June 1, 2015

Policy Number: AX01738225

Michele Yoder
Christopher Yoder
903 148TH STREET CT E
TACOMA, WA 98445-2694

Dear Michele Yoder

Your auto insurance policy has been revised due to a vehicle change.
The enclosed declaration page shows the effective date of the change for your current policy, as well as
your coverages and premium information.
If you have any questions, please call our Client Service department at 1-888-404-5365. Our associates
are able to assist you Monday through Thursday from 6 a.m. to midnight, Friday from 6 a.m. to 10 p.m.,
and Saturday from 7 a.m. to 7 p.m. Central time. For future policy changes you may also visit our online
service center at ameriprise.com/costco.
Thank you for allowing us to continue serving your insurance needs.
Sincerely,

Carol M. Kammin
Vice President, Client Service

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IDS Property Casualty Insurance Company

AMENDED DECLARATION

3500 Packerland Drive

De Pere, WI 54115-9070

POLICY CHANGE OF EFFECTIVE DATE IS 05/30/2015

WASHINGTON
POLICY NUMBER: AX01738225
POLICY PERIOD: 05/17/2015 - 11/17/2015
12:01 AM Standard Time
LAPSE IN COVERAGE: NONE

Michele Yoder
Christopher Yoder
903 148TH STREET CT E
TACOMA, WA 98445-2694

COVERAGE/LIMIT
BODILY INJURY LIABILITY

FOR CLAIMS SERVICE CALL:

1-888-404-5365
FOR CLIENT SERVICE CALL:
1-888-404-5365

2005 DODGE 4
GRAND CARAV

2005 CHRYS
PT CRUISER

2000 FORD
RANGER

$124.00

$155.00

$814.00

INCL

INCL

INCL

$49.00

$66.00

$317.00

$15.00

$21.00

$21.00

$5.00

$2.00

$5.00

NONELECT

$105.00

NONELECT

NONELECT

$37.00

NONELECT

NONELECT

$5.00

NONELECT

NONELECT

$5.00

NONELECT

$193.00

$396.00

$1,157.00

$25,000 EACH PERSON

$50,000 EACH ACCIDENT

PROPERTY DAMAGE LIABILITY

$25,000 EACH ACCIDENT

PERSONAL INJURY PROTECTION BASIC LIMITS

$10,000 MEDICAL & HOSPITAL EXPENSES
$ 2,000 FUNERAL EXPENSES
$10,000/$200 PER WEEK INCOME CONTINUATION
$5,000/$40 PER DAY/$200 PER WEEK LOSS OF SERVICES

UNDERINSURED MOTORISTS
BODILY INJURY
$25,000 EACH PERSON
$50,000 EACH ACCIDENT

PROPERTY DAMAGE
$25,000 EACH ACCIDENT
$300 DED HIT-AND-RUN/PHANTOM VEHICLE
$100 DED ALL OTHER

CAR DAMAGE
COLLISION (COV. D-1)
DEDUCTIBLES CAR 4-$250

OTHER THAN COLLISION (COV. D-2)

DEDUCTIBLES CAR 4-$100

TOWING AND LABOR COSTS

$75 PER DISABLEMENT

RENTAL EXPENSE
$20 PER DAY/$600 PER OCCURRENCE

TOTAL SEMIANNUAL PREMIUM PER CAR

TOTAL SEMIANNUAL PREMIUM ALL CARS $1,746.00

Coverage is provided only when both a premium and limit are shown.

adwa01a (001)

06/01/2015

DRIVER INFORMATION
&

~ 1. Michele Yoder
~ 2. Christopher Yoder

4.

* ~ 3. Kyle Jamers Yoder

6.

5.

* QUALIFIES FOR GOOD STUDENT DISCOUNT

& QUALIFIES FOR EDUCATION LEVEL DISCOUNT

ACCIDENT FORGIVEN

CAR INFORMATION
2005
2005
2000

DODGE
CHRYS
FORD

~ QUALIFIES FOR SAFE DRIVING HISTORY

CARS KEPT AT LOCATION OTHER THAN RESIDENCE

1D4GP24R75B323295
3C8FY68B65T629024
1FTYR14V4YPA51492

YOUR POLICY HAS THE FOLLOWING DISCOUNTS:

MULTI-CAR, LOYALTY - PREFERRED, COSTCO
2005 DODGE - DUAL AIRBAG, ABS
2005 CHRYS - DUAL AIRBAG, ABS
2000 FORD - DUAL AIRBAG, ABS

YOUR POLICY HAS THE FOLLOWING ENDORSEMENTS:

AMENDATORY ENDORSEMENT
SPECIAL EQUIPMENT/CUSTOMIZATION: NONE

LIENHOLDER INFORMATION

adgn01b

KEPT AT LOCATION OTHER THAN RESIDENCE - 98321

Washington Auto Insurance Identification Card

Issued by
IDS Property Casualty Insurance Company
NAIC 29068
3500 Packerland Drive
De Pere, WI 54115-9070

Named Insured(s)
Michele Yoder
Christopher Yoder

2000 FORD RANGER

1FTYR14V4YPA51492
Policy Number
AX01738225
Effective
05/30/2015 - 11/17/2015
Drivers
Michele Yoder
Christopher Yoder
Kyle Jamers Yoder

ID Cards
You can get ID cards and
Declaration pages online any
time you need them!
Just visit:
ameriprise.com/costco
Click on: Manage My Policy
Client Service hours (Central time):
Mon-Thu 6 a.m. - midnight
Fri 6 a.m. - 10 p.m.
Sat 7 a.m. - 7 p.m.

Washington Auto Insurance Identification Card

Issued by
IDS Property Casualty Insurance Company
NAIC 29068
3500 Packerland Drive
De Pere, WI 54115-9070

Named Insured(s)
Michele Yoder
Christopher Yoder

2000 FORD RANGER

1FTYR14V4YPA51492
Policy Number
AX01738225
Effective
05/30/2015 - 11/17/2015
Drivers
Michele Yoder
Christopher Yoder
Kyle Jamers Yoder

Directions:
State law requires each driver to keep an
insurance ID card in his or her vehicle at all times.
Carefully separate the cards along the perforations
and place one in your vehicle's glove box.
If you insure more than one vehicle with us, a set
of ID cards has been issued for each vehicle.

idxx01 (001)

Claims 1-888-404-5365
Client Service 1-888-404-5365
ameriprise.com/costco

THIS CARD MUST BE CARRIED IN THE INSURED MOTOR VEHICLE

FOR PRODUCTION UPON DEMAND
Claims 1-888-404-5365
Client Service 1-888-404-5365
ameriprise.com/costco

THIS CARD MUST BE CARRIED IN THE INSURED MOTOR VEHICLE

FOR PRODUCTION UPON DEMAND

idxx01 (001)