SPITZER INSURANCE AGENCY LLC

8529 N DIXIE DR #100

DAYTON, OH 45414

Auto Insurance Policy Changes

Your Farmers Policy
Policy Number: 19588-96-68
ELIZABETH PLESSINGER Effective: 3/7/2022 12:01 AM
AMANDA NICHOLE HANSON Expiration: 9/7/2022 12:01 AM
180 PAT LN
FAIRBORN OH 45324-4204
Your Farmers Agent
Spitzer Insurance Agency LLC
8529 N Dixie Dr #100
3/8/2022 Dayton, OH 45414
(937) 280-5777
Dear Elizabeth Plessinger and Amanda Nichole Hanson, aspitzer@farmersagent.com

A summary of your premium and policy change information is shown below. To file a claim log on to Farmers.com
or the Farmers® Mobile App or call
Premium at-a-glance 1-800-435-7764
Full-term Premium (excluding fees) $1,011.30
Did you know?
Prorated Premium (3/7/2022 - 9/7/2022) $198.70
Total for this Transaction $198.70 Go Mobile
The Farmers ® Mobile App gives you
This is not a bill. 24/7 account access on the go. Text
Your bill with the amount due will be mailed separately. GETAPP to 29141 to download it
today!
Summary of Changes
Previous Current
2017 Nissan Versa 4D V:520
Coverage:Loss of Use-K5 Not Covered Covered
2012 Honda Odyssey V:622 Covered Not Covered
2011 Ford Tru F150 Cre V:439 Not Covered Covered
Coverage:Loss of Use-K5 Not Covered Covered
2018 Nissan Versa 4D V:001
Coverage:Loss of Use-K5 Not Covered Covered

If you have any questions or would like to learn more about our other insurance products
and services, please contact your agent.

We appreciate your business.

Sincerely,

Farmers Insurance Group®

farmers.com

25-8164 1-14
Ohio Ohio Ohio
Evidence of Insurance Evidence of Insurance Evidence of Insurance
KEEP WITH VEHICLE KEEP WITH VEHICLE KEEP WITH VEHICLE
Named Insured(s): Policy Number: 195889668 Named Insured(s): Policy Number: 195889668 Named Insured(s): Policy Number: 195889668
Elizabeth Plessinger Effective: 3/7/2022 Elizabeth Plessinger Effective: 3/7/2022 Elizabeth Plessinger Effective: 3/7/2022
Amanda Nichole Hanson Expiration: 9/7/2022 Amanda Nichole Hanson Expiration: 9/7/2022 Amanda Nichole Hanson Expiration: 9/7/2022
NAIC Number: 36889 NAIC Number: 36889 NAIC Number: 36889
Your Agent: Underwriting Company : Your Agent: Underwriting Company : Your Agent: Underwriting Company :
Spitzer Insurance Agency LLC Farmers Insurance of Columbus, Inc. Spitzer Insurance Agency LLC Farmers Insurance of Columbus, Inc. Spitzer Insurance Agency LLC Farmers Insurance of Columbus, Inc.
5990 West Creek Rd. 5990 West Creek Rd. 5990 West Creek Rd.
Agent Phone: (937) 280-5777 Agent Phone: (937) 280-5777 Agent Phone: (937) 280-5777
Independence, OH 44131 Independence, OH 44131 Independence, OH 44131
Phone: 1-888-327-6335 Phone: 1-888-327-6335 Phone: 1-888-327-6335

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Vehicles (s): Registered Owner(s): Vehicles (s): Registered Owner(s): Vehicles (s): Registered Owner(s):

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2017 Nissan Versa 4D 1.6 S/1.6 Sv/1.6 Kevin Plessinger 2017 Nissan Versa 4D 1.6 S/1.6 Sv/1.6 Kevin Plessinger 2017 Nissan Versa 4D 1.6 S/1.6 Sv/1.6 Kevin Plessinger
3N1CN7AP5HL883520 3N1CN7AP5HL883520 3N1CN7AP5HL883520
2018 Nissan Versa 4D 1.6 S/1.6 Sv/1.6 Elizabeth Plessinger 2018 Nissan Versa 4D 1.6 S/1.6 Sv/1.6 Elizabeth Plessinger 2018 Nissan Versa 4D 1.6 S/1.6 Sv/1.6 Elizabeth Plessinger
3N1CN7AP5JL885001 3N1CN7AP5JL885001 3N1CN7AP5JL885001
2011 Ford Truck F150 Crew C Pu 4X4 Super Amanda N Hanson 2011 Ford Truck F150 Crew C Pu 4X4 Super Amanda N Hanson 2011 Ford Truck F150 Crew C Pu 4X4 Super Amanda N Hanson
1FTFW1ET3BFC23439 1FTFW1ET3BFC23439 1FTFW1ET3BFC23439

Listed Driver(s): Listed Driver(s): Listed Driver(s):

Christopher Allen Plessinger Christopher Allen Plessinger Christopher Allen Plessinger

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Contact Farmers Claim Department or Roadside Assistance 24 hours a day Contact Farmers Claim Department or Roadside Assistance 24 hours a day Contact Farmers Claim Department or Roadside Assistance 24 hours a day
at (800) 435-7764 at (800) 435-7764 at (800) 435-7764
Para Español, llame al (877) 732-5266 Para Español, llame al (877) 732-5266 Para Español, llame al (877) 732-5266
Report a claim at www.farmers.com, via the Farmers® Mobile Report a claim at www.farmers.com, via the Farmers® Mobile Report a claim at www.farmers.com, via the Farmers® Mobile
App or Contact your Farmers® Agent App or Contact your Farmers® Agent App or Contact your Farmers® Agent
At the scene of an accident: At the scene of an accident: At the scene of an accident:
1. Obtain the following: 1. Obtain the following: 1. Obtain the following:
– Name, address, and phone number of each driver, passenger, – Name, address, and phone number of each driver, passenger, – Name, address, and phone number of each driver, passenger,
and witness. Obtain a driver’s license number for each driver. and witness. Obtain a driver’s license number for each driver. and witness. Obtain a driver’s license number for each driver.
– License plate number, insurance company, and policy – License plate number, insurance company, and policy – License plate number, insurance company, and policy
number of each involved vehicle. number of each involved vehicle. number of each involved vehicle.
– Photos of vehicle damage and accident scene. – Photos of vehicle damage and accident scene. – Photos of vehicle damage and accident scene.
2. Report the accident to the proper authorities. 2. Report the accident to the proper authorities. 2. Report the accident to the proper authorities.
3. Do not admit fault. An investigation may later reveal you were 3. Do not admit fault. An investigation may later reveal you were 3. Do not admit fault. An investigation may later reveal you were
not responsible for the accident. not responsible for the accident. not responsible for the accident.
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KEEP THIS CERTIFICATE IN YOUR VEHICLE AT ALL TIMES. KEEP THIS CERTIFICATE IN YOUR VEHICLE AT ALL TIMES. KEEP THIS CERTIFICATE IN YOUR VEHICLE AT ALL TIMES.
25-5973 1-19 25-5973 1-19 25-5973 1-19
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Auto Insurance Declaration Page

Policy Number: 19588-96-68 Premiums

Effective: 3/7/2022 12:01 AM Full-term Premium (excluding fees) $1,011.30
Expiration: 9/7/2022 12:01 AM
Named Insured(s): Elizabeth Plessinger Prorated Premium (3/7/2022 - 9/7/2022) $198.70
Amanda Nichole Hanson
Total for this Transaction $198.70
180 Pat Ln
Fairborn, OH 45324-4204
This is not a bill.
e-mail liz.plessinger@gmail.com
Your bill with the amount due will be mailed separately.
Address(es):
Underwritten By: Farmers Insurance of Columbus, Inc.
5990 West Creek Rd.
Independence, OH 44131

Household Drivers
All persons who drive or will occasionally be driving any of the cars on the policy should be listed below. If anyone is missing or needs to
be added, such as a newly licensed driver, you should contact your agent or the company to add that person before they begin to drive
any of the cars covered on the policy.
Name Driver Status Name Driver Status
Elizabeth Plessinger Covered Christopher Allen Plessinger Covered
Amanda Nichole Hanson Covered

Vehicle Information
Veh. # Year/Make/Model/VIN Coverage Deductible Limit
1 2017 Nissan Versa 4D 1.6 S/1.6 Sv/1.6 Comprehensive: $1,000
3N1CN7AP5HL883520 Collision: $1,000 .

2 2011 Ford Truck F150 Crew C Pu 4X4 Super Comprehensive: $1,000

1FTFW1ET3BFC23439 Collision: $1,000 .

3 2018 Nissan Versa 4D 1.6 S/1.6 Sv/1.6 Comprehensive: $1,000

3N1CN7AP5JL885001 Collision: $1,000

Vehicle Level Coverage Items

Premiums by Vehicle
Limits
Coverage (applicable to all vehicles) Vehicle 1 Vehicle 2 Vehicle 3
Bodily Injury Liability $25,000 each person $77.80 $77.50 $78.50
$50,000 each accident
Property Damage Liability $25,000 each accident $56.10 $72.40 $56.60
Medical Coverage $5,000 each person $15.30 $8.80 $15.50
Comprehensive $22.30 $25.20 $22.70
Collision $97.10 $68.70 $100.00
Towing and Road Service Not Covered Not Covered Not Covered

farmers.com Policy No. 19588-96-68 Questions? Manage your account:

Call your agent Spitzer Insurance
Agency LLC at (937) 280-5777 or email
aspitzer@farmersagent.com
56-6176 2nd Edition 4-18 3/8/2022
Go to www.farmers.com to access
your account any time!
Page 1 of 3
Declaration Page (continued)

Premiums by Vehicle
Limits
Coverage (applicable to all vehicles) Vehicle 1 Vehicle 2 Vehicle 3
Glass Deductible Buyback $8.50 $8.50 $8.50
Loss of Use K5: $50 per day/ $1,000 $52.60 $52.60 $52.60
max

Policy Level Coverage Items

Limits
Coverage (for all vehicles) Per Policy
Uninsured Motorist $25,000 each person $23.60
$50,000 each accident
Underinsured Motorist $25,000 each person $9.90
$50,000 each accident
Full-term Premium $1,011.30

Discounts
Discount Type Applies to Vehicle(s) Discount Type Applies to Vehicle(s)
Auto/Home 1, 2, 3 Multiple Car 1, 2, 3
Transfer 1, 2, 3 Early Shopping 1, 2, 3
Homeownership 1, 2, 3 EFT 1, 2, 3
Youthful Driver 1, 2, 3 Signal 1, 2, 3
ePolicy 1, 2, 3

Other Policy Features and Benefits

• Accident Forgiveness - prevents one accident from impacting your premium
• Incident Forgiveness - protects your premium from increases due to minor traffic violations
• Guaranteed Renewal - claims activity will not lead to cancellation or nonrenewal

Lienholder and Additional Interest

Vehicle Lienholder Loan Number
2017 Nissan Versa 4D 1.6 S/1.6 Sv/1.6 US Bank Nat Asspc Not Applicable
VIN: 3N1CN7AP5HL883520 PO Box 3490
Oshkosh, WI
54903-3490
2018 Nissan Versa 4D 1.6 S/1.6 Sv/1.6 Wright-Patt Cu Not Applicable
VIN: 3N1CN7AP5JL885001 PO Box 5009
Westfield, IN
46074-5009

farmers.com Policy No. 19588-96-68 Questions? Manage your account:

Call your agent Spitzer Insurance
Agency LLC at (937) 280-5777 or email
aspitzer@farmersagent.com
56-6176 2nd Edition 4-18
Go to www.farmers.com to access
your account any time!
Page 2 of 3
Declaration Page (continued)

Policy and Endorsements

This section lists the policy form number and any applicable endorsements that make up your insurance contract. Any endorsements
that you have purchased to extend coverage on your policy are also listed in the coverages section of this declarations document:
56-5044 2nd ed.; H1171 1st ed.; J6284 1st ed.; J6488 1st ed.; J6489 1st ed.; J6491 1st ed.; J6492 1st ed.; J6674 1st ed.; J6683 1st ed.;
J6712 1st ed.; J6774 1st ed.; J6934 1st ed.; J6972 2nd ed.; J6973 2nd ed.; J6974 2nd ed.; J7200 1st ed.; OH013 1st ed.; OH015A 3rd
ed.; OH024 1st ed.; OH033 1st ed.; 25-2884 ; 25-5928 3-19; J6279 1st ed.

Other Information
• Vehicle 1,2,3 - Deductible reduced to $100 for glass loss.
• Vehicle 1,2,3 - Deductible waived if glass repaired rather than replaced.
• Farmers Friendly Reviews are a great way to make sure you are receiving all the discounts for which you qualify, and identify any
potential gaps in coverage. Contact your agent to learn more about the policy discounts, coverage options, and other product
offerings that may be available to you.

*Information on Additional Fees

The "Fees" stated in the "Premium/Fees" section on the front apply on a per-policy, not an account basis. The following additional fees
also apply:

1. Service Charge per installment (In consideration of our
agreement to allow you to pay in installments):
- For Recurring Electronic Funds Transfer (EFT) and fully
enrolled online billing (paperless): $0.00 (applied per
account)
- For other Recurring EFT plans: $2.00 (applied per account)
- For all other payment plans: $5.00 (applied per account)
If this account is for more than one policy, changes in these fees are
not effective until the revised fee information is provided for each
policy.
2. Late Fee: $10.00 (applied per account)
3. Returned Payment Charge: $25.00 (applied per check,
electronic transaction, or other remittance which is not
honored by your financial institution for any reason including
but not limited to insufficient funds or a closed account)
4. Reinstatement Fee: $25.00 (applied per policy)
One or more of the fees or charges described above may be
deemed a part of premium under applicable state law.

Countersignature

Authorized Representative

farmers.com Policy No. 19588-96-68 Questions? Manage your account:

Call your agent Spitzer Insurance
Agency LLC at (937) 280-5777 or email
aspitzer@farmersagent.com
56-6176 2nd Edition 4-18
Go to www.farmers.com to access
your account any time!
Page 3 of 3
Policy Endorsements 1

Loss of Use Endorsement (J6279 - 1st Edition)

This coverage applies only to the vehicle(s) for which this endorsement is listed on the Declarations page.

For an additional premium, we will pay your extra expense arising from any of the options you have purchased as described in the
schedule below and designated in the Declarations. The chosen option applies when the loss exceeds the deductible amount applicable
under PART IV of your E-Z Reader Car Policy.

Option Schedule
Coverage
Designation Coverage Description
K-1 We will pay you $10 per day while your insured car is in the custody of a garage for repairs resulting from a collision.
The maximum payable is $100. If your insured car is a total loss (regardless of salvage value) we will pay you $100.
K-2 We will pay you $15 per day while your insured car is in the custody of a garage for repairs resulting from a Collision or
Comprehensive loss. The maximum payable is $300. If your insured car is a total loss (regardless of salvage value) we
will pay you $300. This option does not cover total theft of your insured car.
K-3 Car Return Expenses: If Coverage K-1, K-2 or K-4 loss occurs more than 50 miles from your residence, we will pay you
for the reasonable and necessary extra expense for commercial transportation, gasoline, lodging and meals incurred to
return your insured car, after it is repaired, to your residence or destination. The maximum payable for car return
expenses is $200.
K-4 We will pay you $25 per day while your insured car is in the custody of a garage for repairs resulting from a Collision or
Comprehensive loss. If your insured car is a total loss (regardless of salvage value) we will pay you $500.
We will pay you an amount in excess of the amount paid per day under paragraph 1 of Supplementary Payments in Part
IV of this policy, resulting from total theft of your insured car. The maximum we will pay for the combined total of
paragraph 1 of Supplementary Payments and K4 is $25 per day.
The maximum payable under K-4 is $500.
K-5 We will pay you $50 per day while your insured car is in the custody of a garage for repairs resulting from a Collision or
Comprehensive loss. If your insured car is a total loss (regardless of salvage value) we will pay you $1000.
If loss occurs more than 50 miles from your residence we will also pay your car return expenses for the reasonable and
necessary extra expense for commercial transportation, gasoline, lodging and meals incurred to return your insured
car, after it is repaired, to your residence or destination. The maximum payable for car return expenses is $500.
We will pay you an amount in excess of the amount paid per day under paragraph 1 of Supplementary Payments in Part
IV of this policy resulting from the total theft of your insured car. The maximum we will pay for the combined total of
paragraph 1 of Supplementary Payments and K5 is $50 per day.
The maximum payable under K-5 is $1,000.
The insurance afforded by this endorsement does not apply to any collision or comprehensive loss occurring before the effective date
of this endorsement as shown in the Declarations.

This endorsement is also subject to the following provisions:

1. Coverage applies only to your insured car other than a private passenger car, utility car, or utility trailer not owned by you or
a family member while being temporarily used as a substitute vehicle.
2. If you are paid under this endorsement, we shall have your rights to seek recovery. You shall do whatever is necessary to secure
such rights. You shall do nothing to prejudice these rights.

farmers.com Policy No. 19588-96-68 (Continued Next Page)

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Policy Endorsements (continued) 2

3. The premium charged for this insurance is fully earned unless the entire policy is cancelled. (Not applicable in Michigan).

93-6279 1st Edition 2-07 This endorsement is part of your policy. It supersedes and controls anything to the contrary.
It is otherwise subject to all other terms of the policy.

farmers.com Policy No. 19588-96-68

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