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SUING CARD Insurance Office of Central Ohio 165 W. Main Street 614.939.5471 P. 0. Box 780 New Alb

your Agent/Company as soon as possible. Obtain the following information: 1. Name and address of each driver, passenger and witness. 2. Name of Insurance Company and policy number for each vehicle involved. Rental car coverage is provpdecl. see o-frne of cove-age MISREPRESENTATION OF INSURANCE IS A FIRST DE

SUING CARD Insurance Office of Central Ohio 165 W. Main Street P. O. Box 780 New Albany OH 43054

to your Agent/Company as soon as possible. Obtain the following information: 1. Name and address of each driver. passenger and witness. 2. Name of Insurance Company and policy number for each vehicle involved. Address for notification of commencement of medical treatment: THE FRONT OF THIS DOCUMENT CCNTMNS AN

*SUMO CARD Insurance Office of Central Ohio 165 W. Main Street 614.939.5471 P. O. Box 780 New Alb

to your AgentiCompany as soon as possible. Obtain the following information: 1. Name and address of each driver, passenger and witness. 2. Name of Insurance Company and policy number for each vehicle involved. *cos) so monon OACORD CORPORATION 19/4.2007. AP Main msayuL EFTA00523626