Auto Insurance Policy (PIP Insurance Company) 2018 PDF

PIP Insurance Company Declarations Page 101 Main Street Tustin, CA 92780 This is a description of your coverage. Please retain for your records. Date issued: January 1, 2018 Policy Number: 1223-43-23-22 Coverage Period: 01/01/2018 through 7/1/2018 Jane Smith 123 Blue Street Corona, CA 91232 Na...

PIP Insurance Company Declarations Page 101 Main Street Tustin, CA 92780 This is a description of your coverage. Please retain for your records. Date issued: January 1, 2018 Policy Number: 1223-43-23-22 Coverage Period: 01/01/2018 through 7/1/2018 Jane Smith 123 Blue Street Corona, CA 91232 Named Insured Jane Smith Bob Smith Additional Drivers None Drivers Excluded None Vehicles 1) 2017 Mazda Vehicle ID Number (VIN) 1ABCD123234E6754 Vehicle Location Corona, CA 91232 Lienholder ADB Finance Company 2) 1997 Ford Escort 2345ABCD123234E6 Corona, CA 91232 None Deductible Premium Vehicle 1 Vehicle 2 Coverages LIABILITY Bodily Injury Limits $100,000 per person $300,000 per occurrence $225 $220 Property Damage $100,000 per occurrence $ 70 $70 Uninsured Motorist $100,000 per person $300,000 per occurrence $200 $200 Collision Comprehensive Medical Payments Actual Cash Value Actual Cash Value $5,000 each person $150 $50 $30 $30 $725 $520 $250 $250 Six month premium per vehicle: Total Six Month Premium $1,245 DISCOUNTS:  Good Driver discount  Anti-theft devices  Multi-car Rating Information Vehicle 1 - Married female age 42 with 25 years of driving experience. Annual mileage 12,000. Vehicle 2 - Married male age 45 with 27 years of driving experience. Annual mileage 12,000. - © No coverage is provided in Mexico Confirmation of coverage has been sent to your lienholder and/or additional insured.