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Ufficio Centrale Italiano Valid I521 /: (Both Dates Inclusive)

This document is an international motor insurance card issued by ADMIRAL EUROPE COMPAÑIA DE SEGUROS S.A. for Rossana Pansani that provides compulsory motor vehicle insurance coverage in various countries from December 11, 2020 to January 10, 2021 for a Volkswagen Polo with registration number GC037XY. The card outlines the territories where insurance is valid and contact information for claims assistance.

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458 views1 page

Ufficio Centrale Italiano Valid I521 /: (Both Dates Inclusive)

This document is an international motor insurance card issued by ADMIRAL EUROPE COMPAÑIA DE SEGUROS S.A. for Rossana Pansani that provides compulsory motor vehicle insurance coverage in various countries from December 11, 2020 to January 10, 2021 for a Volkswagen Polo with registration number GC037XY. The card outlines the territories where insurance is valid and contact information for claims assistance.

Uploaded by

max
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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1. INTERNATIONAL MOTOR INSURANCE CARD 2.

ISSUED UNDER THE AUTHORITY OF


1. CARTE INTERNATIONALE D'ASSURANCE AUTOMOBILE
1. CARTA INTERNAZIONALE DI ASSICURAZIONE VEICOLI A MOTORE UFFICIO CENTRALE ITALIANO
4. Country Code/Insurers Code Number
3. VALID
FROM TO
Day Month Year Day Month Year
I521 / 10000000523860
11 12 2020 10 1 2021
(Both Dates Inclusive)

5. Registration No. (or if none) Chassis or Engine No. 6. Category of Vehicle* 7. Make of Vehicle
VOLKSWAGEN Polo 6ª serie Polo 1.0 EVO 80
GC037XY A CV 5p. Sport BlueMotion Technology

8. TERRITORY VALIDITY
This card is valid in Countries for which the relevant box is not crossed out (for further information, please see www.cobx.org).

In each Country visited, the Bureau of that country guarantees, in respect to the use of the vehicle referred to herein, the insurance
cover in accordance with the laws relating to compulsory insurance in that country.

For the identification of the relevant Bereau, see www.cobx.org

A B BG CY(**) CZ D DK E EST F FIN

GB GR H HR I IRL IS L LT LV M

N NL P PL RO S SK SLO CH AL AND
X
AZ(**) BIH BY IL IR MA MD MK MNE RUS SRB(**)
X X
TN TR UA

(**) The cover provided under Green Cards issued for Republics of Azerbaijan, Cyprus and Serbia is restricted to those geographical parts of these
countries which are under the control of treir respective governments. For more information, please consult http://gc-territorial-validity.cobx.org

9. Name and Address of the policyholder (or User of the vehicle)


Rossana Pansani VIA di San Gennaro 84, 55012 CAPANNORI ( LU )

10. This Card has been issued by: 11. Signature of Insurer
ADMIRAL EUROPE COMPAÑIA DE SEGUROS S.A
Madrid (Spagna) presso Calle Sánchez Pacheco, 85, 28002, Madrid.

ASSISTENZA SINISTRI
06 83 460 460 H24 - 365 gg/anno

(* )CATEGORY OF VEHICLES CODE:


A CAR C LORRY OR TRACTOR E BUS G OTHERS
B MOTORCYCLE D CYCLE FITTED WITH AUXILARY ENGINE F TRAILER

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