Form_SCTNID_CTGRY.

MN07226489_DECPAGE

949146270 E IC64918 INS DECPAGE E POLWHITEFONT MGE6JJFD7F32U6SBLPY5CYTMMA0001 RPUID TRACWHITEFONT BDF_AA

PROGRESSIVE
P.O. BOX 31260
TAMPA, FL 33631

Policy Number: 949146270

Underwritten by:
Progressive Direct Insurance Co
October 16, 2023
BEATRIZ COLON
Policy Period: May 18, 2023 - Nov 18, 2023
404 TURRIL ST
LE SUEUR, MN 56058 Page 1 of 2

progressive.com
Online Service
Make payments, check billing activity, update
policy information or check status of a claim.

Auto Insurance 1-800-776-4737

Coverage Summary
For customer service and claims service,
24 hours a day, 7 days a week.

This is your Declarations Page

Your coverage has changed
Your coverage began on May 18, 2023 at 12:01 a.m. This policy expires on November 18, 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 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. The policy contract is form 9611D MN (02/16). The contract is modified by
forms A227 MN (05/22) and A331 (11/21).

Policy changes effective September 5, 2023

………………………………………………………………………………………………………………………………………………………..
Changes requested on: Oct 16, 2023
………………………………………………………………………………………………………………………………………………………..
Requested by: Policy Verification
………………………………………………………………………………………………………………………………………………………..
Premium change: -$145.92
………………………………………………………………………………………………………………………………………………………..
Changes: NAYLA DEL CARMEN BOLANO AREVALO has been removed from the policy.

Drivers and household residents

Beatriz Colon
Additional information: Named insured
Ernesto Colon

Form 6489 MN (07/22)

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949146270 E IC64918 INS DECPAGE E POLWHITEFONT MGE6JJFD7F32U6SBLPY5CYTMMA0001 RPUID TRACWHITEFONT BDF_AA

Policy Number: 949146270

Beatriz Colon
Page 2 of 2

Outline of coverage
2012 DODGE JOURNEY 4 DOOR WAGON
VIN: 3C4PDDBG0CT213736
Garaging ZIP Code: 56058
Primary use of the vehicle: Pleasure/Personal
Annual miles: 0 - 3,999
Length of vehicle ownership when policy started or vehicle added: Less than 1 month
Information regarding your vehicle history (prior damage, theft or title issues) has impacted how we determine your premium.
This vehicle is currently enrolled in the Snapshot® Program.
Limits Deductible Premium
………………………………………………………………………………………………………………………………………………………..
Liability To Others $179
Bodily Injury Liability $30,000 each person/$60,000 each accident
Property Damage Liability $10,000 each accident
………………………………………………………………………………………………………………………………………………………..
Personal Injury Protection - Nonstacked $20,000 Medical Expense $100 125
$20,000 Economic Loss $200
………………………………………………………………………………………………………………………………………………………..
Uninsured/Underinsured Motorist $25,000 each person/$50,000 each accident
………………………………………………………………………………………………………………………………………………………..
19
Roadside Assistance 21
………………………………………………………………………………………………………………………………………………………..
Total premium for 2012 DODGE $344
2014 FORD FOCUS 4 DOOR SEDAN
VIN: 1FADP3F29EL218991
Garaging ZIP Code: 56058
Primary use of the vehicle: Pleasure/Personal
Annual miles: 0 - 3,999
Length of vehicle ownership when policy started or vehicle added: Less than 1 month
Limits Deductible Premium
………………………………………………………………………………………………………………………………………………………..
Liability To Others $166
Bodily Injury Liability $30,000 each person/$60,000 each accident
Property Damage Liability $10,000 each accident
………………………………………………………………………………………………………………………………………………………..
Personal Injury Protection - Nonstacked $20,000 Medical Expense $100 110
$20,000 Economic Loss $200
………………………………………………………………………………………………………………………………………………………..
Uninsured/Underinsured Motorist $25,000 each person/$50,000 each accident 18
………………………………………………………………………………………………………………………………………………………..
Roadside Assistance 17
………………………………………………………………………………………………………………………………………………………..
Total premium for 2014 FORD $311
………………………………………………………………………………………………………………………………………………………..
Total 6 month policy premium $655.00

Premium discounts
Policy
………………………………………………………………………………………………………………………………………………………..
949146270 Five-Year Accident Free, Online Quote, Multi-Car, Continuous Insurance:
Platinum, Paperless and Three-Year Safe Driving
Vehicle
………………………………………………………………………………………………………………………………………………………..
2012 DODGE Snapshot Driving
JOURNEY

Company officers

President Secretary

Form 6489 MN (07/22)