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· ,-.., (, '.' ,J;/4~ .scoTISDAU-'INsURANGE cbMPANY'°
<br />GARAGE INSU
<br />0 RANde'.cOVERAGE PART SLIPPLEMENTAL 1 bECL.:ARATION S'(ifohtiriu 'ed)
<br />Poiicy No .;·" ;·· _'' --.... ·· "r.ga~U-~l~i~9_,. __ "_'_• ____ Effeotr.11.1'DatEi : • ..... ,: : !.,, ~01d1 '2'""'Q1ri"-·-f ·
<br />(12:01 A.M. Standard Time)
<br />Na~~d :in~u;e'Ci: rx~~iic"T,n I. i:a'N;~ITT,TAN'J'S 'uir-~B~i1iTIONZ1!1 Agent No.: ___ ._'.._. ___ : _··.:..45.,,.--o .... a ... 'ii.__ _____ _
<br />Item 6. Physical Damage Cover~ge For Dealers and Physical Damage Coverage Fo ·r ·Non-Dealers · •, '·' ;, ' ._. .• ~; '
<br />'
<br />Pta.f!I u II\ ~,!!,;Is. No;!l\P~!~O '.§~1!, Slat ;d ~!tn~t ~(~s ~!~_n6! s~~~ ~B!!:W i\PPlio_:'I_:_,. • -· • • •· •• • ·' • 1· i I -~• -• ' .. -,,,,
<br />Eaoh , ol tho f oJloWlng Phy1tcat Damogo covora oonppUes only lo ltl\e ty p·o.of ~autos'! and ,Interests lndlcated Jj·11l6,w,b'y_i•jg].11 ___ .I
<br />I A-I r. ~ • ;
<br />01RlUsei1 Autos ' r ·' 'Iii'! Yo Or lnlorlislln covefad "a utos• you own . ., · • ... .,, ··•· · · .. I , ! -
<br />ONiiw 'Aiiios-· • .• • Your lnteros_t and tho I11\eresl of ·pny crod llor-named as loss payee •·• • -· , ·· -
<br />. •',.' , ·:. ·':' -~ ,• :: : .. : . ..tf.AJJ int,ef!l~ lnlo~ored •i\iito~fw1i11e'1n o~r'i"o~se oo)on 'on~'()nl;lgrtrnen1 ro1 'sal e ... , ; • a ...
<br />• •••., tf .,• 1 • ,. ••• •• ,. • ..-. I t \'"-• ~ f • I t_. -' •' 1 • • •·•"' , • l/"' I , • ";. .,.•• • fl ;· • ' •
<br />Loe, • · 1,
<br />N,o. ,., Covarnges '"'pi-ori,'Jum
<br />s ·200, ooo -·-Llmltotl11sumnce.-
<br />, ~o~pr!~~n;:'~~~. $ 1, 0 O O Ded11otlblo for nil perff&Jor dacJ1.:eut94 " .:-.:,:; : :;. .. l 'l -$ •;: • ., ·90 G 1•: ~-
<br />$ 5, o o o Mil.Xl!'(lun,_Deductlblo fpr .~l!".lo&s".,IQ)iiy_ one everi_f;--.
<br />-j ' / ,, e, ,.S ~.11 .1:.·f ; ,_,,, •• •• Limit offn;urnqoo., 1 • ~. • •• -·~:.:::c----:
<br />Seec-lfle :1," s,.-f••' ,: · ·., De_ buo tllii o·fc r-oll pe rl1S:lofo iioh1-"ii'1to.11 1 • • ., ~--.. , Cal/:;es of Loss ·" .. •··. ·•-..• ·-...... , V • . (, .. ~ .L ·:s .. f ' Ma'._x1m<flr(0.11cl <i ct\blo'ror_aU ',1o~Lri ,any on_e.evanl. .!I: ,•,( \· .:~
<br />,,
<br />\ • .-~ •• ·• •'> ) · I $ , L!~_l t of lnsurol)co: 1. "N,1,,,1, l ..,,.: ... ~ ·•• t'
<br />• ;-;· ,:, • C6mprehens1vJ I ,$ i.i:i .;_.•; •• Oll~uqtlb li·fot illt perll1("liir'_eic"\1l1a~fo":"; ,,, .. ,., .-• ., $, .• 1 ~· ! ,,,,,' '~,: l $. ·-· Mujc1[1i"uii;, Oe~ucllf,le lii'i~all/!l~as·\1n''.dny one event.•:· , ,~:, 1 •
<br />,.1 1 ,n i
<br />$ Llroitof.!1isiJra110&; : "0.1,,·,--,,, 1 p .,. •111 ....... ~,-
<br />SP.eoilied .. ·•cirnses "of l."Q.SG • $ -___ :_ -·--0t!llu0Llble 'r1fr]:l1perhsJoreao)1 .;ii!Jto.''-\. .. _____ _,,: L .. , ...
<br />-~-,,---·•-•l .... , s ' .... ~ ..... ~.' ' ,Mnx lmun:i.Doduo !lb ieJor 1111.~loss~ fi:i,.llflY.911~ -OVP.11 t ... -. --... -t_ .,
<br />\ ' s {11n kol ConT.a1J11 . ,S,.2 0,0,, o'o o,ft ...... _,umiLPtJnB\l(llOO·o:,.1~-···~· ... ·-:-1:. .... ....,,_ . -.·_,.w ,_.:.~; a .:..
<br />I •• , .. ,-, ,-(~HLo _oation·s)J I $.),.000 ,., :_.,. .• --;0ejuotlbJa,for.,aJlperlis;lor .. i~c.hJAuto.C'. ...... ----$ .l..-.. ,-
<br />1 ....... • ___ ...: .L.._, .. ,_ .. ,-•• ,,,.,. .... .J.,"'-.:t,·· ..:..r ... ,:.;::. ::~ ..... Joli!) &!!.i;ll.lUm.f.or}.U .@~u!Jefns:. $ ---1,.113-ft _
<br />Our Limit of Insurance for "loss"at locations other than those stated In Item 3,
<br />$ ___ 5'--o"'-'o ... o_o ____ Addltlonal locations where you display or store covered "autos."
<br />$=..5..,o..,,'""o'""o.,.o ______ In Transit.
<br />There Is no coverage if "l~ss" occurs more than forty.five (45) days after your use of the location begins.
<br />PHYSICAL DAMAGE VALUE LIMlrATION SCHEDULE: The Limit of Insurance of $35,000 for '1oss" to any one covered
<br />"auto" shown In the Limits of Insurance seqtions contained In the CHANGES IN THE AUTO DEALERS COVERAGE FORM
<br />endorsement Is changed by completlon of the rollowlng:
<br />The maximum Limit of Insurance of "loss" to any one covered "auto" Is: $ ___ ---"'s.o ... ,"'.o:..:o:..::o'-.
<br />Loss Payee• Any loss Is payable as Interest may appear to you and:
<br />CGS-0434 (10-16)
<br />Includes oopyrlght•d m aterlal of ISO Properties, Ina., with It• pennlsslon,
<br />Copyrlght, ISO Properties, Inc,, 2009
<br />Page3of1
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<br />RECEIVED
<br />MAR 2 3 2018
<br />' l~IT'i'l"\'l'IS r.!)•JNTY SHERIFF
<br />. I\~ ::, :.iN Tl>./G
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