Form_SCTNID_CTGRY.
NC07216489_DECPAGE
<docindex><index>DECPAGE</index></docindex> BDF_AA
GUIDED INSURANCE SOL
4904 EISENHOWER 350
TAMPA, FL 33634
Policy Number: 962453887
Underwritten by:
Progressive Southeastern Ins Co
April 2, 2024
DELANOR BROOKS
Policy Period: Oct 12, 2023 - Apr 12, 2024
1306 SADDLE TRAIL
GREENSBORO, NC 27406 Page 1 of 3
1-877-611-3030
GUIDED INSURANCE SOL
Contact your agent for personalized service.
agent.progressive.com
Auto Insurance Online Service
Coverage Summary
Make payments, check billing activity, update
policy information or check status of a claim.
This is a copy of your 1-800-274-4499
To report a claim.
Declarations Page
Your coverage began on October 12, 2023 at 12:01 a.m. This policy expires on April 12, 2024 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. The
policy contract is form NC0001 (06/05). The contract is modified by forms NC0301 (07/87), NC0330 (01/14), NC0350 (09/04), NC0012
(10/23) and NC0013 (10/23).
Underwriting Company
Progressive Southeastern Ins Co
P.O. Box 6807
Cleveland , OH 44101
1-800-876-5581
Drivers and household residents
Delanor Brooks
Additional information: Named insured
Outline of coverage
General policy coverage Limits Deductible Premium
………………………………………………………………………………………………………………………………………………………..
Combined Uninsured/Underinsured Motorist $50,000 each person/$100,000 each accident
………………………………………………………………………………………………………………………………………………………..
$28.00
Uninsured Motorist Property Damage $50,000 each accident $100
………………………………………………………………………………………………………………………………………………………..
3.00
Total premium for general policy coverage $31.00
Form 6489 NC (07/21)
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Policy Number: 962453887
Delanor Brooks
Page 2 of 3
2016 NISSAN PATHFINDER 4 DOOR WAGON
VIN: 5N1AR2MM3GC622695
Garaging Zip Code: 27406
Primary use of the vehicle: Pleasure
Annual miles: 0 - 3,999
Length of vehicle ownership when policy started or vehicle added: At least 1 month but less than 1 year
Information regarding your vehicle history (prior damage, theft or title issues) has impacted how we determine your premium.
Limits Deductible Premium
………………………………………………………………………………………………………………………………………………………..
Liability Coverage $188.34
Bodily Injury Liability $50,000 each person/$100,000 each accident
Property Damage Liability $50,000 each accident
………………………………………………………………………………………………………………………………………………………..
Medical Payments $1,000 each person
………………………………………………………………………………………………………………………………………………………..
9.00
Other Than Collision Actual Cash Value
………………………………………………………………………………………………………………………………………………………..
$500 28.00
Collision Actual Cash Value
………………………………………………………………………………………………………………………………………………………..
$500 118.00
Total premium for 2016 NISSAN $343.34
2008 HONDA ACCORD 4 DOOR SEDAN
VIN: 1HGCP26448A040555
Garaging Zip Code: 27406
Primary use of the vehicle: Pleasure
Annual miles: 0 - 3,999
Length of vehicle ownership when policy started or vehicle added: 5 years or more
Limits Deductible Premium
………………………………………………………………………………………………………………………………………………………..
Liability Coverage $182.68
Bodily Injury Liability $50,000 each person/$100,000 each accident
Property Damage Liability $50,000 each accident
………………………………………………………………………………………………………………………………………………………..
Medical Payments $1,000 each person
………………………………………………………………………………………………………………………………………………………..
9.00
Total premium for 2008 HONDA $191.68
2021 HYUNDAI ELANTRA 4 DOOR SEDAN
VIN: KMHLS4AG0MU095292
Garaging Zip Code: 27406
Primary use of the vehicle: <10Miles
Annual miles: 6,000 - 7,999
Length of vehicle ownership when policy started or vehicle added: Less than 1 month
Limits Deductible Premium
………………………………………………………………………………………………………………………………………………………..
Liability Coverage $196.98
Bodily Injury Liability $50,000 each person/$100,000 each accident
Property Damage Liability $50,000 each accident
………………………………………………………………………………………………………………………………………………………..
Medical Payments $1,000 each person
………………………………………………………………………………………………………………………………………………………..
10.00
Other Than Collision Actual Cash Value
………………………………………………………………………………………………………………………………………………………..
$500 50.00
Collision Actual Cash Value
………………………………………………………………………………………………………………………………………………………..
$500 233.00
Total premium for 2021 HYUNDAI $489.98
………………………………………………………………………………………………………………………………………………………..
Subtotal policy premium $1,056.00
………………………………………………………………………………………………………………………………………………………..
Policy fee 15.00
………………………………………………………………………………………………………………………………………………………..
Total 6 month policy premium and fees $1,071.00
Premium discounts
Policy
………………………………………………………………………………………………………………………………………………………..
962453887 Five-Year Accident Free, Automatic Card Payments (ACP), Home Owner,
Multi-Car, Continuous Insurance: Platinum and Three-Year Safe Driving
Form 6489 NC (07/21)
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Policy Number: 962453887
Delanor Brooks
Page 3 of 3
Vehicle
………………………………………………………………………………………………………………………………………………………..
2016 NISSAN Airbag
PATHFINDER
2008 HONDA Airbag
ACCORD
2021 HYUNDAI Airbag and Smart Technology Discount
ELANTRA
Smart Technology Discount ℠ is a service mark of Progressive Casualty Ins. Co.
Lienholder information
Vehicle Lienholder
………………………………………………………………………………………………………………………………………………………..
2016 NISSAN PATHFINDER Langley Federal Credit Union
5N1AR2MM3GC622695 Carmel, IN 46082
………………………………………………………………………………………………………………………………………………………..
2021 HYUNDAI ELANTRA STATE EMPLOYEES CU
KMHLS4AG0MU095292 RALEIGH, NC 27611
A11Y LEH End Locator
Form 6489 NC (07/21)
