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Valid in U.S. and Canada INSURANCE GROUP
This Card Must Be Shown To Any Law Enforcement Officer Upon
Request
Undenwritten by: Bristol West Insurance Company
BRISTOL WEST INSURANCE COMPANY NAIC #19658 This card must be carried for production upon demand.
It is suggested that you carry this card in the insured vehicle.
An authorized Pennsylvania insurer has issued an Owner’s Policy of Liability
Insurance under Section 104(a) of the Pennsylvania No- Fault Motor Vehicle WARNING: Any owner or registrant of a motor vehicle who drives or
Insurance Act. permits a motor vehicle to be driven in this state without the required
POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE financial responsibility may have this registration suspended or revoked.
G01 2811425 00 04/05/2023 10/05/2023
NOTE: THIS CARD IS REQUIRED WHEN:
INSURED NOT VALID MORE THAN ONE YEAR FROM EFFECTIVE DATE
GIORGI SHIUKASHVILI (1) You are involved in an auto accident.
GIORGI SHIUKASHVILI (2) You are convicted of a traffic offense other than a parking offense
11106 TEMPLETON DR that requires a court appearance.
PHILADELPHIA PA 19154-3427 (3) You are stopped for violating any provision of 75 Pa. C.S
(relating to the Vehicle Code) and requested to produce it by a
PRODUCER 3793090 PHONE: 610-533-2224 police officer.
WORLDWIDE INSURANCE NETWORK IN You must provide a copy of this card to the Department of Transportation
842 RED LION RD STE 9 when you request restoration of your operating privilege and/or
PHILADELPHIA PA 19115-1475 registration privilege, which has been previously suspended or revoked.

YEAR MAKE/MODEL
2013 FORD EXPEDITION LIMITE

VEHICLE IDENTIFICATION NO SEE IMPORTANT MESSAGE In the event of a loss, you can submit your loss information
1FMJU2A56DEF37880 ON REVERSE SIDE 24/7 at www.BristolWest.com or call us Toll-Free during business hours at
1-800-274-7865
PA-00005 (03/15) For policy information or billing go to www.BristolWest.com

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FlNAficiAMpsSPOilj miA BRISTOL WESr

Valid in U.S. and Canada INSURANCE GROUP
This Card Must Be Shown To Any Law Enforcement Officer Upon
Request
Undenvritten by: Bristol West Insurance Company
BRISTOL WEST INSURANCE COMPANY NAIC #19658 This card must be earned for production upon demand.
It is suggested that you carry this card in the insured vehicle.
An authorized Pennsylvania insurer has issued an Owner’s Policy of Liability
Insurance under Section 104(a) of the Pennsylvania No- Fault Motor Vehicle WARNING: Any owner or registrant of a motor vehicle who drives or
Insurance Act. permits a motor vehicle to be driven in this state without the required
POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE financial responsibility may have this registration suspended or revoked.
' I G01 2811425 00 04/05/2023 10/05/2023
NOTE: THIS CARD IS REQUIRED WHEN:
INSURED NOT VALID MORE THAN ONE YEAR FROM EFFECTIVE DATE
GIORGI SHIUKASHVILI (1) You are involved in an auto accident.
GIORGI SHIUKASHVILI (2) You are convicted of a traffic offense other than a parking offense
11106 TEMPLETON DR that requires a court appearance.
PHILADELPHIA PA 19154-3427 (3) You are stopped for violating any provision of 75 Pa. C.S
(relating to the Vehicle Code) and requested to produce it by a |
PRODUCER 3793090 PHONE: 610-533-2224 police officer. |
WORLDWIDE INSURANCE NETWORK IN You must provide a copy of this card to the Department of Transportation
842 RED LION RD STE 9 when you request restoration of your operating privilege and/or
PHILADELPHIA PA 19115-1475 registration privilege, which has been previously suspended or revoked.

YEAR MAKE/MODEL
2013 FORD EXPEDITION LIMITE
In the event of a loss, you can submit your loss information
VEHICLE IDENTIFICATION NO SEE IMPORTANT MESSAGE 24/7 at WWW.BristolWest.com or call us Toll-Free during business hours at
1FMJU2A56DEF37880 ON REVERSE SIDE 1-800-274-7865

PA-00005 (03/15) For policy information or billing go to www.BristolWest.com