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.
Question | Answer |
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Form Name | Capdat Acord |
Form Length | 39 pages |
Fillable? | No |
Fillable fields | 0 |
Avg. time to fill out | 9 min 45 sec |
Other names | applications for capdat, cap dat forms, cap dat login, 75 |
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ALASKA |
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INSURANCE IDENTIFICATION CARD |
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(STATE) |
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COMPANY NUMBER |
COMPANY |
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123 |
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Any Insurance Company |
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POLICY NUMBER |
EFFECTIVE DATE |
EXPIRATION DATE |
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ABC987654321 |
5/1/2003 |
5/1/2004 |
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YEAR |
MAKE/MODEL |
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VEHICLE IDENTIFICATION NUMBER |
AutoIDWEB |
2003 |
MERZ / C32 |
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WDBRF6SJ13F301306 |
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AGENCY/COMPANY ISSUING CARD |
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Your Insurance Agency/Company |
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(Replace this logo with your company logo) |
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1234 Main Street |
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AnyCity, US 12345 |
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INSURED
Empire Parts
210 Washington Ave
Albany, NY
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Your Custom Message |
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SEE IMPORTANT NOTICE ON REVERSE SIDE |
Can Go Here! |
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ALABAMA INSURANCE IDENTIFICATION CARD |
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Policy provides the minimum insurance prescribed by law. |
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COMPANY NUMBER |
COMPANY |
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12345 |
Any Insurance Company |
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POLICY NUMBER |
EFFECTIVE DATE |
EXPIRATION DATE |
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ABC987654321 |
5/1/2003 |
5/1/2004 |
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YEAR |
MAKE/MODEL |
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VEHICLE IDENTIFICATION NUMBER |
AutoIDWEB |
2002 |
FORD / MUSTANG |
1FAFP45X42F142005 |
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AGENCY/COMPANY ISSUING CARD |
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Your Insurance Agency/Company |
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(Replace this logo with your company logo) |
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1234 Main Street |
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AnyCity, US 12345 |
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INSURED
Empire Parts
210 Washington Ave
Albany, NY
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Your Custom Message |
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SEE IMPORTANT NOTICE ON REVERSE SIDE |
Can Go Here! |
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ARKANSAS PROOF OF INSURANCE CARD |
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COMPANY NAIC NUMBER |
COMPANY NAME AND ADDRESS |
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12345 |
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Any Insurance Company |
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COMPANY PHONE NUMBER |
100 Fifth Ave |
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New York, NY 10010 |
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POLICY NUMBER |
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EFFECTIVE DATE |
EXPIRATION DATE |
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ABC987654321 |
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5/1/2003 |
5/1/2004 |
AutoIDWEB |
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YEAR |
MAKE/MODEL |
VEHICLE IDENTIFICATION NUMBER |
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2002 |
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BUICK / CENTURY |
2G4WY55J321110951 |
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AGENCY ISSUING CARD |
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(Replace this logo with your company logo) |
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Your Insurance Agency/Company |
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1234 Main Street |
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AnyCity, US 12345 |
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AGENCY PHONE NUMBER |
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INSURED NAME AND ADDRESS |
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Empire Parts |
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210 Washington Ave |
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Albany, NY |
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Your Custom Message |
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SEE IMPORTANT NOTICE ON REVERSE SIDE |
Can Go Here! |
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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 |
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ARIZONA |
INSURANCE IDENTIFICATION CARD |
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(STATE) |
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COMPANY NUMBER |
COMPANY |
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A123 |
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Any Insurance Company |
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POLICY NUMBER |
EFFECTIVE DATE |
EXPIRATION DATE |
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ABC987654321 |
5/1/2003 |
5/1/2004 |
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YEAR |
MAKE/MODEL |
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VEHICLE IDENTIFICATION NUMBER |
AutoIDWEB |
2002 |
TOYOTA / CAMRY |
JTDBE32K420010592 |
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AGENCY/COMPANY ISSUING CARD |
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Your Insurance Agency/Company |
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(Replace this logo with your company logo) |
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1234 Main Street |
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AnyCity, US 12345 |
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INSURED
Empire Parts
210 Washington Ave
Albany, NY
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Your Custom Message |
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SEE IMPORTANT NOTICE ON REVERSE SIDE |
Can Go Here! |
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CALIFORNIA INSURANCE IDENTIFICATION CARD |
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The policy meets the requirements of Section 16056 of the California Vehicle Code. |
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COMPANY NUMBER |
COMPANY |
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12345 |
Any Insurance Company |
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POLICY NUMBER |
EFFECTIVE DATE |
EXPIRATION DATE |
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ABC987654321 |
5/1/2003 |
5/1/2004 |
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YEAR |
MAKE/MODEL |
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VEHICLE IDENTIFICATION NUMBER |
AutoIDWEB |
2002 |
BUICK / RENDEZVOUS |
3G5DA03E12S504064 |
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AGENCY/COMPANY ISSUING CARD |
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Your Insurance Agency/Company |
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(Replace this logo with your company logo) |
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1234 Main Street |
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AnyCity, US 12345 |
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INSURED
Empire Parts
210 Washington Ave
Albany, NY
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Your Custom Message |
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SEE IMPORTANT NOTICE ON REVERSE SIDE |
Can Go Here! |
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COLORADO INSURANCE IDENTIFICATION CARD |
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BI, PD, AND PIP coverages provided as required by law. |
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COMPANY NUMBER |
COMPANY |
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123 |
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Any Insurance Company |
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POLICY NUMBER |
EFFECTIVE DATE |
EXPIRATION DATE |
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ABC987654321 |
5/1/2003 |
5/1/2004 |
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YEAR |
MAKE/MODEL |
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VEHICLE IDENTIFICATION NUMBER |
AutoIDWEB |
2002 |
KIA / SD |
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KNADC123526157767 |
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AGENCY/COMPANY ISSUING CARD |
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Your Insurance Agency/Company |
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(Replace this logo with your company logo) |
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1234 Main Street |
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AnyCity, US 12345 |
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INSURED
Empire Parts
210 Washington Ave
Albany, NY
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 |
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CONNECTICUT INSURANCE IDENTIFICATION CARD |
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Connecticut Insurance Card Issued Pursuant to Connecticut Law |
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COMPANY NUMBER |
COMPANY |
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123 |
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Any Insurance Company |
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POLICY NUMBER |
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EFFECTIVE DATE |
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ABC987654321 |
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5/1/2003 |
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YEAR |
MAKE/MODEL |
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VEHICLE IDENTIFICATION NUMBER |
AutoIDWEB |
2001 |
BUICK / LESABRE |
1G4HP54K514147010 |
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AGENCY/COMPANY ISSUING CARD |
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Your Insurance Agency/Company |
(Replace this logo with your company logo) |
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1234 Main Street |
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AnyCity, US 12345 |
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INSURED
Empire Parts
210 Washington Ave
Albany, NY
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Your Custom Message |
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SEE IMPORTANT NOTICE ON REVERSE SIDE |
Can Go Here! |
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DISTRICT OF COLUMBIA |
INSURANCE IDENTIFICATION CARD |
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(STATE) |
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COMPANY NUMBER |
COMPANY |
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123 |
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Any Insurance Company |
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POLICY NUMBER |
EFFECTIVE DATE |
EXPIRATION DATE |
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ABC987654321 |
5/1/2003 |
5/1/2004 |
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YEAR |
MAKE/MODEL |
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VEHICLE IDENTIFICATION NUMBER |
AutoIDWEB |
2001 |
HONDA / ACCORD |
1HGCF86671A087673 |
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AGENCY/COMPANY ISSUING CARD |
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Your Insurance Agency/Company |
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(Replace this logo with your company logo) |
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1234 Main Street |
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AnyCity, US 12345 |
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INSURED
Empire Parts
210 Washington Ave
Albany, NY
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Your Custom Message |
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SEE IMPORTANT NOTICE ON REVERSE SIDE |
Can Go Here! |
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DELAWARE |
INSURANCE IDENTIFICATION CARD |
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(STATE) |
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COMPANY NUMBER |
COMPANY |
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12345 |
Any Insurance Company |
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POLICY NUMBER |
EFFECTIVE DATE |
EXPIRATION DATE |
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ABC987654321 |
5/1/2003 |
5/1/2004 |
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YEAR |
MAKE/MODEL |
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VEHICLE IDENTIFICATION NUMBER |
AutoIDWEB |
2001 |
OLDSMOBILE / INTRIGUE |
1GWS52H71F186333 |
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AGENCY/COMPANY ISSUING CARD |
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Your Insurance Agency/Company |
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(Replace this logo with your company logo) |
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1234 Main Street |
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AnyCity, US 12345 |
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INSURED
Empire Parts
210 Washington Ave
Albany, NY
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 #: |
EFFECTIVE |
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DATE: 5/1/2003 to |
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YEAR: |
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2001 |
MAKE/ |
5/1/2004 |
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MODEL: CHEVROLET / TRUCK |
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VEHICLE ID #: 1GCHK23G81F134609 |
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PERSONAL INJURY PROTECTION |
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BODILY INJURY |
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X |
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X |
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BENEFITS/PROPERTY DAMAGE LIABILITY |
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LIABILITY |
NAMED Empire Parts
INSURED: 210 Washington Ave
ADDRESS: Albany, NY
(OPTIONAL)
NOT VALID FOR MORE THAN ONE YEAR FROM EFFECTIVE DATE
Your Custom Message |
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Can Go Here! |
PLEASE CUT ALONG ABOVE LINE |
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GEORGIA |
INSURANCE IDENTIFICATION CARD |
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(STATE) |
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COMPANY NUMBER |
COMPANY |
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123 |
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Any Insurance Company |
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POLICY NUMBER |
EFFECTIVE DATE |
EXPIRATION DATE |
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ABC987654321 |
5/1/2003 |
5/1/2004 |
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YEAR |
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MAKE/MODEL |
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VEHICLE IDENTIFICATION NUMBER |
AutoIDWEB |
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2001 |
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CHEVROLET / SILVERADO |
1GCJK39G71E311381 |
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AGENCY/COMPANY ISSUING CARD |
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Your Insurance Agency/Company |
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(Replace this logo with your company logo) |
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1234 Main Street |
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AnyCity, US 12345 |
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INSURED |
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Empire Parts |
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210 Washington Ave |
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Albany, NY |
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Your Custom Message |
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SEE IMPORTANT NOTICE ON REVERSE SIDE |
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Can Go Here! |
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HAWAII MOTOR VEHICLE INSURANCE IDENTIFICATION CARD |
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COMPANY # |
COMPANY |
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123 |
Any Insurance Company |
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AN AUTHORIZED HAWAII INSURER HAS ISSUED AN INSURANCE POLICY |
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WHICH COMPLIES WITH THE HAWAII MOTOR VEHICLE INSURANCE LAW TO: |
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AutoIDWEB |
INSURED |
Empire Parts |
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NAME AND |
210 Washington Ave |
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ADDRESS: |
Albany, NY |
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AGENCY/COMPANY Your Insurance Agency/Company |
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ISSUING CARD: |
1234 Main Street, AnyCity, US 12345 |
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(Replace this logo with your company logo) |
YEAR: 2001 |
MAKE/MODEL: BUICK / REGAL |
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VEHICLE ID #: |
2G4WB55K611267155 |
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POLICY #: |
ABC987654321 |
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EFFECTIVE DATE: 5/1/2003 |
EXPIRATION DATE: 5/1/2004 |
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SEE IMPORTANT NOTICE ON REVERSE SIDE |
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Your Custom Message |
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Can Go Here! |
PLEASE CUT ALONG ABOVE LINE |
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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 |
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IOWA FINANCIAL LIABILITY COVERAGE CARD |
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COMPANY NUMBER |
COMPANY |
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123 |
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Any Insurance Company |
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POLICY NUMBER |
EFFECTIVE DATE |
EXPIRATION DATE |
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ABC987654321 |
5/1/2003 |
5/1/2004 |
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YEAR |
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MAKE/MODEL |
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VEHICLE IDENTIFICATION NUMBER |
AutoID |
2001 |
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MITSUBISHI / GALANT |
4A3AA46G61E191633 |
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WEB |
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AGENCY/COMPANY ISSUING CARD |
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Your Insurance Agency/Company |
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(Replace this logo with your company logo) |
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AGENCY/COMPANY ADDRESS |
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1234 Main Street |
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AnyCity, US 12345 |
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INSURED |
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Empire Parts |
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210 Washington Ave |
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Albany, NY |
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Your Custom Message |
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COVERAGE PROVIDED BY THIS POLICY MEETS THE MINIMUM LIABILITY LIMITS PRESCRIBED BY LAW |
Can Go Here! |
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SEE IMPORTANT NOTICE ON REVERSE SIDE |
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STATE OF IDAHO LIABILITY INSURANCE IDENTIFICATION CARD |
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(STATE) |
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COMPANY NUMBER |
COMPANY |
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123 |
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Any Insurance Company |
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POLICY NUMBER |
EFFECTIVE DATE |
EXPIRATION DATE |
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ABC987654321 |
5/1/2003 |
5/1/2004 |
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YEAR |
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MAKE/MODEL |
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VEHICLE IDENTIFICATION NUMBER |
AutoIDWEB |
2001 |
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KIA / SEPHIA |
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KNAFB121X5052916 |
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AGENCY/COMPANY ISSUING CARD |
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Your Insurance Agency/Company |
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(Replace this logo with your company logo) |
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1234 Main Street |
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AnyCity, US 12345 |
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INSURED
Empire Parts
210 Washington Ave
Albany, NY
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Your Custom Message |
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SEE IMPORTANT NOTICE ON REVERSE SIDE |
Can Go Here! |
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ILLINOIS INSURANCE IDENTIFICATION CARD |
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Examine policy exclusions carefully. This form does not constitute any part of your insurance policy. |
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COMPANY NUMBER |
COMPANY |
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12345 |
Any Insurance Company |
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POLICY NUMBER |
EFFECTIVE DATE |
EXPIRATION DATE |
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ABC987654321 |
5/1/2003 |
5/1/2004 |
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YEAR |
MAKE/MODEL |
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VEHICLE IDENTIFICATION NUMBER |
AutoIDWEB |
2001 |
BUICK / LESABRE |
1G4HP54K914228687 |
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AGENCY/COMPANY ISSUING CARD |
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Your Insurance Agency/Company |
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(Replace this logo with your company logo) |
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1234 Main Street |
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AnyCity, US 12345 |
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INSURED
Empire Parts
210 Washington Ave
Albany, NY
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:
X
Company:
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 |
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INDIANA |
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INSURANCE IDENTIFICATION CARD |
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(STATE) |
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COMPANY NUMBER |
COMPANY |
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123 |
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Any Insurance Company |
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POLICY NUMBER |
EFFECTIVE DATE |
EXPIRATION DATE |
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ABC987654321 |
5/1/2003 |
5/1/2004 |
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YEAR |
MAKE/MODEL |
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VEHICLE IDENTIFICATION NUMBER |
AutoIDWEB |
2001 |
HONDA / CIVIC |
1HGES16521L028151 |
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AGENCY/COMPANY ISSUING CARD |
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Your Insurance Agency/Company |
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(Replace this logo with your company logo) |
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1234 Main Street |
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AnyCity, US 12345 |
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INSURED
Empire Parts
210 Washington Ave
Albany, NY
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Your Custom Message |
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SEE IMPORTANT NOTICE ON REVERSE SIDE |
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Can Go Here! |
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KANSAS |
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INSURANCE IDENTIFICATION CARD |
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(STATE) |
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COMPANY NUMBER |
COMPANY |
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123 |
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Any Insurance Company |
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POLICY NUMBER |
EFFECTIVE DATE |
EXPIRATION DATE |
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ABC987654321 |
5/1/2003 |
5/1/2004 |
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YEAR |
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MAKE/MODEL |
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VEHICLE IDENTIFICATION NUMBER |
AutoIDWEB |
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2001 |
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HONDA / ACCORD |
JHMCG56621C024204 |
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AGENCY/COMPANY ISSUING CARD |
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Your Insurance Agency/Company |
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(Replace this logo with your company logo) |
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1234 Main Street |
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AnyCity, US 12345 |
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INSURED |
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Empire Parts |
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210 Washington Ave |
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Albany, NY |
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Your Custom Message |
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SEE IMPORTANT NOTICE ON REVERSE SIDE |
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Can Go Here! |
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COMMONWEALTH OF KENTUCKY PROOF OF INSURANCE |
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COMPANY # |
COMPANY NAME AND ADDRESS |
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54321 |
Any Insurance Company |
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100 Fifth Ave |
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New York, NY 10010 |
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AutoIDWEB |
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Empire Parts |
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NAMED |
210 Washington Ave |
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INSURED |
Albany, NY |
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& ADDRESS: |
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POLICY #: |
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ABC987654321 |
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(Replace this logo with your company logo) |
EFFECTIVE DATE: 5/1/2003 |
EXPIRATION DATE: 5/1/2004 |
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YEAR: 2001 |
MAKE/MODEL: BUICK / LESABRE |
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VEHICLE ID #: |
1G4HP54K314140704 |
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AGENCY/COMPANY Your Insurance Agency/Company |
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ISSUING CARD: |
1234 Main Street, AnyCity, US 12345 |
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AGCY/CO PHONE #: |
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SEE IMPORTANT NOTICE ON REVERSE SIDE |
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Your Custom Message |
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Can Go Here! |
PLEASE CUT ALONG ABOVE LINE |
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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 |
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LOUISIANA AUTO INSURANCE IDENTIFICATION CARD |
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COMPANY NAIC NUMBER |
COMPANY AFFORDING COVERAGE (NAME & ADDRESS) |
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12345 |
Any Insurance Company |
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100 Fifth Ave |
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New York, NY 10010 |
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An |
insurer authorized to transact business in Louisiana |
has |
issued the |
AutoIDWEB |
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Motor Vehicle Policy identified here on. The coverage provided by this |
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policy meets the |
minimum liability insurance limits prescribed |
by law. |
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POLICY NUMBER |
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EFFECTIVE DATE |
EXPIRATION DATE |
(Replace this logo with your company logo) |
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ABC987654321 |
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5/1/2003 |
5/1/2004 |
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YEAR |
MAKE/MODEL |
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VEHICLE IDENTIFICATION NUMBER |
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2001 |
BUICK / PARK AVE |
1G4CW54K614203856 |
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NAME OF INSURED |
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Empire Parts |
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210 Washington Ave, Albany, NY |
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THIS CARD MUST BE CARRIED IN THE VEHICLE AT ALL TIMES |
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AS EVIDENCE OF INSURANCE |
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Your Custom Message |
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SEE IMPORTANT NOTICE ON REVERSE SIDE |
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Can Go Here! |
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MASSACHUSETTS |
INSURANCE IDENTIFICATION CARD |
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(STATE) |
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COMPANY NUMBER |
COMPANY |
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123 |
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Any Insurance Company |
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POLICY NUMBER |
EFFECTIVE DATE |
EXPIRATION DATE |
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ABC987654321 |
5/1/2003 |
5/1/2004 |
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YEAR |
MAKE/MODEL |
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VEHICLE IDENTIFICATION NUMBER |
AutoIDWEB |
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2001 |
HONDA / CIVIC |
2HGES15581H537384 |
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AGENCY/COMPANY ISSUING CARD |
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Your Insurance Agency/Company |
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(Replace this logo with your company logo) |
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1234 Main Street |
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AnyCity, US 12345 |
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INSURED
Empire Parts
210 Washington Ave
Albany, NY
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Your Custom Message |
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SEE IMPORTANT NOTICE ON REVERSE SIDE |
Can Go Here! |
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MARYLAND |
INSURANCE IDENTIFICATION CARD |
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(STATE) |
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COMPANY NUMBER |
COMPANY |
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123 |
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Any Insurance Company |
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POLICY NUMBER |
EFFECTIVE DATE |
EXPIRATION DATE |
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ABC987654321 |
5/1/2003 |
5/1/2004 |
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YEAR |
MAKE/MODEL |
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VEHICLE IDENTIFICATION NUMBER |
AutoIDWEB |
2001 |
BUICK / LESABRE |
1G4HP54K414272841 |
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AGENCY/COMPANY ISSUING CARD |
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Your Insurance Agency/Company |
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(Replace this logo with your company logo) |
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1234 Main Street |
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AnyCity, US 12345 |
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INSURED
Empire Parts
210 Washington Ave
Albany, NY
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:
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 |
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MAINE MOTOR VEHICLE INSURANCE IDENTIFICATION CARD |
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The policy provides the minimum insurance required by law. |
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COMPANY NUMBER |
COMPANY |
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123 |
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Any Insurance Company |
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POLICY NUMBER |
EFFECTIVE DATE |
EXPIRATION DATE |
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ABC987654321 |
5/1/2003 |
5/1/2004 |
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YEAR |
MAKE/MODEL |
VEHICLE IDENTIFICATION NUMBER |
AutoIDWEB |
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2001 |
BUICK / LESABRE |
1G4HP54K31U199252 |
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AGENCY/COMPANY ISSUING CARD |
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Your Insurance Agency/Company |
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(Replace this logo with your company logo) |
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1234 Main Street |
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AnyCity, US 12345 |
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INSURED
Empire Parts
210 Washington Ave
Albany, NY
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Your Custom Message |
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SEE IMPORTANT NOTICE ON REVERSE SIDE |
Can Go Here! |
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MINNESOTA INSURANCE IDENTIFICATION CARD |
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COMPANY NUMBER |
COMPANY |
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123 |
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Any Insurance Company |
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POLICY NUMBER |
EFFECTIVE DATE |
EXPIRATION DATE |
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ABC987654321 |
5/1/2003 |
5/1/2004 |
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YEAR |
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MAKE/MODEL |
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VEHICLE IDENTIFICATION NUMBER |
AutoIDWEB |
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2000 |
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DODGE / INTREPID |
2B3HD46R1YH402476 |
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AGENCY/COMPANY ISSUING CARD |
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Your Insurance Agency/Company |
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(Replace this logo with your company logo) |
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1234 Main Street |
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AnyCity, US 12345 |
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INSURED |
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Empire Parts |
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210 Washington Ave |
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Albany, NY |
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Every driver shall have in his or her possession while operating a motor vehicle, |
Your Custom Message |
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and shall produce on demand proof of insurance covering the vehicle being operated. |
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Failure to produce the required proof of insurance can result in a misdemeanor conviction. |
Can Go Here! |
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SEE IMPORTANT NOTICE ON REVERSE SIDE |
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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 |
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ABC987654321 |
5/1/2003 |
5/1/2004 |
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YEAR |
MAKE/MODEL |
VEHICLE IDENTIFICATION NUMBER |
AutoIDWEB |
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2000 |
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BUICK / LESABRE |
1G4HP54K4YU345524 |
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AGENCY/COMPANY ISSUING CARD |
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Your Insurance Agency/Company |
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(Replace this logo with your company logo) |
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1234 Main Street |
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AnyCity, US 12345 |
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INSURED NAME AND ADDRESS |
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Empire Parts |
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210 Washington Ave |
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Albany, NY |
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Your Custom Message |
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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 |
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MISSISSIPPI INSURANCE IDENTIFICATION CARD |
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COMPANY NUMBER |
COMPANY |
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123 |
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Any Insurance Company |
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POLICY NUMBER |
EFFECTIVE DATE |
EXPIRATION DATE |
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ABC987654321 |
5/1/2003 |
5/1/2004 |
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YEAR |
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MAKE/MODEL |
VEHICLE IDENTIFICATION NUMBER |
AutoIDWEB |
2000 |
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BUICK / LESABRE |
1G4HP54K6Y4104919 |
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AGENCY/COMPANY ISSUING CARD AND LOCAL OR CUSTOMER SERVICE PHONE NUMBER |
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Your Insurance Agency/Company |
(Replace this logo with your company logo) |
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1234 Main Street |
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AnyCity, US 12345 |
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INSURED |
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Empire Parts |
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210 Washington Ave |
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Albany, NY |
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Your Custom Message |
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SEE IMPORTANT NOTICE ON REVERSE SIDE |
Can Go Here! |
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MONTANA |
INSURANCE IDENTIFICATION CARD |
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(STATE) |
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COMPANY NUMBER |
COMPANY |
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123 |
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Any Insurance Company |
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POLICY NUMBER |
EFFECTIVE DATE |
EXPIRATION DATE |
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ABC987654321 |
5/1/2003 |
5/1/2004 |
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YEAR |
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MAKE/MODEL |
VEHICLE IDENTIFICATION NUMBER |
AutoIDWEB |
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2000 |
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DODGE / 2500H |
3B7KF26W8YM221465 |
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AGENCY/COMPANY ISSUING CARD |
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Your Insurance Agency/Company |
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(Replace this logo with your company logo) |
|||
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1234 Main Street |
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AnyCity, US 12345 |
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INSURED
Empire Parts
210 Washington Ave
Albany, NY
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Your Custom Message |
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SEE IMPORTANT NOTICE ON REVERSE SIDE |
Can Go Here! |
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NORTH CAROLINA |
INSURANCE IDENTIFICATION CARD |
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(STATE) |
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COMPANY NUMBER |
COMPANY |
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123 |
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Any Insurance Company |
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POLICY NUMBER |
EFFECTIVE DATE |
EXPIRATION DATE |
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ABC987654321 |
5/1/2003 |
5/1/2004 |
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YEAR |
MAKE/MODEL |
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VEHICLE IDENTIFICATION NUMBER |
AutoIDWEB |
2000 |
BUICK / LESABRE |
1G4HP54K5Y4105348 |
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AGENCY/COMPANY ISSUING CARD |
|
|||
|
Your Insurance Agency/Company |
|
(Replace this logo with your company logo) |
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||
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1234 Main Street |
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AnyCity, US 12345 |
|
|
INSURED
Empire Parts
210 Washington Ave
Albany, NY
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
|
|
|
|
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
|
|
|
|
Your Custom Message |
|
|
SEE IMPORTANT NOTICE ON REVERSE SIDE |
Can Go Here! |
|
|
|
|
||
|
|
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|
|
|
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
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
|
|
|
|
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
|
|
|
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 / |
JHLRD186XYS010192 |
|
AGENCY/COMPANY ISSUING CARD AND PHONE NUMBER |
|
||
Your Insurance Agency/Company |
(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
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 |
|
|
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|
||||||||
Effective Date |
Expiration Date |
|
||||||||||
|
Your Insurance Agency/Company |
|
||||||||||
|
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|
|||||
|
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: |
|
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|||||||
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|
(Replace this logo with your company logo) |
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|
|
Year |
Make |
|||||
|
Empire Parts |
KMHJG35F5YU206087 |
|
|
||||||||
|
210 Washington Ave |
Vehicle Identification Number |
|
|||||||||
|
Albany NY 12210 |
|
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||
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||||
|
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|
|
|
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|
|
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
|
|
|
|
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
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
© 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
INSURED
Empire Parts
210 Washington Ave
Albany, NY
|
|
|
|
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
|
|
|
|
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
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
|
|
|
|
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
|
|
|
|
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
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 |
|
|
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 |
|
||
1234 Main Street |
|
|
TRADUCCION DE ESPANOL |
AnyCity, US 12345 |
|
||
INSURED |
|
|
|
Empire Parts |
|
|
|
210 Washington Ave |
|
|
|
Albany, NY |
|
|
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
|
|
|
|
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
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
|
|
|
|
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
|
|
|
|
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
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
|
|
|
|
|
|
|
|
|
|
|
|
|
Your Custom Message |
|
|
|
|
SEE IMPORTANT NOTICE ON REVERSE SIDE |
|
|
|
|
Can Go Here! |
||||
|
|
|
|
|
|
|
|
|
|||||
|
|
|
|
|
|
|
|
|
|
|
|
||
WEST VIRGINIA CERTIFICATE OF INSURANCE |
|
|
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|
|
|
|
|
|||||
|
|
|
|
|
|
||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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 |
|
|
|
|
|
|
|
|
|
||
|
|
|
|
|
|
|
|||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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
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 |
|
||||
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 |
|
|
|
|
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 |
|
||||
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 |
|
|
|
|
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
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
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 |
|
|
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VEHICLE IDENTIFICATION NUMBER |
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1999 |
CHEVROLET / VENTURE |
1GNDX03EXXD224231 |
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AGENCY/COMPANY ISSUING FORM (INCLUDE ADDRESS AND TELEPHONE NUMBER) |
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Your Insurance Agency/Company |
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1234 Main Street |
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AnyCity, US 12345 |
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NAME OF INSURED |
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Empire Parts |
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COVERAGES: |
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* |
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A LIABILITY INSURANCE POLICY HAS BEEN ISSUED PURSUANT TO THE COMPULSORY |
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INSURANCE LAW OF OKLAHOMA. IF THIS IS AN OWNERS FORM, KEEP IN THE MOTOR VEHICLE |
Your Custom Message |
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AT ALL TIMES. IF AN OPERATORS FORM, CARRY IT WHENEVER OPERATING ANY VEHICLE. |
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SEE IMPORTANT INFORMATION ON REVERSE SIDE |
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Can Go Here! |
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OKLAHOMA OWNERS SECURITY VERIFICATION FORM |
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MOTOR VEHICLE AGENCY SURRENDER COPY |
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COMPANY NUMBER |
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COMPANY NAME AND ADDRESS |
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123 |
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Any Insurance Company |
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100 Fifth Ave, New York, NY 10010 |
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POLICY NUMBER |
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EFFECTIVE DATE |
EXPIRATION DATE |
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ABC987654321 |
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5/1/2003 |
5/1/2004 |
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YEAR |
MAKE/MODEL |
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VEHICLE IDENTIFICATION NUMBER |
AutoIDWEB |
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1999 |
CHEVROLET / VENTURE |
1GNDX03EXXD224231 |
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AGENCY/COMPANY ISSUING FORM (INCLUDE ADDRESS AND TELEPHONE NUMBER) |
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Your Insurance Agency/Company |
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(Replace this logo with your company logo) |
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1234 Main Street |
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AnyCity, US 12345 |
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NAME OF INSURED |
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Empire Parts |
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COVERAGES: |
A |
C |
D |
G |
L |
N |
R R1 U |
S |
T |
Z |
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* |
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A LIABILITY INSURANCE POLICY HAS BEEN ISSUED PURSUANT TO THE COMPULSORY INSUR- |
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ANCE LAW OF OKLAHOMA. SUBMIT THIS PART WITH YOUR APPLICATION FOR REGISTRATION. |
Your Custom Message |
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SEE IMPORTANT INFORMATION ON REVERSE SIDE |
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Can Go Here! |
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HOW TO IDENTIFY YOUR COVERAGE |
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A |
LIABILITY (BODILY INJURY/ |
R |
CAR RENTAL |
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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
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HOW TO IDENTIFY YOUR COVERAGE |
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A |
LIABILITY (BODILY INJURY/ |
R |
CAR RENTAL |
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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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