Form_SCTNID_CTGRY.

CA01186489_DECPAGE

934142428 N TF58795 INS DECPAGE E POLWHITEFONT UC6XNJQQEPZZUGOD6QEFD5XXNE0002 RPUID TRACWHITEFONT

PROGRESSIVE
P.O. BOX 31260
TAMPA, FL 33631

Policy Number: 934142428

Underwritten by:
Progressive Select Ins Co
KRISANDRA B STEWART November 8, 2019
1151 WALNUT AVE
Policy Period: Nov 8, 2019 - May 8, 2020
23
LONG BEACH, CA 90813 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 began on November 8, 2019 at the later of 12:01 a.m. or the effective time shown on your application. This policy
period ends on May 8, 2020 at 12:01 a.m.
Your insurance policy and any policy endorsements contain a full explanation of your coverage. The policy contract is form 9611D CA
(09/16). The contract is modified by form Z357 CA (12/15).

Your email address

Any policy-related emails will be sent to the email address currently listed on your policy: krisandra.stewart@yahoo.com.
If you want to update your email address, please call us.

Underwriting Company
Progressive Select Ins Co

Drivers and household residents Years licensed Years experienced Marital status
………………………………………………………………………………………………………………………………………………………..
Krisandra B Stewart 06 06 Single
Additional information: Named insured

Outline of coverage
2016 HYUNDAI ELANTRA 4 DOOR SEDAN
VIN: KMHDH4AH3GU553651 Garaging ZIP Code:90813 Annual miles: 10000 Vehicle use: Commute
Limits Deductible Premium
………………………………………………………………………………………………………………………………………………………..
Liability To Others $392
Bodily Injury Liability $15,000 each person/$30,000 each accident
Property Damage Liability $5,000 each accident
………………………………………………………………………………………………………………………………………………………..
Uninsured/Underinsured Motorist $15,000 each person/$30,000 each accident
………………………………………………………………………………………………………………………………………………………..
26
Comprehensive Actual Cash Value
………………………………………………………………………………………………………………………………………………………..
$2,500 42
Collision Actual Cash Value
………………………………………………………………………………………………………………………………………………………..
$2,500 344
Roadside Assistance 5
………………………………………………………………………………………………………………………………………………………..
Subtotal policy premium $809.00
………………………………………………………………………………………………………………………………………………………..
Anti-Fraud fee 0.88
………………………………………………………………………………………………………………………………………………………..
Total 6 month policy premium $809.88

Form 6489 CA (01/18)

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934142428 N TF58795 INS DECPAGE E POLWHITEFONT UC6XNJQQEPZZUGOD6QEFD5XXNE0002 RPUID TRACWHITEFONT

Policy Number: 934142428

Krisandra B Stewart
Page 2 of 2
Payment schedule
Dec 8, 2019.........................$133.44 Feb 8, 2020 .........................$133.44 Apr 8, 2020 .........................$133.44
Jan 8, 2020..........................$133.44 Mar 8, 2020 ........................$133.44
An installment fee of $4.00 has been included in each payment. You may avoid paying additional installment fees by
paying your remaining balance in full by the due date. You may reduce the amount you pay in installment fees by paying
your premium in larger amounts and fewer installments. Please call 1-800-776-4737 for details.
The following additional fees may apply:
Cancel fee $50.00
Fee for returned checks or refused payments $20.00
Premium discount
Driver
………………………………………………………………………………………………………………………………………………………..
Krisandra B Stewart Good Driver

Lienholder information
Vehicle Lienholder
………………………………………………………………………………………………………………………………………………………..
2016 HYUNDAI ELANTRA BRIDGECREST ACCPT CO
KMHDH4AH3GU553651 PHOENIX, AZ 85062

Company officers

President Secretary

Form 6489 CA (01/18)