Form_SCTNID_CTGRY.

WA03176489_DECPAGE

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PROGRESSIVE
P.O. BOX 31260
TAMPA, FL 33631

Policy Number: 979156538

Underwritten by:
Progressive Direct Insurance Co
WEI PAN May 22, 2024
10700 NE 10TH STREET
Policy Period: Mar 27, 2024 - Sep 27, 2024
C401
BELLEVUE, WA 98004 Page 1 of 1

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 began on March 27, 2024 at the later of 12:01 a.m. or the effective time shown on your application. This policy period
ends on September 27, 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 contract is form 9611D WA (07/16). The contract is modified by forms 4884 (10/08) and Z357 (01/07).

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

resident relatives Additional information
Wei Pan Named insured
………………………………………………………………………………………………………………………………………………………..
Hongbo Jiang

Outline of coverage
2018 TOYOTA RAV4 4 DOOR WAGON
VIN: JTMWFREV9JJ211579
Garaging ZIP Code: 98004
Primary use of the vehicle: Commute
Limits Deductible Premium
………………………………………………………………………………………………………………………………………………………..
Liability To Others $218
Bodily Injury Liability $25,000 each person/$50,000 each accident
Property Damage Liability $10,000 each accident
………………………………………………………………………………………………………………………………………………………..
Personal Injury Protection Rejected --
………………………………………………………………………………………………………………………………………………………..
Underinsured Motorist Rejected --
………………………………………………………………………………………………………………………………………………………..
Underinsured Motorist Property Damage Rejected --
………………………………………………………………………………………………………………………………………………………..
Total 6 month policy premium $218.00

Premium discounts
Policy
………………………………………………………………………………………………………………………………………………………..
979156538 Multi-Policy, Paid in Full, Online Signature - First Policy Period Only, Online
Quote, Continuous Insurance: Gold and Paperless
Company officers

Secretary

Form 6489 WA (03/17)