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    Id Card, and Dec Page

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    melderkristoffer7
    The document is an automobile insurance identification card for Kristoffer Melder of Forest Hill, Louisiana. It provides coverage details for Melder's 1995 Ford, including bodily injury and property damage liability limits that meet Louisiana's minimum requirements. The card must be kept in the vehicle as proof of insurance and failure to present it could result in fines or other penalties.

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    Id Card, and Dec Page

    Uploaded by

    melderkristoffer7
    161 views3 pages
    The document is an automobile insurance identification card for Kristoffer Melder of Forest Hill, Louisiana. It provides coverage details for Melder's 1995 Ford, including bodily injury and property damage liability limits that meet Louisiana's minimum requirements. The card must be kept in the vehicle as proof of insurance and failure to present it could result in fines or other penalties.

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    Id Card, And Dec Page

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    The document is an automobile insurance identification card for Kristoffer Melder of Forest Hill, Louisiana. It provides coverage details for Melder's 1995 Ford, including bodily injury and property damage liability limits that meet Louisiana's minimum requirements. The card must be kept in the vehicle as proof of insurance and failure to present it could result in fines or other penalties.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    161 views3 pages

    Id Card, and Dec Page

    Uploaded by

    melderkristoffer7
    The document is an automobile insurance identification card for Kristoffer Melder of Forest Hill, Louisiana. It provides coverage details for Melder's 1995 Ford, including bodily injury and property damage liability limits that meet Louisiana's minimum requirements. The card must be kept in the vehicle as proof of insurance and failure to present it could result in fines or other penalties.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 3

    LOUISIANA AUTO INSURANCE IDENTIFICATION CARD

    An insurer authorized to transact business in Louisiana has issued the Motor Vehicle Policy identified hereon. The coverage
    provided by this policy meets the minimum liability insurance limits prescribed by law.
    Imperial Fire & Casualty Insurance Company
    KRISTOFFER MELDER
    PO Box 3199 ● Winston Salem, NC 27102-3199
    4135 Highway 112
    Forest Hill, LA 71430 NAIC POLICY NUMBER
    44369 2020168288
    Policy Term Effective Date Policy Term Expiration Date
    09/22/2023 03/22/2024
    Report all accidents by calling:
    1-800-468-3466
    AGENCY: 83906 VEHICLE INFORMATION
    Usagencies-709 YEAR MAKE VIN
    440 3rd St Fl 8 1995 FORD 2FALP73W5SX154070
    Baton Rouge LA 70802 This card must be carried in the vehicle at all times
    Phone: (800) 958-8545 as evidence of liability insurance.
    EXCLUDED DRIVERS:

    IMPORTANT NOTICE - La. R.S. 32:863.1 requires that an operator of a motor vehicle produce upon demand by a law enforcement officer documentation of
    motor vehicle security which is required to be maintained within the vehicle at all times. Failure to comply may result in fines, revocation of registration
    privileges and block against the renewal or issuance of a driver's license.
    MOD 00 11840 (09012016)

    Cut on Solid Line – Store In Your Vehicle


    Policy Number: Date of Notice
    2020168288 09/22/2023 04:35 PM
    PO Box 3199 ● Winston Salem, NC 27102-3199 Named Insured:
    KRISTOFFER MELDER

    KRISTOFFER MELDER Policy Period:


    4135 HIGHWAY 112 09/22/2023 - 03/22/2024
    FOREST HILL, LA 71430 Policy Underwritten by:
    Imperial Fire & Casualty Insurance Company

    24 Hour Claim Reporting: 1-800-468-3466


    For Policy Information: 1-877-468-3466
    www.MyNatGenPolicy.com
    Your Agent:
    Usagencies-709
    440 3rd St Fl 8
    Baton Rouge LA 70802
    (800) 958-8545

    LA PERSONAL AUTO DECLARATIONS PAGE


    New Business Effective 09/22/2023 04:35 PM

    Drivers and Household Residents


    #1 KRISTOFFER MELDER
    Driver Status License # Lic. State Date of Birth Gender Marital Status Driver Pts Yrs. Lic.
    Rated Driver XXXXX3712 LA 04/04/1978 Male Single 0 29

    Insured Personal Auto(s) and Schedule of Coverages


    #1 1995 FORD CROWN VI VIN: 2FALP73W5SX154070-FE3134
    Usage: Pleasure/Commute
    Garaging Location: 71430
    Coverages Provided Limits/Deductibles Premium
    Bodily Injury $15,000 Each Person / $30,000 Each Accident $465.00
    Property Damage $25,000 Each Accident $281.00
    Total For This Vehicle $746.00

    Premium and Fee Totals


    Combined Vehicle Coverage Premium $746.00
    Acquisition Expense $50.00
    Motor Vehicle Record Fee $5.00
    Total 6 Month Policy Premium $801.00

    Discounts Applied
    Policy Level
    Accident Free Claims Free
    Paperless Discount

    Additional Policy Information


    Insured email: [email protected]
    Tier: 3

    10039LA (02012019)
    Disclosure of Possible Additional Charges
    The amounts below are authorized for use in this state. However, they are only charged if they apply to your policy.
    Convenience Fee $3.00
    Financial Responsibility Filing Fee $20.00
    Late Charge $15.00
    Nonsufficient Funds Charge $35.00
    Reinstatement Charge $30.00
    Renters Fee $25.00
    MVR Fee $5.00

    Forms and Endorsements


    Form Edition Form Name
    12396 02012019 PERSONAL AUTO POLICY

    Authorized Signature

    10039LA (02012019)

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