Be Part A Home
Resume:
Form_SCTNID_CTGRY.MN****CHECKLISTEFF_COVERLTR
***390319 $ 011HN INS CHECKLST POLWHITEFONT YSMSBD5CFRRQUJGIL2FX62CGUC0001 RPUID TRACWHITEFONT Policy Number: 945390319
Policyholder:
HENRIETTA CARTER
Policy Period: Jan 7, 2021 - Jul 7, 2021
Contact your agent for personalized service.
KEVIN COX AGENCY LLC
This information will complete
your purchase of insurance.
Please review the items listed below and fax or mail everything that is requested to Progressive as soon as possible. Your insurance premium is based on the information you provided on the application. If we do not receive the items requested, your insurance premium may change.
Please Note: review carefully as additional items may display on the back of this form. If no items are displayed, then no additional documentation is required at this time.
Provide a copy of
Residency proof indicating that you are the named insured under a home owner, condominium, renter or mobile home owner policy covering your principal residence. Proof can be a declarations page, renewal offer or installment bill. Please make sure you or your spouse, if applicable, are listed on the proof documents.
Proof of when you took ownership of the vehicle(s) listed below. Proof should include the date of first ownership, vehicle identification number (VIN) and the owner's name (e.g. a vehicle registration when the vehicle was first acquired, bill of sale, lease agreement, finance document, declarations page (coverage summary) from a previous carrier showing the date it was first insured).
Vehicle VIN
2007 INFINITI G35 JNKBV61F77M813336
2005 CADILLAC CTS 1G6DP567X50189510
Form CHECKLISTEFF MN (03/02)
Form_SCTNID_CTGRY.MN05197982_APPLICAT
945390319 $ 011HN INS APPLICAT POLWHITEFONT YSMSBD5CFRRQUJGIL2FX62CGUC0002 RPUID TRACWHITEFONT Policy Number: 945390319
Policyholder:
HENRIETTA CARTER
January 7, 2021
Page 1 of 5
Application for Insurance
Please review, sign where
indicated and return
Policy and premium information for policy number 945390319
Insurance company: Progressive Preferred Insurance Co PO Box 6807
Cleveland, OH 44101
Agent: KEVIN P COX
KEVIN COX AGENCY LLC
277 Coon Rapids Blvd, #410
Coon Rapids, MN 55433
011HN
Named insured:
Home:
Work:
e-mail address:
HENRIETTA CARTER
2214 135TH LN NW
ANDOVER, MN 55304
********@*****.***
Financial responsibility vendor: EXPERIAN
Policy period: Jan 7, 2021 - Jul 7, 2021
Effective date and time: Jan 7, 2021 at 03:09PM ET Total policy premium: $925.00
Initial payment required: $185.00
Initial payment received: $185.00
Payment plan: 6 payments
Drivers and resident relatives
The applicant, spouse and all resident relatives 15 years of age or older, all regular drivers of the vehicles described in this application, and all children who live away from home who drive these vehicles, even occasionally, are listed below. Your total policy premium can be affected by all persons of driving age. While designating drivers as List Only or Excluded may increase policy premium, the violation and accident history of Excluded and List Only drivers does not affect premium. Name Date of birth Sex Marital status Relationship
Driver status:
HENRIETTA CARTER Oct 29, 1967 Female Married Insured Rated
Education level: College degree
Occupation: Administrative Assistant
Driver status:
DICKSON MOLULON Jul 23, 1960 Male Married Spouse
Rated
Education level: College degree
Occupation: Manager - Other than Executive/GM
Total residents:
The total number of residents currently residing in your household, including listed drivers, young children, roommates or anyone else living in the home for 60 days or more during the next 12 months. 2
4
Continued
945390319 $ 011HN INS APPLICAT POLWHITEFONT YSMSBD5CFRRQUJGIL2FX62CGUC0002 RPUID TRACWHITEFONT Policy Number: 945390319
HENRIETTA CARTER
Page 2 of 5
Outline of coverage
Your insurance policy and any policy endorsements contain a full explanation of your coverage. The policy limits shown for a vehicle may not be combined with the limits for the same coverage on another vehicle, unless the policy contract or endorsements indicate otherwise.
2007 INFINITI G35 4 DOOR SEDAN
VIN: JNKBV61F77M813336
Garaging ZIP Code: 55304
Primary use of the vehicle: Commute
Length of vehicle ownership when policy started or vehicle added: At least 1 year but less than 3 years Information regarding your vehicle history (prior damage, theft or title issues) has impacted how we determine your premium.
Limits Deductible Premium . Liability To Others $249
Bodily Injury Liability $100,000 each person/$300,000 each accident
Property Damage Liability $100,000 each accident . Personal Injury Protection - Nonstacked $20,000 Medical Expense $0 179
$20,000 Economic Loss
Uninsured/Underinsured Motorist $100,000 each person/$300,000 each accident 52
Total premium for 2007 INFINITI $480
2005 CADILLAC CTS 4 DOOR SEDAN
VIN: 1G6DP567X50189510
Garaging ZIP Code: 55304
Primary use of the vehicle: Commute
Length of vehicle ownership when policy started or vehicle added: At least 3 years but less than 5 years Information regarding your vehicle history (prior damage, theft or title issues) has impacted how we determine your premium.
Limits Deductible Premium . Liability To Others $237
Bodily Injury Liability $100,000 each person/$300,000 each accident
Property Damage Liability $100,000 each accident . Personal Injury Protection - Nonstacked $20,000 Medical Expense $0 158
$20,000 Economic Loss
Uninsured/Underinsured Motorist $100,000 each person/$300,000 each accident 50
Total premium for 2005 CADILLAC $445
Total 6 month policy premium $925.00
Premium discounts
Policy
945390319 Paperless, Residence Insurance, Multi-Car and Electronic Funds Transfer (EFT) 4
Continued
945390319 $ 011HN INS APPLICAT POLWHITEFONT YSMSBD5CFRRQUJGIL2FX62CGUC0002 RPUID TRACWHITEFONT Policy Number: 945390319
HENRIETTA CARTER
Page 3 of 5
Driving history
• Your application (APP)
•
• Motor Vehicle Reports and/or court data (MVR) - provided by
• Progressive claims history (PROG) Comprehensive Loss Underwriting Exchange (CLUE) - provided by a consumer reporting agency
a consumer reporting agency
Please review the following information carefully because driving history is used to determine your premium. All accidents are considered at-fault and over any applicable payment threshold unless we receive additional information from you or another source that proves otherwise. We obtain driving and claims history from one or more of the following sources: Driver and Description Date Source/Consumer reporting agency
HENRIETTA CARTER
not at fault accident Jul 30, 2020 CLUE/LexisNexis
DICKSON MOLULON
not at fault accident Jan 24, 2020 CLUE/LexisNexis
Underwriting information
Prior insurance: No
4
Continued
945390319 $ 011HN INS APPLICAT POLWHITEFONT YSMSBD5CFRRQUJGIL2FX62CGUC0002 RPUID TRACWHITEFONT Policy Number: 945390319
HENRIETTA CARTER
Page 4 of 5
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Application agreement
Verification of content
I declare that the statements contained herein are true to the best of my knowledge and belief and do agree to pay any surcharges applicable under the Company rules which are necessitated by inaccurate statements. I declare that no persons other than those listed in this application regularly operate the vehicle(s) described in this application. I declare that none of the vehicles listed in this application will be used to carry persons or property for compensation or a fee, or for retail or wholesale delivery, including, but not limited to, the pickup, transport, or delivery of magazines, newspapers, mail, or food, except for rideshare use of any such vehicle for which Progressive Rideshare Insurance has been purchased. I understand that this policy may be cancelled if this application contains any false information or if any information that would alter the Company’s exposure is omitted or misrepresented. Notice of information practices
I understand that to calculate an accurate price for my insurance, the Company may obtain information from third parties, such as consumer reporting agencies that provide driving, claims and credit histories. The Company may use a credit-based insurance score based on the information contained in the credit history. The Company or its affiliates may obtain new or updated information to calculate my renewal premium or service my insurance. I may access information about me and correct it if inaccurate. In some cases, the law permits the Company to disclose the information it collects without authorization. However, the Company will not share personal information with nonaffiliated companies for their marketing purposes without consent. Complete details are in the Company’s Privacy Policy, which will be provided with this insurance policy and upon request.
Acknowledgement and agreement
• If I make my initial payment by electronic funds transfer, check, draft, or other remittance, the coverage afforded under this policy is conditioned on payment to the Company by the financial institution. If the transfer, check, draft, or other remittance is not honored by the financial institution, the Company shall be deemed not to have accepted the payment and this policy shall be void.
• If I make my initial payment by credit card, the coverage afforded under this policy is conditioned on payment to the Company by the card issuer. I understand that if the Company is unable to collect my initial payment from the card issuer, the Company shall be deemed not to have accepted the payment and this policy shall be void. I also understand that if I authorize a credit card transaction for any payment other than the initial payment, this policy will be subject to cancellation for nonpayment of premium if the Company is unable to collect payment from the card issuer. The Company is deemed "unable to collect" in the following instances: (1) when I reach my credit limit on my credit card and the card issuer refuses the charge; (2) when the card issuer cancels or revokes my credit card; or (3) when the card issuer does not pay the Company, for any reason whatsoever, upon the Company's request.
• This insurance and personalized service is available at this price exclusively through this Progressive independent agent. Other Progressive independent agents and affiliated companies selling insurance directly may have different prices or products. The Snapshot Program is not available from all agents.
• The Company may obtain information, including vehicle history information, from third parties. I understand that this information may affect my policy premium or could result in a policy declination, cancellation, or nonrenewal. Other charges
I agree to pay the installment fees shown on my billing statement that become due during the policy term and each renewal policy term in accordance with the payment plan I have selected. I understand that the amount of these fees may change upon policy renewal or if I change my payment plan. Any change in the amount of installment fees will be reflected on my payment schedule.
I understand that a returned payment fee of $20.00 will be assessed to the balance due on my policy if any check offered in payment is not honored by my bank or other financial institution. Imposition of such charge shall not deem the Company to have accepted the check unconditionally. I agree to pay a late fee of $10.00 when the payment for the minimum amount due is not received or postmarked by the premium due date. The amount of this fee may change upon policy renewal. 4
Continued
945390319 $ 011HN INS APPLICAT POLWHITEFONT YSMSBD5CFRRQUJGIL2FX62CGUC0002 RPUID TRACWHITEFONT Policy Number: 945390319
HENRIETTA CARTER
Page 5 of 5
This application becomes part of my insurance policy. I understand that I may be eligible to receive the following premium reductions: (a) a discount on Comprehensive coverage if any of my vehicles have been equipped with certain anti-theft devices, (b) a discount on PIP coverage if I am age 65 or older, and choose to waive work loss benefits, or am at least 60 years old and retired and receiving a pension and choose to waive work loss benefits, and (c) a discount if anyone in the household is at least 55 years old and has successfully completed an approved accident prevention course. I understand that I may purchase Full Comprehensive Window Glass Coverage which will pay to replace damaged window glass, without a deductible, for a vehicle for which I have purchased the coverage. I UNDERSTAND THE INSURER MAY ELECT TO CANCEL COVERAGE AT ANY TIME DURING THE FIRST 59 DAYS FOLLOWING ISSUANCE OF THE COVERAGE FOR ANY REASON WHICH IS NOT SPECIFICALLY PROHIBITED BY STATUTE.
Signature of named insured Date
X Form 7982 MN (05/19)
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Electronically Signed 2021-01-26 15:21:57 UTC - 73.94.13.156 AssureSign® fc40f806-0d0e-4647-a197-acbb010f53ca 1/26/2021 Form_SCTNID_CTGRY.MN07123057_SIGNFORM
945390319 $ 011HN INS PIPCOV POLWHITEFONT YSMSBD5CFRRQUJGIL2FX62CGUC0003 RPUID TRACWHITEFONT Policy Number: 945390319
HENRIETTA CARTER
Page 1 of 1
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Personal Injury Protection Coverage
I understand that if I insure two or more vehicles (covered under the same policy or covered by more than one company under more than one policy), I may elect to have the limit of liability for Basic Economic Loss Benefits under Personal Injury Protection Coverage for those vehicles added together to determine the total limit of liability available to you or a family member for any one accident. If electing the Stacked Personal Injury Protection Option, I will be responsible for the payment of additional premium.
(If electing the Stacked Personal Injury Protection Coverage, you must check the first choice listed below.)
I elect the Stacked Personal Injury Protection Option. I do not elect the Stacked Personal Injury Protection Option.
Signature of named insured Date
X Form 3057 MN (07/12)
Electronically Signed 2021-01-26 15:24:06 UTC - 73.94.13.156 AssureSign® e47277e5-d08f-403a-b730-acbb010f53d9
Electronically Signed 2021-01-26 15:24:14 UTC - 73.94.13.156 AssureSign® 23f2f7a4-63f7-4673-b3c9-acbb010f53e4 1/26/202*-********* $ 011HN INS NOTICE POLWHITEFONT YSMSBD5CFRRQUJGIL2FX62CGUC0004 RPUID Policy Number: 945390319
HENRIETTA CARTER
Page 1 of 1
Form_SCTNID_CTGRY.XX0405Z181_NOTICE
Agent compensation disclosure
The insurance producer who sold you this policy is a licensed independent insurance agent authorized by Progressive Preferred Insurance Co and other insurance companies to solicit business on their behalf. Progressive Preferred Insurance Co believes that independent agents who represent more than one company can better assist you in finding the combination of coverage, price and service that meets your needs. Progressive Preferred Insurance Co will pay your agent a commission for placing your policy with us. We may also help your agent pay for advertising and marketing that is designed to attract new customers. Form Z181 (04/05)
Form_SCTNID_CTGRY.MN02077845_NOTICE
945390319 $ 011HN INS NOTICE POLWHITEFONT YSMSBD5CFRRQUJGIL2FX62CGUC0005 RPUID TRACWHITEFONT Policy Number: 945390319
HENRIETTA CARTER
Page 1 of 1
Notice of Right to Disability and Income Loss Benefits Minnesota law requires us to provide you with disability and income loss benefits under Part II of your policy. If you are age 65 or older, or are at least 60 years old and retired and receiving a pension, you may elect not to have this coverage. If you elect not to have this coverage, you will receive a premium discount and your election will remain in effect until revoked by you.
Please contact your agent if you want to waive your Income Loss Benefits coverage. Form 7845 MN (02/07)
Form_SCTNID_CTGRY.XX08929208_NOTICE
945390319 $ 011HN INS NOTICE POLWHITEFONT YSMSBD5CFRRQUJGIL2FX62CGUC0005 RPUID TRACWHITEFONT Policy Number: 945390319
HENRIETTA CARTER
Page 1 of 1
NOTICE CONCERNING POLICYHOLDER RIGHTS IN AN INSOLVENCY UNDER THE MINNESOTA INSURANCE GUARANTY ASSOCIATION LAW The financial strength of your insurer is one of the most important things for you to consider when determining from whom to purchase a property or liability insurance policy. It is your best assurance that you will receive the protection for which you purchased the policy. If your insurer becomes insolvent, you may have protection from the Minnesota Insurance Guaranty Association as described below but to the extent that your policy is not protected by the Minnesota Insurance Guaranty Association or if it exceeds the guaranty association's limits, you will only have the assets, if any, of the insolvent insurer to satisfy your claim.
Residents of Minnesota who purchase property and casualty or liability insurance from insurance companies licensed to do business in Minnesota are protected, SUBJECT TO LIMITS AND EXCLUSIONS, in the event the insurer becomes insolvent. This protection is provided by the Minnesota Insurance Guaranty Association. Minnesota Insurance Guaranty Association
7600 Parklawn Ave. STE 460
Edina, Minnesota 55435
The maximum amount that the Minnesota Insurance Guaranty Association will pay in regard to a claim under all policies issued by the same insurer is limited to $300,000. This limit does not apply to workers' compensation insurance. Protection by the guaranty association is subject to other substantial limitations and exclusions. If your claim exceeds the guaranty association's limits, you may still recover a part or all of that amount from the proceeds from the liquidation of the insolvent insurer, if any exist. Funds to pay claims may not be immediately available. The guaranty association assesses insurers licensed to sell property and casualty or liability insurance in Minnesota after the insolvency occurs. Claims are paid from the assessment.
THE PROTECTION PROVIDED BY THE GUARANTY ASSOCIATION IS NOT A SUBSTITUTE FOR USING CARE IN SELECTING INSURANCE COMPANIES THAT ARE WELL MANAGED AND FINANCIALLY STABLE. IN SELECTING AN INSURANCE COMPANY OR POLICY, YOU SHOULD NOT RELY ON PROTECTION BY THE GUARANTY ASSOCIATION. THIS NOTICE IS REQUIRED BY MINNESOTA STATE LAW TO ADVISE POLICYHOLDERS OF PROPERTY AND CASUALTY INSURANCE POLICIES OF THEIR RIGHTS IN THE EVENT THEIR INSURANCE CARRIER BECOMES INSOLVENT. THIS NOTICE IN NO WAY IMPLIES THAT THE COMPANY CURRENTLY HAS ANY TYPE OF FINANCIAL PROBLEMS. ALL PROPERTY AND CASUALTY INSURANCE COMPANIES ARE REQUIRED TO PROVIDE THIS NOTICE. Form 9208 (08/92)
Form_SCTNID_CTGRY.XX06166252_SIGNFORM
945390319 $ 011HN INS EFT POLWHITEFONT YSMSBD5CFRRQUJGIL2FX62CGUC0006 RPUID TRACWHITEFONT Policy Number: 945390319
HENRIETTA CARTER
Page 1 of 1
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Electronic Funds Transfer Authorization
I authorize Progressive Preferred Insurance Co and its corporate and mutual company affiliates ("Progressive") to initiate an electronic transfer of funds for scheduled deductions from the bank account ("Account") listed below for payment on the policy and any renewals of the policy. In addition, I authorize the financial institution identified by the routing number below to accept and post entries to this Account. I understand that this includes my permission to credit this Account if there is an incorrect deduction or to provide a refund if necessary. I also understand that I can only do this because I am the owner and/or authorized signer on the Account. I recognize that this authorization allows Progressive to adjust my scheduled deductions to reflect any premium changes. Progressive agrees to notify me at least ten days prior to making any deduction that will be greater than the previous deduction or less than the previous deduction by more than $1,000. I understand that Progressive will not send me a bill before scheduled deductions are made and that it is my responsibility to make sure that there are sufficient funds in this Account at the time of each deduction. I also understand that the policy may cancel or expire if there are insufficient funds in the Account. Lastly, I acknowledge that the origination of the Automated Clearing House transaction to this Account must comply with the provisions of U.S. law.
Bank Information
Name on the Account:
Routing Number:
Account Number:
Dickson Molulon
2212
3201
This authorization will remain in effect until you notify Progressive that you wish to end it -- either in writing, by accessing your policy online, or by calling a customer service representative -- and allow us a reasonable amount of time to act on it. Signature Date
X
(of the person authorized to sign on the Account)
IMPORTANT NOTICE FOR CREDIT UNION MEMBERS: Many smaller credit unions use a different Account number than the one shown on your check. You may wish to verify your Account number through your local office to make sure you have the correct setup for withdrawals.
Form 6252 (06/16)
Electronically Signed 2021-01-26 15:25:15 UTC - 73.94.13.156 AssureSign® 623d52bb-6b5d-4711-839f-acbb010f53ef 1/26/2021 Form_SCTNID_CTGRY.XX0616Z159_PYMTSCDL
945390319 $ 011HN INS PYMTSCDL POLWHITEFONT YSMSBD5CFRRQUJGIL2FX62CGUC0007 RPUID TRACWHITEFONT Policy Number: 945390319
Policyholder:
HENRIETTA CARTER
Policy period: Jan 7, 2021 - Jul 7, 2021
Page 1 of 1
Automatic Payments Schedule
Date of Amount Date of Amount
automatic payment automatic payment automatic payment Date of Amount
Feb 7, 2021 152.00
Mar 7, 2021 152.00
Apr 7, 2021 152.00
May 7, 2021 152.00
Jun 7, 2021 152.00
An installment fee of $4.00 has been included in each payment. You may avoid paying installment fees by paying your policy premium in full.
Form Z159 (06/16)
Form_SCTNID_CTGRY.XX0110Z330_NOTICE
945390319 $ 011HN INS NOTICE2 POLWHITEFONT YSMSBD5CFRRQUJGIL2FX62CGUC0008 RPUID TRACWHITEFONT Policy Number: 945390319
Policyholder:
HENRIETTA CARTER
As a Progressive customer, you'll get great service around the clock.
Thank you for your business! As your agent, I'm pleased to give you the convenience of a Progressive policy. Whether it's 9 a.m. or midnight, a weekend or holiday - you'll always have options to service your policy. Here's how: Call us first
We offer personalized service and counsel that's tailored to your needs. Whether you need advice on coverage changes, need to add or change vehicles or drivers, get proof of insurance, discuss other insurance needs or even make a payment, call us first.
Kevin Cox Agency
Agent, KEVIN P COX
277 Coon Rapids Blvd, #410
Coon Rapids, MN 55433
Phone: 1-612-***-****
Our office hours*:
Monday 9:00 a.m. to 5:00 p.m.
Tuesday 9:00 a.m. to 5:00 p.m.
Wednesday 9:00 a.m. to 5:00 p.m.
Thursday 9:00 a.m. to 5:00 p.m.
Friday 9:00 a.m. to 5:00 p.m.
*Hours may vary.
Access your policy online, anytime
Don't forget that you can always log in to your policy online to make changes, pay your bill, check the status of a claim, or access policy documents anytime. Just visit us at progressiveagent.com. Paperless Enrollment
Thank you for choosing Paperless. To keep your Paperless Discount and start receiving your policy documents and other messages by e-mail, please remember to complete your enrollment at progressiveagent.com. It's fast and secure. Customer Service
You can call Progressive's toll-free, Customer Service number, 1-800-***-****, to make or confirm payments over the phone, order ID cards and Declarations pages, and more. Superior Claims Service
With a Progressive policy, you have the option of using a repair facility in Progressive's network of repair shops if you're ever in an accident. To report a claim, call 1-800-***-**** and press menu option one and a claims rep will discuss this option with you. All you have to do is schedule an appointment to drop your vehicle off at the network repair shop and we'll handle the rest. We keep you informed about your claim and the status of your repairs. And, repairs are backed by our Limited Lifetime Guarantee for as long as you own or lease your vehicle. Form Z330 (01/10)
Form_SCTNID_CTGRY.XX0616RECEIPT_RECEIPT
945390319 $ 011HN INS RECEIPT POLWHITEFONT KEVIN YSMSBD5CFRRQUJGIL2FX62CGUC0009 P COX RPUID TRACWHITEFONT KEVIN COX AGENCY LLC
277 Coon Rapids Blvd, #410
Coon Rapids, MN 55433
HENRIETTA CARTER
2214 135TH LN NW
ANDOVER, MN 55304
Policy Number: 945390319
Underwritten by:
Progressive Preferred Insurance Co
January 7, 2021
Policy Period: Jan 7, 2021 - Jul 7, 2021
Customer Service
Online Service
progressiveagent.com
Payment Receipt
for your auto insurance payment
Payment information
Receipt for your initial payment
Amount:
Payment method:
$185.00
Insured Checking Acct (EFT)
Merchant ID: Progressive Preferred Insurance Co
Form RECEIPT (06/16)
Form_SCTNID_CTGRY.XX0311A022_IDCARD
945390319 $ 011HN INS IDCARD POLWHITEFONT YSMSBD5CFRRQUJGIL2FX62CGUC0010 RPUID TRACWHITEFONT KEEP THIS CARD IN YOUR VEHICLE WHILE IN OPERATION. Keep these cards handy--in your glove compartment or wallet. And contact us anytime you have a question or need to report a claim. If you have a claim, we'll get you back on the road as soon as possible. And while you'll always have a choice where to repair your vehicle, when you use a shop in our preapproved network, we'll guarantee your repair for as long as you own or lease your vehicle. Thank you for choosing Progressive.
HENRIETTA CARTER
DICKSON MOLULON
Form A022 (03/11)
IF YOU'RE IN AN ACCIDENT
1. Remain at the scene. Don't admit fault.
2. Find a safe location, call the police, and exchange driver information. TO REPORT A CLAIM
Call 1-800-***-**** or go to claims.progressive.com. 3. Call Progressive right away.
Policy Number:
Effective Date:
Named Insured(s):
Expiration Date:
Insurer:
INSURANCE IDENTIFICATION CARD - Minnesota
945390319 NAIC Number: 37834
01/07/2021 07/07/2021
Progressive Preferred Insurance Co 1-800-***-****
PO Box 6807 Cleveland, OH 44101
HENRIETTA CARTER
DICKSON MOLULON
Your Agent:
KEVIN COX AGENCY LLC 1-612-***-****
277 Coon Rapids Blvd, #410
Coon Rapids, MN 55433
Year Make Model VIN
2007 INFINITI G35 JNKBV61F77M813336
2005 CADILLAC CTS 1G6DP567X50189510
Manage your policy anytime
with just a few clicks at
progressiveagent.com
Form_SCTNID_CTGRY.XX0311A022_IDCARD
945390319 $ 011HN INS IDCARD POLWHITEFONT YSMSBD5CFRRQUJGIL2FX62CGUC0010 RPUID TRACWHITEFONT KEEP THIS CARD IN YOUR VEHICLE WHILE IN OPERATION. Keep these cards handy--in your glove compartment or wallet. And contact us anytime you have a question or need to report a claim. If you have a claim, we'll get you back on the road as soon as possible. And while you'll always have a choice where to repair your vehicle, when you use a shop in our preapproved network, we'll guarantee your repair for as long as you own or lease your vehicle. Thank you for choosing Progressive.
HENRIETTA CARTER
DICKSON MOLULON
Form A022 (03/11)
IF YOU'RE IN AN ACCIDENT
1. Remain at the scene. Don't admit fault.
2. Find a safe location, call the police, and exchange driver information. TO REPORT A CLAIM
Call 1-800-***-**** or go to claims.progressive.com. 3. Call Progressive right away.
Policy Number:
Effective Date:
Named Insured(s):
Expiration Date:
Insurer:
INSURANCE IDENTIFICATION CARD - Minnesota
945390319 NAIC Number: 37834
01/07/2021 07/07/2021
Progressive Preferred Insurance Co 1-800-***-****
PO Box 6807 Cleveland, OH 44101
HENRIETTA CARTER
DICKSON MOLULON
Your Agent:
KEVIN COX AGENCY LLC 1-612-***-****
277 Coon Rapids Blvd, #410
Coon Rapids, MN 55433
Year Make Model VIN
2007 INFINITI G35 JNKBV61F77M813336
2005 CADILLAC CTS 1G6DP567X50189510
Manage your policy anytime
with just a few clicks at
progressiveagent.com
Contact this candidate