14305 NE 88TH ST VANCOUVER, WA (360) Business Fax: Fax: (360) NE 88TH ST VANCOUVER, WA NO
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1 Addresses Business Business Phone: Mail Mail Phone: NE 88TH ST VANCOUVER, WA (360) Business Fax: Fax: (360) NE 88TH ST VANCOUVER, WA Mail Fax: Undeliverable Mail: NO Authorities: Common Authority: INACTIVE Application Pending: NO Contract Authority: NONE Application Pending: NO Broker Authority: NONE Application Pending: NO Property: YES Passenger: NO Household Goods: NO Private: NO Enterprise: NO Insurance Requirements: BIPD Exempt: Cargo Exempt: BOC-3: Comments: Active/Pending Insurance: NO BIPD Waiver: NO BIPD Required: $750,000 BIPD on File: $0 YES Cargo Required: NO Cargo on File: NO NO Bond Required: NO Bond on File: NO Older process agent filings may not be shown in the database. To inquire if a carrier has process agents, even if they are not shown here, please call (202) Form: Type: Posted Date: Coverage From: $0 Effective Date: Cancellation Date: Rejected Insurances: Form: Type: Coverage From: Received: Rejected: Rejected Reason: $0 Page 1 of 7
2 CA Coverage From 01/23/2004 To: 06/02/2004 PROGRESSIVE NORTHERN INSURANCE COMPANY CUSTOMER SERVICE P.O. BOX CLEVELAND, OH US (800) Fax: (440) CA Coverage From 08/02/2004 To: 11/24/2004 PROGRESSIVE NORTHERN INSURANCE COMPANY CUSTOMER SERVICE P.O. BOX CLEVELAND, OH US (800) Fax: (440) CA Coverage From 11/24/2004 To: 02/02/2005 PROGRESSIVE NORTHERN INSURANCE COMPANY CUSTOMER SERVICE P.O. BOX CLEVELAND, OH US (800) Fax: (440) /02/2005 To: 02/02/2006 Page 2 of 7
3 02/02/2005 To: 08/21/ /02/2005 To: 02/02/ /02/2006 To: 09/06/2006 Disposition: Name Changed 02/02/2006 To: 07/19/2006 Page 3 of 7
4 07/19/2006 To: 02/02/ /02/2007 To: 02/02/ /02/2007 To: 12/23/ /02/2007 To: 02/02/2007 Page 4 of 7
5 02/02/2008 To: 01/11/ /02/2008 To: 10/26/ /02/2008 To: 07/02/ /02/2008 To: 04/17/2008 Page 5 of 7
6 02/02/2008 To: 02/02/ /02/2008 To: 02/02/ /02/2008 To: 02/02/2008 Authority History: Sub No. Authority Type Original Action Disposition Action MOTOR PROPERTY COMMON CARRIER REINSTATED 08/10/2004 REVOKED 01/20/2009 MOTOR PROPERTY COMMON CARRIER GRANTED 02/11/2004 REVOKED 06/08/2004 Pending Application: Authority Type Filed Status Insurance BOC-3 Page 6 of 7
7 Revocation History: Authority Type 1st Serve Date 2nd Serve Date Reason COMMON 12/15/ /20/2009 INVOLUNTARY REVOCATION COMMON 05/06/ /08/2004 INVOLUNTARY REVOCATION Page 7 of 7
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FMCSA Motor Carrier. DBA (Doing-Business-As) Name. Addresses: Business Address:
Addresses: Business Business Phone: Mail 405 FARMER RD APT 3B ASHEBORO, NC 27203 (336) 521-1409 Business Fax: Fax: (336) 419-4400 Mail Phone: Mail Fax: Undeliverable Mail: NO Authorities: Common Authority:
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AL No 2 Yes No See footnote 2. AK No Yes No N/A AZ Yes Yes Yes No specific coverage or rate information available. AR No Yes No N/A CA Yes No No Section 11590 of the CA State Insurance Code mandates the
SOUTH CAROLINA AUTO SUPPLEMENT
AGENCY AGENCY CUSTOMER ID: SOUTH CAROLINA AUTO SUPPLEMENT APPLICANT/NAMED INSURED POLICY NUMBER CARRIER NAIC CODE. OFFER OF ADDITIONAL UNINSURED MOTORIST COVERAGE AND OPTIONAL UNDERINSURED MOTORIST COVERAGE