Stocking
Resume:
POLICY NUMBER:
Effective Date
Expiration Date
This policy expires at 12:01 AM Standard Time at the Address of the Named Insured as Herein.
**** *********** **., ***** ***
Downers Grove, IL 60515
RETURN SERVICE REQUESTED
Declarations Page: ENDORSEMENT
This is a description of your coverage. Please retain for your records. 42AU000973367
01/19/2022
07/07/2022
This Policy Expires at 12:01 A.M.
Standard Time at the Address of the
Named Insured as stated herein.
NAMED INSURED
ROGER DALE JR. ADAMS
4937 STUART RD TRLR 158
DENTON, TX 76207-4229
YOUR AMERICAN ACCESS AGENT IS
A-MAX AUTO INSURANCE - MCKINNEY
1703 COLEMAN ST
MCKINNEY TX 75069
If more than one automobile is described on this declarations page, the listing of separate premiums for each vehicle's coverage does not increase the coverage available under this policy. Stacking of coverage is not allowed under this policy. VEHICLES COVERED
# Description VIN Vehicle Total
1. 2014 FORD MUSTANG 1ZVBP8AM5E5295348 $1,038
Total Vehicle Premium $1,038
FEES
Description Fee Total
Total Fees $0.00
TOTAL POLICY PREMIUM $1,038.00
TXDEC2020 Ed 1-02 Page 1 of 2 Generated on 01/18/2022 at 11:57:21 AM Declarations Page: ENDORSEMENT
Policy Number 42AU000973367
LISTED OPERATORS – THIS POLICY DOES NOT PROVIDE COVERAGE FOR INDIVIDUALS LISTED AS EXCLUDED.
# Name Date of Birth Driver's License
Number SR-22
1. ROGER DALE JR. ADAMS 03/02/198*-******** No
VEHICLES
1. 2014 FORD MUSTANG VIN 1ZVBP8AM5E5295348
Coverage Limit Deductible Premium
Bodily Injury $30,000 per person
$60,000 per accident None $320
Property Damage Lesser of $25,000 or
Actual Cash Value per accident None $203
Medical Payments $1,000 per accident None $0
Uninsured Motorist - Bodily Injury $30,000 per person
$60,000 per accident None $0
Uninsured Motorist Property Damage
Lesser of $25,000 or
Actual Cash Value per accident less deductible None $0 Underinsured Motorist - Bodily Injury $30,000 per person
$60,000 per accident None $0
Underinsured Motorist - Property Damage Lesser of $25,000 or Actual Cash Value per accident None $0
Personal Injury Protection $2,500 per accident None $0 Comprehensive Actual Cash Value less deductible $500 $198 Collision Actual Cash Value less deductible $500 $317 Roadside Assistance $100 per occurrence
2 occurrences per term None $0
Rental Reimbursement $20 per day
up to 20 Days None $0
Vehicle 1 Total $1,038
LIENHOLDER/ADDITIONAL INTEREST
Any loss or damage payable under Part D of this policy for any vehicle listed below shall be paid to the named insured and any loss payee or lienholder shown below for such vehicle, as their interest may appear.
# Vehicle Lienholder/Additional Interest Interest
1. 2014 FORD MUSTANG
VIN 1ZVBP8AM5E5295348
GLOBAL LENDING
PO Box 4588
,
Lienholder
YOUR POLICY IS SUBJECT TO THE FOLLOWING FORMS AND ENDORSEMENTS TXPOL2021 Ed 1-00, TXAPP2020 Ed 1-00, TXUMPIP2020 Ed 1-01, TXDEC2020 Ed 1-02 NOTICES
• • Your policy contract, TXPOL2021 Ed 1-00 is available online at www.aains.com/policy-holders/Texas/. For a paper copy of your policy at no charge, please call 1-888-***-****. TXDEC2020 Ed 1-02 Page 2 of 2 Generated on 01/18/2022 at 11:57:21 AM TEXAS LIABILITY INSURANCE CARD
NAIC COMPANY #10730
2211 BUTTERFIELD RD, SUITE 200
DOWNERS GROVE, ILLINOIS 60515
Policy Number: Effective Date: Expiration Date:
42AU000973367 01/18/2022 11:57AM CT 07/07/2022
Year Make/Model VIN
2014 FORD/MUSTANG 1ZVBP8AM5E5295348
AGENCY INSURANCE CO. ISSUING CARD:
A-MAX AUTO INSURANCE - MCKINNEY 972-***-****
Insured: ROGER DALE JR. ADAMS
Driver(s) Covered: ROGER DALE JR. ADAMS
Address City, State, Zip
4937 STUART RD TRLR 158 DENTON, TX 76207-4229
This policy provides at least the minimum amounts of liability insurance required by the state of Texas Motor Vehicle Safety Responsibility Act for the specified vehicles and named insured and may provide coverage for other persons and other vehicles as provided by the insurance policy. IF YOU HAVE AN ACCIDENT NOTIFY POLICE IMMEDIATELY
REPORT ALL ACCIDENTS TO YOUR AGENT OR AMERICAN ACCESS CASUALTY COMPANY AS SOON AS POSSIBLE BY CALLING OUR TOLL-FREE REPORT LINE AT 888-***-****.
OBTAIN THE FOLLOWING INFORMATION:
1. Name, address, and telephone numbers of each driver, passenger, and witness.
2. Name of insurance company and policy number for each vehicle involved.
Do not admit fault. Do not discuss the accident with anyone except your insurance agent, American Access Casualty Company or the police. Examine Policy Exclusions Carefully. This Form Does Not Constitute Any Part of Your Insurance Policy.
See Important Information On Reverse Side
TEXAS LIABILITY INSURANCE CARD
Keep this card
IMPORTANT: This card or a copy of your insurance policy must be shown when you apply for or renew your:
Motor vehicle registration
Driver's License
Motor vehicle safety inspection sticker
You also may be asked to show this card or your policy if you have an accident or if a peace officer asks to see it.
All drivers in Texas must carry liability insurance on their vehicles or otherwise meet legal requirements for financial responsibility. Failure to do so could result in fines up to $1,000, suspension of your driver’s license and motor vehicle registration, and impoundment of your vehicle for up to 180 days (at a cost of $15 per day). Tarjeta de Seguro de Responsabilidad Civil de Texas Guarde esta tarjeta.
IMPORTANTE: Usted debe mostrar esta tarjeta o una copia de su póliza de seguro cuando solicite o renueve su:
Registro del vehículo motorizado
Licencia de conducir
Etiqueta de inspección de seguridad para su vehículo También se puede pedir que usted muestre esta tarjeta o su póliza si tiene un accidente o si se la pide un oficial de policía. Todos los conductores en Texas deben tener un seguro de responsabilidad civil para sus vehículos, o de lo contrario deben cumplir con los requisitos legales de responsabilidad financiera. Si usted no cumple con los requisitos de responsabilidad financiera, podría estar sujeto a pagar una multa de hasta $1,000, más la suspensión de su licencia de conducir y la suspensión del registro del vehículo, y además su vehículo podría ser confiscado por hasta 180 días (a un costo de $15 por día).
TXID2020 Ed 1-00
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