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Binder 1

This document is an auto insurance binder for Gabriel Williams, effective from October 2, 2024, to November 2, 2024. It outlines the coverage details, including bodily injury limits of $25,000 per person and $50,000 per accident, with no coverage for comprehensive, collision, or uninsured motorist. The binder can be canceled by either party with appropriate notice and will be replaced by a policy upon issuance.

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gabrielwilliams66
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17 views1 page

Binder 1

This document is an auto insurance binder for Gabriel Williams, effective from October 2, 2024, to November 2, 2024. It outlines the coverage details, including bodily injury limits of $25,000 per person and $50,000 per accident, with no coverage for comprehensive, collision, or uninsured motorist. The binder can be canceled by either party with appropriate notice and will be replaced by a policy upon issuance.

Uploaded by

gabrielwilliams66
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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AUTO INSURANCE BINDER

THIS BINDER IS A TEMPORARY CONTRACT, SUBJECT TO THE CONDITIONS


SHOWN AT THE BOTTOM OF THE FORM.

PRODUCER INSURED

11324 TARA BLVD. GABRIEL WILLIAMS

HAMPTON GA 30228 370 NORTHSIDE DR NW


(770) 573-0922 Atlanta GA 30318

COVERAGES
BELOW IS THE DESCRIPTION OF OPERATIONS, VEHICLES AND PROPERTY INCLUDING LOCATION

COMPANY BINDER NO. DEDUCTIBLES AMOUNT


VERVE 1305098 COMBINED SINGLE LIMIT

BODILY INJURY(per person) $25,000


BODILY INJURY(per accident) $50,000
EFFECTIVE DATE & TIME EXPIRATION DATE & TIME
PROPERTY DAMAGE $25,000

10/02/2024 10:36 AM 11/02/2024 12:01 AM COMPREHENSIVE No Coverage


COLLISION No Coverage
UNINSURED MOTORIST None
VEHICLE VIN
MEDICAL PAYMENTS No Coverage
2010 TOYOTA RAV4
JTMBF4DVXA5029210
PUNITIVE DAMAGE EXCLUDED Yes

ACTUAL CASH VALUE

LIENHOLDER INFORMATION OTHER

FEES

TAXES

ESTIMATED AMOUNT
CONDITIONS

This company binds the kind(s) of insurance stipulated on this form. The insurance is subject to the terms, conditions and
limitations of the policy(ies) in current use by the company.

This binder may be cancelled by the insured by surrender of this binder or written notice to the company stating that
when cancellation will be effective. This binder may be cancelled by the company by notice to the insured in accordance
with the policy conditions. This auto insurance binder will cancel when replaced by a policy.

PRODUCER AGENT PRODUCER SIGNATURE DATE

Sayra Guzman 10/02/2024

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