Form_SCTNID_CTGRY.FL********_DECPAGE

********* E IC94549 INS DECPAGE E POLWHITEFONT DVWCAAHPMF4EEFGYG37Q4IN74E0001 RPUID TRACWHITEFONT BDF_AA Policy Number: 969250106

Underwritten by:

Progressive Select Insurance Co

October 21, 2023

Policy Period: Apr 29, 2023 - Oct 29, 2023

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Make payments, check billing activity, update

Online Service

progressive.com

policy information or check status of a claim.

For customer service and claims service,

24 hours a day, 7 days a week.

1-800-***-****

PROGRESSIVE

P.O. BOX 31260

TAMPA, FL 33631

IAN SHIPMAN

1350 N DIXIE HWY APT 63

BOCA RATON, FL 33432

Auto Insurance

Coverage Summary

This is your Declarations Page

Your policy information has changed

Your coverage began on April 29, 2023 at the later of 12:01 a.m. or the effective time shown on your application. This policy period ends on October 29, 2023 at 12:01 a.m.

This coverage summary replaces your prior one. Your insurance policy and any policy endorsements contain a full explanation of your coverage. The policy contract is form 9611D FL (07/17) . The contract is modified by forms A264 (10/18), A261 FL (08/21) and A340

(01/22).

Policy changes effective October 20, 2023

Premium change: $9.45

Changes: A Snapshot Participation discount has been removed from the 2020 MITSUBISHI OUTLANDER.

Drivers and household residents

Ian Shipman

Additional information: Named insured

Form 6489 FL (05/21) 4

Continued

969250106 E IC94549 INS DECPAGE E POLWHITEFONT DVWCAAHPMF4EEFGYG37Q4IN74E0001 RPUID TRACWHITEFONT BDF_AA Policy Number: 969250106

Ian Shipman

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Outline of coverage

2020 MITSUBISHI OUTLANDER 4 DOOR WAGON

VIN: JA4AD3A37LZ028553

Garaging ZIP Code: 33432

Primary use of the vehicle: Pleasure/Personal

Annual miles: 12,000 - 13,999

Length of vehicle ownership when policy started or vehicle added: Less than 1 month Information regarding your vehicle history (prior damage or title issues) has impacted how we determine your premium.

Limits Deductible Premium . Liability To Others

Bodily Injury Liability $10,000 each person/$20,000 each accident $283

Property Damage Liability $10,000 each accident 595 . Personal Injury Protection/Deductible applies to $10,000 $1,000/person 403 Named Insured/Spouse/Dependent Resident Relatives Work Loss Excluded

Uninsured Motorist Rejected -- . Comprehensive Actual Cash Value $1,000 142 . Collision Actual Cash Value $1,000 518

Total 6 month policy premium $1,941.00

Premium discounts

Policy

969250106 Five-Year Accident Free, Online Signature - First Policy Period Only, Electronic Funds Transfer (EFT), Online Quote, Continuous Insurance: Gold, Paperless and Three-Year Safe Driving

Vehicle

2020 MITSUBISHI

OUTLANDER

Anti-Lock Brakes, Driver and Passenger-side Airbag, Passive Anti-theft Device and Smart Technology Discount

Smart Technology Discount is a service mark of Progressive Casualty Ins. Co. Lienholder information

Vehicle Lienholder

2020 MITSUBISHI OUTLANDER

JA4AD3A37LZ028553

GLOBAL LENDING SVCS

CARMEL, IN 46082

Policyholder inquiries

You may call Customer Service at 1-800-***-**** to present inquiries or obtain information about coverage, and to obtain assistance with any complaints.

Agent signature

Company officers

Secretary

Form 6489 FL (05/21)

Contact this candidate