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2015-130Q
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2015-130Q
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11/5/2015 12:23:05 PM
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THE CROCKETT GRP <br />3375 20TH ST # 110 <br />VERO BEACH, FL 32960 <br />Named insured <br />CROSSOVER MISSION INC <br />PO BOX 643312 <br />VERO BEACH, FL 32964 <br />Commercial Auto <br />Insurance Coverage Summary <br />This is your Declarations Page <br />PROGREIIIVE6 <br />Policy number: 02533419-0 <br />Underwritten by <br />Progressive Express Ins Company <br />June 19, 2015 <br />Policy Period' Jun 18, 2015 - Jun 18, 2016 <br />Page 1 of 2 <br />progressiveagent.com <br />Online Service <br />Make payments, check billing activity, print <br />policy documents, or check the status of a <br />claim. <br />1-772-562-9664 <br />THE CROCKETT GRP <br />Contact your agent for personalized service. - <br />1 -800-444-4487 <br />For customer service if your agent is <br />unavailable or to report a claim. <br />Your coverage began the later of June 18, 2015 at 12.01 a.m. or at the time your application is executed on the first day of the policy <br />period. This policy period ends on June 18, 2016 at 12:01 a.m. <br />Your insurance policy and any policy endorsements contain a full explanation of your coverage. The policy limits shown for an auto <br />may not be combined with the limits for the same coverage on another auto, unless the policy contract allows the stacking of limits. <br />The policy contract is form 6912 (06/10) The contract is modified by forms 2852FL (10/04), 1652FL (08/12), 4757FL (01/13), 4852FL <br />(10/04), 4881FL (01/13) and 2228 (01/11). <br />The named insured organization type is a corporation. <br />Outline of coverage <br />Description <br />Liability To Others <br />Bodily Injury and Property Damage Liability <br />Uninsured Motorist Non -Stacked <br />Basic Personal Injury Protection <br />Without Work Comp -Named Insured .& Relatives <br />Medical Payments <br />Fire And Theft With Combined Additional Coverage <br />See Auto Coverage Schedule <br />Collision <br />See Auto Coverage Schedule <br />Total 12 month policy premium <br />Rated drivers <br />ANTOINE <br />. ..... ..... <br />1. ANTOINE L JENNINGS <br />2. LYNN M THILMANY <br />3 CATHY DESCHOUWER <br />Form 6489 FL (11/12) <br />;limits Deductible <br />;$500,000 combined single limit <br />;$500,000 combined single limit <br />$10,000 each person $O <br />$5,000 each person <br />Limit of liability less deductible <br />• Limit of liability less deductible <br />Premium <br />$1,888 <br />557 <br />178 <br />63 <br />89 <br />116 <br />$2,891 <br />Contin <br />
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