Form_SCTNID_CTGRY.

XX1106FAXCRC_OTHER

Progressive
PO Box 31260
Tampa, FL 33631
Policy Number: 939473381
Underwritten by:
Progressive County Mutual Ins Co
Policyholder:
Willet Daniels
January 25, 2021
Page 1 of 1

Customer Service
1-800-776-4737
24 hours a day, 7 days a week

Mailing Address:
Progressive
PO Box 31260
Tampa, FL 33631-3260

Requested policy documents

………………………………………………………………………………………………………………………………………………………..

Verification of Insurance
Form_SCTNID_CTGRY.XX0713VOI_OTHER

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

Progressive
PO Box 31260
Tampa, FL 33631
NAIC Company Code: 29203
Policy Number: 939473381
Underwritten by:
Progressive County Mutual Ins Co
Policyholder:
Willet Daniels
Page 1 of 1
January 25, 2021
Customer Service
1-800-776-4737
24 hours a day, 7 days a week

Verification of Insurance for

Willet Daniels
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: 939473381
……………………………………………………………………………………………………………………………………
Policy state: Texas
……………………………………………………………………………………………………………………………………
Policy period:
…………………………………………………………………………………………………………………………………… Dec 20, 2020 - Jan 21, 2021
There was no lapse in coverage during this policy
…………………………………………………………………………………………………………………………………… period.
Effective date:
…………………………………………………………………………………………………………………………………… Jan 21, 2021
Drivers: Willet Daniels Insured Driver
Clifford Daniels
……………………………………………………………………………………………………………………………………
Address: 921 Skyline Vista
Houston, TX 77019

Vehicle information
……………………………………………………………………………………………………………………………………
Vehicle: 2018 Toyota Highlander
……………………………………………………………………………………………………………………………………
Vehicle identification number: 5TDZZRFH5JS244885
……………………………………………………………………………………………………………………………………
Lienholder: ccm finance llc
PO Box 850307
richardson, TX 75085

Coverage information
……………………………………………………………………………………………………………………………………
Bodily Injury Liability: $30,007 each person/$60,007 each accident
Property Damage Liability: $25,007 each accident
……………………………………………………………………………………………………………………………………
Collision: Deductible: $499 Deductible
……………………………………………………………………………………………………………………………………
Comprehensive: Deductible: $499 deductible
……………………………………………………………………………………………………………………………………
Personal Injury Protection: $2,503 each person/each accident

Form VOI (07/13)