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59 views2 pages

Declaration Page

Uploaded by

nrbkn9dfdw
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Tel: 1-800-841-3000 Declarations Page

This is a description of your coverage.


Please retain for your records.
GEICO Indemnity Company
One GEICO Boulevard Policy Number: 6082-64-49-04
Fredericksburg, VA 22412-0003
Coverage Period:
10-06-23 through 04-06-24
12:01 a.m. local time at the address of the named insured.

Date Issued: September 2, 2023

SIDNEY LUNDY LOCKLEAR


182 TALON DR
MORAVIAN FLS NC 28654-9111

Email Address: Locklear2sidney@gmail.com

NOTICE: THE PREMIUM THAT WE ARE CHARGING FOR AUTOMOBILE


PHYSICAL DAMAGE AND RELATED EXPENSES THAT COVERS THE DAMAGE
TO YOUR COVERED VEHICLE(S) EXCEEDS THE PREMIUM BASED UPON THE
APPROVED RATES IN NORTH CAROLINA, IN ACCORDANCE WITH G.S.
58-36-30(b).

Named Insured Additional Drivers


Sidney Lundy Locklear John Wesley Frazier

Vehicle VIN Vehicle Location Finance Company/


Lienholder
1 2017 Ford Escape 1FMCU9GD8HUE44726 MORAVIAN FLS NC CARMAX AUTO FINANCE
28654-9111

Coverages* Limits and/or Deductibles Vehicle 1

A Liability Coverage
Bodily Injury Liability
Each Person/Each Occurrence $30,000/$60,000 $360.34
Property Damage Liability
Each Occurrence $25,000 $468.00
C Uninsured Motorists Bodily Injury
Bodily Injury Liability
Each Person/Each Occurrence $30,000/$60,000 $8.00
Uninsured Motorist Property Damage
Each Occurrence $25,000 $1.00
Comprehensive $500 Ded $215.00
Collision $1,000 Ded $673.00

T-F
Continued on Back
DEC_PAGE (03-14) (Page 1 of 2) Renewal Page 5 of 12
Coverages* Limits and/or Deductibles Vehicle 1

Towing & Labor Costs $22.50


Extended Transportation Expenses $30 Per Day
Coverage $900 Max $35.00

Total Six Month Premium $1,782.84

*Coverage applies where a premium or $0.00 is shown for a vehicle.

If you elect to pay your premium in installments, you maybe subject to an additional fee for each installment. The fee
amount will be shown on your billing statements and is subject to change.

Contract Type: A6

Contract Amendments: ALL VEHICLES - A295 A6

Unit Endorsements: UE316N(VEH 1); CRA115NC(VEH 1); CRA431NC(VEH 1)

Important Policy Information


- Although an Uninsured Motorist and/or Underinsured Motorist premium is only listed for one vehicle, the coverage
applies to all vehicles. The premium listed is for the policy, not the vehicle.
- Reminder - Physical damage coverage will not cover loss for custom options on an owned automobile, including
equipment, furnishings or finishings including paint, if the existence of those options has not been previously reported
to us. This reminder does NOT apply in VIRGINIA, however, in Virginia coverage is limited for custom furnishings or
equipment on pick-up trucks and vans but you may purchase coverage for this equipment. Please call us at
1-800-841-3000 or visit us at geico.com if you have any questions.
- Your premium reflects changes in rates placed into effect under Article 36, Chapter 58 of the North Carolina General
Statutes.
- Confirmation of coverage has been sent to your lienholder and/or additional insured.
- Claims incurred while an insured vehicle is being used to carry passengers for hire may not be covered by this
contract. Please review the contract for a full list of exclusions and contact us if you plan to use any of your insured
vehicles for this purpose.
- The Safe Driver Insurance Plan surcharge for the accidents or convictions during the experience period applies
equally to all eligible vehicles on your policy, even though it is shown in the subclass for only one unit.

DEC_PAGE (03-14) (Page 2 of 2) Renewal Page 6 of 12

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