Form_SCTNID_CTGRY.

TX05226489_DECPAGE

924345309 Q CD034MN INS DECPAGE U POLWHITEFONT O7PG6EYCULDSEDC2IC25V22GIB0002 RPUID TRACWHITEFONT BDF_AA

PATRICK MUNOZ
401 E SONTERRA BLVD 375
SAN ANTONIO, TX 78258

Policy Number: 924345309

Underwritten by:
Progressive County Mutual Ins Co
August 8, 2023
PAULA MENDEZ
Policy Period: Sep 10, 2023 - Mar 10, 2024
127 OSAGE DRIVE
SAN ANTONIO, TX 78207 Page 1 of 2

1-210-775-1242
PATRICK MUNOZ
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 your Renewal 1-800-274-4499

To report a claim.
Declarations Page
The coverages, limits and policy period shown apply only if you pay for this policy to renew.
Your coverage begins on September 10, 2023 at 12:01 a.m. This policy expires on March 10, 2024 at 12:01 a.m.
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 9611A TX (08/15). The
contract is modified by forms 4884 (10/08), A284 TX (07/19), A229 TX (10/19), A311 TX (02/21) and A331 (11/21).

Motor Vehicle Crime Prevention Authority Fee

Your payment includes a $4.00 fee per vehicle each year. This fee helps fund:
• auto burglary, theft, and fraud prevention;
• criminal justice efforts; and
• trauma care and emergency medical services for victims of accidents due to traffic offenses.
By law, we send this fee to the Motor Vehicle Crime Prevention Authority (MVCPA).
Drivers and household residents
Paula Mendez
Additional information: Named insured
John A Mendez

Form 6489 TX (05/22)

4
Continued
924345309 Q CD034MN INS DECPAGE U POLWHITEFONT O7PG6EYCULDSEDC2IC25V22GIB0002 RPUID TRACWHITEFONT BDF_AA

Policy Number: 924345309

Paula Mendez
Page 2 of 2

Outline of coverage
2006 FORD MUSTANG 2 DOOR COUPE
VIN: 1ZVFT82H065115323
Garaging ZIP Code: 78207
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.
This vehicle is currently enrolled in the Snapshot® Program.
Limits Deductible Premium
………………………………………………………………………………………………………………………………………………………..
Liability to Others $201
Bodily Injury Liability $30,055 each person/$60,055 each accident
Property Damage Liability $25,055 each accident
………………………………………………………………………………………………………………………………………………………..
Personal Injury Protection Rejected --
………………………………………………………………………………………………………………………………………………………..
Uninsured/Underinsured Motorist Bodily Injury Rejected --
………………………………………………………………………………………………………………………………………………………..
Uninsured/Underinsured Property Damage Rejected --
………………………………………………………………………………………………………………………………………………………..
Comprehensive Actual Cash Value $495 72
………………………………………………………………………………………………………………………………………………………..
Collision Actual Cash Value $495 121
………………………………………………………………………………………………………………………………………………………..
Total premium for 2006 FORD $394
2018 CHEVROLET COLORADO EXTENDED CAB
VIN: 1GCHSCEA0J1147673
Garaging ZIP Code: 78207
Primary use of the vehicle: Commute
Length of vehicle ownership when policy started or vehicle added: Less than 1 month
This vehicle is currently enrolled in the Snapshot® Program.
Limits Deductible Premium
………………………………………………………………………………………………………………………………………………………..
Liability to Others $282
Bodily Injury Liability $30,055 each person/$60,055 each accident
Property Damage Liability $25,055 each accident
………………………………………………………………………………………………………………………………………………………..
Personal Injury Protection Rejected --
………………………………………………………………………………………………………………………………………………………..
Uninsured/Underinsured Motorist Bodily Injury Rejected --
………………………………………………………………………………………………………………………………………………………..
Uninsured/Underinsured Property Damage Rejected --
………………………………………………………………………………………………………………………………………………………..
Comprehensive Actual Cash Value $495 176
………………………………………………………………………………………………………………………………………………………..
Collision Actual Cash Value $495 303
………………………………………………………………………………………………………………………………………………………..
Total premium for 2018 CHEVROLET $761
………………………………………………………………………………………………………………………………………………………..
Subtotal policy premium $1,155.00
………………………………………………………………………………………………………………………………………………………..
Policy fee 50.00
………………………………………………………………………………………………………………………………………………………..
Motor Vehicle Crime Prevention Authority Fee 4.00
………………………………………………………………………………………………………………………………………………………..
Total 6 month policy premium and fees $1,209.00

Premium discounts
Policy
………………………………………………………………………………………………………………………………………………………..
924345309 Five-Year Accident Free, Automatic Card Payments (ACP), Five-Year Claim Free,
Home Owner, Multi-Car, Continuous Insurance: Diamond and Three-Year Safe
Driving
Vehicle
………………………………………………………………………………………………………………………………………………………..
2006 FORD Snapshot Driving
MUSTANG
2018 CHEVROLET Snapshot Driving
COLORADO

Form 6489 TX (05/22)