IDENTIFICATION CARD(INSURANCEorg)

IDENTIFICATION CARD(INSURANCEorg) - Name(s Age Mo/Day/Yr of...

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IDENTIFICATION CARD (STATE OF MICHIGAN CERTIFICATION OF NO-FAULT INSURANCE) NEED TO REPORT A CLAIM? 800-285-2524 QBE Insurance Corporation NAIC # 39217 P.O. Box 9064 Carlsbad, CA 92018-9064 AGENT: Astro Insurance Agencies Inc (Lincoln Park) PHONE NUMBER: (313)928-1262 POLICY NUMBER: 0703673400 INCEPTION DATE: 06/13/2012 12:02 PM PST APP NUMBER: 81306764 EXPIRATION DATE: 07/28/2012 12:02 PM PST NAMED INSURED AND ADDRESS: ADDITIONAL DRIVER(S): DEANTHONY FLETCHER 286 HYACINTHE ST ECORSE, MI 48229 VEHICLE YEAR MAKE/MODEL VEHICLE ID# 1 1999 Oldsmobile ALERO 4 Door 1G3NL52E5XC326775 An authorized Michigan insurer, certifies that it has issued a policy complying with Act 294 P.A. 2972, as amended for the described motor vehicle. WARNING: KEEP THIS CERTIFICATE IN YOUR VEHICLE AT ALL TIMES . If you fail to produce it upon a police officer’s request, you will be responsible for a civil infraction. Michigan Law (MCLA 500.3101) requires that the owner or registrant of a motor vehicle registered in this state must have insurance or other approved security for the payment of no-fault benefits on the vehicle at all times. An owner or registrant who drives or permit a vehicle to be driven upon a public
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  • Fall '11
  • etc
  • Motor vehicle, PM PST, Astro Insurance Agencies

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