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OTTSDALE INSURANCE C OMPANP. <br />GARAGE INSURANCE coVERAbE PART;SUPPLEMIiENTACDECLAPATIONS <br />Policy No,: Effective Date: <br />(12:01 A,M. Standard Time) <br />Named insured' t,T N A ?,Tr T A 1. 00 $ WA T T Q1,T A W Agent No <br />Item 3. Locations Where You Conduct Garage 0perations <br />,Loc <br />N o.' <br />Address your'maln business location'as Location No, I <br />P re rn lu M <br />45727 SE 140TH ST BEND, WA 98045_ <br />$ 2, 921 <br />Item 4., Liability Coverages -,Premiums k <br />Loc. <br />'No, <br />Rating - Units Dealer Rating Units: -Non -Dealer <br />P re rn lu M <br />Premium <br />$ 2, 921 <br />$ 200,.0.00 Limit oflnsurance. <br />$ <br />Dam 9 a to Rented Promises .PersqinalAnd,,Adveftislng Injury...,..,. Broadened, coverage <br />Premium: $ <br />Premium: <br />Item 5. . Garagekeep , e r L s , Coverages and Prdim1uhrts <br />Garagekeepers Coverage applies on a legal liability basis unless the Direct Primaryy-InsuraInce option below has been indi- <br />cated by "[D." <br />El DIRECT PRIMARY INSURANCE: Garagekeepers Coverage Is changed to apply without regard to your or any other "in- <br />sured's" legal liability for "loss"to a covered "auto" and is primary'Insurance. <br />Loc <br />N o. <br />Coverages <br />Lim It of Insurance and Deductible for Each Location <br />Premium <br />$ 200,.0.00 Limit oflnsurance. <br />Comprehensive <br />$ 1, 00.0 Ded uctib,l.&. for"611 I560.106-r-ea6h "customers - auto"" <br />$ 497 <br />$ 5, 000 Maximum Deductible for all "loss"'In an - y . one event; . <br />$ Limit of Insurance. <br />Specified <br />Causes of Loss <br />$ Deductible for all perils for each "customer's auto.." <br />$ Maximum Deductible for all "loss" In any one event, <br />. ....... .. <br />$200,000 Limit of Insurance, <br />Collision <br />. ...... .. <br />$ 11 000 Deductible for all perils for each "customer's auto." <br />$ 426 <br />$ Limit of insurance. <br />Comprehensive <br />$ <br />'Ded'uctib.le for - all <br />11 . perlls f I o r each "customer's auto." <br />$ Maximum Deductible for all "loss" In any I one event, <br />$ Limit of Insuran ce. <br />Specified <br />Causes of Loss <br />$ <br />$ Deductible for all perils for each "customer's auto." <br />Maximum Deductible for all "loss" In any one event. <br />$ Limit of Insurance. <br />Collision <br />$ <br />$ Deductible for all perils for each "customer's auto." <br />Includes copyrighted material of ISO Properties, Inc., with Its permission, <br />Copyright, ISO Properties, Inc., 2009 <br />CGS -0434 (10-16) Page I of 4 <br />INSURED <br />RECEIVED <br />MAR 2 3 2018 <br />i<ITTITAS COUNTY SHERIFF <br />A(C0UN-r1j%jG <br />