Orange County NC Website
Your Policy Declarations <br />Nationwide Auto Policy <br />Policy Period:Jan 12,2020 -Jul 12,2020 <br />Policy Number:6132P 493603 <br />Insured Driver(s) <br />Driver Dateof Marital Driver Driver Assigned <br /># Name Birth Status Gender Type Vehicle <br />01 Pamela M Hines 06/28/70 Single Female Principal 01 <br />Insured Vehicle(s) and Schedule of Coverages <br />2010 Hyundai Sonata G <br />VIN 5NPET4AC9AH636286 <br />Limitsof Liability PremiumCoverages <br />A Damage To Your Auto $102.00 <br />Other Than Collision Actual Cash Value Less $ 100 <br />(Comprehensive) <br />Collision Actual Cash Value Less $ 250 $183.00 <br />B Liability <br />Property Damage Liability $50,000 Each Accident $146.11 <br />Bodily Injury Liability $50,000 Each Person <br />$100,000 Each Accident $105.11 <br />C Medical Payments $1,000 Each Person $12.00 <br />Increased Limits Endorsement 3083A $21.00 <br />Transportation $ 50 Per Day <br />Expenses Coverage $1,500 Per Accident <br />Towing and Labor Plus-Covers Disablement/ $10.00 <br />(Roadside Assistance)$ 100 Lockout <br />$ 500 TripInterruption <br />Endorsement 3450 3446 <br />$579.22Total for thisVehicle <br />Policy Level Schedule of Coverages <br />Coverages Limits of Liability Premium <br />Part D2-Combined <br />Uninsured and Underinsured <br />Motorist - Bodily Injury $50,000 Each Person $14.00 <br />$100,000 Each Accident <br />Uninsured - Property Damage $50,000 Each Accident $2.00 <br />Coverage For Damage To Rented Endorsement 3092B $2.00 <br />Vehicles Totalfor Policy Coverages $18.00 <br />Continued on the next page <br />XXXXX <br />XXXXXXXXXX <br />XXXXX <br />XXXXXXXXXX <br />XXXXXXXXX <br />XXXXX <br />XXXXXXXXXX <br />XXXXX <br />XXXXXXXXXX <br />XXXXXXXXXX <br />XXXXXXXXXX <br />XXXXXXXXXX <br />XXXXX <br />XXXXXXXXXX <br />XXXXX <br />DocuSign Envelope ID: 71FE3C0F-91F9-4BFA-B54A-5C3E1FE79255