Boy Scouts of America - BSA auto insurance by PrivateLabelArticles

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									CERTIFICATE OF AUTO INSURANCE
VEHICLE 1
Make of Vehicle_________________ Kind____________________ Year___________ Number of passengers with seat belts: _________ Owner _________________________________________________________________ Driver License Number____________________________________________________ Name of Insurance Company_______________________________________________ Coverage: Each person $________________ Each Accident $________________ Property Damage $________________ (Suggested Coverage) $50,000 $100,000 $50,000

VEHICLE 2
Make of Vehicle_________________ Kind____________________ Year___________ Number of passengers with seat belts: _________ Owner _________________________________________________________________ Driver License Number____________________________________________________ Name of Insurance Company_______________________________________________ Coverage: Each person $________________ Each Accident $________________ Property Damage $________________ (Suggested Coverage) $50,000 $100,000 $50,000

Signed___________________________________________ Date________________
Signature of owner


								
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