Form_SCTNID_CTGRY.

ND01206489_DECPAGE

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PROGRESSIVE
P.O. BOX 31260
TAMPA, FL 33631

Policy Number: 959416613

Underwritten by:
Progressive Direct Insurance Co
July 6, 2022
MELISSA M LAPLANTE
Policy Period: Jul 9, 2022 - Jan 9, 2023
116 1ST AVE W
FLASHER, ND 58535 Page 1 of 3

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 a copy of your

Declarations Page
Your coverage begins on July 9, 2022 at 12:01 a.m. This policy expires on January 9, 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. The
policy contract is form 9611D ND (05/16). The contract is modified by forms 4884 (10/08), Z357 (01/07) and A252 ND (02/18).

Drivers and ………………………………………………………………………………………………………………………………………………………..

resident relatives Additional information
Melissa M LaPlante Named insured
………………………………………………………………………………………………………………………………………………………..
Courtney J LaPLante

Outline of coverage
1994 CHEVROLET C2500/K2500 CLUB CAB PICKUP
VIN: 1GCGC29K4RE312750
Garaging ZIP Code: 58535
Primary use of the vehicle: Commute
Length of vehicle ownership when policy started or vehicle added: 5 years or more
Limits Deductible Premium
………………………………………………………………………………………………………………………………………………………..
Liability To Others $61
Bodily Injury Liability $25,000 each person/$50,000 each accident
Property Damage Liability $25,000 each accident
………………………………………………………………………………………………………………………………………………………..
Personal Injury Protection $30,000 27
Workloss/Replacement Services/Funeral Expenses WL $150 each week/RS $15 each day/FE $3,500
………………………………………………………………………………………………………………………………………………………..
Uninsured Motorist $25,000 each person/$50,000 each accident
………………………………………………………………………………………………………………………………………………………..
5
Underinsured Motorist $25,000 each person/$50,000 each accident
………………………………………………………………………………………………………………………………………………………..
5
Total premium for 1994 CHEVROLET $98

Form 6489 ND (01/20)

4
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Policy Number: 959416613

Melissa M LaPlante
Page 2 of 3
2016 CHEVROLET MALIBU 4 DOOR SEDAN
VIN: 1G1ZE5ST3GF301813
Garaging ZIP Code: 58535
Primary use of the vehicle: Commute
Length of vehicle ownership when policy started or vehicle added: At least 3 years but less than 5 years
Limits Deductible Premium
………………………………………………………………………………………………………………………………………………………..
Liability To Others $94
Bodily Injury Liability $25,000 each person/$50,000 each accident
Property Damage Liability $25,000 each accident
………………………………………………………………………………………………………………………………………………………..
Personal Injury Protection $30,000 59
Workloss/Replacement Services/Funeral Expenses WL $150 each week/RS $15 each day/FE $3,500
………………………………………………………………………………………………………………………………………………………..
Uninsured Motorist $25,000 each person/$50,000 each accident
………………………………………………………………………………………………………………………………………………………..
5
Underinsured Motorist $25,000 each person/$50,000
………………………………………………………………………………………………………………………………………………………..
each accident 6
Comprehensive Actual Cash Value
………………………………………………………………………………………………………………………………………………………..
$750 218
Collision Actual Cash Value
………………………………………………………………………………………………………………………………………………………..
$1,000 147
Total premium for 2016 CHEVROLET $529
2013 HONDA PILOT 4 DOOR WAGON
VIN: 5FNYF4H27DB001362
Garaging ZIP Code: 58535
Primary use of the vehicle: Commute
Length of vehicle ownership when policy started or vehicle added: Less than 1 month
Limits Deductible Premium
………………………………………………………………………………………………………………………………………………………..
Liability To Others $119
Bodily Injury Liability $25,000 each person/$50,000 each accident
Property Damage Liability $25,000 each accident
………………………………………………………………………………………………………………………………………………………..
Personal Injury Protection $30,000 56
Workloss/Replacement Services/Funeral Expenses WL $150 each week/RS $15 each day/FE $3,500
………………………………………………………………………………………………………………………………………………………..
Uninsured Motorist $25,000 each person/$50,000 each accident 5
………………………………………………………………………………………………………………………………………………………..
Underinsured Motorist $25,000 each person/$50,000 each accident 5
………………………………………………………………………………………………………………………………………………………..
Comprehensive Actual Cash Value $750 142
………………………………………………………………………………………………………………………………………………………..
Collision Actual Cash Value $1,000 109
………………………………………………………………………………………………………………………………………………………..
Total premium for 2013 HONDA $436
………………………………………………………………………………………………………………………………………………………..
Total 6 month policy premium $1,063.00

Premium discounts
Policy
………………………………………………………………………………………………………………………………………………………..
959416613 Five-Year Accident Free, Online Signature - First Policy Period Only, Electronic
Funds Transfer (EFT), Home Owner, Online Quote, Multi-Car, Continuous
Insurance: Platinum and Paperless
Vehicle
………………………………………………………………………………………………………………………………………………………..
2016 CHEVROLET Smart Technology Discount
MALIBU

Smart Technology Discount ℠ is a service mark of Progressive Casualty Ins. Co.

Lienholder information
Vehicle Lienholder
………………………………………………………………………………………………………………………………………………………..
2016 CHEVROLET MALIBU ALLY FIN (LOAN)
1G1ZE5ST3GF301813 COCKEYSVILLE, MD 21030

Form 6489 ND (01/20)

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Policy Number: 959416613

Melissa M LaPlante
Page 3 of 3
Vehicle Lienholder
………………………………………………………………………………………………………………………………………………………..
2013 HONDA PILOT GATE CITY BANK
5FNYF4H27DB001362 FORT WORTH, TX 76124

Form 6489 ND (01/20)