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; '·;; )k.-SCOTTSDALE INSURANCE G~MPANY'°.
<br />GARAGE INSURANCE c·ovERAGE PART. s0PPLEMENTAL'DECLA:RATIONS
<br />Poltcy No ,: ~----"--·-"t:...,G...,1t...,O, tJ..U1.,9..,9.._ __ -_. ;.__..:.... __ Effective Date : ____ ....,,.._n .._1.._1,2,._J,._(wi..,Q""luB.__ ____ _
<br />(12:01 A.M. Standard Time)
<br />NaniG.d lnsure.d:. EIN!MC I/\I, CPNSTJ LTJ\NTS IMT~llN11T IPNA.Li:'·i\gen ·t No ;~~ _.._; • > ·:,;,• •• _ ;!!6H0'li ""
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<br />" · · Address ~·state your'm aln bllslriess location ·astocatfolf N·o: 1 ·
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<br />l '45727 ·S&,,140TH ST .,NORTH BEND, ,WA-98 045 .• '"" ................... ;...·-···-··0.';/"'..:','c • ..'·:-.._:·_:..•·_:';.;",;,;_
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<br />!tom ,4. Llabflity ~q11erogqs.d 'roml111T)l) ~---, . .. -,, :.~· . ,... .. :·· :.: ... : ' ... ,-,-. .'i ......... ,., ,..._ ---• •·•-• ..,. I
<br />Loe. ., _ _..Ratfiin \) i,11s': Dea ler . " IV 'No.· ., !',·. ._ ,.; ._·,, ,. r: ·: Rating Un'l!s '~Non-De,1far
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<br />. --Dilhi age Jo·Ran cd Prem lses r • ""~,,P~ri(O!lfll",and _A8ve_i;tl.sf~g .. lnJ Vry-_~l ·'"' \:,.~a·r.0'1idqi:i o<1 .¢.(!VO(ruie .• -: .. •
<br />Preni ium:$ .... , .: ,,, r .,: ,, •. Premiu m:$:,,., ... ,;·, [ ·,·;; Prenflum:'.$i,'., .... ,·;;·;•.\,H'•;:.~~,.:,•-
<br />ftem 5, Garag 'eka"epiirs Co•ieiaiJ\fo' Eii,a Premium's' :,,: /:"-• .:-·.:;, ·,, · .. ' ,,·--r:,;'; ·'.;:· H[ "' ;:,,•:, :, ,,;>.-; •: :;-,., :·:•; , :·.,: :, c ·. ·:. ,
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<br />Garagekeepers Coverage appffes on a legal liability basis unless the Dlr eo t Primary Insurance opUon below has been Indi-
<br />cated by "is]."
<br />D DIRECT PRIMARY INSURANCE: Garagekeepers Coverage Is changed to apply without regard to your or any other "ln-
<br />sured's' legal liablllty for "loss" to a covered "auto" and Is primary 'lnsurance. -.. -·-· .. -~-. ....... -~ ... ....... -. -. .. .. -'• -Loe: coverages Lim ft of Insurance and Dad uctlble for Each Location Premium No. . .. -----' ... ---.. -·--. ............. -----
<br />$2_00 .• ,0~0 · "Lim.I~ o.f liislir o.hQ9 •. : ·.:. . ----
<br />,-, --• •-H•,...~ •• 0 -,-
<br />Comprehensive $1,00? Deduetl bJ.ofii'Mill jierl_lslif{i,aiiiL'q_u11tornor'p~n\JJih'' ••• $ 497
<br />l Specified
<br />Causes of Loss
<br />. Collision -·. . . ..
<br />Comprehensive
<br />--
<br />Specified
<br />Causes of Loss
<br />Co lll slon
<br />CGS-0134 (1 D-16)
<br />$5,000 Maxlml!m Deduellb_le Y~t a.fl '1o;.s·:1~ a"1iy _ b n(eyeQt,,_
<br />$ Limit of Insurance , -
<br />$ Deductible for all pofile for each "cust:pmor's auto)'
<br />$ Ma><lmum Ooduotlble for all "loss" In any one ovo nr.
<br />$200,000 limit of Insurance.
<br />$ 1,'00 ·0 -Ooducllble Jor all_ porl!s for each "customer's auto)'
<br />:s . .
<br />l.lJll ll of l!1-$UraJlCO, -.. . . --·s __ .,
<br />D11iff1c"ilb le fo r all P~rll~tfi:i(eac h_~O\JS tqm.11r'G ·a uto.''
<br />$' .. -~1ax 1m 4m _D!),OUOtlbJii_rcir o.11,"fo~'' In :.\OY 9.11~ _ovorit-•
<br />$ Lim It ol l!)!!Utanoa .
<br />.. --.. ·----.. . . .. -
<br />$ Deductible for all perils for each ''oustome r':i auto.''
<br />s MaKfmum Deductible for all "loss" In any one event.
<br />$ Limit of Insurance.
<br />$ Deductible for all perils for each "c ustomer's auto."
<br />lnoludes copyrlghled m aterlel of ISO Pr oporlles, Inc., with Its permls,lon.
<br />Copyright, ISO Pro porl loo, Ina,, 2000
<br />Pago 1 or4
<br />INSURED
<br />' ''
<br />-
<br />~
<br />$
<br />$
<br />--~
<br />$
<br />$
<br />, ... .. ,.
<br />426
<br />. '
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<br />RECEJVED
<br />MAR 2 3 2018
<br />l~ITT\TAS Ca°UNTY SHERIFF
<br />1 \, ACCOUNTING
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