Accord Cap Dat Details

The world is a better place when we're all working together. In the global marketplace, an agreement between two parties will be made in order to share resources and raise productivity. This blog post explains Capdat Acord, which is a contract for international trade that can help businesses succeed in today's competitive environment. Capdat Acord stands for "Contract of Agreement". It has been used by companies with operations abroad since the 1970s and helps cover both foreign exchange risks as well as variable costs like freight rates or import duties. For more information on this topic, please visit www.

This figure provides details about capdat acord. It can be useful to know its length, the average time to complete the form, the fields you will have to fill in, and so on.

QuestionAnswer
Form NameCapdat Acord
Form Length39 pages
Fillable?No
Fillable fields0
Avg. time to fill out9 min 45 sec
Other namesapplications for capdat, cap dat forms, cap dat login, 75

Form Preview Example

 

ALASKA

 

INSURANCE IDENTIFICATION CARD

 

 

(STATE)

 

 

 

COMPANY NUMBER

COMPANY

 

 

123

 

Any Insurance Company

 

POLICY NUMBER

EFFECTIVE DATE

EXPIRATION DATE

 

ABC987654321

5/1/2003

5/1/2004

 

YEAR

MAKE/MODEL

 

VEHICLE IDENTIFICATION NUMBER

AutoIDWEB

2003

MERZ / C32

 

WDBRF6SJ13F301306

AGENCY/COMPANY ISSUING CARD

 

 

Your Insurance Agency/Company

 

(Replace this logo with your company logo)

 

 

 

 

1234 Main Street

 

 

 

 

AnyCity, US 12345

 

 

INSURED

Empire Parts

210 Washington Ave

Albany, NY 12210-1312

 

 

 

 

Your Custom Message

 

 

SEE IMPORTANT NOTICE ON REVERSE SIDE

Can Go Here!

 

 

 

 

 

 

 

 

 

ALABAMA INSURANCE IDENTIFICATION CARD

 

 

Policy provides the minimum insurance prescribed by law.

 

COMPANY NUMBER

COMPANY

 

 

12345

Any Insurance Company

 

POLICY NUMBER

EFFECTIVE DATE

EXPIRATION DATE

 

ABC987654321

5/1/2003

5/1/2004

 

YEAR

MAKE/MODEL

 

VEHICLE IDENTIFICATION NUMBER

AutoIDWEB

2002

FORD / MUSTANG

1FAFP45X42F142005

AGENCY/COMPANY ISSUING CARD

 

 

Your Insurance Agency/Company

 

(Replace this logo with your company logo)

 

 

 

 

1234 Main Street

 

 

 

 

AnyCity, US 12345

 

 

INSURED

Empire Parts

210 Washington Ave

Albany, NY 12210-1312

 

 

 

 

 

 

Your Custom Message

 

 

 

 

SEE IMPORTANT NOTICE ON REVERSE SIDE

Can Go Here!

 

 

 

 

 

 

 

 

 

 

 

 

 

ARKANSAS PROOF OF INSURANCE CARD

 

COMPANY NAIC NUMBER

COMPANY NAME AND ADDRESS

 

12345

 

 

 

Any Insurance Company

 

COMPANY PHONE NUMBER

100 Fifth Ave

 

 

New York, NY 10010

 

 

800-555-1212

 

 

 

 

 

 

 

POLICY NUMBER

 

EFFECTIVE DATE

EXPIRATION DATE

 

ABC987654321

 

5/1/2003

5/1/2004

AutoIDWEB

YEAR

MAKE/MODEL

VEHICLE IDENTIFICATION NUMBER

2002

 

 

BUICK / CENTURY

2G4WY55J321110951

AGENCY ISSUING CARD

 

 

 

(Replace this logo with your company logo)

 

 

 

 

Your Insurance Agency/Company

 

 

1234 Main Street

 

 

 

 

AnyCity, US 12345

 

 

 

AGENCY PHONE NUMBER

123-456-7890

 

 

INSURED NAME AND ADDRESS

 

 

 

 

Empire Parts

 

 

 

 

 

 

 

 

210 Washington Ave

 

 

 

 

Albany, NY 12210-1312

 

Your Custom Message

 

 

 

 

SEE IMPORTANT NOTICE ON REVERSE SIDE

Can Go Here!

 

 

 

 

 

 

 

 

 

 

 

 

 

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

ACORD 50 (1/83)

© ACORD CORPORATION 1983

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

ACORD 50 (1/83)

© ACORD CORPORATION 1983

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

ACORD 50 AR (2003/07)

© ACORD CORPORATION 2003

 

ARIZONA

INSURANCE IDENTIFICATION CARD

 

 

(STATE)

 

 

 

COMPANY NUMBER

COMPANY

 

 

A123

 

Any Insurance Company

 

POLICY NUMBER

EFFECTIVE DATE

EXPIRATION DATE

 

ABC987654321

5/1/2003

5/1/2004

 

YEAR

MAKE/MODEL

 

VEHICLE IDENTIFICATION NUMBER

AutoIDWEB

2002

TOYOTA / CAMRY

JTDBE32K420010592

AGENCY/COMPANY ISSUING CARD

 

 

Your Insurance Agency/Company

 

(Replace this logo with your company logo)

 

 

 

 

1234 Main Street

 

 

 

 

AnyCity, US 12345

 

 

INSURED

Empire Parts

210 Washington Ave

Albany, NY 12210-1312

 

 

 

 

Your Custom Message

 

 

SEE IMPORTANT NOTICE ON REVERSE SIDE

Can Go Here!

 

 

 

 

 

 

 

 

 

CALIFORNIA INSURANCE IDENTIFICATION CARD

 

 

The policy meets the requirements of Section 16056 of the California Vehicle Code.

 

COMPANY NUMBER

COMPANY

 

 

12345

Any Insurance Company

 

POLICY NUMBER

EFFECTIVE DATE

EXPIRATION DATE

 

ABC987654321

5/1/2003

5/1/2004

 

YEAR

MAKE/MODEL

 

VEHICLE IDENTIFICATION NUMBER

AutoIDWEB

2002

BUICK / RENDEZVOUS

3G5DA03E12S504064

AGENCY/COMPANY ISSUING CARD

 

 

Your Insurance Agency/Company

 

(Replace this logo with your company logo)

 

 

 

 

1234 Main Street

 

 

 

 

AnyCity, US 12345

 

 

INSURED

Empire Parts

210 Washington Ave

Albany, NY 12210-1312

 

 

 

 

Your Custom Message

 

 

SEE IMPORTANT NOTICE ON REVERSE SIDE

Can Go Here!

 

 

 

 

 

 

 

 

 

COLORADO INSURANCE IDENTIFICATION CARD

 

 

BI, PD, AND PIP coverages provided as required by law.

 

COMPANY NUMBER

COMPANY

 

 

123

 

Any Insurance Company

 

POLICY NUMBER

EFFECTIVE DATE

EXPIRATION DATE

 

ABC987654321

5/1/2003

5/1/2004

 

YEAR

MAKE/MODEL

 

VEHICLE IDENTIFICATION NUMBER

AutoIDWEB

2002

KIA / SD

 

KNADC123526157767

AGENCY/COMPANY ISSUING CARD

 

 

Your Insurance Agency/Company

 

(Replace this logo with your company logo)

 

 

 

 

1234 Main Street

 

 

 

 

AnyCity, US 12345

 

 

INSURED

Empire Parts

210 Washington Ave

Albany, NY 12210-1312

Your Custom Message

Can Go Here!

SEE IMPORTANT NOTICE ON REVERSE SIDE

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

ACORD 50 (1/83)

© ACORD CORPORATION 1983

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

ACORD 50 (1/83)

© ACORD CORPORATION 1983

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

ACORD 50 (1/83)

© ACORD CORPORATION 1983

 

 

 

CONNECTICUT INSURANCE IDENTIFICATION CARD

 

 

Connecticut Insurance Card Issued Pursuant to Connecticut Law

 

COMPANY NUMBER

COMPANY

 

123

 

Any Insurance Company

 

POLICY NUMBER

 

EFFECTIVE DATE

 

ABC987654321

 

5/1/2003

 

YEAR

MAKE/MODEL

 

VEHICLE IDENTIFICATION NUMBER

AutoIDWEB

2001

BUICK / LESABRE

1G4HP54K514147010

AGENCY/COMPANY ISSUING CARD

 

 

Your Insurance Agency/Company

(Replace this logo with your company logo)

 

 

 

1234 Main Street

 

 

 

 

AnyCity, US 12345

 

 

INSURED

Empire Parts

210 Washington Ave

Albany, NY 12210-1312

 

 

 

 

Your Custom Message

 

 

SEE IMPORTANT NOTICE ON REVERSE SIDE

Can Go Here!

 

 

 

 

 

 

 

 

DISTRICT OF COLUMBIA

INSURANCE IDENTIFICATION CARD

 

 

(STATE)

 

 

 

COMPANY NUMBER

COMPANY

 

 

123

 

Any Insurance Company

 

POLICY NUMBER

EFFECTIVE DATE

EXPIRATION DATE

 

ABC987654321

5/1/2003

5/1/2004

 

YEAR

MAKE/MODEL

 

VEHICLE IDENTIFICATION NUMBER

AutoIDWEB

2001

HONDA / ACCORD

1HGCF86671A087673

AGENCY/COMPANY ISSUING CARD

 

 

Your Insurance Agency/Company

 

(Replace this logo with your company logo)

 

 

 

 

1234 Main Street

 

 

 

 

AnyCity, US 12345

 

 

INSURED

Empire Parts

210 Washington Ave

Albany, NY 12210-1312

 

 

 

 

Your Custom Message

 

 

SEE IMPORTANT NOTICE ON REVERSE SIDE

Can Go Here!

 

 

 

 

 

 

 

 

DELAWARE

INSURANCE IDENTIFICATION CARD

 

 

(STATE)

 

 

 

COMPANY NUMBER

COMPANY

 

 

12345

Any Insurance Company

 

POLICY NUMBER

EFFECTIVE DATE

EXPIRATION DATE

 

ABC987654321

5/1/2003

5/1/2004

 

YEAR

MAKE/MODEL

 

VEHICLE IDENTIFICATION NUMBER

AutoIDWEB

2001

OLDSMOBILE / INTRIGUE

1GWS52H71F186333

AGENCY/COMPANY ISSUING CARD

 

 

Your Insurance Agency/Company

 

(Replace this logo with your company logo)

 

 

 

 

1234 Main Street

 

 

 

 

AnyCity, US 12345

 

 

INSURED

Empire Parts

210 Washington Ave

Albany, NY 12210-1312

Your Custom Message

Can Go Here!

SEE IMPORTANT NOTICE ON REVERSE SIDE

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

ACORD 50 (1/83)

© ACORD CORPORATION 1983

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

ACORD 50 (1/83)

© ACORD CORPORATION 1983

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

THE FRONT OF THIS DOCUMENT CONTAINS AN ARTIFICIAL WATERMARK - HOLD AT AN ANGLE TO VIEW

ACORD 50 WM (2/95)

© ACORD CORPORATION 1993

AutoIDWEB

(Replace this logo with your company logo)

FLORIDA AUTO INSURANCE IDENTIFICATION CARD

COMPANY: Any Insurance Company

POLICY #:

ABC987654321-FL123

EFFECTIVE

DATE: 5/1/2003 to

 

 

 

 

 

YEAR:

 

2001

MAKE/

5/1/2004

 

MODEL: CHEVROLET / TRUCK

 

 

 

 

 

 

VEHICLE ID #: 1GCHK23G81F134609

 

 

 

 

 

PERSONAL INJURY PROTECTION

 

 

BODILY INJURY

 

X

 

X

 

BENEFITS/PROPERTY DAMAGE LIABILITY

 

LIABILITY

NAMED Empire Parts

INSURED: 210 Washington Ave

ADDRESS: Albany, NY 12210-1312

(OPTIONAL)

NOT VALID FOR MORE THAN ONE YEAR FROM EFFECTIVE DATE

Your Custom Message

 

Can Go Here!

PLEASE CUT ALONG ABOVE LINE

 

 

 

 

GEORGIA

INSURANCE IDENTIFICATION CARD

 

 

 

 

 

 

(STATE)

 

 

 

 

 

COMPANY NUMBER

COMPANY

 

 

 

 

123

 

 

 

Any Insurance Company

 

 

 

POLICY NUMBER

EFFECTIVE DATE

EXPIRATION DATE

 

 

 

ABC987654321

5/1/2003

5/1/2004

 

 

 

YEAR

 

 

MAKE/MODEL

 

VEHICLE IDENTIFICATION NUMBER

AutoIDWEB

2001

 

 

CHEVROLET / SILVERADO

1GCJK39G71E311381

AGENCY/COMPANY ISSUING CARD

 

 

Your Insurance Agency/Company

 

(Replace this logo with your company logo)

 

 

 

 

 

 

1234 Main Street

 

 

 

 

 

 

AnyCity, US 12345

 

 

 

 

INSURED

 

 

 

 

 

 

 

 

Empire Parts

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

210 Washington Ave

 

 

 

 

 

 

 

Albany, NY 12210-1312

 

 

 

 

 

 

 

 

 

 

 

Your Custom Message

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SEE IMPORTANT NOTICE ON REVERSE SIDE

 

Can Go Here!

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HAWAII MOTOR VEHICLE INSURANCE IDENTIFICATION CARD

 

 

 

 

 

 

COMPANY #

COMPANY

 

 

 

 

 

 

 

123

Any Insurance Company

 

 

 

 

 

 

AN AUTHORIZED HAWAII INSURER HAS ISSUED AN INSURANCE POLICY

 

 

 

 

 

 

WHICH COMPLIES WITH THE HAWAII MOTOR VEHICLE INSURANCE LAW TO:

 

 

 

AutoIDWEB

INSURED

Empire Parts

 

 

 

 

NAME AND

210 Washington Ave

 

 

 

ADDRESS:

Albany, NY 12210-1312

 

 

 

 

 

 

 

AGENCY/COMPANY Your Insurance Agency/Company

 

 

 

ISSUING CARD:

1234 Main Street, AnyCity, US 12345

 

 

 

(Replace this logo with your company logo)

YEAR: 2001

MAKE/MODEL: BUICK / REGAL

 

 

 

 

 

 

VEHICLE ID #:

2G4WB55K611267155

 

 

 

 

 

 

 

POLICY #:

ABC987654321

 

 

 

 

 

 

 

EFFECTIVE DATE: 5/1/2003

EXPIRATION DATE: 5/1/2004

 

 

 

 

 

 

 

SEE IMPORTANT NOTICE ON REVERSE SIDE

 

 

 

 

Your Custom Message

 

 

 

 

 

 

 

Can Go Here!

PLEASE CUT ALONG ABOVE LINE

 

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

Rental car coverage is provided, see outline of coverage.

MISREPRESENTATION OF INSURANCE IS A FIRST DEGREE MISDEMEANOR

ACORD 50 FL (3/94)

© ACORD CORPORATION 1994

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1. Name and address of each driver, passenger and witness.

2. Name of Insurance Company and policy number for each vehicle involved.

ACORD 50 (1/83)

© ACORD CORPORATION 1983

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

THE FRONT OF THIS DOCUMENT CONTAINS AN ARTIFICIAL WATERMARK -

HOLD AT AN ANGLE TO VIEW.

ACORD 50 HI (1/99)

© ACORD CORPORATION 1994

 

 

 

IOWA FINANCIAL LIABILITY COVERAGE CARD

 

COMPANY NUMBER

COMPANY

 

 

123

 

 

 

Any Insurance Company

 

POLICY NUMBER

EFFECTIVE DATE

EXPIRATION DATE

 

ABC987654321

5/1/2003

5/1/2004

 

YEAR

 

 

MAKE/MODEL

 

VEHICLE IDENTIFICATION NUMBER

AutoID

2001

 

 

MITSUBISHI / GALANT

4A3AA46G61E191633

 

 

WEB

AGENCY/COMPANY ISSUING CARD

 

Your Insurance Agency/Company

 

(Replace this logo with your company logo)

AGENCY/COMPANY ADDRESS

 

 

 

1234 Main Street

 

 

 

AnyCity, US 12345

 

 

 

INSURED

 

 

 

 

 

 

Empire Parts

 

 

 

 

 

 

 

 

 

 

 

 

210 Washington Ave

 

 

 

 

 

Albany, NY 12210-1312

 

 

 

 

 

 

 

 

Your Custom Message

 

 

 

 

 

 

 

 

 

 

 

 

COVERAGE PROVIDED BY THIS POLICY MEETS THE MINIMUM LIABILITY LIMITS PRESCRIBED BY LAW

Can Go Here!

 

 

 

 

SEE IMPORTANT NOTICE ON REVERSE SIDE

 

 

 

 

 

 

 

 

 

STATE OF IDAHO LIABILITY INSURANCE IDENTIFICATION CARD

 

 

 

 

(STATE)

 

 

 

COMPANY NUMBER

COMPANY

 

 

123

 

 

 

Any Insurance Company

 

POLICY NUMBER

EFFECTIVE DATE

EXPIRATION DATE

 

ABC987654321

5/1/2003

5/1/2004

 

YEAR

 

 

MAKE/MODEL

 

VEHICLE IDENTIFICATION NUMBER

AutoIDWEB

2001

 

 

KIA / SEPHIA

 

KNAFB121X5052916

AGENCY/COMPANY ISSUING CARD

 

 

Your Insurance Agency/Company

 

(Replace this logo with your company logo)

 

 

 

 

1234 Main Street

 

 

 

 

AnyCity, US 12345

 

 

INSURED

Empire Parts

210 Washington Ave

Albany, NY 12210-1312

 

 

 

 

Your Custom Message

 

 

SEE IMPORTANT NOTICE ON REVERSE SIDE

Can Go Here!

 

 

 

 

 

 

 

 

 

ILLINOIS INSURANCE IDENTIFICATION CARD

 

 

Examine policy exclusions carefully. This form does not constitute any part of your insurance policy.

 

COMPANY NUMBER

COMPANY

 

 

12345

Any Insurance Company

 

POLICY NUMBER

EFFECTIVE DATE

EXPIRATION DATE

 

ABC987654321

5/1/2003

5/1/2004

 

YEAR

MAKE/MODEL

 

VEHICLE IDENTIFICATION NUMBER

AutoIDWEB

2001

BUICK / LESABRE

1G4HP54K914228687

AGENCY/COMPANY ISSUING CARD

 

 

Your Insurance Agency/Company

 

(Replace this logo with your company logo)

 

 

 

 

1234 Main Street

 

 

 

 

AnyCity, US 12345

 

 

INSURED

Empire Parts

210 Washington Ave

Albany, NY 12210-1312

Your Custom Message

Can Go Here!

SEE IMPORTANT NOTICE ON REVERSE SIDE

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

EMERGENCY PHONE NUMBER OF:

X

Agency: 123-456-7890

X

Company: 800-555-1212

ACORD 50 IA (2002/12)

© ACORD CORPORATION 2002

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

ACORD 50 (1/83)

© ACORD CORPORATION 1983

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

EXCLUDED DRIVERS

ACORD 50 (1/83)

© ACORD CORPORATION 1983

 

INDIANA

 

INSURANCE IDENTIFICATION CARD

 

 

(STATE)

 

 

 

COMPANY NUMBER

COMPANY

 

 

123

 

Any Insurance Company

 

POLICY NUMBER

EFFECTIVE DATE

EXPIRATION DATE

 

ABC987654321

5/1/2003

5/1/2004

 

YEAR

MAKE/MODEL

 

VEHICLE IDENTIFICATION NUMBER

AutoIDWEB

2001

HONDA / CIVIC

1HGES16521L028151

AGENCY/COMPANY ISSUING CARD

 

 

Your Insurance Agency/Company

 

(Replace this logo with your company logo)

 

 

 

 

1234 Main Street

 

 

 

 

AnyCity, US 12345

 

 

INSURED

Empire Parts

210 Washington Ave

Albany, NY 12210-1312

 

 

 

 

 

 

 

Your Custom Message

 

 

 

 

SEE IMPORTANT NOTICE ON REVERSE SIDE

 

Can Go Here!

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

KANSAS

 

INSURANCE IDENTIFICATION CARD

 

 

 

 

 

 

 

(STATE)

 

 

 

 

 

 

COMPANY NUMBER

COMPANY

 

 

 

 

 

123

 

 

 

Any Insurance Company

 

 

 

 

POLICY NUMBER

EFFECTIVE DATE

EXPIRATION DATE

 

 

 

 

ABC987654321

5/1/2003

5/1/2004

 

 

 

 

YEAR

 

 

MAKE/MODEL

 

VEHICLE IDENTIFICATION NUMBER

AutoIDWEB

2001

 

 

HONDA / ACCORD

JHMCG56621C024204

AGENCY/COMPANY ISSUING CARD

 

 

Your Insurance Agency/Company

 

(Replace this logo with your company logo)

 

 

 

 

 

 

 

1234 Main Street

 

 

 

 

 

 

 

AnyCity, US 12345

 

 

 

 

 

INSURED

 

 

 

 

 

 

 

 

 

Empire Parts

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

210 Washington Ave

 

 

 

 

 

 

 

 

Albany, NY 12210-1312

 

 

 

 

 

 

 

 

 

 

 

 

Your Custom Message

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SEE IMPORTANT NOTICE ON REVERSE SIDE

 

Can Go Here!

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COMMONWEALTH OF KENTUCKY PROOF OF INSURANCE

 

 

 

 

 

 

COMPANY #

COMPANY NAME AND ADDRESS

 

 

 

 

 

 

54321

Any Insurance Company

 

 

 

 

 

 

 

100 Fifth Ave

 

 

 

 

 

 

 

 

 

New York, NY 10010

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AutoIDWEB

 

Empire Parts

 

 

 

 

 

NAMED

210 Washington Ave

 

 

 

 

INSURED

Albany, NY 12210-1312

 

 

 

 

& ADDRESS:

 

 

 

 

POLICY #:

 

 

 

 

 

 

ABC987654321

 

 

 

 

 

(Replace this logo with your company logo)

EFFECTIVE DATE: 5/1/2003

EXPIRATION DATE: 5/1/2004

 

 

 

 

 

 

YEAR: 2001

MAKE/MODEL: BUICK / LESABRE

 

 

 

 

 

 

VEHICLE ID #:

1G4HP54K314140704

 

 

 

 

 

 

 

 

AGENCY/COMPANY Your Insurance Agency/Company

 

 

 

 

 

 

ISSUING CARD:

1234 Main Street, AnyCity, US 12345

 

 

 

 

 

 

AGCY/CO PHONE #: 800-456-7890

 

 

 

 

 

 

 

 

 

SEE IMPORTANT NOTICE ON REVERSE SIDE

 

 

 

 

Your Custom Message

 

 

 

 

 

 

 

 

Can Go Here!

PLEASE CUT ALONG ABOVE LINE

 

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1. Name and address of each driver, passenger and witness.

2. Name of Insurance Company and policy number for each vehicle involved.

ACORD 50 (1/83)

© ACORD CORPORATION 1983

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1. Name and address of each driver, passenger and witness.

2. Name of Insurance Company and policy number for each vehicle involved.

ACORD 50 (1/83)

© ACORD CORPORATION 1983

INSTRUCTIONS TO POLICYHOLDER

Two proof of insurance cards are provided herewith. Present one copy to the County Clerk when renewing your motor vehicle registration. The other copy shall be carried in the identified motor vehicle at all times as evidence of insurance, and shall be shown to a peace officer upon request. Note: if Vehicle Identification is designated 'Fleet' keep the other copy with your insurance records.

Important: Compare the Vehicle Identification Number shown on the Proof of Insurance card and on the motor vehicle registration with the Vehicle Identification Number on the motor vehicle. They should match. If the number shown on the Proof of Insurance card is incor- rect, contact your insurance company representative to have the number corrected. If the number shown on the registration is incor- rect, contact the County Clerk to have the number corrected.

ACORD 50 KY (3/98)

© ACORD CORPORATION 1994

 

LOUISIANA AUTO INSURANCE IDENTIFICATION CARD

 

 

COMPANY NAIC NUMBER

COMPANY AFFORDING COVERAGE (NAME & ADDRESS)

 

 

12345

Any Insurance Company

 

 

 

 

 

100 Fifth Ave

 

 

 

 

 

 

New York, NY 10010

 

 

 

 

An

insurer authorized to transact business in Louisiana

has

issued the

AutoIDWEB

Motor Vehicle Policy identified here on. The coverage provided by this

 

policy meets the

minimum liability insurance limits prescribed

by law.

 

POLICY NUMBER

 

EFFECTIVE DATE

EXPIRATION DATE

(Replace this logo with your company logo)

 

 

ABC987654321

 

5/1/2003

5/1/2004

 

YEAR

MAKE/MODEL

 

VEHICLE IDENTIFICATION NUMBER

 

2001

BUICK / PARK AVE

1G4CW54K614203856

 

 

NAME OF INSURED

 

 

 

 

 

Empire Parts

 

 

 

 

 

210 Washington Ave, Albany, NY 12210-1312

 

 

 

 

THIS CARD MUST BE CARRIED IN THE VEHICLE AT ALL TIMES

 

 

 

AS EVIDENCE OF INSURANCE

 

 

Your Custom Message

 

 

SEE IMPORTANT NOTICE ON REVERSE SIDE

 

 

Can Go Here!

 

 

 

 

 

MASSACHUSETTS

INSURANCE IDENTIFICATION CARD

 

 

(STATE)

 

 

 

 

 

COMPANY NUMBER

COMPANY

 

 

 

 

123

 

Any Insurance Company

 

 

 

POLICY NUMBER

EFFECTIVE DATE

EXPIRATION DATE

 

 

ABC987654321

5/1/2003

5/1/2004

 

 

 

YEAR

MAKE/MODEL

 

VEHICLE IDENTIFICATION NUMBER

AutoIDWEB

2001

HONDA / CIVIC

2HGES15581H537384

 

AGENCY/COMPANY ISSUING CARD

 

 

 

 

Your Insurance Agency/Company

 

 

 

(Replace this logo with your company logo)

 

 

 

 

 

 

1234 Main Street

 

 

 

 

 

AnyCity, US 12345

 

 

 

 

INSURED

Empire Parts

210 Washington Ave

Albany, NY 12210-1312

 

 

 

 

Your Custom Message

 

 

SEE IMPORTANT NOTICE ON REVERSE SIDE

Can Go Here!

 

 

 

 

 

 

 

 

MARYLAND

INSURANCE IDENTIFICATION CARD

 

 

(STATE)

 

 

 

COMPANY NUMBER

COMPANY

 

 

123

 

Any Insurance Company

 

POLICY NUMBER

EFFECTIVE DATE

EXPIRATION DATE

 

ABC987654321

5/1/2003

5/1/2004

 

YEAR

MAKE/MODEL

 

VEHICLE IDENTIFICATION NUMBER

AutoIDWEB

2001

BUICK / LESABRE

1G4HP54K414272841

AGENCY/COMPANY ISSUING CARD

 

 

Your Insurance Agency/Company

 

(Replace this logo with your company logo)

 

 

 

 

1234 Main Street

 

 

 

 

AnyCity, US 12345

 

 

INSURED

Empire Parts

210 Washington Ave

Albany, NY 12210-1312

Your Custom Message

Can Go Here!

SEE IMPORTANT NOTICE ON REVERSE SIDE

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 privi- leges, and block against the renewal or issuance of a drivers license.

INSURANCE AGENT (NAME, ADDRESS & TELEPHONE NUMBER)

Your Insurance Agency/Company

1234 Main Street

AnyCity, US 12345

Telephone: 123-456-7890

EXCLUDED DRIVERS

ACORD 50 LA (4/96)

© ACORD CORPORATION 1996

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

ACORD 50 (1/83)

© ACORD CORPORATION 1983

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

ACORD 50 (1/83)

© ACORD CORPORATION 1983

 

 

MAINE MOTOR VEHICLE INSURANCE IDENTIFICATION CARD

 

 

 

The policy provides the minimum insurance required by law.

 

COMPANY NUMBER

COMPANY

 

 

123

 

Any Insurance Company

 

POLICY NUMBER

EFFECTIVE DATE

EXPIRATION DATE

 

ABC987654321

5/1/2003

5/1/2004

 

YEAR

MAKE/MODEL

VEHICLE IDENTIFICATION NUMBER

AutoIDWEB

2001

BUICK / LESABRE

1G4HP54K31U199252

AGENCY/COMPANY ISSUING CARD

 

 

Your Insurance Agency/Company

 

(Replace this logo with your company logo)

 

 

 

 

1234 Main Street

 

 

 

AnyCity, US 12345

 

 

INSURED

Empire Parts

210 Washington Ave

Albany, NY 12210-1312

 

 

 

 

 

 

Your Custom Message

 

 

 

 

SEE IMPORTANT NOTICE ON REVERSE SIDE

Can Go Here!

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MINNESOTA INSURANCE IDENTIFICATION CARD

 

COMPANY NUMBER

COMPANY

 

 

123

 

 

 

Any Insurance Company

 

POLICY NUMBER

EFFECTIVE DATE

EXPIRATION DATE

 

ABC987654321

5/1/2003

5/1/2004

 

YEAR

 

 

MAKE/MODEL

 

VEHICLE IDENTIFICATION NUMBER

AutoIDWEB

2000

 

 

DODGE / INTREPID

2B3HD46R1YH402476

AGENCY/COMPANY ISSUING CARD

 

 

Your Insurance Agency/Company

 

(Replace this logo with your company logo)

 

 

 

 

1234 Main Street

 

 

 

 

AnyCity, US 12345

 

 

INSURED

 

 

 

 

 

 

Empire Parts

 

 

 

 

 

 

 

 

 

 

 

 

210 Washington Ave

 

 

 

 

 

Albany, NY 12210-1312

 

 

 

 

 

 

 

 

 

 

 

Every driver shall have in his or her possession while operating a motor vehicle,

Your Custom Message

and shall produce on demand proof of insurance covering the vehicle being operated.

 

Failure to produce the required proof of insurance can result in a misdemeanor conviction.

Can Go Here!

 

 

 

 

SEE IMPORTANT NOTICE ON REVERSE SIDE

 

 

 

 

 

MISSOURI AUTO INSURANCE IDENTIFICATION CARD

INSURANCE COMPANY NAME AND ADDRESS

Any Insurance Company

100 Fifth Ave

New York, NY 10010

POLICY NUMBER

EFFECTIVE DATE

EXPIRATION DATE

 

ABC987654321

5/1/2003

5/1/2004

 

YEAR

MAKE/MODEL

VEHICLE IDENTIFICATION NUMBER

AutoIDWEB

2000

 

 

BUICK / LESABRE

1G4HP54K4YU345524

AGENCY/COMPANY ISSUING CARD

 

Your Insurance Agency/Company

 

(Replace this logo with your company logo)

 

 

1234 Main Street

 

 

AnyCity, US 12345

 

 

INSURED NAME AND ADDRESS

 

 

 

 

Empire Parts

 

 

 

 

 

 

 

 

210 Washington Ave

 

 

 

 

Albany, NY 12210-1312

 

 

 

 

 

 

 

Your Custom Message

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Can Go Here!

SEE IMPORTANT NOTICE ON REVERSE SIDE

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

ACORD 50 (1/83)

© ACORD CORPORATION 1983

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

It is unlawful for any person to display, cause or permit the display of, or have in possession proof of insurance that is fictitious or fraudulent.

In addition to criminal penalties, any person convicted of a misdemeanor because of any of the above is subject to drivers license revocation, and a fine of not less that $200.

ACORD 50 (1/83)

© ACORD CORPORATION 1983

THIS CARD MUST BE CARRIED IN THE INSURED

MOTOR VEHICLE FOR PRODUCTION UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

ACORD 50 MO (2/98)

© ACORD CORPORATION 1998

 

 

 

MISSISSIPPI INSURANCE IDENTIFICATION CARD

 

COMPANY NUMBER

COMPANY

 

 

123

 

 

 

Any Insurance Company

 

POLICY NUMBER

EFFECTIVE DATE

EXPIRATION DATE

 

ABC987654321

5/1/2003

5/1/2004

 

YEAR

 

 

 

MAKE/MODEL

VEHICLE IDENTIFICATION NUMBER

AutoIDWEB

2000

 

 

 

BUICK / LESABRE

1G4HP54K6Y4104919

AGENCY/COMPANY ISSUING CARD AND LOCAL OR CUSTOMER SERVICE PHONE NUMBER

 

Your Insurance Agency/Company

123-456-7890

(Replace this logo with your company logo)

 

 

 

1234 Main Street

 

 

 

AnyCity, US 12345

 

 

INSURED

 

 

 

 

 

 

Empire Parts

 

 

 

 

 

 

 

 

 

 

210 Washington Ave

 

 

 

 

 

Albany, NY 12210-1312

 

 

 

 

 

 

 

 

Your Custom Message

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SEE IMPORTANT NOTICE ON REVERSE SIDE

Can Go Here!

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MONTANA

INSURANCE IDENTIFICATION CARD

 

 

 

 

(STATE)

 

 

COMPANY NUMBER

COMPANY

 

 

123

 

 

 

Any Insurance Company

 

POLICY NUMBER

EFFECTIVE DATE

EXPIRATION DATE

 

ABC987654321

5/1/2003

5/1/2004

 

YEAR

 

 

MAKE/MODEL

VEHICLE IDENTIFICATION NUMBER

AutoIDWEB

2000

 

 

DODGE / 2500H

3B7KF26W8YM221465

AGENCY/COMPANY ISSUING CARD

 

 

Your Insurance Agency/Company

 

(Replace this logo with your company logo)

 

 

 

 

1234 Main Street

 

 

 

AnyCity, US 12345

 

 

INSURED

Empire Parts

210 Washington Ave

Albany, NY 12210-1312

 

 

 

 

Your Custom Message

 

 

SEE IMPORTANT NOTICE ON REVERSE SIDE

Can Go Here!

 

 

 

 

 

 

 

 

NORTH CAROLINA

INSURANCE IDENTIFICATION CARD

 

 

(STATE)

 

 

 

COMPANY NUMBER

COMPANY

 

 

123

 

Any Insurance Company

 

POLICY NUMBER

EFFECTIVE DATE

EXPIRATION DATE

 

ABC987654321

5/1/2003

5/1/2004

 

YEAR

MAKE/MODEL

 

VEHICLE IDENTIFICATION NUMBER

AutoIDWEB

2000

BUICK / LESABRE

1G4HP54K5Y4105348

AGENCY/COMPANY ISSUING CARD

 

 

Your Insurance Agency/Company

 

(Replace this logo with your company logo)

 

 

 

 

1234 Main Street

 

 

 

 

AnyCity, US 12345

 

 

INSURED

Empire Parts

210 Washington Ave

Albany, NY 12210-1312

Your Custom Message

Can Go Here!

SEE IMPORTANT NOTICE ON REVERSE SIDE

MISSISSIPPI LAW REQUIRES THIS CARD TO BE KEPT IN THE INSURED

MOTOR VEHICLE FOR PRESENTMENT UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

ACORD 50 MS (2001/01)

© ACORD CORPORATION 2001

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

ACORD 50 (1/83)

© ACORD CORPORATION 1983

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

ACORD 50 (1/83)

© ACORD CORPORATION 1983

 

NORTH DAKOTA

INSURANCE IDENTIFICATION CARD

 

 

(STATE)

 

 

 

COMPANY NUMBER

COMPANY

 

 

123

 

Any Insurance Company

 

POLICY NUMBER

EFFECTIVE DATE

EXPIRATION DATE

 

ABC987654321

5/1/2003

5/1/2004

 

YEAR

MAKE/MODEL

 

VEHICLE IDENTIFICATION NUMBER

AutoIDWEB

2000

MAZDA / PROTEGE

JM1BJ2220Y0215681

AGENCY/COMPANY ISSUING CARD

 

 

Your Insurance Agency/Company

 

(Replace this logo with your company logo)

 

 

 

 

1234 Main Street

 

 

 

 

AnyCity, US 12345

 

 

INSURED

Empire Parts

210 Washington Ave

Albany, NY 12210-1312

 

 

 

 

Your Custom Message

 

 

SEE IMPORTANT NOTICE ON REVERSE SIDE

Can Go Here!

 

 

 

 

 

 

 

NEBRASKA AUTO LIABILITY INSURANCE IDENTIFICATION CARD

 

 

(STATE)

 

 

 

COMPANY NUMBER

COMPANY

 

 

123

 

Any Insurance Company

 

POLICY NUMBER

EFFECTIVE DATE

EXPIRATION DATE

 

ABC987654321

5/1/2003

5/1/2004

 

YEAR

MAKE/MODEL

 

VEHICLE IDENTIFICATION NUMBER

AutoIDWEB

2000

PONTIAC / BONNEVILLE

1G2HY54K8Y4239499

AGENCY/COMPANY ISSUING CARD

 

 

Your Insurance Agency/Company

 

(Replace this logo with your company logo)

 

 

 

 

1234 Main Street

 

 

 

 

AnyCity, US 12345

 

 

INSURED

Empire Parts

210 Washington Ave

Albany, NY 12210-1312

 

 

 

 

Your Custom Message

 

 

SEE IMPORTANT NOTICE ON REVERSE SIDE

Can Go Here!

 

 

 

 

 

 

 

 

NEW HAMPSHIRE

INSURANCE IDENTIFICATION CARD

 

 

(STATE)

 

 

 

COMPANY NUMBER

COMPANY

 

 

123

 

Any Insurance Company

 

POLICY NUMBER

EFFECTIVE DATE

EXPIRATION DATE

 

ABC987654321

5/1/2003

5/1/2004

 

YEAR

MAKE/MODEL

 

VEHICLE IDENTIFICATION NUMBER

AutoIDWEB

2000

HYUNDAI / SONATA

KMHWF25S7YA149179

AGENCY/COMPANY ISSUING CARD

 

 

Your Insurance Agency/Company

 

(Replace this logo with your company logo)

 

 

 

 

1234 Main Street

 

 

 

 

AnyCity, US 12345

 

 

INSURED

Empire Parts

210 Washington Ave

Albany, NY 12210-1312

Your Custom Message

Can Go Here!

SEE IMPORTANT NOTICE ON REVERSE SIDE

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

ACORD 50 (1/83)

© ACORD CORPORATION 1983

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

ACORD 50 (1/83)

© ACORD CORPORATION 1983

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

ACORD 50 (1/83)

© ACORD CORPORATION 1983

 

STATE OF NEW JERSEY INSURANCE IDENTIFICATION CARD

 

 

(STATE)

 

 

 

COMPANY NUMBER

COMPANY

 

 

NJ1

 

Any Insurance Company

 

POLICY NUMBER

EFFECTIVE DATE

EXPIRATION DATE

 

ABC987654321

5/1/2003

5/1/2004

 

YEAR

MAKE/MODEL

 

VEHICLE IDENTIFICATION NUMBER

AutoIDWEB

2000

HYUNDAI / SONATA

KMHWF25S2YA185653

AGENCY/COMPANY ISSUING CARD

 

 

Your Insurance Agency/Company

 

(Replace this logo with your company logo)

 

 

 

 

1234 Main Street

 

 

 

 

AnyCity, US 12345

 

 

INSURED

Empire Parts

210 Washington Ave

Albany, NY 12210-1312

 

 

 

 

Your Custom Message

 

 

SEE IMPORTANT NOTICE ON REVERSE SIDE

Can Go Here!

 

 

 

 

 

 

 

 

NEW MEXICO

INSURANCE IDENTIFICATION CARD

 

 

(STATE)

 

 

 

COMPANY NUMBER

COMPANY

 

 

123

 

Any Insurance Company

 

POLICY NUMBER

EFFECTIVE DATE

EXPIRATION DATE

 

ABC987654321

5/1/2003

5/1/2004

 

YEAR

MAKE/MODEL

 

VEHICLE IDENTIFICATION NUMBER

AutoIDWEB

2000

BUICK / LASABRE

1G4HP54K9Y4105420

AGENCY/COMPANY ISSUING CARD

 

 

Your Insurance Agency/Company

 

(Replace this logo with your company logo)

 

 

 

 

1234 Main Street

 

 

 

 

AnyCity, US 12345

 

 

INSURED

Empire Parts

210 Washington Ave

Albany, NY 12210-1312

 

 

 

Your Custom Message

 

SEE IMPORTANT NOTICE ON REVERSE SIDE

Can Go Here!

 

 

 

 

 

 

NEVADA INSURANCE IDENTIFICATION CARD

 

COMPANY NUMBER

COMPANY NAME AND ADDRESS

 

123

Any Insurance Company

 

 

100 Fifth Ave, New York, NY 10010

 

 

 

POLICY NUMBER

EFFECTIVE DATE

EXPIRATION DATE

 

ABC987654321

5/1/2003

5/1/2004

 

YEAR

MAKE/MODEL

VEHICLE IDENTIFICATION NUMBER

AutoIDWEB

2000

HONDA / CR-V

JHLRD186XYS010192

AGENCY/COMPANY ISSUING CARD AND PHONE NUMBER

 

Your Insurance Agency/Company

123-456-7890

(Replace this logo with your company logo)

1234 Main Street

 

 

AnyCity, US 12345

 

 

 

COVERAGE MEETS REQUIREMENTS SET FORTH IN NRS 485.185

 

INSURED NAME AND ADDRESS

Empire Parts

210 Washington Ave

Albany, NY 12210-1312

Your Custom Message

Can Go Here!

SEE IMPORTANT NOTICE ON REVERSE SIDE

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

NOTICE TO INSURED: Insert address for notification of commencement of medical treatment:

THE FRONT OF THIS DOCUMENT CONTAINS AN ARTIFICIAL WATERMARK - HOLD AT AN ANGLE TO VIEW

ACORD 50 WM (2/95)

© ACORD CORPORATION 1993

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

THE FRONT OF THIS DOCUMENT CONTAINS AN ARTIFICIAL WATERMARK - HOLD AT AN ANGLE TO VIEW

ACORD 50 WM (2/95)

© ACORD CORPORATION 1993

THIS CARD MUST BE CARRIED IN THE INSURED

MOTOR VEHICLE FOR PRODUCTION UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

THE FRONT OF THIS DOCUMENT CONTAINS AN

ARTIFICIAL WATERMARK - HOLD AT AN ANGLE TO VIEW

THIS CARD HAS BEEN APPROVED BY THE COMMISSIONER OF INSURANCE

ACORD 50 NV (2002/04)

© ACORD CORPORATION 2002

 

NEW YORK STATE INSURANCE IDENTIFICATION CARD

 

 

317 Any Insurance Company

Policy Number

 

 

 

 

 

ABC987654321

 

 

 

 

Name & Adresss of Issuer

 

 

 

 

Effective Date

Expiration Date

 

 

Your Insurance Agency/Company

 

 

 

 

 

 

 

 

 

 

1234 Main Street

05/01/2003

 

05/01/2004

 

 

 

AnyCity US

12:01 a.m.

12:01 a.m.

 

12345

 

 

 

 

(Not acceptable to obtain registration

 

An authorized NEW YORK insurer has issued an Owner's Policy of

after 45 days from effective date.)

AutoIDWEB

2000

 

 

HYUN

 

 

 

 

 

 

 

Liability Insurance complying with Article 6 (Motor Vehicle Financial

Applicable with respect to the following

 

Security Act) of the NEW YORK Vehicle and Traffic Law to:

Motor Vehicle:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Replace this logo with your company logo)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Year

Make

 

Empire Parts

KMHJG35F5YU206087

 

 

 

210 Washington Ave

Vehicle Identification Number

 

 

Albany NY 12210

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Your Custom Message

 

 

 

 

Can Go Here!

 

 

SEE IMPORTANT NOTICE ON REVERSE SIDE

 

 

 

 

 

 

 

OHIO

 

INSURANCE IDENTIFICATION CARD

 

 

(STATE)

 

 

 

COMPANY NUMBER

COMPANY

 

 

123

 

Any Insurance Company

 

POLICY NUMBER

EFFECTIVE DATE

EXPIRATION DATE

 

ABC987654321

5/1/2003

5/1/2004

 

YEAR

MAKE/MODEL

 

VEHICLE IDENTIFICATION NUMBER

AutoIDWEB

1999

BUICK / LESABRE

1G4HP52K8XH403452

AGENCY/COMPANY ISSUING CARD

 

 

Your Insurance Agency/Company

 

(Replace this logo with your company logo)

 

 

 

 

1234 Main Street

 

 

 

 

AnyCity, US 12345

 

 

INSURED

Empire Parts

210 Washington Ave

Albany, NY 12210-1312

 

 

 

 

Your Custom Message

 

 

SEE IMPORTANT NOTICE ON REVERSE SIDE

Can Go Here!

 

 

 

 

 

 

 

 

OREGON

INSURANCE IDENTIFICATION CARD

 

 

(STATE)

 

 

 

COMPANY NUMBER

COMPANY

 

 

123

 

Any Insurance Company

 

POLICY NUMBER

EFFECTIVE DATE

EXPIRATION DATE

 

ABC987654321

5/1/2003

5/1/2004

 

YEAR

MAKE/MODEL

 

VEHICLE IDENTIFICATION NUMBER

AutoIDWEB

1999

TOYOTA / CAMRY

JT2BG22K9X0373443

AGENCY/COMPANY ISSUING CARD

 

 

Your Insurance Agency/Company

 

(Replace this logo with your company logo)

 

 

 

 

1234 Main Street

 

 

 

 

AnyCity, US 12345

 

 

INSURED

Empire Parts

210 Washington Ave

Albany, NY 12210-1312

Your Custom Message

Can Go Here!

SEE IMPORTANT NOTICE ON REVERSE SIDE

THIS CARD MUST BE CARRIED IN THE INSURED

VEHICLE FOR PRODUCTION UPON DEMAND

WARNING: Any person who isssues or produces an ID card knowing that an Owner's Policy of Insurance is not in effect may be committing a misdemeanor. In addition, a person who presents an ID card if insurance is not in effect may be committing a misdemeanor.

The name of the registrant and the name of the insured must coincide.

REPLACEMENT VEHICLE NOTATION: DMV WILL ONLY PROCESS A VEHICLE CHANGE (RE-REGISTRATION) USING THE REPLACED VEHICLE'S CURRENT REGISTRATION.

FS-20

© FERGTECH, INC. 2003

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

ACORD 50 (1/83)

© ACORD CORPORATION 1983

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

ACORD 50 (1/83)

© ACORD CORPORATION 1983

PENNSYLVANIA FINANCIAL RESPONSIBILITY IDENTIFICATION CARD

 

NAIC NUMBER

COMPANY

 

 

12345

Any Insurance Company

 

POLICY NUMBER

EFFECTIVE DATE NOT VALID MORE THAN ONE (1)

 

ABC987654321

5/1/2003

YEAR FROM EFFECTIVE DATE

 

 

 

YEAR

MAKE/MODEL

 

VEHICLE IDENTIFICATION NUMBER

AutoIDWEB

1999

BUICK / LESABRE

 

1G4HP52K3XH403942

AGENCY/COMPANY ISSUING CARD

 

 

Your Insurance Agency/Company

 

 

(Replace this logo with your company logo)

1234 Main Street, AnyCity, US 12345

 

 

 

AGENCY/COMPANY TELEPHONE NUMBER

123-456-7890

INSURED

Empire Parts

210 Washington Ave

Albany, NY 12210-1312

 

 

 

 

Your Custom Message

 

 

SEE IMPORTANT NOTICE ON REVERSE SIDE

Can Go Here!

 

 

 

 

 

 

 

 

 

PR

 

INSURANCE IDENTIFICATION CARD

 

 

(STATE)

 

 

 

COMPANY NUMBER

COMPANY

 

 

123

 

Any Insurance Company

 

POLICY NUMBER

EFFECTIVE DATE

EXPIRATION DATE

 

ABC987654321

5/1/2003

5/1/2004

 

YEAR

MAKE/MODEL

 

VEHICLE IDENTIFICATION NUMBER

AutoIDWEB

1999

FORD / TAURUS

1FAFP53S6XA175296

AGENCY/COMPANY ISSUING CARD

 

 

Your Insurance Agency/Company

 

(Replace this logo with your company logo)

 

 

 

 

1234 Main Street

 

 

 

 

AnyCity, US 12345

 

 

INSURED

Empire Parts

210 Washington Ave

Albany, NY 12210-1312

 

 

 

 

Your Custom Message

 

 

SEE IMPORTANT NOTICE ON REVERSE SIDE

Can Go Here!

 

 

 

 

 

 

 

RHODE ISLAND AUTOMOBILE INSURANCE IDENTIFICATION CARD

 

 

 

Policy meets Rhode Island limits.

 

COMPANY NUMBER

COMPANY

 

 

12345

Any Insurance Company

 

POLICY NUMBER

EFFECTIVE DATE

EXPIRATION DATE

 

ABC987654321

5/1/2003

5/1/2004

 

YEAR

MAKE/MODEL

 

VEHICLE IDENTIFICATION NUMBER

AutoIDWEB

1999

HONDA / CIVIC

1HGEJ6671XL028829

AGENCY/COMPANY ISSUING CARD

 

 

Your Insurance Agency/Company

 

(Replace this logo with your company logo)

 

 

 

 

1234 Main Street

 

 

 

 

AnyCity, US 12345

 

 

INSURED

Empire Parts

210 Washington Ave

Albany, NY 12210-1312

Your Custom Message

Can Go Here!

SEE IMPORTANT NOTICE ON REVERSE SIDE

THIS CARD MUST BE CARRIED FOR PRODUCTION UPON DEMAND

KEEP THIS CARD IN THE INSURED VEHICLE

WARNING: Any owner or registrant of a motor vehicle who drives or permits a motor vehicle to be driven in Pennsylvania without the required financial responsibility may have his or her registration suspended or revoked.

NOTE - THIS CARD IS REQUIRED WHEN:

1.You are involved in an auto accident.

2.You are convicted of a traffic offense other than a parking offense that requires a court appearance.

3.You are stopped for violating any provision of the Vehicle Code (75 Pa.C.S.) and requested to produce it by a police officer.

You must provide a copy of this card to the Department of Transportation when you request restoration of your operating privilege and/or registration privilege which was previously suspended or revoked.

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company and to the police as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

ACORD 50 PA (2002/08)

© ACORD CORPORATION 2002

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

ACORD 50 (1/83)

© ACORD CORPORATION 1983

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

ACORD 50 (1/83)

© ACORD CORPORATION 1983

 

 

SOUTH CAROLINA INSURANCE IDENTIFICATION CARD

 

 

Coverage meets SC minimum financial responsibility requirements.

 

COMPANY NUMBER

COMPANY

 

 

123

 

Any Insurance Company

 

POLICY NUMBER

EFFECTIVE DATE

EXPIRATION DATE

 

ABC987654321

5/1/2003

5/1/2004

 

YEAR

MAKE/MODEL

 

VEHICLE IDENTIFICATION NUMBER

AutoIDWEB

1999

BUICK / LESABRE

1G4HP52K1XH402451

AGENCY/COMPANY ISSUING CARD

 

 

Your Insurance Agency/Company

 

(Replace this logo with your company logo)

 

 

 

 

1234 Main Street

 

 

 

 

AnyCity, US 12345

 

 

INSURED

Empire Parts

210 Washington Ave

Albany, NY 12210-1312

 

 

 

 

Your Custom Message

 

 

SEE IMPORTANT NOTICE ON REVERSE SIDE

Can Go Here!

 

 

 

 

 

 

 

SOUTH DAKOTA AUTOMOBILE INSURANCE IDENTIFICATION CARD

 

 

Coverage provided by this policy meets the minimum liability limits prescribed by law.

 

COMPANY NUMBER

COMPANY

 

 

123

 

Any Insurance Company

 

POLICY NUMBER

EFFECTIVE DATE

EXPIRATION DATE

 

ABC987654321

5/1/2003

5/1/2004

 

YEAR

MAKE/MODEL

 

VEHICLE IDENTIFICATION NUMBER

AutoIDWEB

1999

TOYOTA / COROLLA

1NXBR12E4XZ147093

AGENCY/COMPANY ISSUING CARD

 

 

Your Insurance Agency/Company

 

(Replace this logo with your company logo)

 

 

 

 

1234 Main Street

 

 

 

 

AnyCity, US 12345

 

 

INSURED

Empire Parts

210 Washington Ave

Albany, NY 12210-1312

 

 

 

 

Your Custom Message

 

 

SEE IMPORTANT NOTICE ON REVERSE SIDE

Can Go Here!

 

 

 

 

 

 

 

 

 

TENNESSEE INSURANCE IDENTIFICATION CARD

 

An insurance policy has been issued that meets requirements of Tennessee Financial Responsibility law of 1977.

 

COMPANY NUMBER

COMPANY

 

 

123

 

Any Insurance Company

 

POLICY NUMBER

EFFECTIVE DATE

EXPIRATION DATE

 

ABC987654321

5/1/2003

5/1/2004

 

YEAR

MAKE/MODEL

 

VEHICLE IDENTIFICATION NUMBER

AutoIDWEB

1999

BUICK / LESABRE

1G4HP52K4XH404565

AGENCY/COMPANY ISSUING CARD

 

 

Your Insurance Agency/Company

 

(Replace this logo with your company logo)

 

 

 

 

1234 Main Street

 

 

 

 

AnyCity, US 12345

 

 

INSURED

Empire Parts

210 Washington Ave

Albany, NY 12210-1312

Your Custom Message

Can Go Here!

SEE IMPORTANT NOTICE ON REVERSE SIDE

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

ACORD 50 (1/83)

© ACORD CORPORATION 1983

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

ACORD 50 (1/83)

© ACORD CORPORATION 1983

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

ACORD 50 (1/83)

© ACORD CORPORATION 1983

TEXAS LIABILITY INSURANCE CARD

 

COMPANY PHONE NO.

COMPANY

 

 

800-456-7890

Any Insurance Company

 

POLICY NUMBER

EFFECTIVE DATE

EXPIRATION DATE

 

ABC987654321

5/1/2003

5/1/2004

 

YEAR

MAKE/MODEL

VEHICLE IDENTIFICATION NUMBER

 

1999

BUICK / LESABRE

1G4HP52K5XH404767

SPANISH TRANSLATION

AGENCY

 

AGENCY PHONE NO.

 

 

Your Insurance Agency/Company

123-456-7890

 

1234 Main Street

 

 

TRADUCCION DE ESPANOL

AnyCity, US 12345

 

INSURED

 

 

 

Empire Parts

 

 

210 Washington Ave

 

 

Albany, NY 12210-1312

 

 

This policy provides at least the minimum amounts of liability insurance required by the Texas Motor Vehicle Safety Responsibility Act for the Specified vehicle and named insureds and may provide coverage for other persons and other vehicles as provided by the insurance policy.

 

UTAH

 

INSURANCE IDENTIFICATION CARD

 

 

(STATE)

 

 

 

COMPANY NUMBER

COMPANY

 

 

123

 

Any Insurance Company

 

POLICY NUMBER

EFFECTIVE DATE

EXPIRATION DATE

 

ABC987654321

5/1/2003

5/1/2004

 

YEAR

MAKE/MODEL

 

VEHICLE IDENTIFICATION NUMBER

AutoIDWEB

1999

BUICK / LESABRE

1G4HP52K5XH404249

AGENCY/COMPANY ISSUING CARD

 

 

Your Insurance Agency/Company

 

(Replace this logo with your company logo)

 

 

 

 

1234 Main Street

 

 

 

 

AnyCity, US 12345

 

 

INSURED

Empire Parts

210 Washington Ave

Albany, NY 12210-1312

 

 

 

 

Your Custom Message

 

 

SEE IMPORTANT NOTICE ON REVERSE SIDE

Can Go Here!

 

 

 

 

 

 

 

 

VIRGINIA

INSURANCE IDENTIFICATION CARD

 

 

(STATE)

 

 

 

COMPANY NUMBER

COMPANY

 

 

123

 

Any Insurance Company

 

POLICY NUMBER

EFFECTIVE DATE

EXPIRATION DATE

 

ABC987654321

5/1/2003

5/1/2004

 

YEAR

MAKE/MODEL

 

VEHICLE IDENTIFICATION NUMBER

AutoIDWEB

1999

BUICK / LESABRE

1G4HP52K4XH404713

AGENCY/COMPANY ISSUING CARD

 

 

Your Insurance Agency/Company

 

(Replace this logo with your company logo)

 

 

 

 

1234 Main Street

 

 

 

 

AnyCity, US 12345

 

 

INSURED

Empire Parts

210 Washington Ave

Albany, NY 12210-1312

Your Custom Message

Can Go Here!

SEE IMPORTANT NOTICE ON REVERSE SIDE

Tarjeta de Seguro de Resonabilidad de Texas

Gaurde esta tarjeta

IMPORTANTE: Esta tarjeta o una copia de su poliza de seguro debe ser mostrada cuando usted solicite o renueve su:

°registro de vehiculo de motor

°licencia para conducir

°etiqueta de inspeccion de seguridad para su vehiculo.

Puede que usted tenga tambien que mostrar esta tarjeta

o su poliza de seguro si tiene un accidente o si un oficial de la paz se la pide.

Todos los conductores en Texas deben de tener seguro de responsabilidad para sus vehiculos, o de otra manera llenar los requisitos legales de responsabilidad civil. Fallo en llenar este requisito pudiera resultar en multas de hasta $1,000, suspension de su licencia para conducir y su regi- stro de vehiculo de motor, y la retencion de su vehiculo por un periodo de hasta 180 dias (a un costa de $15 per dia).

Texas Liability Insurance Card

Keep this card.

IMPORTANT: This card or a copy of your insurance policy must be shown when you apply for or renew your:

°motor vehicle registration

°driver's license

°motor vehicle safety inspection sticker.

You may also be asked to show this card or your policy if you have an accident or if a peace officer asks to see it.

All drivers in Texas must carry liability insurance on their vehicles or otherwise meet legal requirements for financial responsibility. Failure to do so could result in fines up to $1,000, suspension of your driver's license and motor vehicle registration, and impoundment of your vehicle for up to 180 days (at a cost of $15 per day).

ACORD 50 TX (2/97)

© ACORD CORPORATION 1991

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

ACORD 50 (1/83)

© ACORD CORPORATION 1983

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

ACORD 50 (1/83)

© ACORD CORPORATION 1983

 

VI

 

INSURANCE IDENTIFICATION CARD

 

 

(STATE)

 

 

 

COMPANY NUMBER

COMPANY

 

 

123

 

Any Insurance Company

 

POLICY NUMBER

EFFECTIVE DATE

EXPIRATION DATE

 

ABC987654321

5/1/2003

5/1/2004

 

YEAR

MAKE/MODEL

 

VEHICLE IDENTIFICATION NUMBER

AutoIDWEB

1998

BUICK / LESABRE

1G4HP52KXWH401393

AGENCY/COMPANY ISSUING CARD

 

 

Your Insurance Agency/Company

 

(Replace this logo with your company logo)

 

 

 

 

1234 Main Street

 

 

 

 

AnyCity, US 12345

 

 

INSURED

Empire Parts

210 Washington Ave

Albany, NY 12210-1312

 

 

 

 

Your Custom Message

 

 

SEE IMPORTANT NOTICE ON REVERSE SIDE

Can Go Here!

 

 

 

 

 

 

 

 

 

VERMONT AUTOMOBILE INSURANCE IDENTIFICATION CARD

 

 

 

Policy provides the minimum insurance prescribed by law.

 

COMPANY NUMBER

COMPANY

 

 

123

 

Any Insurance Company

 

POLICY NUMBER

EFFECTIVE DATE

EXPIRATION DATE

 

ABC987654321

5/1/2003

5/1/2004

 

YEAR

MAKE/MODEL

VEHICLE IDENTIFICATION NUMBER

AutoIDWEB

1998

BUICK / LESABRE

1G4HP52K8WH401697

AGENCY/COMPANY ISSUING CARD

 

 

Your Insurance Agency/Company

 

(Replace this logo with your company logo)

 

 

 

 

1234 Main Street

 

 

 

AnyCity, US 12345

 

 

INSURED

Empire Parts

210 Washington Ave

Albany, NY 12210-1312

 

 

 

 

Your Custom Message

 

 

SEE IMPORTANT NOTICE ON REVERSE SIDE

Can Go Here!

 

 

 

 

 

 

 

 

WASHINGTON

INSURANCE IDENTIFICATION CARD

 

 

(STATE)

 

 

 

COMPANY NUMBER

COMPANY

 

 

123

 

Any Insurance Company

 

POLICY NUMBER

EFFECTIVE DATE

EXPIRATION DATE

 

ABC987654321

5/1/2003

5/1/2004

 

YEAR

MAKE/MODEL

 

VEHICLE IDENTIFICATION NUMBER

AutoIDWEB

1998

BUICK / LESABRE

1G4HP52K9WH401630

AGENCY/COMPANY ISSUING CARD

 

 

Your Insurance Agency/Company

 

(Replace this logo with your company logo)

 

 

 

 

1234 Main Street

 

 

 

 

AnyCity, US 12345

 

 

INSURED

Empire Parts

210 Washington Ave

Albany, NY 12210-1312

Your Custom Message

Can Go Here!

SEE IMPORTANT NOTICE ON REVERSE SIDE

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

ACORD 50 (1/83)

© ACORD CORPORATION 1983

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

ACORD 50 (1/83)

© ACORD CORPORATION 1983

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

ACORD 50 (1/83)

© ACORD CORPORATION 1983

 

WISCONSIN

INSURANCE IDENTIFICATION CARD

 

 

(STATE)

 

 

 

COMPANY NUMBER

COMPANY

 

 

123

 

Any Insurance Company

 

POLICY NUMBER

EFFECTIVE DATE

EXPIRATION DATE

 

ABC987654321

5/1/2003

5/1/2004

 

YEAR

MAKE/MODEL

 

VEHICLE IDENTIFICATION NUMBER

AutoIDWEB

1998

BUICK / LESABRE

1G4HP52K3WH401655

AGENCY/COMPANY ISSUING CARD

 

 

Your Insurance Agency/Company

 

(Replace this logo with your company logo)

 

 

 

 

1234 Main Street

 

 

 

 

AnyCity, US 12345

 

 

INSURED

Empire Parts

210 Washington Ave

Albany, NY 12210-1312

 

 

 

 

 

 

 

 

 

 

 

 

 

Your Custom Message

 

 

 

 

SEE IMPORTANT NOTICE ON REVERSE SIDE

 

 

 

 

Can Go Here!

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

WEST VIRGINIA CERTIFICATE OF INSURANCE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COMPANY NUMBER

COMPANY

 

 

VEHICLE OWNER ENTER PLATE #

 

 

 

 

 

 

 

 

 

 

123

 

 

 

Any Insurance Company

 

 

 

 

 

An authorized West Virginia insurer certifies that there is in effect a motor vehicle liability policy

 

upon the described vehicle in accordance with the provisions of the West Virginia Motor

 

Vehicle Code.

 

 

 

 

 

 

 

 

 

 

POLICY NUMBER

 

EFFECTIVE DATE

 

EXPIRATION DATE

 

ABC987654321

 

5/1/2003

 

5/1/2004

 

 

AutoIDWEB

YEAR

 

MAKE/MODEL

 

VEHICLE IDENTIFICATION NUMBER

1998

 

CHEVY / LUMINA

2G1WL52M0W9242549

INSURED

 

 

 

OWNER

 

 

 

 

(Replace this logo with your company logo)

 

 

 

 

 

 

 

 

 

 

Empire Parts

 

 

 

SAME

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

210 Washington Ave

 

 

 

 

 

 

 

 

 

 

 

Albany, NY 12210-1312

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AGENCY/COMPANY ISSUING CARD

 

 

 

 

DATE ISSUED

 

Your Insurance Agency/Company

 

 

 

 

05/21/2003

 

 

 

1234 Main Street, AnyCity, US 12345

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

THIS CERTIFICATE MUST BE CARRIED IN THE VEHICLE DESCRIBED ABOVE FOR USE AS PROOF OF INSUR-

Your Custom Message

ANCE. A COPY OF THIS CERTIFICATE MAY BE REQUESTED BY THE COMMISSIONER OF MOTOR VEHICLES.

SIGNATURE OF OWNER:

 

 

 

 

 

DATE:

 

 

Can Go Here!

 

 

 

 

 

 

 

 

 

 

SEE IMPORTANT NOTICE ON REVERSE SIDE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

WYOMING

INSURANCE IDENTIFICATION CARD

 

 

 

(STATE)

 

 

 

 

 

 

 

 

 

 

COMPANY NUMBER

COMPANY

 

 

 

 

 

 

 

 

 

123

 

 

 

Any Insurance Company

 

 

 

 

 

POLICY NUMBER

EFFECTIVE DATE

 

 

EXPIRATION DATE

 

ABC987654321

5/1/2003

5/1/2004

 

 

 

 

YEAR

 

MAKE/MODEL

 

VEHICLE IDENTIFICATION NUMBER

AutoIDWEB

1998

 

BUICK / LESABRE

1G4HP52KSWH402516

AGENCY/COMPANY ISSUING CARD

 

 

 

 

 

 

 

 

 

Your Insurance Agency/Company

 

 

 

 

 

 

 

 

(Replace this logo with your company logo)

 

 

 

 

 

 

 

 

 

 

 

1234 Main Street

 

 

 

 

 

 

 

 

 

 

 

AnyCity, US 12345

 

 

 

 

 

 

 

 

 

INSURED

Empire Parts

210 Washington Ave

Albany, NY 12210-1312

Your Custom Message

Can Go Here!

SEE IMPORTANT NOTICE ON REVERSE SIDE

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

ACORD 50 (1/83)

© ACORD CORPORATION 1983

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

ACORD 50 WV (3/94)

© ACORD CORPORATION 1994

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

ACORD 50 (1/83)

© ACORD CORPORATION 1983

STATE OF MICHIGAN CERTIFICATE OF NO-FAULT INSURANCE

 

COMPANY

 

 

 

Any Insurance Company

 

 

 

POLICY NUMBER

EFFECTIVE DATE

EXPIRATION DATE

 

ABC987654321

5/1/2003

5/1/2004

 

YEAR

MAKE/MODEL

VEHICLE IDENTIFICATION NUMBER

 

2000

MERCURY / SABLE LS

1MEFM59S5YA606169

 

WEB

AGENCY/COMPANY ISSUING CARD

 

 

 

Your Insurance Agency/Company

 

 

 

1234 Main Street, AnyCity, US 12345

 

 

(Replace this logo with your company logo)

 

 

 

AutoID

INSURED

 

 

 

 

Empire Parts

 

 

 

 

210 Washington Ave

 

 

 

 

Albany, NY 12210-1312

 

 

 

An authorized Michigan insurer, certifies that it has issued a policy comply-

 

ing with Act 294, P.A. 1972, as amended for the described motor vehicle.

 

WARNING: KEEP THIS CERTIFICATE IN YOUR VEHICLE AT ALL TIMES.

Your Custom Message

Can Go Here!

If you fail to produce it upon a police officer's request, you will be respon-

sible for a civil infraction.

 

 

 

 

 

STATE OF MICHIGAN CERTIFICATE OF NO-FAULT INSURANCE

 

COMPANY

 

 

 

Any Insurance Company

 

 

 

POLICY NUMBER

EFFECTIVE DATE

EXPIRATION DATE

 

ABC987654321

5/1/2003

5/1/2004

 

YEAR

MAKE/MODEL

VEHICLE IDENTIFICATION NUMBER

 

2000

MERCURY / SABLE LS

1MEFM59S5YA606169

 

WEB

AGENCY/COMPANY ISSUING CARD

 

 

 

Your Insurance Agency/Company

 

 

 

1234 Main Street, AnyCity, US 12345

 

 

(Replace this logo with your company logo)

 

 

 

AutoID

INSURED

 

 

 

 

Empire Parts

 

 

 

 

210 Washington Ave

 

 

 

 

Albany, NY 12210-1312

 

 

 

An authorized Michigan insurer, certifies that it has issued a policy comply-

 

ing with Act 294, P.A. 1972, as amended for the described motor vehicle.

 

 

 

 

 

Your Custom Message

 

SECRETARY OF STATE'S COPY

 

Can Go Here!

 

 

 

 

 

 

 

 

Michigan Law (MCLA 500.3101) requires that the owner or registrant of a motor vehicle regis- tered in this state must have insurance or other approved security for the payment of no-fault benefits on the vehicle at all times. An owner or registrant who drives or permits a vehicle to be driven upon a public highway without the proper insurance or other security is guilty of a misdemeanor.

An owner or registrant convicted of such a misdemeanor shall be fined not less than $200.00 nor more than $500.00, or imprisoned for not more than 1 year, or both.

A PERSON WHO SUPPLIES FALSE INFORMATION TO THE SECRETARY OF STATE OR WHO ISSUES OR USES AN INVALID CERTIFICATE OF INSURANCE IS GUILTY OF A MISDEMEAN- OR PUNISHABLE BY IMPRISONMENT FOR NOT MORE THAN 1 YEAR, OR A FINE OF NOT MORE THAN $1,000.00, OR BOTH.

If this vehicle is driven by the person(s) named below, residual liability insurance does not apply and the vehicle will be considered uninsured:

WARNING - when a named excluded person operates a vehicle, all liability coverage is void - no one is insured. Owners of the vehicle and others legally responsible for the acts of the named excluded person remain fully responsible.

ACORD 50 MI (6/93)

© ACORD CORPORATION 1993

Michigan Law (MCLA 500.3101) requires that the owner or registrant of a motor vehicle regis- tered in this state must have insurance or other approved security for the payment of no-fault benefits on the vehicle at all times. An owner or registrant who drives or permits a vehicle to be driven upon a public highway without the proper insurance or other security is guilty of a misdemeanor.

An owner or registrant convicted of such a misdemeanor shall be fined not less than $200.00 nor more than $500.00, or imprisoned for not more than 1 year, or both.

THIS FORM MUST BE PRESENTED AS EVIDENCE OF INSURANCE WITH YOUR APPLICA- TION FOR LICENSE PLATES, EITHER BY MAIL OR AT ANY SECRETARY OF STATE LICENSE PLATE BRANCH OFFICE. A PERSON WHO ISSUES OR WHO SUPPLIES FALSE INFORMA- TION TO THE SECRETARY OF STATE OR USES AN INVALID CERTIFICATE OF INSURANCE IS GUILTY OF A MISDEMEANOR PUNISHABLE BY IMPRISONMENT FOR NOT MORE THAN

1 YEAR, OR A FINE OF NOT MORE THAN $1,000.00, OR BOTH.

If this vehicle is driven by the person(s) named below, residual liability insurance does not apply and the vehicle will be considered uninsured:

WARNING - when a named excluded person operates a vehicle, all liability coverage is void - no one is insured. Owners of the vehicle and others legally responsible for the acts of the named excluded person remain fully responsible.

ACORD 50 MI (6/93)

© ACORD CORPORATION 1993

 

OKLAHOMA OWNERS SECURITY VERIFICATION FORM

 

 

 

 

 

 

MOTOR VEHICLE COPY

 

 

 

COMPANY NUMBER

 

 

COMPANY NAME AND ADDRESS

 

 

 

 

123

 

 

 

Any Insurance Company

 

 

 

 

 

 

 

100 Fifth Ave, New York, NY 10010

 

 

 

 

 

 

 

 

 

 

 

 

POLICY NUMBER

 

 

 

 

 

 

EFFECTIVE DATE

EXPIRATION DATE

 

ABC987654321

 

 

 

 

 

 

5/1/2003

5/1/2004

 

YEAR

MAKE/MODEL

 

 

 

 

VEHICLE IDENTIFICATION NUMBER

AutoIDWEB

1999

CHEVROLET / VENTURE

1GNDX03EXXD224231

AGENCY/COMPANY ISSUING FORM (INCLUDE ADDRESS AND TELEPHONE NUMBER)

 

Your Insurance Agency/Company

 

 

 

 

123-456-7890

(Replace this logo with your company logo)

 

 

 

 

 

1234 Main Street

 

 

 

 

 

 

 

 

 

 

 

AnyCity, US 12345

 

 

 

 

 

 

 

 

 

 

NAME OF INSURED

 

 

 

 

 

 

 

 

 

 

 

Empire Parts

 

 

 

 

 

 

 

 

 

 

 

COVERAGES:

A

C

D

G

L

N

R R1 U

S

T

Z

 

 

 

*

 

 

 

 

 

 

 

 

 

 

 

A LIABILITY INSURANCE POLICY HAS BEEN ISSUED PURSUANT TO THE COMPULSORY

 

INSURANCE LAW OF OKLAHOMA. IF THIS IS AN OWNERS FORM, KEEP IN THE MOTOR VEHICLE

Your Custom Message

AT ALL TIMES. IF AN OPERATORS FORM, CARRY IT WHENEVER OPERATING ANY VEHICLE.

 

 

 

SEE IMPORTANT INFORMATION ON REVERSE SIDE

 

Can Go Here!

 

 

 

 

 

 

 

 

 

OKLAHOMA OWNERS SECURITY VERIFICATION FORM

 

 

MOTOR VEHICLE AGENCY SURRENDER COPY

 

COMPANY NUMBER

 

 

COMPANY NAME AND ADDRESS

 

 

 

 

123

 

 

 

Any Insurance Company

 

 

 

 

 

 

 

100 Fifth Ave, New York, NY 10010

 

 

 

 

 

 

 

 

 

 

 

 

POLICY NUMBER

 

 

 

 

 

 

EFFECTIVE DATE

EXPIRATION DATE

 

ABC987654321

 

 

 

 

 

 

5/1/2003

5/1/2004

 

YEAR

MAKE/MODEL

 

 

 

 

VEHICLE IDENTIFICATION NUMBER

AutoIDWEB

1999

CHEVROLET / VENTURE

1GNDX03EXXD224231

AGENCY/COMPANY ISSUING FORM (INCLUDE ADDRESS AND TELEPHONE NUMBER)

 

Your Insurance Agency/Company

 

 

 

 

123-456-7890

(Replace this logo with your company logo)

 

 

 

 

 

1234 Main Street

 

 

 

 

 

 

 

 

 

 

 

AnyCity, US 12345

 

 

 

 

 

 

 

 

 

 

NAME OF INSURED

 

 

 

 

 

 

 

 

 

 

 

Empire Parts

 

 

 

 

 

 

 

 

 

 

 

COVERAGES:

A

C

D

G

L

N

R R1 U

S

T

Z

 

 

 

*

 

 

 

 

 

 

 

 

 

 

 

A LIABILITY INSURANCE POLICY HAS BEEN ISSUED PURSUANT TO THE COMPULSORY INSUR-

 

ANCE LAW OF OKLAHOMA. SUBMIT THIS PART WITH YOUR APPLICATION FOR REGISTRATION.

Your Custom Message

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SEE IMPORTANT INFORMATION ON REVERSE SIDE

 

Can Go Here!

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HOW TO IDENTIFY YOUR COVERAGE

A

LIABILITY (BODILY INJURY/

R

CAR RENTAL

 

PROPERTY DAMAGE)

R1

CAR RENTAL AND TRAVEL EXPENSE

C

MEDICAL PAYMENTS

U

UNINSURED MOTOR VEHICLE

D

COMPREHENSIVE

S

DEATH, DISMEMBERMENT

G

COLLISION

T

DISABILITY

L

LOSS TO YOUR RECREATIONAL VEH.

Z

LOSS OF EARNINGS

NEMERGENCY ROAD SERVICE

EXAMINE POLICY EXCLUSIONS CAREFULLY. THIS FORM DOES NOT CONSTITUTE ANY PART OF YOUR INSURANCE POLICY.

OKLAHOMA STATE LAW REQUIRES THAT THIS COPY OF THE OWNERS SECURITY VERIFICATION FORM BE CARRIED IN THE MOTOR VEHICLE AT ALL TIMES, AND BE PRODUCED BY ANY DRIVER OF THE VEHICLE UPON REQUEST FOR INSPECTION BY ANY PEACE OFFICER OR REPRESENTATIVE OF THE DEPARTMENT OF PUBLIC SAFETY. IN THE CASE OF A COLLISION, THIS FORM SHALL BE SHOWN UPON REQUEST OF ANY PERSON AFFECTED BY THE COLLISION.

ACORD 50 OK (2002/07)© ACORD CORPORATION 1994

 

HOW TO IDENTIFY YOUR COVERAGE

A

LIABILITY (BODILY INJURY/

R

CAR RENTAL

 

PROPERTY DAMAGE)

R1

CAR RENTAL AND TRAVEL EXPENSE

C

MEDICAL PAYMENTS

U

UNINSURED MOTOR VEHICLE

D

COMPREHENSIVE

S

DEATH, DISMEMBERMENT

G

COLLISION

T

DISABILITY

L

LOSS TO YOUR RECREATIONAL VEH.

Z

LOSS OF EARNINGS

NEMERGENCY ROAD SERVICE

EXAMINE POLICY EXCLUSIONS CAREFULLY. THIS FORM DOES NOT CONSTITUTE ANY PART OF YOUR INSURANCE POLICY.

OKLAHOMA STATE LAW REQUIRES THAT A CURRENT COPY OF THE OWNERS SECURITY VERIFICATION FORM MUST BE SURRENDERED TO THE MOTOR LICENSE AGENT OR OTHER REGISTERING AGENCY UPON APPLICATION OR RENEWAL FOR A MOTOR VEHICLE LICENSE PLATE

ACORD 50 OK (2002/07)

© ACORD CORPORATION 1994

DYNAFORM PROCESSING LOG - 5/21/2003 * 6:09:43 PM

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