BINDER OF INSURANCE BINDER NUMBER

BGFL00001047

Pending issuance and delivery of a policy pursuant to the application of the insured and to all the terms and conditions of
the policy issued by the company Cimarron Insurance Company, Inc.

DOES HEREBY INSURE: DMITRII DRUZHININ

1865 SOUTH OCEAN DRIVE
HALLANDALE BEACH, FL 33009

COVERAGE INFORMATION
VEHICLE VIN GARAGING ZIP CODE

2021 FORD MUSTANG 1FATP8UH4M5106537 33009

COVERAGE LIMITS/DEDUCTIBLE
Bodily Injury Liability 10,000/20,000
Property Damage Liability 10000
Comprehensive 500
Collision 500
Medical Payments NONE
Personal Injury Protection 10000
Deductible 1000
NI/RR Named Insured Resident Relative
Work Loss Exclusion Exclude
Uninsured Motorist Bodily Injury NONE
UM Stacked/Non-Stacked NONE
Rental Reimbursement 50/1500
Roadside Assistance NONE
Loan NONE
ACPE NONE

Effective, 11/20/2023 4:56 PM expiring not to exceed five (5) days hence and to become void immediately upon
issuance of a policy in place hereof.

LIENHOLDER AND ADDITIONAL INTEREST

VEHICLE LIENHOLDER/ADDRESS

FL 109-BND 1023 Page 1 of 1