Form_SCTNID_CTGRY.
MA12206489_COVGSELC
985114648 Q IC94549 INS COVGSUMM E POLWHITEFONT IFMMWSXDOJ4GESOQOA4K33QBIF0002 RPUID TRACWHITEFONT BDF_AA
PROGRESSIVE
P.O. BOX 31260
TAMPA, FL 33631
Policy Number: 985114648
Underwritten by:
Progressive Direct Insurance Co
DIEGO RAPHAELL FERREIRA LUIGI January 13, 2025
30 MARCELLO AVE
Policy Period: Feb 10, 2025 - Aug 10, 2025
13
LEOMINSTER, MA 01453 Page 1 of 3
progressive.com
Online Service
Make payments, check billing activity, update
policy information or check status of a claim.
Auto Insurance 1-800-776-4737
Coverage Summary
For customer service and claims service,
24 hours a day, 7 days a week.
P.O. Box 31260
This is your Renewal Tampa, FL 33631
Coverage Selections Page
The coverages, limits and policy period shown apply only if you pay for this policy to renew.
Your coverage begins on February 10, 2025 at 12:01 a.m. This policy expires on August 10, 2025 at 12:01 a.m.
This page and any attached endorsements form a part of your policy and contain a full explanation of your coverage. The
policy contract is form 9609D MA (11/16). The contract is modified by forms Z628 MA (11/07), A057 MA (05/14), Z624 MA
(05/14), Z538 MA (05/14) and 9869 MA (05/14).
Drivers and household members
Diego Raphaell Ferreira Luigi
Additional information: Named insured
Ana Cruz Luigi
Additional information: excluded driver
Form 6489 MA (12/20)
4
Continued
985114648 Q IC94549 INS COVGSUMM E POLWHITEFONT IFMMWSXDOJ4GESOQOA4K33QBIF0002 RPUID TRACWHITEFONT BDF_AA
Policy Number: 985114648
Diego Raphaell Ferreira Luigi
Page 2 of 3
Outline of coverage
This policy provides only the coverages for which a premium charge is shown.
Auto 1
2013 BMW 328 4 DOOR SEDAN
VIN: WBA3B5G5XDNS00704
Principal garaging address: 01453
Primary use of the vehicle: Pleasure/Personal
Annual miles: 0 - 3,999
Length of vehicle ownership when policy started or vehicle added: At least 3 years but less than 5 years
Information regarding your vehicle history (prior damage, theft or title issues) has impacted how we determine your premium.
Coverages Parts 1-12
Compulsory insurance Limits
……………………………………………………………………………………………………………………………………………………….. Deductible Premium
Bodily Injury to Others (Part 1) $20,000
………………………………………………………………………………………………………………………………………………………..
each person/$40,000 each accident $321
Personal Injury Protection (Part 2) $8,000 each person $250 44
Deductible applies to You and household members
………………………………………………………………………………………………………………………………………………………..
Bodily Injury Caused by An Uninsured Auto (Part 3) $20,000 each person/$40,000 each accident 5
(Compulsory Limits $20,000/$40,000)
………………………………………………………………………………………………………………………………………………………..
Damage to Someone Else's Property (Part 4) $100,000 each accident 279
(Compulsory Limit $5,000)
Optional insurance Limits
………………………………………………………………………………………………………………………………………………………..
Deductible Premium
Optional Bodily Injury to Others (Part 5) $20,000 each person/$40,000 each accident 5
………………………………………………………………………………………………………………………………………………………..
Collision (Part 7) Actual Cash Value $1,000 258
………………………………………………………………………………………………………………………………………………………..
Comprehensive (Part 9) Actual Cash Value $1,000 62
Comprehensive Window Glass $1,000 glass
………………………………………………………………………………………………………………………………………………………..
Total 6 month policy premium $974.00
Part 5 - Optional Bodily Injury To Others
The limits shown for this Part are the total limits you have under Compulsory Bodily Injury to Others (Part 1) and this Part.
This means that the Compulsory limits are included within the limits shown for this Part and are not in addition to them.
Premium discounts
Several discounts are available and your premium has been reduced if one or more discounts are indicated below. Contact
customer service for further details.
Policy
………………………………………………………………………………………………………………………………………………………..
985114648 Five-Year Accident Free, Electronic Funds Transfer (EFT), Residence Insurance,
Continuous Insurance: Gold, Paperless and Three-Year Safe Driving
Vehicle
………………………………………………………………………………………………………………………………………………………..
2013 BMW Smart Technology Discount
328
Smart Technology Discount℠ is a service mark of Progressive Casualty Ins. Co.
Driver information
Name Date of birth
………………………………………………………………………………………………………………………………………………………..
Diego Raphaell Ferreira Luigi May 27, 1990
License status Years licensed Operator status
Valid 16 Rated
Form 6489 MA (12/20)
4
Continued
985114648 Q IC94549 INS COVGSUMM E POLWHITEFONT IFMMWSXDOJ4GESOQOA4K33QBIF0002 RPUID TRACWHITEFONT BDF_AA
Policy Number: 985114648
Diego Raphaell Ferreira Luigi
Page 3 of 3
Driver information (continued)
Name Date of birth
………………………………………………………………………………………………………………………………………………………..
Ana Cruz Luigi Jan 1, 1990
License status Years licensed Operator status
Valid 19 Excluded
Check carefully that all operators of your auto(s) are shown. Your failure to list a household member or any individual who
customarily operates your auto may have very serious consequences.
NOTICE: If you or someone else on your behalf has knowingly given us false, deceptive, misleading or incomplete
information and if such false, deceptive, misleading or incomplete information increases our risk of loss, we may refuse to
pay claims under any or all of the Optional Insurance Parts and we may cancel your policy. Such information includes the
description and the place of garaging of the vehicle(s) to be insured, the names of all household members and customary
operators required to be listed and the answers given above for all listed operators. We may also limit our payments
under Part 3 and Part 4. Check to make certain that you have correctly listed all operators and the completeness of their
previous driving records. We may verify the accuracy of the previous driving records of all listed operators.
We will not pay for a collision or limited collision loss for an accident which occurs while your auto is being operated by a
household member who is not listed as an operator on your policy. Payment is withheld when the household member, if
listed, would require the payment of additional premium on your policy because the household member would be
classified as an inexperienced operator or would require payment of additional premium on your policy under our rates.
Countersigned by
Authorized Signature
Authorized Signature
Form 6489 MA (12/20)
