Form_SCTNID_CTGRY.

XX0713VOI_OTHER

<docindex><index>VOI</index></docindex>

PROGRESSIVE
P.O. BOX 6807
CLEVELAND, OH 44101
NAIC Company Code: 37834
Policy Number: 928824744
Underwritten by:
Progressive Preferred Insurance Co
Policyholder :
DEBRA BOLIN
Page 1 of 1
July 16, 2021
Customer Service
1-800-876-5581
24 hours a day, 7 days a week

Verification of Insurance for

DEBRA BOLIN
This verification of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by
the policies listed herein. Notwithstanding any requirement, term or condition of any contract or other document with
respect to which this verification of insurance may be issued or may pertain, the insurance afforded by the policies
described herein is subject to all the terms, exclusions and conditions of the policies.

Please accept this letter as verification of insurance for this policy.

Policy and driver information

……………………………………………………………………………………………………………………………………
Policy number: 928824744
……………………………………………………………………………………………………………………………………
Policy state: Minnesota
……………………………………………………………………………………………………………………………………
Policy period:
…………………………………………………………………………………………………………………………………… Apr 9, 2021 - Oct 9, 2021
There was no lapse in coverage during this policy
…………………………………………………………………………………………………………………………………… period.
Effective date:
…………………………………………………………………………………………………………………………………… Apr 9, 2021
Drivers: DEBRA BOLIN
……………………………………………………………………………………………………………………………………
Address: 3626 E 44TH ST APT 511
MINNEAPOLIS, MN 55406

Vehicle information
……………………………………………………………………………………………………………………………………
Vehicle: 2019 HONDA FIT
……………………………………………………………………………………………………………………………………
Vehicle identification number: 3HGGK5H47KM714786
……………………………………………………………………………………………………………………………………
Lienholder: AFFINITY PLUS FCU
PO Box 924247
FORT WORTH, TX 76124

Coverage information
……………………………………………………………………………………………………………………………………
Liability To Others
Bodily Injury Liability $100,000 each person/$300,000 each accident
Property Damage Liability $100,000 each accident
……………………………………………………………………………………………………………………………………
Personal Injury Protection - Nonstacked $20,000 Medical Expense Deductible: $100
$20,000 Economic
…………………………………………………………………………………………………………………………………… Loss Deductible: $200
Comprehensive Actual Cash Value Deductible: $500
Comprehensive Safety Glass
…………………………………………………………………………………………………………………………………… Deductible: $0 glass
Collision Actual Cash Value Deductible: $500

Form VOI (07/13)