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= QU OUN Kk 04 U4: Dv INDEX NO. 708593/2024
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EXHIBIT C
INDEX NO. 708593/2024
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NYSCEF,
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DOC. NO. 4 RECEIVED MaRET al /2024
JUNE 30, 2023
USAA® AUTOMOBILE POLICY PACKET
MICHAEL ANTHONY SAUNDERS
PV2 USA
11869 MONTAUK ST
SAINT ALBANS NY 11412-4021
GIC 05504 65 39 7101 7
POLICY PERIOD: FROM JUL 01 2023 TO JAN 01 2024
IMPORTANT MESSAGES
Refer to your Declarations Page and endorsements to verify that coverages, limits, deductibles and other
policy details are correct and meet your insurance needs. Required information forms are also enclosed
for your review.
Check your vehicle for a safety recall today! Visit www.usaa.com/autorecall
to learn more.
The laws of the State of Georgia prohibit insurers from unfairly
discriminating against any person based upon his or her status as a victim
of family violence.
Thank you for enrolling for the Automatic Payment Plan option, which
enables you to receive up to a 3% discount on your policy. For details,
please review your Supplemental Information page.
Please read the enclosed Georgia Uninsured Motorist Coverage Notice for
information about your policy. If not previously signed, the State of
Georgia requires you to sign and return the attached acknowledgment of the
notice.
Your policy has been issued with uninsured motorists coverage that meets
state requirements. We encourage you to read the attached flier, "Uninsured
Motorists Coverage in Georgia,” to learn about the coverage, available
options and what you need to do if you elect to change it.
An Accident Report form is enclosed to assist you in the event you have an
accident, your vehicle is disabled or you need a rental car. Please keep
the form in your vehicle.
This is not a bill. Any premium charge or change for this policy will be reflected on your
next regular monthly statement. Your current billing statement should still be paid by
the due date indicated.
To receive this document and others electronically, or manage your Auto Policy online,
go to usaa.com.
For U.S. calls: Policy Service (800) 531-8111. Claims (800) 531-8222.
ACS1 49708-0406
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AUTOMOBILE POLICY PACKET CONTINUED
Your safety matters to USAA. Visit http://usaa.com/autoadvice for our
latest auto insurance and driving safety tips.
Coverage exclusions apply when your vehicle is used in ride sharing. If you
need coverage for ride sharing activities, we're pleased to offer Ride
Share Gap Protection. For details, see the enclosed documents titled
"Amendment of Policy Provisions — Ride Sharing Activity’ and "Important
Information About Ride Sharing Activity.”
USAA considers many factors when determining your premium. Maintaining
safe driving habits is one of the most important steps you can take in
keeping your premium as low as possible. A history of claim or driving
activity and your USAA payment history may affect your policy premium.
We have provided your ID cards in this packet. You can use the cards
to show proof of insurance, if necessary.
ACS2
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Insurance Policy Information Card
The electronic record sent to the Georgia Department of Revenue is the only proof of insurance that
will be accepted by law enforcement.
We've issued a policy information card for your motor vehicle(s) as evidence of liability insurance. You
may be required to produce your information card if an accident occurs or you travel out of state.
Keep a copy in your vehicle at all times.
For your convenience, additional copies are available on usaa.com.
53GA1 Rev. 11-19 55051-1119
a
88 9800 Fredericksburg Road 18600
San Antonio, Texas 78288
U GEORGIA INSURANCE POLICY INFORMATION CARD
Insurance Company Name Original Issue Date
USAA GENERAL INDEMNITY COMPANY 07/01/23
Policy Number 05504 65 39G 7101 7
Expiration Date 01/01/24
Name MICHAEL ANTHONY SAUNDERS
Vehicle Insured
Year: jake: Model: Vehicle Identification Number:
2003 LEXUS GS 300 4D JT8BD69S230188429
CONTACT US: 210-531-USAA(8722)
OR 800-531-USAA
The urrent status of actual vehicle liability insurance coverage is
motor
maintained by the Georgia Department of Revenue and is accessible to law
enforcement agencies upon a check of the vehicle registrations
KEEP THIS CARD IN YOUR MOTOR VEHICLE WHILE IN OPERATION
Additional copies available at usaa.com
0901119cbaab5a92
INDEX NO. PAGE59372024
NY. DOCUSWA GENERAL INDEMNITY COMPANY a neeee Moa NS) 2024
(A Stock Insurance Company) State|O1 POLICY NUMBER
USAA® 9800 Fredericksburg - San Antonio, Texas 78288 IGA B69 Ter 05504 65 39G 7101 7
GEORGIA AUTO POLICY 01 A.M. standard time)
DECLARATIONS FROM JUL 01 2023 T O JAN 01 2024
OPERATORS
Named Insured and Address 01 MICHAEL ANTHONY SAUNDERS
MICHAEL ANTHONY SAUNDERS
PV2 USA
11869 MONTAUK ST
rE
SAINT ALBANS NY 11412-4021
Description of Vehicle(s) EH USE"
VEH|YEAR TRADE NAME MODEL, BODY TYPE AMEE IDENTIFICATION NUMBER
01) 03) LEXUS GS 300 4D 4D 9000 JT8BD69S230188429 P
The Vehicle(s) described herein is principallygaraged
ly, at the above address unless otherwise stated. [WC=WorkiSchoot, B=Blsiness, F=Fam:P=Pleasure
ol HINESVILLE GA 3131
may polic provides ONLY those coverages where a premium is shown below. The limits shown
e duce: by polic
provisions and ma not be combined regardless of the number of
vehicles for which a premium is listed unless specifically authorized elsewhere in this policy.
EH VEH VEH
COVERAGES LIMITS OF LIABILITY orn 6-MONTH
("ACV" MEANS ACTUAL CASH VALUE) D=DED PREMIUM LB=DED PREMIUM p=DED PREMIUM p=pED PREMIUM
JAMOUN
PART A - LIABILITY
BODILY INJURY EA PER $ 25,000
EA ACC $ 50,009 626. 28
PROPERTY DAMAGE EA ACC $ 25,009 333 14
IPART C - UNINSURED MOTORISTS
UNINSURED MOTORIST REDUCED BY
AT-FAULT'S LIABILITY LIMITS
BODILY INJURY EA PER $ 25,009
EA ACC $ 50,000
PROPERTY DAMAGE EA ACC $ 25,00QD 250) 75 65
PART D - PHYSICAL DAMAGE COVERAGE
TOWING AND LABOR 10 99
EHICLE TOTAL PREMIUM 1046 04
6 MONTH PREMIUM $ 1046.06
PREMIUM DUE AT INCEPTION. THIS Ig NOT (A BILL, STATEMENT TjO FOULOW.
THE FOLLOWING COVERAGE (S) DEFINED IN THIS POLICY ARE NOT PROVIDED FOR:
VEH 01 - MEDICAL PAYMENTS, EXTENDED BENEFITS COVERAGE, COMPREHENSIVE,
COLLISION, RENTAL REIMBURSEMENT
ENDORSEMENTS: A402 (02) A200GA (04) RSGPCW (01) 5100GA (02)
INFORMATION FORMS: NIPFPP (05) IIRSGPCW (01) ADDRDISC (01) 485GGP (01) 88356 (01)
999GA (13)
r 4
i 7] Rsmrspoopo] |] TT TE I | LIT TTT EL LLL EL I | LIT
IN WITNESS WHEREOF, we have caused this policy to be signed by our President and Secretary at San Antonio, Texas,
on this date JUNE 30, 2023
Kelle svmeivang KE =
5000 G 05-12
53384-05-12
Kelly Armstrong , Secretary Randy Termeer, President
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SUPPLEMENTAL INFORMATION
USAA® FROM JUL 01 2023 TO JAN 01 2024
The following approximate premium discounts or credits have already been applied to reduce your policy
premium costs.
NOTE: Age or senior citizen status, if allowed by your state/location, was taken into consideration when
your rates were set and your premiums have already been adjusted.
VEHICLE 01
ANNUAL MILEAGE DISCOUNT -$ 10 13
AUTOMATIC PAYMENT PLAN DISCOUNT -$ 31 02
DEFENSIVE DRIVING DISCOUNT -$ 103 02
OPERATOR 01 -- (CERTIFICATE EXPIRES 03-15-25)
DRIVER TRAINING DISCOUNT -$ 48 80
OPERATOR 01
PARTICIPATION IN SAFE DRIVING -$ 112 65
SUPDECCW Rev. 7-95 JUNE 30, 2023
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AMENDATORY ENDORSEMENT
The coverage provided by this Endorsement is subject to all the provisions of the policy and
amendments except as they are modified as follows.
PART D - PHYSICAL DAMAGE COVERAGE
INSURING AGREEMENT b, If Rental Reimbursement Coverage is
afforded, the vehicle class for
Paragraph A. is replaced in its entirety by the transportation expenses is the
following: vehicle class shown on the
Declarations for Rental
A. Comprehensive Coverage (excluding Reimbursement for that vehicle.
collision),
Paragraph C. is replaced in its entirety by the
1 Physical damage. We will pay for loss following:
caused by other than collision to your
covered auto, including its equipment, C. Rental Reimbursement Coverage (for loss
and personal property contained in your other than total theft).
covered auto, minus any applicable
deductible shown on the Declarations. 1 We will reimburse you for expenses
The deductible will be waived for loss you or any family member incurs to
to window glass that can be repaired rent a substitute for your covered
rather than replaced. In cases where the auto, This coverage applies only if:
repair proves unsuccessful and the
window glass must be replaced, the full a Your covered auto is withdrawn
amount of the deductible, if any, must from use due to a loss, other than a
be paid. total theft, to that auto; and
Transportation expenses. We will also The loss is covered under
pay: Comprehensive Coverage or caused
by collision, and the cause of loss
a The reasonable amount for is not otherwise excluded under Part
transportation expenses incurred by D of this policy.
you or any family member, but no
more than the cost of renting an
We will reimburse you only for that
Economy Class vehicle, as defined period of time reasonably required to
under Rental Reimbursement repair or replace your covered auto. If
Coverage. This applies only in the we determine your covered auto is a
event of a total theft of your
total loss, the rental period will end no
covered auto. We will pay only
later than seven days after we have
transportation expenses incurred
made a settlement offer.
during the period beginning 48
hours after the theft and ending
when your covered auto is
LIMIT OF LIABILITY
returned to use or, if not recovered
or not repairable, up to seven days Paragraph A. of the Limit of Liability section is
after we have made a settlement replaced in its entirety by the following.
offer.
126836-0314_02
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A. Total loss to your covered auto. Our limit D. Under Rental Reimbursement Coverage, our
of liability under Comprehensive Coverage maximum limit of liability is the reasonable
and Collision Coverage is the actual cash amount necessary to reimburse you for
value of the vehicle, inclusive of any expenses incurred to rent a vehicle in the
custom equipment, and the cost to applicable class shown on the Declarations:
transfer or replace any equipment,
furnishings or parts designed to assist 1 Economy Class. For purposes of this
disabled persons. endorsement, Economy Class means
“mini,” small or compact 2— and 4—door
1 The maximum amount we will include cars that are not considered sports or
for loss to custom equipment in or on luxury vehicles and are not the station
your covered auto is $5,000. wagon type.
We will declare your covered auto to Standard Class. For purposes of this
be a total loss if, in our judgment, the endorsement, Standard Class means
cost to repair it would be greater than standard and full size 2— and 4—door
its actual cash value minus its salvage cars that are not considered sports or
value after the loss. luxury vehicles and are not the station
wagon type.
|f Car Replacement Assistance is shown
on the Features Declarations for this Multipassenger/Truck Class. For
your covered auto, we will pay an purposes of this endorsement,
additional 20% of the actual cash Multipassenger/Truck Class means:
value of the vehicle at the time of a
total loss. This additional amount: a Sports, convertible and luxury cars
of any size;
a Is separate from the limit available
for loss to your covered auto Station wagons;
under Comprehensive Coverage or
Collision Coverage; and Minivans;
ls available if the total loss is paid: Mid-size cargo and passenger vans;
(1) Under this policy's Pickup trucks; and
Comprehensive Coverage or
Collision Coverage; or
"Mini," small and midsize sport utility
(2) Because of the PD by or on vehicles (SUVs) that are not
behalf of persons or considered luxury SUVs.
organizations who may be legally
responsible. Large SUV Class. For purposes of this
endorsement, Large SUV Class means
However, Car Replacement Assistance luxury SUVs of any size, large SUVs,
does not apply to total loss to any any private passenger vehicle equipped
nonowned vehicle. to assist the disabled (when available)
and large cargo or passenger vans.
Paragraph D. is replaced in its entirety by the
following:
A402(02) Rev. 05-14 Page 2 of 3
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PART E - GENERAL PROVISIONS
OUR RIGHT TO RECOVER PAYMENT
The Our Right to Recover Payment section is
amended to add the following:
Our rights in this section do not apply with
respect to amounts paid in excess of the
actual cash value of your covered auto
because of Car Replacement Assistance.
Copyright, USAA, 2013. All rights reserved.
A402(02) Rev. 05-14 Page 3 of 3
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AMENDMENT OF POLICY PROVISIONS - GEORGIA
This Amendment forms a part of the auto policy to which it is attached, and it modifies that policy as
follows:
DEFINITIONS
Under J. "Newly acquired vehicle.” item 1. is b. A miscellaneous vehicle that is not
deleted in its entirety and replaced by the used in any business or occupation;
following: or
1 "Newly acquired vehicle" means a c. A motorcycle, but only if a
vehicle, not insured under another motorcycle is shown on the current
policy, that is acquired by you or any Declarations.
family member during the policy period
and is:
a A private passenger auto, pickup,
trailer, or van;
PART A - LIABILITY COVERAGE
Under EXCLUSIONS, A, Item 10 is added:
10. For punitive or exemplary damages recovered.
PART C - UNINSURED MOTORISTS COVERAGE
(referred to as UM Coverage)
Under EXCLUSIONS, Item F is added:
F. We do not provide UMPD Coverage for the first $250 of the amount of PD to the property of
each covered person as the result of any one accident.
Copyright, USAA, 2020. All rights reserved.
128904-0520_02
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°
U
AMENDMENT OF POLICY PROVISIONS - RIDE SHARING ACTIVITY
This Amendment forms a part of the auto policy to which it is attached, and it modifies that policy as
follows:
Notwithstanding Paragraph 3. of the definition online-enabled application or platform and
of covered person in Part A — Liability, available to accept a passenger or delivery
covered person does not include any assignment, but has not yet accepted a
Transportation Network Company. passenger or delivery assignment.
EXCLUSION When a passenger or delivery assignment
has been accepted, coverage will not
We do not provide coverage under this policy extend while the passenger or property to
for accident or loss that occurs while any be delivered is occupying your covered
covered person is operating or occupying a auto.
vehicle engaged in ride sharing activity in
conjunction with a Transportation Network DEFINITIONS
Company. This exclusion does not apply to a
share-the-expense car pool. The following definitions apply:
This exclusion applies during the time the 1 “Ride sharing activity" means use of
covered person is logged on to the your covered auto to provide prearranged
Transportation Network Company's transportation of persons or property in
online—-enabled application or platform and conjunction with a Transportation Network
available to accept a passenger or delivery Company.
assignment, whether or not a passenger or
delivery assignment has been accepted. When a "Transportation Network Company"
passenger or delivery assignment has been means a person or entity that provides
accepted, coverage is excluded while the prearranged transportation services for
Passenger or property to be delivered is
compensation using an online-enabled
occupying your covered auto.
application or platform to connect clients
with drivers who use their personal vehicles
However, if a premium for Ride Share Gap to provide the requested transportation.
Protection is shown on the Declarations for Examples of a Transportation Network
your covered auto: Company include, but are not limited to
Uber, SideCar and Lyft.
1 This exclusion does not apply with respect
to that vehicle during the time when the DUTIES
covered person is logged on to the
Transportation Network Company's
The following duties apply:
online-enabled application or platform and
available to accept a passenger or delivery
assignment, but has not yet accepted a 1 You must notify us if any covered person
Passenger or delivery assignment; and is participating in ride sharing activity.
Coverage under this policy will extend with For accident or loss that occurs while any
covered person is operating a vehicle
respect to that vehicle during the time when
the covered person is logged on to the engaged in ride sharing activity, any
Transportation Network Company's person or entity seeking any coverage or
128974-1114__03
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payment of any benefits must cooperate b. When a passenger or delivery
with us to ensure we are provided with assignment was accepted through
pertinent data regarding the loss, including such application or platform.
the precise dates and times:
You must cooperate with us by executing
a The covered person logged on and off an authorization to obtain the pertinent data
the Transportation Network and records regarding the loss, if such
Company's online-enabled application authorization is necessary for release of
or platform; and the data or records.
Copyright, USAA 2014. All rights reserved.
RSGPCW(01) 12-14 Page 2 of 2
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9800 Fredericksburg Road
San Antonio, Texas 78288
USAA®
QUICK REFERENCE
GEORGIA AUTO POLICY
DECLARATIONS PAGE
READ YOUR POLICY, DECLARATIONS AND
ENDORSEMENTS CAREFULLY Named Insured and Address
Policy Period
The automobile insurance contract between the Operators
named insured and the company shown on the Description of Vehicle(s)
Declarations page consists of this policy plus the Coverages, Amounts of Insurance
Declarations page and any applicable and Premiums
endorsements. The Quick Reference section Endorsements
outlines essential information contained on the Beginning
Declarations and the major parts of the policy. on Page 3} Agreement and Definitions
Part A 4] Liability Coverage
The policy provides the coverages and
amounts of insurance shown on the Definitions
Declarations for which a premium is shown. Insuring Agreement
Bodily Injury Liability Coverage and
This is a participating policy. You are entitled to Property Damage Liability Coverage
dividends as may be declared by the board of Limit of Liability
directors. Supplementary Payments
Exclusions
If this policy is issued by United Services Out of State Coverage
Automobile Association ("USAA"), a reciprocal Other Insurance
interinsurance exchange, the following apply:
Part B 7| Medical Payments Coverage
. By purchasing this policy you are a member Definitions
of USAA and are subject to its bylaws. Insuring Agreement
Medical Payments Coverage
This is a non-assessable policy. You are liable Extended Benefits Coverage
only for the amount of your premium as Limit of Liability
USAA has a free surplus in compliance with Exclusions
Article 19.03 of the Texas Insurance Code of Other Insurance
1951, as amended. Special Provisions
Part C 10} Uninsured Motorists Coverage
The board of directors may annually allocate
a portion of USAA’s surplus to Subscriber's Definitions
Accounts. Amounts allocated to such Insuring Agreement
accounts remain a part of USAA’s surplus Limit of Liability
and may be used as necessary to support the Exclusions
operations of the Association. A member Other Insurance
shall have no right to any balance in the Non-Duplication
member's account except until following Loss Payable Clause
termination of membership, as provided in
the bylaws.
(Quick Reference continued on Page 2)
5100GA(02) Rev. 02-14 54110-0713_05
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Part D 13| Physical Damage Coverage PartE 18] General Provisions
Definitions Bankruptcy
Insuring Agreement Changes
Comprehensive Coverage Conformity to Law
Collision Coverage Duties After an Accident or Loss
Rental Reimbursement Coverage Legal Action Against Us
USAA Roadside Assistance Misrepresentation
Limit of Liability Non-Duplication of Payment
Payment of Loss Our Right to Recover Payment
Loss Payable Clause Ownership
Waiver of Collision Deductible Policy Period and Territory
Exclusions Reducing the Risk of Loss
No Benefit to Bailee Spouse Access
Other Sources of Recovery Termination
Appraisal Transfer of Your Interest in this
Policy
Two or More Auto Policies
5100GA(02) Rev. 02-14 Page 2 of 24
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GEORGIA AUTO POLICY
AGREEMENT
In return for payment of the premium and subject to all the terms of this policy, we will provide the
coverages and limits of liability for which a premium is shown on the Declarations.
DEFINITIONS
The words defined below are used throughout F, "Family member" means a person related
this policy. They are in boldface when used. to you by blood, marriage, or adoption
who resides primarily in your household.
A "You" and "your" refer to the "named This includes a ward or foster child.
insured” shown on the Declarations and
spouse if a resident of the same household. G "Fungi" means any type or form of fungi,
including mold or mildew, and includes any
"We," "us," and "our" refer to the mycotoxins, spores, scents, or byproducts
Company providing this insurance. produced or released by fungi.
“Auto business" means the business of H. “Miscellaneous vehicle" means the
altering, customizing, leasing, parking, following motorized vehicles: motor home;
repairing, road testing, delivering, selling, golfcart; snowmobile; all-terrain vehicle; or
servicing, towing, repossessing or storing dune buggy.
vehicles.
"Motorcycle" means any motor vehicle
"Bodily injury" (referred to as Bl). traveling on public streets or highways
having a seat or saddle for the use of the
1 "Bodily injury” means bodily harm, rider and designed to travel on not more
sickness, disease or death. than three wheels in contact with the
ground, but excluding a tractor or moped.
2. "Bodily injury" does not include
mental injuries such as emotional
"Newly acquired vehicle."
distress, mental anguish, humiliation,
mental distress, or any similar injury
1 “Newly acquired vehicle" means a
unless it arises out of physical injury to
vehicle, not insured by you or any
some person.
family member during the policy
period and is:
"Driving contest or challenge" includes,
but is not limited to:
a A private passenger auto, pickup,
trailer, or van;
1 A prearranged or organized competion
against other people, vehicles, or time;
A miscellaneous vehicle that is
or
not used in any business or
A prearranged or organized activity that occupation; or
challenges the speed or handling
characteristics of a vehicle or improves A motorcycle, but only if a
or demonstrates driving skills, provided motorcycle is shown on the current
the activity occurs on a track or course Declarations.
that is closed from non-participants.
5100GA(02) Rev. 02-14 Page 3 of 24
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(DEFINITIONS Cont'd.)
2. We will automatically provide for the For purposes of this policy, electronic
newly acquired vehicle the
Preview
= QU OUN Kk 04 U4: Dv INDEX NO. 708593/2024 NYSCEF BOC. NO. 4 RECEIVED NYSCEF: 04/22/2024 EXHIBIT C INDEX NO. 708593/2024 wt NYSCEF, N & SS DOC. NO. 4 RECEIVED MaRET al /2024 JUNE 30, 2023 USAA® AUTOMOBILE POLICY PACKET MICHAEL ANTHONY SAUNDERS PV2 USA 11869 MONTAUK ST SAINT ALBANS NY 11412-4021 GIC 05504 65 39 7101 7 POLICY PERIOD: FROM JUL 01 2023 TO JAN 01 2024 IMPORTANT MESSAGES Refer to your Declarations Page and endorsements to verify that coverages, limits, deductibles and other policy details are correct and meet your insurance needs. Required information forms are also enclosed for your review. Check your vehicle for a safety recall today! Visit www.usaa.com/autorecall to learn more. The laws of the State of Georgia prohibit insurers from unfairly discriminating against any person based upon his or her status as a victim of family violence. Thank you for enrolling for the Automatic Payment Plan option, which enables you to receive up to a 3% discount on your policy. For details, please review your Supplemental Information page. Please read the enclosed Georgia Uninsured Motorist Coverage Notice for information about your policy. If not previously signed, the State of Georgia requires you to sign and return the attached acknowledgment of the notice. Your policy has been issued with uninsured motorists coverage that meets state requirements. We encourage you to read the attached flier, "Uninsured Motorists Coverage in Georgia,” to learn about the coverage, available options and what you need to do if you elect to change it. An Accident Report form is enclosed to assist you in the event you have an accident, your vehicle is disabled or you need a rental car. Please keep the form in your vehicle. This is not a bill. Any premium charge or change for this policy will be reflected on your next regular monthly statement. Your current billing statement should still be paid by the due date indicated. To receive this document and others electronically, or manage your Auto Policy online, go to usaa.com. For U.S. calls: Policy Service (800) 531-8111. Claims (800) 531-8222. ACS1 49708-0406 0901119cbaab5a92 INDEX NO. 708593/2024 NYSCEF DOC. NO. 4 RECEIVED NYSCEF: 8/27/2024 THIS PAGE INTENTIONALLY LEFT BLANK 0901119cbaab5a92 INDEX NO. 708593/2024 NYSCEF DOC. NO. 4 oc RECEIVED YgceR 04/32 12924 AUTOMOBILE POLICY PACKET CONTINUED Your safety matters to USAA. Visit http://usaa.com/autoadvice for our latest auto insurance and driving safety tips. Coverage exclusions apply when your vehicle is used in ride sharing. If you need coverage for ride sharing activities, we're pleased to offer Ride Share Gap Protection. For details, see the enclosed documents titled "Amendment of Policy Provisions — Ride Sharing Activity’ and "Important Information About Ride Sharing Activity.” USAA considers many factors when determining your premium. Maintaining safe driving habits is one of the most important steps you can take in keeping your premium as low as possible. A history of claim or driving activity and your USAA payment history may affect your policy premium. We have provided your ID cards in this packet. You can use the cards to show proof of insurance, if necessary. ACS2 0901119cbaab5a92 INDEX NO. 708593/2024 NYSCEF DOC. NO. 4 RECEIVED nyscer?@4/29/2024 Insurance Policy Information Card The electronic record sent to the Georgia Department of Revenue is the only proof of insurance that will be accepted by law enforcement. We've issued a policy information card for your motor vehicle(s) as evidence of liability insurance. You may be required to produce your information card if an accident occurs or you travel out of state. Keep a copy in your vehicle at all times. For your convenience, additional copies are available on usaa.com. 53GA1 Rev. 11-19 55051-1119 a 88 9800 Fredericksburg Road 18600 San Antonio, Texas 78288 U GEORGIA INSURANCE POLICY INFORMATION CARD Insurance Company Name Original Issue Date USAA GENERAL INDEMNITY COMPANY 07/01/23 Policy Number 05504 65 39G 7101 7 Expiration Date 01/01/24 Name MICHAEL ANTHONY SAUNDERS Vehicle Insured Year: jake: Model: Vehicle Identification Number: 2003 LEXUS GS 300 4D JT8BD69S230188429 CONTACT US: 210-531-USAA(8722) OR 800-531-USAA The urrent status of actual vehicle liability insurance coverage is motor maintained by the Georgia Department of Revenue and is accessible to law enforcement agencies upon a check of the vehicle registrations KEEP THIS CARD IN YOUR MOTOR VEHICLE WHILE IN OPERATION Additional copies available at usaa.com 0901119cbaab5a92 INDEX NO. PAGE59372024 NY. DOCUSWA GENERAL INDEMNITY COMPANY a neeee Moa NS) 2024 (A Stock Insurance Company) State|O1 POLICY NUMBER USAA® 9800 Fredericksburg - San Antonio, Texas 78288 IGA B69 Ter 05504 65 39G 7101 7 GEORGIA AUTO POLICY 01 A.M. standard time) DECLARATIONS FROM JUL 01 2023 T O JAN 01 2024 OPERATORS Named Insured and Address 01 MICHAEL ANTHONY SAUNDERS MICHAEL ANTHONY SAUNDERS PV2 USA 11869 MONTAUK ST rE SAINT ALBANS NY 11412-4021 Description of Vehicle(s) EH USE" VEH|YEAR TRADE NAME MODEL, BODY TYPE AMEE IDENTIFICATION NUMBER 01) 03) LEXUS GS 300 4D 4D 9000 JT8BD69S230188429 P The Vehicle(s) described herein is principallygaraged ly, at the above address unless otherwise stated. [WC=WorkiSchoot, B=Blsiness, F=Fam:P=Pleasure ol HINESVILLE GA 3131 may polic provides ONLY those coverages where a premium is shown below. The limits shown e duce: by polic provisions and ma not be combined regardless of the number of vehicles for which a premium is listed unless specifically authorized elsewhere in this policy. EH VEH VEH COVERAGES LIMITS OF LIABILITY orn 6-MONTH ("ACV" MEANS ACTUAL CASH VALUE) D=DED PREMIUM LB=DED PREMIUM p=DED PREMIUM p=pED PREMIUM JAMOUN PART A - LIABILITY BODILY INJURY EA PER $ 25,000 EA ACC $ 50,009 626. 28 PROPERTY DAMAGE EA ACC $ 25,009 333 14 IPART C - UNINSURED MOTORISTS UNINSURED MOTORIST REDUCED BY AT-FAULT'S LIABILITY LIMITS BODILY INJURY EA PER $ 25,009 EA ACC $ 50,000 PROPERTY DAMAGE EA ACC $ 25,00QD 250) 75 65 PART D - PHYSICAL DAMAGE COVERAGE TOWING AND LABOR 10 99 EHICLE TOTAL PREMIUM 1046 04 6 MONTH PREMIUM $ 1046.06 PREMIUM DUE AT INCEPTION. THIS Ig NOT (A BILL, STATEMENT TjO FOULOW. THE FOLLOWING COVERAGE (S) DEFINED IN THIS POLICY ARE NOT PROVIDED FOR: VEH 01 - MEDICAL PAYMENTS, EXTENDED BENEFITS COVERAGE, COMPREHENSIVE, COLLISION, RENTAL REIMBURSEMENT ENDORSEMENTS: A402 (02) A200GA (04) RSGPCW (01) 5100GA (02) INFORMATION FORMS: NIPFPP (05) IIRSGPCW (01) ADDRDISC (01) 485GGP (01) 88356 (01) 999GA (13) r 4 i 7] Rsmrspoopo] |] TT TE I | LIT TTT EL LLL EL I | LIT IN WITNESS WHEREOF, we have caused this policy to be signed by our President and Secretary at San Antonio, Texas, on this date JUNE 30, 2023 Kelle svmeivang KE = 5000 G 05-12 53384-05-12 Kelly Armstrong , Secretary Randy Termeer, President 0901119cbaab5a92 =: INDEX NO. 70859372024 NYSCEF ay” 4 STCRECELVED NYSCEF: 04/2372024 SUPPLEMENTAL INFORMATION USAA® FROM JUL 01 2023 TO JAN 01 2024 The following approximate premium discounts or credits have already been applied to reduce your policy premium costs. NOTE: Age or senior citizen status, if allowed by your state/location, was taken into consideration when your rates were set and your premiums have already been adjusted. VEHICLE 01 ANNUAL MILEAGE DISCOUNT -$ 10 13 AUTOMATIC PAYMENT PLAN DISCOUNT -$ 31 02 DEFENSIVE DRIVING DISCOUNT -$ 103 02 OPERATOR 01 -- (CERTIFICATE EXPIRES 03-15-25) DRIVER TRAINING DISCOUNT -$ 48 80 OPERATOR 01 PARTICIPATION IN SAFE DRIVING -$ 112 65 SUPDECCW Rev. 7-95 JUNE 30, 2023 0901119cbaab5a92 INDEX NO. 708593/2024 NYSCEF DOC. NO. 4 GIc ossosREGELVED NYSCER: 84/22/2024 AMENDATORY ENDORSEMENT The coverage provided by this Endorsement is subject to all the provisions of the policy and amendments except as they are modified as follows. PART D - PHYSICAL DAMAGE COVERAGE INSURING AGREEMENT b, If Rental Reimbursement Coverage is afforded, the vehicle class for Paragraph A. is replaced in its entirety by the transportation expenses is the following: vehicle class shown on the Declarations for Rental A. Comprehensive Coverage (excluding Reimbursement for that vehicle. collision), Paragraph C. is replaced in its entirety by the 1 Physical damage. We will pay for loss following: caused by other than collision to your covered auto, including its equipment, C. Rental Reimbursement Coverage (for loss and personal property contained in your other than total theft). covered auto, minus any applicable deductible shown on the Declarations. 1 We will reimburse you for expenses The deductible will be waived for loss you or any family member incurs to to window glass that can be repaired rent a substitute for your covered rather than replaced. In cases where the auto, This coverage applies only if: repair proves unsuccessful and the window glass must be replaced, the full a Your covered auto is withdrawn amount of the deductible, if any, must from use due to a loss, other than a be paid. total theft, to that auto; and Transportation expenses. We will also The loss is covered under pay: Comprehensive Coverage or caused by collision, and the cause of loss a The reasonable amount for is not otherwise excluded under Part transportation expenses incurred by D of this policy. you or any family member, but no more than the cost of renting an We will reimburse you only for that Economy Class vehicle, as defined period of time reasonably required to under Rental Reimbursement repair or replace your covered auto. If Coverage. This applies only in the we determine your covered auto is a event of a total theft of your total loss, the rental period will end no covered auto. We will pay only later than seven days after we have transportation expenses incurred made a settlement offer. during the period beginning 48 hours after the theft and ending when your covered auto is LIMIT OF LIABILITY returned to use or, if not recovered or not repairable, up to seven days Paragraph A. of the Limit of Liability section is after we have made a settlement replaced in its entirety by the following. offer. 126836-0314_02 A402(02) Rev. 05-14 Page 1 of 3 0901119cbaab5a92 INDEX NO. 708593/2024 NYSCEF DOC. NO. 4 GIc ossosREGELVED NYSCEF: 64/22/2024 A. Total loss to your covered auto. Our limit D. Under Rental Reimbursement Coverage, our of liability under Comprehensive Coverage maximum limit of liability is the reasonable and Collision Coverage is the actual cash amount necessary to reimburse you for value of the vehicle, inclusive of any expenses incurred to rent a vehicle in the custom equipment, and the cost to applicable class shown on the Declarations: transfer or replace any equipment, furnishings or parts designed to assist 1 Economy Class. For purposes of this disabled persons. endorsement, Economy Class means “mini,” small or compact 2— and 4—door 1 The maximum amount we will include cars that are not considered sports or for loss to custom equipment in or on luxury vehicles and are not the station your covered auto is $5,000. wagon type. We will declare your covered auto to Standard Class. For purposes of this be a total loss if, in our judgment, the endorsement, Standard Class means cost to repair it would be greater than standard and full size 2— and 4—door its actual cash value minus its salvage cars that are not considered sports or value after the loss. luxury vehicles and are not the station wagon type. |f Car Replacement Assistance is shown on the Features Declarations for this Multipassenger/Truck Class. For your covered auto, we will pay an purposes of this endorsement, additional 20% of the actual cash Multipassenger/Truck Class means: value of the vehicle at the time of a total loss. This additional amount: a Sports, convertible and luxury cars of any size; a Is separate from the limit available for loss to your covered auto Station wagons; under Comprehensive Coverage or Collision Coverage; and Minivans; ls available if the total loss is paid: Mid-size cargo and passenger vans; (1) Under this policy's Pickup trucks; and Comprehensive Coverage or Collision Coverage; or "Mini," small and midsize sport utility (2) Because of the PD by or on vehicles (SUVs) that are not behalf of persons or considered luxury SUVs. organizations who may be legally responsible. Large SUV Class. For purposes of this endorsement, Large SUV Class means However, Car Replacement Assistance luxury SUVs of any size, large SUVs, does not apply to total loss to any any private passenger vehicle equipped nonowned vehicle. to assist the disabled (when available) and large cargo or passenger vans. Paragraph D. is replaced in its entirety by the following: A402(02) Rev. 05-14 Page 2 of 3 0901119cbaab5a92 INDEX NO. 708593/2024 NYSCEF DOC. NO. 4 GIc ossosREGELVED NYSCEF: 64/22/2024 PART E - GENERAL PROVISIONS OUR RIGHT TO RECOVER PAYMENT The Our Right to Recover Payment section is amended to add the following: Our rights in this section do not apply with respect to amounts paid in excess of the actual cash value of your covered auto because of Car Replacement Assistance. Copyright, USAA, 2013. All rights reserved. A402(02) Rev. 05-14 Page 3 of 3 0901119cbaab5a92 INDEX NO. 708593/2024 NYSCEF DOC. NO. 4 GIc ossosREGELVED NYSCEF: “Ga/22/2024 AMENDMENT OF POLICY PROVISIONS - GEORGIA This Amendment forms a part of the auto policy to which it is attached, and it modifies that policy as follows: DEFINITIONS Under J. "Newly acquired vehicle.” item 1. is b. A miscellaneous vehicle that is not deleted in its entirety and replaced by the used in any business or occupation; following: or 1 "Newly acquired vehicle" means a c. A motorcycle, but only if a vehicle, not insured under another motorcycle is shown on the current policy, that is acquired by you or any Declarations. family member during the policy period and is: a A private passenger auto, pickup, trailer, or van; PART A - LIABILITY COVERAGE Under EXCLUSIONS, A, Item 10 is added: 10. For punitive or exemplary damages recovered. PART C - UNINSURED MOTORISTS COVERAGE (referred to as UM Coverage) Under EXCLUSIONS, Item F is added: F. We do not provide UMPD Coverage for the first $250 of the amount of PD to the property of each covered person as the result of any one accident. Copyright, USAA, 2020. All rights reserved. 128904-0520_02 A200GA(04) 02-20 Page 1 of 1 0901119cbaab5a92 =: INDEX NO. 708593/2024 mRN NO. 4 GIC ossoaREGERVED NYSCER: "84/22/2024 ° U AMENDMENT OF POLICY PROVISIONS - RIDE SHARING ACTIVITY This Amendment forms a part of the auto policy to which it is attached, and it modifies that policy as follows: Notwithstanding Paragraph 3. of the definition online-enabled application or platform and of covered person in Part A — Liability, available to accept a passenger or delivery covered person does not include any assignment, but has not yet accepted a Transportation Network Company. passenger or delivery assignment. EXCLUSION When a passenger or delivery assignment has been accepted, coverage will not We do not provide coverage under this policy extend while the passenger or property to for accident or loss that occurs while any be delivered is occupying your covered covered person is operating or occupying a auto. vehicle engaged in ride sharing activity in conjunction with a Transportation Network DEFINITIONS Company. This exclusion does not apply to a share-the-expense car pool. The following definitions apply: This exclusion applies during the time the 1 “Ride sharing activity" means use of covered person is logged on to the your covered auto to provide prearranged Transportation Network Company's transportation of persons or property in online—-enabled application or platform and conjunction with a Transportation Network available to accept a passenger or delivery Company. assignment, whether or not a passenger or delivery assignment has been accepted. When a "Transportation Network Company" passenger or delivery assignment has been means a person or entity that provides accepted, coverage is excluded while the prearranged transportation services for Passenger or property to be delivered is compensation using an online-enabled occupying your covered auto. application or platform to connect clients with drivers who use their personal vehicles However, if a premium for Ride Share Gap to provide the requested transportation. Protection is shown on the Declarations for Examples of a Transportation Network your covered auto: Company include, but are not limited to Uber, SideCar and Lyft. 1 This exclusion does not apply with respect to that vehicle during the time when the DUTIES covered person is logged on to the Transportation Network Company's The following duties apply: online-enabled application or platform and available to accept a passenger or delivery assignment, but has not yet accepted a 1 You must notify us if any covered person Passenger or delivery assignment; and is participating in ride sharing activity. Coverage under this policy will extend with For accident or loss that occurs while any covered person is operating a vehicle respect to that vehicle during the time when the covered person is logged on to the engaged in ride sharing activity, any Transportation Network Company's person or entity seeking any coverage or 128974-1114__03 RSGPCW(01) 12-14 Page 1 of 2 0901119cbaab5a92 INDEX NO. 708593/2024 NYSCEF DOC. NO. 4 GIc ossosREGELVED NYSCEF: “Ga/22/2024 payment of any benefits must cooperate b. When a passenger or delivery with us to ensure we are provided with assignment was accepted through pertinent data regarding the loss, including such application or platform. the precise dates and times: You must cooperate with us by executing a The covered person logged on and off an authorization to obtain the pertinent data the Transportation Network and records regarding the loss, if such Company's online-enabled application authorization is necessary for release of or platform; and the data or records. Copyright, USAA 2014. All rights reserved. RSGPCW(01) 12-14 Page 2 of 2 0901119cbaab5a92 =: INDEX NO. 708593/2024 USAA GIC ossoaREGERVED NYSCER: “64/22/2024 9800 Fredericksburg Road San Antonio, Texas 78288 USAA® QUICK REFERENCE GEORGIA AUTO POLICY DECLARATIONS PAGE READ YOUR POLICY, DECLARATIONS AND ENDORSEMENTS CAREFULLY Named Insured and Address Policy Period The automobile insurance contract between the Operators named insured and the company shown on the Description of Vehicle(s) Declarations page consists of this policy plus the Coverages, Amounts of Insurance Declarations page and any applicable and Premiums endorsements. The Quick Reference section Endorsements outlines essential information contained on the Beginning Declarations and the major parts of the policy. on Page 3} Agreement and Definitions Part A 4] Liability Coverage The policy provides the coverages and amounts of insurance shown on the Definitions Declarations for which a premium is shown. Insuring Agreement Bodily Injury Liability Coverage and This is a participating policy. You are entitled to Property Damage Liability Coverage dividends as may be declared by the board of Limit of Liability directors. Supplementary Payments Exclusions If this policy is issued by United Services Out of State Coverage Automobile Association ("USAA"), a reciprocal Other Insurance interinsurance exchange, the following apply: Part B 7| Medical Payments Coverage . By purchasing this policy you are a member Definitions of USAA and are subject to its bylaws. Insuring Agreement Medical Payments Coverage This is a non-assessable policy. You are liable Extended Benefits Coverage only for the amount of your premium as Limit of Liability USAA has a free surplus in compliance with Exclusions Article 19.03 of the Texas Insurance Code of Other Insurance 1951, as amended. Special Provisions Part C 10} Uninsured Motorists Coverage The board of directors may annually allocate a portion of USAA’s surplus to Subscriber's Definitions Accounts. Amounts allocated to such Insuring Agreement accounts remain a part of USAA’s surplus Limit of Liability and may be used as necessary to support the Exclusions operations of the Association. A member Other Insurance shall have no right to any balance in the Non-Duplication member's account except until following Loss Payable Clause termination of membership, as provided in the bylaws. (Quick Reference continued on Page 2) 5100GA(02) Rev. 02-14 54110-0713_05 Page 1 of 24 0901119cbaab5a92 INDEX NO. 708593/2024 NYSCEF DOC. NO. 4 GIc ossosREGELVED NYSCER: “64/22/2024 Part D 13| Physical Damage Coverage PartE 18] General Provisions Definitions Bankruptcy Insuring Agreement Changes Comprehensive Coverage Conformity to Law Collision Coverage Duties After an Accident or Loss Rental Reimbursement Coverage Legal Action Against Us USAA Roadside Assistance Misrepresentation Limit of Liability Non-Duplication of Payment Payment of Loss Our Right to Recover Payment Loss Payable Clause Ownership Waiver of Collision Deductible Policy Period and Territory Exclusions Reducing the Risk of Loss No Benefit to Bailee Spouse Access Other Sources of Recovery Termination Appraisal Transfer of Your Interest in this Policy Two or More Auto Policies 5100GA(02) Rev. 02-14 Page 2 of 24 0901119cbaab5a92 INDEX NO. 708593/2024 NYSCEF DOC. NO. 4 GIc ossosREGELVED NYSCEF: “Ga/22/2024 GEORGIA AUTO POLICY AGREEMENT In return for payment of the premium and subject to all the terms of this policy, we will provide the coverages and limits of liability for which a premium is shown on the Declarations. DEFINITIONS The words defined below are used throughout F, "Family member" means a person related this policy. They are in boldface when used. to you by blood, marriage, or adoption who resides primarily in your household. A "You" and "your" refer to the "named This includes a ward or foster child. insured” shown on the Declarations and spouse if a resident of the same household. G "Fungi" means any type or form of fungi, including mold or mildew, and includes any "We," "us," and "our" refer to the mycotoxins, spores, scents, or byproducts Company providing this insurance. produced or released by fungi. “Auto business" means the business of H. “Miscellaneous vehicle" means the altering, customizing, leasing, parking, following motorized vehicles: motor home; repairing, road testing, delivering, selling, golfcart; snowmobile; all-terrain vehicle; or servicing, towing, repossessing or storing dune buggy. vehicles. "Motorcycle" means any motor vehicle "Bodily injury" (referred to as Bl). traveling on public streets or highways having a seat or saddle for the use of the 1 "Bodily injury” means bodily harm, rider and designed to travel on not more sickness, disease or death. than three wheels in contact with the ground, but excluding a tractor or moped. 2. "Bodily injury" does not include mental injuries such as emotional "Newly acquired vehicle." distress, mental anguish, humiliation, mental distress, or any similar injury 1 “Newly acquired vehicle" means a unless it arises out of physical injury to vehicle, not insured by you or any some person. family member during the policy period and is: "Driving contest or challenge" includes, but is not limited to: a A private passenger auto, pickup, trailer, or van; 1 A prearranged or organized competion against other people, vehicles, or time; A miscellaneous vehicle that is or not used in any business or A prearranged or organized activity that occupation; or challenges the speed or handling characteristics of a vehicle or improves A motorcycle, but only if a or demonstrates driving skills, provided motorcycle is shown on the current the activity occurs on a track or course Declarations. that is closed from non-participants. 5100GA(02) Rev. 02-14 Page 3 of 24 0901119cbaab5a92 INDEX NO. 708593/2024 NYSCEF DOC. NO. 4 GIc ossosREGELYED NYSCER: “64/22/2024 (DEFINITIONS Cont'd.) 2. We will automatically provide for the For purposes of this policy, electronic newly acquired vehicle the