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  1. 1. Temporary Insurance Identification Card Automobile Club Inter-Insurance Exchange (NAIC #15512) 12901 North Forty Dr., St. Louis, MO 63141 THIS CARD MUST BE CARRIED IN THE INSURED MOTOR VEHICLE FOR PRODUCTION UPON DEMAND. Policy Number: A10334951 IN CASE OF AN ACCIDENT Effective Date: 02/16/2012 Expiration Date: 04/16/2012 Report any accident immediately to: Year: 2010 Make / Model: KIA OPTIMA SED Claims VIN#: KNAGG4A86A5394482 1–866–222–2378 Insured: Calvin L Carr , Debra K Carr Examine your policy carefully. This form does not Address: 680 SE Highway EE constitute any part of your insurance policy. Leeton, MO 64761 THIS CARD IS VOID 60 DAYS FROM THE EFFECTIVE DATE SHOWN. SEE IMPORTANT NOTICE ON REVERSE SIDE. Form #199 (12/2009) ^ l Fold Here Temporary Insurance Identification Card Automobile Club Inter-Insurance Exchange (NAIC #15512) 12901 North Forty Dr., St. Louis, MO 63141 THIS CARD MUST BE CARRIED IN THE INSURED MOTOR VEHICLE FOR PRODUCTION UPON DEMAND. Policy Number: A10334951 IN CASE OF AN ACCIDENT Effective Date: 02/16/2012 Expiration Date: 04/16/2012 Report any accident immediately to: Year: 2001 Make / Model: CHEV C-1500 Claims VIN#: 1GCEC14T41E199906 1–866–222–2378 Insured: Calvin L Carr , Debra K Carr Examine your policy carefully. This form does not Address: 680 SE Highway EE constitute any part of your insurance policy. Leeton, MO 64761 THIS CARD IS VOID 60 DAYS FROM THE EFFECTIVE DATE SHOWN. SEE IMPORTANT NOTICE ON REVERSE SIDE. Form #199 (12/2009) ^ l Fold Here

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