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(Blank) Grand Total Auto Physical Damage & Liability 2015-16 Renewal Policy # 70APS049702 - the National Indemnity Co

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(Blank) Grand Total Auto Physical Damage & Liability 2015-16 Renewal Policy # 70APS049702 - the National Indemnity Co Row Labels Big Bend CC Centralia College Clark College Lower Columbia College (blank) Grand Total Auto Physical Damage & Liability 2015-16 Renewal Policy # 70APS049702 - The National Indemnity Co. 7/1/17-7/1/18 Agency Model Radius Seating Value Liab PhyD Comp Coll Agency Name Make Model VIN # City & State Code Year (mi) Capacity Depreciated Ded Ded 629 Big Bend CC 1988 MCI Bus Moses Lake, WA 300 49 $52,000 X X $5,000 $5,000 632 Centralia College 2003 Blue Bird Bus Centralia WA 12 18 $36,000 x x $500 $500 632 Centralia College 2016 Starcraft Quest Bus Centralia WA $66,500 x x $500 $500 632 Centralia College 2016 Starcraft Quest Bus Centralia WA $66,500 x x $500 $500 635 Clark College 2013 International Starcraft XK Vancouver, WA 350 32 $100,000 X X $1,000 $1,000 635 Clark College 2005 CHEV K3PU Vancouver, WA 25 3 $12,000 X X $500 $500 635 Clark College 2005 CHEV C2PU Vancouver, WA 35 3 $12,000 X X $500 $500 635 Clark College 2010 FORD F150 Vancouver, WA 40 3 $14,200 X X $500 $500 635 Clark College 2009 FORD E3WAGON Vancouver, WA 350 12 $12,400 X X $500 $500 635 Clark College 2008 CHEV EXPVAN Vancouver, WA 350 8 $11,500 X X $500 $500 635 Clark College 2015 FORD F350 Vancouver, WA 350 8 $23,500 X X $500 $500 657 Lower Columbia College 2011 Chevrolet Bus # 5 Longview 10 20 $71,415 X X $500 $500 657 Lower Columbia College 2011 Dodge Grand Caravan Express # 18 Longview 10 7 $24,500 X X $500 $500 657 Lower Columbia College 2010 Chevrolet Colorado Truck # 17 Longview 20 2 $16,000 X X $500 $500 657 Lower Columbia College 2009 Ford Bus #10 Longview 10 20 $52,394 X X $500 $500 657 Lower Columbia College 2008 Chevrolet Bus # 3 Longview 10 20 $54,000 X X $500 $500 657 Lower Columbia College 2008 Chevrolet Uplander - 7 pssg van # 16 Longview 10 7 $20,000 X X $500 $500 657 Lower Columbia College 2006 Dodge Grand Caravan (ext'd mini- Longview 10 7 $17,560 X X $500 $500 van) # 15 657 Lower Columbia College 2006 Ford Bus #2 Longview 20 27 $52,394 X X $500 $500 657 Lower Columbia College 2006 GMC Bus #9 Longview 10 18 $54,950 X X $500 $500 657 Lower Columbia College 2003 Chevrolet Bus # 1 Longview 10 20 $47,000 X X $500 $500 657 Lower Columbia College 2002 GMC Bus #8 Longview 10 20 $47,000 X X $500 $500 Removed on 6/15 - should not be on renewal 657 Lower Columbia College 2002 GMC Bus #7 Longview 10 20 $47,000 X X $500 $500 Removed on 6/15 - should not be on renewal 657 Lower Columbia College 2002 GMC Bus #6 Longview 10 16 $49,000 X X $500 $500 Removed on 6/15 - should not be on renewal 657 Lower Columbia College 2001 GMC Cube Truck (Food Service) Longview 10 2 $32,580 X X $500 $500 #14 657 Lower Columbia College 2016 Isuzu NPR Gas Truck Longview 10 2 $46,107 x x $500 $500 657 Lower Columbia College 2017 Glaval Legacy (Bus) Longview WA $202,022 X X $500 $500 Total Insured Values $1,240,522 Removal of three LCC busses $143,000 $1,097,522 Auto Physical Damage & Liability 2015-16 Renewal Policy # 70APS049702 - The National Indemnity Co. 7/1/17-7/1/18 # Of Moving # of Traffic # of Yrs Accidents Violations # of Yrs # of Yrs Driving Agency Drivers License in past 3 in past 3 # of Yrs Driving Driving Vans & 16 Years Months Code Agency Name Driver Name DOB Drvr's License # Expiration Date Type years years State Licensed Trucks Buses Passngr Empl Empl Address City State Zip 629 Big Bend Community College B, CDL 0 0 WA 1 1 1 630 Big Bend Community College B, CDL 0 0 WA 51 4 5 2017-18 Aviation Liability and Physical Damage Renewal National Union Fire Insurance Company - AV003790763-08 Value Agency Tail Number Aircraft Year Spare Parts Agency Code Aircraft Make Aircraft Model Engine Hours Engine Type Seating - Crew Airframe Hours Spare Engines Limit of Liability Date last Annual Certificate applicable Hull Coverage? Engines Aircraft Hangared Mortgage or Lien Seating - Passenger Engine Horse Power Aircraft Serial Number installed on aircraft Details of Mortgage, if Purchased (New/Used) Standard Airworthiness TCAS/TCAD Equipped Any Unrepaired DamageModifications - Aircraft or Is any special equipment Aircraft Special Equipment BOW required for Mortgagee 375 Central Washingon University N24612 1999 Cessna 172R $82,081 2 2 Used Apr-16 7,196 2,382 Lycoming 160 Yes No None No Yes No N/A N/A N/A $25,000,000 No Deleted 6/1 375 Central Washingon University N35092 2001 Cessna 172R $87,600 2 2 Used Aug-16 7,850 2,387 Lycoming 160 Yes No None No Yes No N/A N/A N/A $25,000,000 No Deleted 6/1 375 Central Washingon University N814HA 1999 Cessna 172R $77,305 2 2 Used Nov-16 7,478 436 Lycoming 160 Yes No None No No No N/A N/A N/A $25,000,000 No Central Washingon University N9577W 1998 Cessna 172R $76,708 2 2 Used Feb-16 8,672 1,322 Lycoming 160 Yes No None No No No N/A N/A N/A Yes Bank of $25,000,000 Commerce, Redding, CA 530-244- 375 8158 No 375 Central Washingon University N457CM 2000 Cessna 172R $99,050 2 2 Used Jun-16 8,575 1,557 Lycoming 160 Yes No None No Yes No N/A N/A N/A $25,000,000 No 375 Central Washingon University N9572W 1998 Cessna 172R $83,840 2 2 Used Jul-16 6,888 1,634 Lycoming 180 Yes No No No No n/a n/a n/a n/a yes $25,000,000 No Central Washingon University N3711N BE-76 $97,346 Electronic Engine 375 1980 Beech 2 2 Used Apr-17 9,041 423.7-195.4 Lycoming 180 Yes No Instruments No No No N/A N/A N/A $25,000,000 No Central Washingon University 6628X-211 BE-76 $60,121 Electronic Engine 375 1979 Beech 2 2 Used Oct-16 5,023 1645.7 -1645.7 Lycoming 180 Yes No Instruments No No No N/A N/A N/A No N/A N/A $25,000,000 No Central Washingon University 6710T-213 BE-76 $24,215 Electronic Engine 375 1979 Beech 2 2 used Dec-16 12,954 144.2-144.2 Lycoming 180 Yes No Instruments No No No N/A N/A N/A No N/A N/A $25,000,000 No 375 Central Washingon University N296DM 1976 Piper PA28R-200 N/A 1 3 Used 12/13/2016 5,373 1317.15 M Lycoming 200 Yes No No No Yes No No N/A N/A No N/A N/A $25,000,000 No 375 Central Washingon University N512MS 1992 Piper PA-28-161 N/A 1 3 New 12/7/2016 11,900 923.3 Lycoming 160 Yes No No No Yes No No N/A N/A No N/A N/A $25,000,000 No 375 Central Washingon University N513MS 1992 Piper PA-28-161 N/A 1 3 Used 6/23/2016 9,345 1201.2 Lycoming 160 Yes No No No Yes No No N/A N/A No N/A N/A $25,000,000 No 696 Clover Park Tech College N53372 2003 Cessna 172R N/A 1 3 New 2/29/16 3,762 1,754 Lycoming 160 Yes No No No No No $25,000,000 No 696 Clover Park Tech College N2391M 2003 Cessna 172R N/A 1 3 New 12/2/15 4,444 462 Lycoming 160 Yes No No No No No $25,000,000 No 696 Clover Park Tech College N5363Z 2003 Cessna 172R N/A 1 3 New 3/9/16 3,952 38 Lycoming 160 Yes No No No No No $25,000,000 No 696 Clover Park Tech College N739QL 1978 Cessna 172 N/A 1 3 New 7/3/15 10,370 1,800 Lycoming 160 Yes No RAM No No No $25,000,000 No 696 Clover Park Tech College N739MF 1978 Cessna 172 N/A 1 3 New 2/16/16 11,560 1,150 Lycoming 160 Yes No RAM No No No $25,000,000 No 696 Clover Park Tech College N5955E 1978 Cessna 172 N/A 1 3 New 3/4/16 10,800 1,700 Lycoming 160 Yes No RAM No No No $25,000,000 No 696 Clover Park Tech College N4725D 1979 Cessna 172 N/A 1 3 New 9/4/15 12,048 1,000 Lycoming 160 Yes No RAM No No No $25,000,000 No 696 Clover Park Tech College N757KM 1979 Cessna 152 N/A 1 1 Used 12/4/15 6,804 800 Lycoming 110 Yes No No No No No $25,000,000 No 696 Clover Park Tech College N736MJ 1979 Cessna 182RG N/A 1 3 Used 7/20/15 4,780 803 Lycoming 235 Yes No No No No No $25,000,000 No 696 Clover Park Tech College N 53351 1981 Cessna 172 N/A 1 3 Used 8/26/15 8,124 930 Lycoming 160 Yes No No No No No $25,000,000 No 696 Clover Park Tech College N7592Y 1978 Cessna 182RG N/A 1 3 Used 7/16/14 3,340 681 Lycoming 235 Yes No No No No No $25,000,000 No 696 Clover Park Tech College N1294F 1979 Cessna 172 N/A 1 3 New 5/15/15 3,764 1,200 Lycoming 160 Yes No No No No No $25,000,000 No 696 Clover Park Tech College N260JL 2016 Tecnam P2006T $770,000 2 2 New 8/25/16 75 75 Rotax 100 Yes None No No Yes No No No No No None $25,000,000 Yes Community Colleges of N472EA 1977 King Air E-90 2 5 Used 3/1/2012 10,164 R: 10,130 Pratt & 650 ea No No No No Yes No No No No Yes State COP $25,000,000 Spokane Beechcraft L: 10,130 Witney 676 N/A PT6A No 676 Community Colleges of N9745C 1978 Piper Warrior PA-28-161 1 3 Used 3/10/2012 10,203 2,800 Reciproc 160 Yes No No No Yes No No No No Yes State COP $25,000,000 Spokane ating, Lycoming 320 N/A Series No 676 Community Colleges of N310P 1955 Cessna C-310 $7,000 1 4 Used No ? No Logbooks Continent 225 Yes No No No Yes/No No No No No No $25,000,000 Spokane Logbooks al O-470 No New 676 Community Colleges of N1722H 1955 Cessna C-310 $7,000 1 4 Used 7/31/1997 4,948 R: 1116 Continent 225 Yes No No No Yes/No No No No No No $25,000,000 Spokane L: 1310 al O-470 No New 676 Community Colleges of N50949 1968 Cessna C-150J $6,500 1 1 Used 10/25/1995 5,325 1,162 Continent 100 Yes No No No Yes/No No No No No No $25,000,000 Spokane al O-200 No New 676 Community Colleges of N704QA 1976 Cessna C-150M $9,000 1 1 Used 1/19/1996 2,654 631 Continent 100 Yes No No No Yes/No No No No No No $25,000,000 Spokane al O-200 No New 605 Everett Community College N8471Z 1963 Cessna 210-5 N/A 1 3 USED NA UNK UNK CONT 240 NA NONE AF NO YES STOL KIT NONE NONE NO $25,000,000 No 605 Everett Community College N312XW 1955 Provost Mark Jet 2 N/A 2 0 USED NA UNK UNK perdmark 2 NA NA NONE NA NO YES NONE NONE NONE NO $25,000,000 No 605 Everett Community College N294XW 1955 Provost Mark Jet 2 N/A 2 0 USED NA UNK UNK perdmark 2 NA NA NONE NA NO YES NONE NONE NONE NO $25,000,000 No 605 Everett Community College NO REG 1969 Bell OH-58A N/A 2 2 X -MIL NA UNK UNK Allison (250-C20) NA NONE NA NO YES NONE NONE
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