Policy Number	Insured	Agent	Last Update
Z11859DD	Richard Mariner	Jordan Helvetica	5/6/08, 1:06 PM by Susan Campbell

	Policy Info			Insured Info			Requirements/Notes			Attachments

	Insurance Type: Disability Policy Series: 1100 Product Description: Provider Plus Benefit Amount: $5,000.00 Annual Premium: $3,874.00 Billing Mode: Annually Premium Type: Level Payment: $0.00 Elimination Period: 90 days Benefit Period: X45 Occupation Class: 4P Type of Business: Owner of Employer?: N Type of Employer Entity: Concurrent Additional Disability App? N Telemed: No Status: Underwriting Riders: Cost of Living Residual Riders-Options: COLA-3%, Residual Underwriter: Denise Davis Submit Date: 12/28/2006 FIO Amount: $0.00 Anniv. Date: Discounts: Non-Smoker Special Risk: Premium, in Suspense: $0.00 Policy information shown may not be 100% accurate; automatic increase riders and policy information changes could be missed on this page. This page is merely intended to be a close suggestion to what your clients have. For an exact Guardian policy status form please call us and we'll fax a report to you.