THE GREEN CARD BELOW ASSIGNED IS AUTHENTICATED BY THE CERTIFICATE

DIGITAL °SERIES
N 06 35 95www.assuminute.euEquifax Secure Certificate Authority
CABINET VARAUT 01.39.60.03.85

TO BE REMEMBERED IN ALL CORRESPONDENCE

AGENCY POLICE NUMBER POLICY UNDERWRITER

M. Patrick VARAUT
A 27 824M Patrick 051 792 830 40 General Leclerc Street
. VARAUT
40 General Leclerc Street Certificate No. 95320 SAINT-LEU-LA-FORET
Phone: 01 39 60 03 85
95320 SAINT-LEU-LA-FORET
WEB-STLEU2019351 23575
Phone: 01 39 60 03 85
ASSURE
name DRAFT first_nameMURIEL
address
COMMUNE :MILES
66170 COUNTRY:FRANCE

VALID youJanuary 7, 2021 à 15:10:00 in June 1, 2022 à 14:59:00

Vehicle: Genre A Brand: OPEL

Model: ASTRA Registration: CG-874-XT
Date 1eracirculationJune 26, 2012
Dear Customer,
You will find attached:
Your international car insurance card (Green Card) valid for the indicated period.
We advise you to keep this document with you when you are driving the insured vehicle.
In case of an accident abroad, we recommend that you carefully read the 'ADVICE TO' section.
07-01-21 June 1, 2022 ASSURES IN CASE OF ACCIDENT ABROAD" which appears on the back of this document.
Your insurance certificate, valid for the indicated period.
You must affix it to your vehicle.
Our Representatives are at your disposal, if needed, to provide you with plastic bags.
CG-874-XT necessary for this affixing.
We beg you to accept, Dear Customer, the expression of our devoted feelings.
The General Director
A 27 824 051 792 830
GUARANTEES:
Automobile Liability: Damages suffered by third parties
WEB-STLEU2019351 Bodily injury: without limitation of amount, damages
materials: 100 million euros per incident.
Or for damage caused by fire or explosion: 3,100,000 euros per incident.
For property damage of all kinds occurring at airports: 460,000 euros per incident,
Legal Protection Recourse within the limit of 7,100 euros

INTERNATIONAL AUTOMOBILE INSURANCE CARD 2. ISSUED WITH AUTHORIZATION

INTERNATIONAL AUTOMOBILE INSURANCE CARD
INTERNATIONAL INSURANCE CARD FROM THE FRENCH CENTRAL OFFICE
INTERNATIONAL MOTOR INSURANCE CARD
In each country visited, the Bureau of that country assumes, as far as it concerns 3. VALID 4. Card Number and Policy Number to recall
in the use of the vehicle described above, the responsibility that an insurer would have YOU (These two dates included) AU in all correspondence
in accordance with the laws of this country relating to the obligation of insurance. r M ois Year
Jyou Jour Mo is Year

2° Le soussigné, souscripteur du contrat d’assurance, autorise p ar la présente le Bureau

Central French as well as the Offices of the country or countries indicated above, to which the 07-01-21 January 6, 2022 WEB-STLEU2019351
The French Central Bureau has delegated its powers to receive notifications, to instruct and 3:10 PM 14:59:00
to settle, on its behalf, any claim for damages that calls into question the
liability towards third parties, which the laws on compulsory insurance of the country or countries F 376 A 27 824 051 792830
specified here impose an obligation to cover by insurance and who can 6.
result from the use of the vehicle in this country (or these countries).
5.
Category A
The insurance coverage provided by the green cards issued for Cyprus is CG-874-XT OPEL
limited to the geographical parts of Cyprus that are under the control of the Government
of the Republic of Cyprus.
ASTRA
Registration number or number of
4° The insurance coverage provided by the green cards issued for Serbia and chassis or engine number Vehicle category and brand *
Montenegro is limited to the geographic parts of Serbia and Montenegro that are 7. Name and address of the insurance contract subscriber (or the vehicle user)
under the control of the Government of the Federal Republic of Serbia and Montenegro.
5°Signature of the subscriber 6° For people going to the RICORT MURIEL
of the insurance contract United Kingdom of Great Britain and MILAS 66170
from Northern Ireland only:
Signature of all other persons who FRANCE
can use the vehicle

THIS CARD IS NOT VALID FOR THE COUNTRIES WHOSE BOX HAS BEEN CROSSED OUT

(This insurance card is only valid if it is signed by the policyholder of the insurance contract)

8. This card was issued by: 9. SIGNATURE OF THE INSURER

DEFINITION OF CATEGORY CODE Gan Insurance IARD The General Director
French company for fire, accident, and various risk insurance and reinsurance
A. AUTOMOBILE C. TRUCK OR TRACTOR E. BUS OR COACH Company governed by the Insurance Code - 542 063 797 R.C.S Paris APE: 660 E
Public limited company with a capital of 109,817,739 euros
B. MOTORCYCLE D. CYCLE WITH AUXILIARY ENGINE F. TRAILER Head Office: 8-10, rue d'Astorg - 75383 PARIS CEDEX 08 - Phone: 01 44 56 7777

ORIGINAL Tour Gan – CB21 – 16, place de l'Iris – 92082 PARIS-LA DEFENSE
 ADVICE TO POLICYHOLDERS IN CASE OF ACCIDENT ABROAD

1 - If possible, have the accident reported by the local police authorities.

2 - Take the names, addresses, statements of witnesses, and if possible, photos showing the position of the vehicles after the collision as well as the location of the damages.
3 - In any case, report the accident immediately to the local correspondent of Gan Assurances IARD, specifying where the incident occurred.
4 - Report the accident to your Insurance Advisor as soon as you return to France, indicating whether you have already been heard by a judicial or police authority. Send without delay all
letters, documents, summons or citations to Gan Assurances IARD to enable them to defend you effectively.
5 – If you have been forced to permanently abandon your vehicle on the spot, inform your Insurance Advisor as your situation regarding customs needs to be regularized.

LIST OF GAN Assurances IARD CONTACTS ABROAD TO CONTACT AS A PRIORITY

A AUSTRIA DANUBE GENERAL INSURANCE I Ireland MILLER FARRELL
Schottenring 15, P.O. Box 770, 1011 VIENNA Nutley Building, Merrion Center, Nutley Lane, DUBLIN 4
43 1 31 311 2323 353 1 66 15 [email protected]
AND ANDOREE CORIS IT IS ICELAND AVUS France LLC
Andorra C/Sant Salvador, 7 ANDORRA VILLA 44, Lafayette Street, 75009 PARIS
Tel. 00 376 877 677 - Fax 00 376 860 093 - Email:[email protected] 01 55 33 14 [email protected]
B BELGIUM BIRS-ISB L Luxembourg THE LUXEMBOURGER
Lenneke Marelaan 12 - 1932 SINT STEVENS WOLUWE (ZAVENTEM) 10 Aldringen Street, 2095 Luxembourg
Tél. 00 32 2 710 10 10 – Fax 00 32 2 710 10 20 – E-mail : [email protected] Tel. 352 47 61 1 - Fax 352 47 61 200 - Email :[email protected]
CH SWITZERLAND CORIS LT LITHUANIA ERGO LITHUANIA INSURANCE AG
P.O. Box 113, 2 Route de la Fonderie, 1705 FRIBOURG Gelecinio volko 6a – 2600 VILNIUS
00 41 26 425 80 00 00 370 53 68 30 21
Czech Republic CORIS PRAGUE [email protected]
Sdruzeni 2 – 140 00 PRAGUE 4 LV LATVIA ERGO LATVIA INSURANCE AG
Tel. 420 (2) 62 222 444 - Fax 420 (2) 643 03 47 - Email:[email protected] Unijas Str. 45 – 1039 RIGA
D GERMANY VAN AMEYDE 00 371 784 01 01ilmars@[email protected]
Weinsbergstrasse, 190, 50825 COLOGNE. IN MOROCCO RAMA
Tel. 49 22 1 954 206 0 300 Mostapha El Maani Street, 20000 CASABLANCA
[email protected] 00 212 22 20 46 09 and 96
DK DENMARK VAN AMEYDE DENMARK Aps N NORWAY AVUS France LLC
Amaliegade, 43 1256 COPENHAGEN.K 44, rue Lafayette, 75009 PARIS
Tel. 45 33 32 47 [email protected] 01 55 33 14 [email protected]
E Spain GROUPAMA PLUS ULTRA NL NETHERLANDS VAN AMEYDE Interschade b.v
Diagonal Avenue, 523 – 08029 BARCELONA De Rbuyn Kopsstraat, 9, 2288 EC, Po Box 3038, 2280 GA RIJSCWICK
00 34 932 534 708 Tel. 31 70 307 26 00
[email protected] E-mail:[email protected]
F FINLAND AVUS France LLC P PORTUGAL HELP ASSISTANCE
44 Lafayette Street, 75009 PARIS Avenue Eng Duarte Pacheo, Tower 1, 3efloor – Room 2/3, 1070 LISBON
Phone: 01 55 33 14 00 – Fax: 01 47 70 02 12 – Email:[email protected] Tel. 351 21 381 66 00
UK MUTUAIDE ASSISTANCE AFA Ltd. PL POLAND CORIS
UNITED KINGDOM 1 Cambridge Court, 210 Sheperds Bush Road, LONDON W67NL Ul Batalionow Chlopskich 78 – 01 308 WARSAWA
and IRELAND 00 44 207 602 2220 48(22) 665 81 [email protected]
FROM THE NORTH [email protected] S SUEDE LIFE INSURANCE - WASA
GR GRECE CORIS 40 – Stockholm 10650 STOCKHOLM
253, Syngrou Avenue, 17122 ATHENS 00 46 8 690 10 00
30 10 940 73 [email protected] SK SLOVAK REP. CORIS
H HUNGARY AVUS BUDAPEST LTD. Mliekarenska 8 – 821 08 BRATISLAVVA
Dessewffy 37-1-2 1397 BUDAPEST, PO Box 520 Tél. 421 (2) 534 16 371 – Fax 421 (2) 534 16 357 – E-mail : [email protected]
00 36 1 473 30 [email protected] CORIS
I Italy VAN AMEYDE Ul Bratov babnik 10 – 1000 LJUBLJANA
Corso Porta Romana 89, 20122 MILAN Tel. +386 (1) 519 2020 – Fax +386 (1) 519 1698 – Email :[email protected]
39 02 542 51 [email protected]