Form_SCTNID_CTGRY.

LA06226489_DECPAGE

53321943 E L541773 INS DECPAGE E POLWHITEFONT CAYPHNVNMNHVEX6V6HMVJIFY4B0001 RPUID TRACWHITEFONT BDF_AA

EMERY & JAMES LTD

300 E MORRIS AVE
HAMMOND, LA 70403

Policy Number: 53321943

Underwritten by:
Progressive Security Insurance Co
ANDREW B KIRSCH October 24, 2024
14419 W HOFFMAN RD Policy Period: May 26, 2024 - Nov 26, 2024
HAMMOND, LA 70403 Page 1 of 3
1-985-345-0376
EMERY & JAMES LTD
Contact your agent for personalized

Auto Insurance service.

1-800-274-4499
Coverage Summary To report a claim.

This is your Declarations Page

Your coverage began on May 26, 2024 at 12:01 a.m. This policy expires on November 26, 2024 at 12:01 a.m.
This coverage summary replaces your prior one. Your insurance policy and any policy endorsements contain a full explanation of
your coverage. The policy limits shown for a vehicle may not be combined with the limits for the same coverage on another
vehicle. The policy contract is form 9611A LA (09/15). The contract is modified by forms 8052 LA (04/21), A264 (02/22), A331
(11/21) and A352 LA (06/22).
Progressive Security Insurance Co is a stock company (NYSE: PGR).

Policy changes effective October 24, 2024

………………………………………………………………………………………………………………………………………………………..
Changes requested on: Oct 24, 2024 12:32 p.m.
………………………………………………………………………………………………………………………………………………………..
Premium change: $0.00
The changes take effect as of the date and time requested shown above.
Drivers and household residents
Andrew B Kirsch
Additional information: Named insured
Dana C Kirsch

Form 6489 LA (06/22)

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53321943 E L541773 INS DECPAGE E POLWHITEFONT CAYPHNVNMNHVEX6V6HMVJIFY4B0001 RPUID TRACWHITEFONT BDF_AA

Policy Number: 53321943

Andrew B Kirsch
Page 2 of 3

Outline of coverage
2011 NISSAN FRONTIER CREW PICKUP
VIN: 1N6AD0ER9BC448235
Garaging ZIP Code: 70403
Primary use of the vehicle: Pleasure/Personal
Deductible Premium
………………………………………………………………………………………………………………………………………………………..
Liability To Others $376
Bodily Injury Liability
Limits: $25,000 each person/$50,000 each accident
Property Damage Liability
Limits: $25,000 each accident
………………………………………………………………………………………………………………………………………………………..
Uninsured Motorist 155
Limits: $25,000 each person/$50,000 each accident
………………………………………………………………………………………………………………………………………………………..
Comprehensive 121
Limits: Actual Cash Value
………………………………………………………………………………………………………………………………………………………..
$500
Collision 167
Limits: Actual Cash Value $500
………………………………………………………………………………………………………………………………………………………..
Total premium for 2011 NISSAN $819
2020 BUICK ENCLAVE 4 DOOR WAGON
VIN: 5GAERBKW5LJ112964
Garaging ZIP Code: 70403
Primary use of the vehicle: Pleasure/Personal
Length of vehicle ownership when policy started or vehicle added: Less than 1 month
This vehicle is currently enrolled in the Snapshot® Program.
Deductible Premium
………………………………………………………………………………………………………………………………………………………..
Liability To Others $170
Bodily Injury Liability
Limits: $25,000 each person/$50,000 each accident
Property Damage Liability
Limits: $25,000 each accident
………………………………………………………………………………………………………………………………………………………..
Uninsured Motorist 89
Limits: $25,000 each person/$50,000 each accident
………………………………………………………………………………………………………………………………………………………..
Comprehensive 167
Limits: Actual Cash Value
………………………………………………………………………………………………………………………………………………………..
$500
Collision 224
Limits: Actual Cash Value $500
………………………………………………………………………………………………………………………………………………………..
Total premium for 2020 BUICK $650
………………………………………………………………………………………………………………………………………………………..
Total 6 month policy premium $1,469.00

Premium discounts
Policy
………………………………………………………………………………………………………………………………………………………..
53321943 Five-Year Accident Free, Automatic Card Payments (ACP), Five-Year Claim
Free, Mobile Home Owner, Multi-Car, Continuous Insurance: Diamond,
Paperless and Three-Year Safe Driving
Vehicle
………………………………………………………………………………………………………………………………………………………..
2020 BUICK Anti-Theft Device and Snapshot Driving
ENCLAVE

Form 6489 LA (06/22)

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Policy Number: 53321943

Andrew B Kirsch
Page 3 of 3

Lienholder information
Vehicle Lienholder
………………………………………………………………………………………………………………………………………………………..
2011 NISSAN FRONTIER Eagle Federal Credit Union
1N6AD0ER9BC448235 Forth Worth, TX 76124

A11Y LEH End Locator

Financial Security Requirement

If you do not keep your liability insurance in force during the entire registration period, your registering privileges will be
subject to revocation. By law your insurance carrier is required to report specific termination information to the
Commissioner of the Department of Public Safety and Corrections.

Company officers

Secretary

Form 6489 LA (06/22)