's Name and Mailing Address Auto(s) principally garaged at mailing address unless Zip Code Leon D Black otherwise stated. 8 #10-12 200 The Narrows Bedford Hills, NY 10506 Loss Payee Per Auto TAX TERRITORY 05704 DESCRIPTION OF AUTO(S) OR FRAME Arro Model Sse- we. identification Number wet Age Class / Tier Ten. Year Trade Name, Model, Body Type 10 2012 Mercedes Benz R350 GL 4JGCB5HE9CA146170 U 2012 883120H 65 15% 11 2004 Acura TL 19UUA68284A046329 K 2004 861120H 65 15% 12 2013 Mercedes Benz 5600 VADDNG7G84DA515347 Y 2013 802120H 65 15% Coverage Is Provided Where A Premium And Limit Of Liability Are Shown For The Coverage Coverages Limit of Liability Full Term Premium S Ate 10 a Aare II S Aso n A. Liability (Single Limit) 5 500,000 Each Aecidaw 406 677 406 A. liability (Split limits) Bodily Injury S ,000 Each Pasco S ,000 Each Accident Property Damage S ,000 Each Accident B. Medical Payments S 100.000 Each Person 9 9 9 C- Uninsured/Undcrinsured Motorists (Single Limit) S 500,000 Each Accident —170 '170 "170 C. Uninsured Bodily Injury 5 ,000 Each Person Motorists S .000 Each Accident (Split Limits) Property Damage S ,000 Each Accident D. Damage Collision Loss (ACV Means Actual Cash Value) To Auto ICI: ACV Minus 51000 Deductible 705 526 1738 Your Auto II: ACV Minus 51000 Deductible Auto Auto 12: ACV Minus S1000 Deductible Other Than Auto :5 ACV Minus $ Detlimile Collision Loss Auto 10:3 Minus 51000 Detcale 226 125 855 Auto lit 5 Minus $1000 mato* Auto 12: 51,000 Minus S Cdocnble Towing and Labor Costs Each Disablement 'Ind 'ind 'Intl Banal Reimbursement or Ext. TIIIOSpatit(011 Sec Endorsement 'Ind eel 'incl Personal Injury Protection see attached See Endowment 76 121 76 NY Motor Vehicle Enforcement Fee 10 10 10 'Prestige Auto 'Ind 'Ind 'Intl "Supplemental Endorsement (SUM) Endorsements Attached Total Premium Pc Antra 1602 1638 3264 Endorsement Premium S 'Ind Taal Policy Premium S 21075 Discounts: see attached - Dane of Issue Camtasignature of Authorized Agent 7/18/13 CEB 5965-5-95 This Declarations Page Is Issued Li Conjunction WM And Is Part Of The Personal Auto Policy INSURED COPY Page a of 4 EFTA01077977 Fireman% Fund PERSONAL AUTOMOBILE POLICY DECLARATIONS SUPPLEMENT EFFECTIVE DATE COMPANY 07/26/2013 ASSOCIATED INDEMNITY CORPORATION NAMED INSURED YOUR AGENT IS LEON D BLACK WELLS FARGO INS SVCS USA. INC DEBRA R BLACK .31-576.750 POLICY PERIOD: FROM 07/26/2013 TO 07/26/2014 THE FOLLOWING INFORMATION CONCERNING CREDIT, SURCHARGES, OR MINIMUM COVERAGE IS REQUIRED BY LAW. ***THE MAXIMUM AMOUNT PAYABLE UNDER THE SUM COVERAGE SHALL BE THE POLICY'S SUM LIMIT REDUCED AM) THUS OFFSET BY MOTOR VEHICLE BODILY INJURY LIABILITY INSURANCE POLICY OR BOND PAYMENTS RECEIVED PROM, OR ON BEHALF OF, ANY NEGLIGENT PARTY INVOLVED IN THE ACCIDENT. DISCOUNTS VEE 1 VEH 2 VEH 3 VEH 4 VEH 5 VEE 6 Passive Restraint $ 57 $ 40 S 57 S 57 $ 57 S 57 Anti-Theft Device $ N/A $ N/A S 25 S 36 S 141 314 Anti-Lock Brakes $ 33 3 61 S 36 S 47 3 57 3 28 Accident Free $ 73 S 146 S 78 S 103 S 140 $ 59 Daytime Running Lights $ 23 $ N/A S 24 S 30 S N/A S 19 Tier Factor S INCL S INCL S INCL S INCL $ INCL S INCL Multi-Car S INCL S INCL S INCL $ INCL $ INCL S INCL $ $ S $ $ S 3 S S S $ $ S S $ $ $ S $ $ $ $ S $ S S $ $ $ S SURCHARGES INCLUDED IN THE TOTAL PREMIUM CHARGE IS A SURCHARGE OF S 254 CHARGED AS A RESULT OF VIOLATION ACTIVITY OR ACCIDENT INVOLVMENT. Violations: 4/12/10, 9/24/10 & 1/21/11 NEW YORK REGULATIONS REQUIRE THAT EACH DISCOUNT OR SURCHARGE BE SHOWN AS IF IT WERE THE ONLY DISCOUNT OR SURCHARGE APPLICABLE. IF A POLICY HAS MULTIPLE DISCOUNTS OR SURCHARGES, THEIR COMBINATION MAY RESULT IN A TOTAL AMOUNT THAT DIFFERS FROM THOSE SHOWN INDIVIDUALLY. NYSUPPI Page 1 of 2 EFTA01077978 A Firemads Fiord PERSONAL AUTOMOBILE POLICY DECLARATIONS SUPPLEMENT POLICY NUMBER EFFECTIVE DATE COMPANY 07/26/2013 ASSOCIATED INDEMNITY CORPORATION NAMED INSURED YOUR AGENT IS LEON O BLACK • WELLS FARGO INS SVCS USA, INC DEBRA R BLACK 31-576-750 POLICY PERIOD: FROM 07/26/2013 TO 07/26/2014 THE FOLLOWING INFORMATION CONCERNING CREDIT, SURCHARGES, OR MINIMUM COVERAGE IS REQUIRED BY LAW. ***THE MAXIMUM AMOUNT PAYABLE UNDER THE SUM COVERAGE SHALL BE THE POLICY'S SUM IIMIT REDUCED AND THUS OFFSET BY MOTOR VEHICLE BODILY INJURY LIABILITY INSURANCE POLICY OR BOND PAYMENTS RECEIVED FROM, OR ON BEHALF OF, ANY NEGLIGENT PARTY INVOLVED IN THE ACCIDENT. DISCOUNTS VEH 7 VEB 8 VEH 9 VE13 10 YEE! 11 VEH 12 Passive Restraint $ 57 S 57 S 57 S 57 5 57 S 57 Anti-Theft Device $ 338 $ 21 S 22 $ 74 $ 26 $ 342 Ann-Lock Brakes $ 106 S 33 $ 39 - $ 53 $ 58 $ 107 Accident Free $ 309 $ 69 $ 83 S 121 S 68 S 279 Daytime Running Lights S 66 $ N/A $ N/A S 34 S N/A S 68 Tier Factor S INCL SINCL $ INCL SINCL SINCL SINCL Multi-Cat S INCL SINCL SINCL SINCL SINCL MCI S• $ $ $ $ $ $ $ S $ S S $ S $ $ S $ $ $ $ $ S $ $ S $ S $ $ SURCHARGES INCLUDED IN THE TOTAL PREMIUM CHARGE IS A SURCHARGE OF S 254 CHARGED AS A RESULT OF VIOLATION ACTIVITY OR ACCIDENT INVOLVMENT. Violations: 4/12/10, 9/24/10 & 1/21/11 NEW YORK REGULATIONS REQUIRE THAT EACH DISCOUNT OR SURCHARGE BE SHOWN AS IP rr WERE THE ONLY DISCOUNT OR SURCHARGE APPLICABLE. IF A POLICY HAS MULTIPLE DISCOUNTS OR SURCHARGES, THEIR COMBINATION MAY RESULT IN A TOTAL AMOUNT THAT DIFFERS FROM THOSE SHOWN INDIVIDUALLY. NYSUPPI Page 2 of 2 EFTA01077979  Firemiut Fund PERSONAL AUTOMOBILE POLICY DECLARATIONS SUPPLEMENT PERSONAL INJURY PROTECTION POLICY UMB t. EFFECTIVE DATE COMPANY 07/26/2013 ASSOCIATED INDEMNITY. CORPORATION NAMED INSURED YOUR AGENT IS LEON D BLACK WELLS FARGO INS SVCS USA, INC DEBRA R BLACK 31-576-750 VEJ3 VEH 2 VEH 3 VEH 4 VEH 5 MANDATORY BASIC ECON LOSS LIMIT: S 50,000 S 57 S 138 S 57 S64 S 59 ADDITIONAL PERSONAL INJURY S 100,000 S 15 S16 S15 S IS S IS OPTIONAL BASIC ECON LOSS S 25,000 S4 $5 S4 $4 S5 AGGREGATE NO-FAULT BENEFITS LIMIT: S 175,000 S 76 S 159 S 76 S 83 S 79 WORK LOSS COORD DOES NOT APPLY DEDUCTIBLE OF S ND. APPLIES MAXIMUM MONTHLY WORK LOSS LEIZT: S 4,000 S 1NCL S 1NCL S INCL S INCL S 1NCL DEATH BENEFIT LIMIT: 3 2,000 S INCL S INCL S RICL S INCL S INCL OTHER NECESSARY EXPENSES S 25 per day EXCLUSION OF MEDICAL EXPENSE FROM PERSONAL 1NTURY PROTECTION COVERAGE PER ENDORSEMENT Registrant No.1 Registrant No.2 Vehicle I Leon D Black 788071306 Debra R Black 539647350 Vehicle 2 Leon D Black 788071306 Debra 12 Black 539647350 Vehicle 3 Leon D Black 738071306 Debra R Black 539647350 Vehicle 4 Leon D Black 788071306 Debra 12 Black 539647350 Vehicle 5 Leon D Black 788071306 Debra 12 Black 539647350 Vehicle 6 NYSUPP2 Page I of 3 EFTA01077980 S Firemarts Fund PERSONAL AUTOMOBILE POLICY DECLARATIONS SUPPLEMENT PERSONAL INJURY PROTECTION EFFECTIVE DATE COMPANY 07/26/2013 ASSOCIATED INDEMNITY CORPORATION NAMED INSURED YOUR AGENT IS LEON D BLACK WELLS FARGO INS SVCS USA, INC 31-576-750 VEH 6 VEX 7 YE; 8 VE11 9 vEH 10 MANDATORY BASIC ECON LOSS LTh4IT: S 50,000 S 57 5 64 S 59 366 S 57 ADDITIONAL PERSONAL INJURY LJMIT: S 100,000 S 15 515 S15 S15 S15 OPTIONAL BASIC WON LOSS S 25,000 S4 S4 35 $5 S4 AGGREGATE NO-FAULT BENEFITS LACE: S 175,000 S 76 S 83 S 79 586 I 76 WORK LOSS COORD DOES NOT APPLY DEDUCTIBLE OF S NIL APPLES MAXIMUM MONTHLY WORK LOSS LIMIT: S 4,000 S INCL S INCL S INCL S INCL S INCL DEATH BENEFIT LIMIT: S 2,000S INCL S INCL S INCL S INCL S INCL OTHER NECESSARY EXPENSES S 25 per day EXCLUSION OF MEDICAL EXPENSE FROM PERSONAL INJURY PROTECTION COVERAGE PER ENDORSEMENT Registrant No.1 Registrant No.2 Vehicle 1 Leon D Black Debra Ft Black Vehicle 2 Leon D Black Debra It Black Vehicle 3 Leon D Black Debra It Black Vehicle 4 Leon D Black Debra R Bleak Vehicle 5 Leon D Black Debra R Black Vehicle 6 NYSUPP2 Page 2 of 3 EFTA01077981 S Fireman's Fund PERSONAL AUTOMOBILE POLICY DECLARATIONS SUPPLEMENT PERSONAL INJURY PROTECTION EFFECTIVE DATE COMPANY 07/26/2013 ASSOCIATED INDEMNITY CORPORATION NAMED INSURED YOUR AGENT IS LEON D BLACK WELLS FARGO INS SVCS USA, INC 31-576-750 VER II VEH 12 YEA VEll Via t MANDATORY BASIC ECON LOSS LIMIT: 5 50,000 S 101 S 57 S S S ADDITIONAL PERSONAL INJURY S 100,000 5 15 S I5 OPTIONAL BASIC ECON LOSS LIMIT: S 25,000 55 S4 AGGREGATE NO-FAULT BENEFITS S 175,000 S 121 S 76 WORK LOSS COORD DOES NOT APPLY DEDUCTIBLE OF S NIL APPLIES MAMMUM MONTHLY WORK LOSS LIMIT: S 4,000 S INCL • S INCL DEATH BENEFIT MITT: S 2,000 S NCL SINCL S S S OTHER NECESSARY EXPENSES S 25 per day EXCLUSION OP MEDICAL EXPENSE FROM PERSONAL INJURY PROTECTION COVERAGE PER ENDORSEMENT Registrant No.1 Registrant No.2 Vehicle 1 Leon D Black Debra R Black Vehicle 2 Leon I) Black Debra R Black Vehicle 3 Vehicle 4 Vehicle S Vehicle 6 NYSUPP2 Page 3 of 3 EFTA01077982  Prestige Autos Premier Coverage Endorsement - New York With respect to the coverage provided by this endorsement, the provisions of the policy apply unless modified by this endorsement. ValueLocke COVERAGE SCHEDULE Auto Description ValueLocke Limit of liability 1) 2011 Chevrolet K1500 Silverado $ 14,053 2) 1989 Mercedes Benz 560SL $ 15,950 3) 2012 Chevrolet Tahoe LT $ 55,677 4) .2012 Chevrolet Silverado K2500BD $ 45,270 5) 2004 Mercedes Benz $600 $ 13,337 6) 2004 Toyota Highlander $ 10,589 7) 2007 Bentley Continental GTC $ 108,575 8).2008 Jeep Patriot Limited $ 14,807 9) 2009 Honda Pilot $ 19,945 1O;2012 Mercedes Benz R350GL $ 63,000 11) 2004 Acura TL $ 11,381 .12) 2013 Mercedes Benz 5600 $ 180,000 DEFINITIONS EXTENDED NON-OWNED AUTO COVERAGE The following provisions are added to and replace any COVERAGE FOR VEHICLES FURNISHED FOR conflicting provisions in Definition Ja, and Definition YOUR REGULAR USE K.2. when includectin your policy: Part A and Part B are amended as follows with respect The broadest coverage of any of your covered autos to you: shown in the Declarations will apply to a newly ac- quired ;vehicle provided you ask us to insure it within A. PART A - LIABILITY COVERAGE 30 days after you become the owner if: Exclusions Al. and 13.2.b. do not apply. 1. The vehicle is in addition to any vehicle shown in the Declarations; or B. PART B - MEDICAL PAYMENTS COVER- AGE 2. You ward Collision and Other Than Collision coverage. Exclusion 5.b. does not'apply. The last sentence of Exclusion 8. is replaced by the following However, if Collision or Other Than. Collision coverage does not apply to any vehicle already shown in the This exclusion (8.) does not apply to bodily injury • Declarations, you must ask us to insure it within 4 days sustained while occupying r. • after you become the owner. We will provide these 1. Private passenger auto, pickup, or van, or coverages with a deductible of $500 to the newly ac- quired vehicle. . 2. Trailer- used with a vehicle described in 1. above. Coverage begins from the date you become the owner if you ask us to insure the vehicle within the specified WORLDWIDE COVERAGE FOR OWNED, time period. NON-OWNED, AND NEWLY ACQUIRED VEHI- CLES 102173 1-06 Mt IradocIes copyrighted Mate-121s of losuranoe Sealers Office, lac., rib in perroisslco, 1997 Page) of 7 EFTA01077983  WARMNG 1. The occurrence involves the unlawful forced re- moval or detention of you or a family member In Mexico, and other countries, only liability coverage while operating or occupying your covered auto purchased from a local licensed insurance company will or non-owned auto during the theft or attempted meet the auto insurance requirements of that country. theft of the vehicle; and Failure to ptirchase any required insurance policy could result .in fines or other penalties. Check with your 2. The carjarking occurrence is reported promptly to rental car provider. the police or other law enforcement agency. If you rent, borrow, or lease a non-owned auto, pur- Carjarking expenses include the reasonable and neces- chase an auto, or temporarily relocate an auto shown sary costs for: in the Schedule or Declarations outside the United 1. Merliml or psychiatric expenses incurred within. States of America, its territories or possessions, Puerto one year of the ca jacking occurrence for you or a Rico, or Canada, your coverage under Part A .- Liabil- family member who witnessed the ea:jacking oc- ity Coverage, Part B - Medical Payments, and Part D currence; and - Collision, Other Than Collision, and Transportation Expenses for loss of use will apply to the operation or 2. Income continuation benefits if unable to resume use of that vehicle by you or any family member pro- the duties of you or a family member usual occu- vided: pation during the first 60 days following a canarking occurrence. This coverage is .exens 1. An underlying policy of automobile liability in- over any other valid and collectible benefits in- surance is purchased or provided to the extent re- chiding quired by the country or jurisdiction in which the vehicle is being operated. . We will pay only that A. disability insurance, part of a covered loss that exceeds the limit of li- ability of that underlying policy. B. workers compensation, 2. The rental, lease, or use of the non-owned auto is C. unemployment compensation, fora period of not more than 90 days. D. salary or wage continuation plans; or 3. You notify us. within 30 days after you purchase or relocate a vehicle. E. other similar plans. EXCESS MEDICAL PAYMENTS COVERAGE 3. Funeral Expenses up to $10,000 per person. The following is added to the LIMIT OF LIABILITY LIMIT OF LIABILITY protion of PART B: Our limit of liability as a result of any one carjer-king C. In addition to any limit of liability shown in the occurrence shall be the lesser of: ' Declarations for this.coverage, we will pay up to 1. The actual reasonable and necessary =jacking $10,000 for each person injured in any one aCci- expenses incurred; or dent. However, this additional limit shall be excess over any other collectible auto insurance providing 2. $100,000 payments for Medical of funeral .expenses. This is. the most we will pay regardless of the number CARJACENG COVERAGE of: We will pay, without a deductible, carjacking expenses 1. Insureds; incurred by you or a family member solely and directly as a result of a carjackbag occurrence provide& 2. Policies applicable;