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A2052160
H1009809
U1000009
State MICHIGAN Line of Business Automobile
Policy Number A2052160 Version 1.00
Policy Period 05/22/2013 - 05/22/2014 Policy Term Months 1 Year
Inception Date 05/22/2013 Renewal Date 05/22/2014
Agency Ebix Insurance ((514)574-2548 ) CSR Name John Smith
Insured Excluded
JAMES A ZYWICKI
KATHRYN ZYWICKI
Coverage Limits Deductible
Uninsured Motorist - Added on to At-Fault ? $25,000 each person Not Applicable
Liability Bodily Injury $50,000 each occurrence
2013 Chevrolet-CAMARO 2LT/CAMARO RS
Coverage Limits Deductible
Limited Property Damage (Mini-Tort) ? $100,000 each person Not Applicable
$300,000 each person
Broadened Collision ? $100,000 each person Not Applicable
Collision? Actual Cash Value $1,000
Comprehensive? Actual Cash Value $0
Transportation Expense ? $100 each disablement Not Applicable
2006 TOYOTA SIENNA
Coverage Limits Deductible
Limited Property Damage (Mini-Tort)? $100,000 each person Not Applicable
$300,000 each person
Broadened Collision? $100,000 each person Not Applicable
Collision? Actual Cash Value $1,000
Comprehensive? Actual Cash Value $0
Transportation Expense? $100 each disablement Not Applicable

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