Liberty Mutual
PO Box 958416
Lake Mary FL 32795
Kee’Ajah L Boyd
1229 1st Street
#4
Louisville, KY 40203
Date: May 14, 2025 CONTACT US
For questions, please call us at
1-800-225-8285
Dear Kee’Ajah,
Please see the enclosed form(s).
• Certificate of Automobile Insurance (Binder)
• Auto Insurance Identification Cards
Thank you for being a loyal Liberty Mutual customer.
Sincerely,
Liberty Mutual
CERTIFICATE OF AUTOMOBILE INSURANCE
THIS IS TO CERTIFY THAT the named insured is, at the date of this certificate, insured by the
company with respect to the automobiles hereinafter described for the types of insurance and
respective coverages hereinafter designated by entry of the limits of liability or a statement that
the coverage is in effect and in accordance with the provisions of the Automobile Policy in use by
said company.
This Certificate of Insurance neither affirmatively nor negatively amends, extends or alters the
coverage afforded by the policy.
INSURED'S NAME AND ADDRESS
Kee’Ajah L Boyd
1229 1st Street
#4
Louisville, KY 40203
DESCRIPTION OF THE INSURANCE FOR WHICH THIS CERTIFICATE IS ISSUED
Policy Number: AOL43892151289 Effective Date: 05/14/2025 Expiration Date 11/13/2025
PART A PART B PART D — DAMAGE TO YOUR AUTO COVERAGE
COVERAGES: BODILY INJURY MEDICAL COVERAGE FOR DEDUCTIBLE AMOUNT APPLICABLE TO EACH LOSS
PROPERTY PAYMENTS LOSS CAUSED IN DOLLARS
DAMAGE COVERAGE BY COLLISION Loss Caused by Collision Loss Other Than Loss
INCLUDED Caused by Collision
Limits of $25,000/100,000 $25,000/100,000 Yes “ACV” indicates Actual “ACV” indicates Actual
Full Coverage $50,000 Cash Val ue ACV Less Cash Value ACV Less
$500 Deductible $500 Deductible
* Includes Accidental Death Benefit: $ Protection Against Uninsured Motorists Coverage — Limit Selected:$25/50
Medical
Expense
DESCRIPTION OF AUTOMOBILES
Year of Model Trade Name Body Type Identification or Serial Number
2007 BUICK LUCERNE 1G4HD57277U220035
.
ADDITIONALINTEREST NAME AND ADDRESS:
Such insurance as is afforded under the
Full Coverage of the policy shall also
apply, with respect to covered autos, to
each interest hereinafter named, as an
insured; but such inclusion of additional
interest or interests shall not operate to
increase the limit of the company’s
liability and insurance described herein
is in effect on the date of this certificate
and shall remain in force until canceled
in accordance with the terms of the
policy
Loss PAYEE and ADDRESS
Secretary President at:
Dated: 05/14/2025 10:12AM
Countersigned
AUTHORIZED REPRESENTATIVE
PS 485 12 10 Liberty Mutual Personal Insurance Company Page 1 of 2
LOSS PAYEE
Such insurance as is afforded by the policy for loss of or damage to the automobile is payable, as
interest may appear, to the named insured and the Loss Payee indicated on the previous page in
accordance with the terms of the Loss Payable Clause.
Term of Loan: From: To:
LOSS PAYABLE CLAUSE
Loss or damage, under this policy, shall be paid as interest may appear to you and the loss payee
shown on the front of this certificate. This insurance covering the interest of the loss payee shall not
become invalid because of your fraudulent acts or omissions, unless the loss results from your
conversion, secretion or embezzlement of your covered auto. However, we reserve the right to
cancel the policy as permitted by policy terms, and the cancellation shall terminate this agreement
as to the loss payee’s interest. We will give the same advance notice of cancellation to the loss
payee as we give to the named insured shown in the declarations.
When we pay the loss payee, we shall, to the extent of payment, be subrogated to the loss payee’s
rights of recovery.
NOTICE TO OTHERS IF CANCELLATION OCCURS
“We” will not cancel “Your” Policy or reduce the insurance under any of its coverages until at least 10
days after we have mailed a written notice of such cancellation or reduction to the person(s) named
as additional interest on reverse side.
AS1019 (ed 12-89)
PS 485 12 10 Page 2 of 2
Identification Cards Please place your card(s) in your vehicle(s) and/or save to your device.
COMMONWEALTH OF KENTUCKY COMMONWEALTH OF KENTUCKY
PROOF OF INSURANCE PROOF OF INSURANCE
POLICY INFORMATION VEHICLE INFORMATION POLICY INFORMATION VEHICLE INFORMATION
Policy Number YEAR 2007 To report a claim Policy Number YEAR 2007 To report a claim
AOL43892151289 MAKE BUICK AOL43892151289 MAKE BUICK
1-800-2CLAIMS 1-800-2CLAIMS
MODEL LUCERNE MODEL LUCERNE
VIN (1-800-225-2467) VIN (1-800-225-2467)
Policy Effective Date Policy Effective Date
05/14/2025 1G4HD57277U220035 Customer service 05/14/2025 1G4HD57277U220035 Customer service
1-800-225-8285 1-800-225-8285
Policy Expiration Date Policy Expiration Date
11/13/2025 11/13/2025
Name of Insured Name of Insured
Kee’Ajah L Boyd Kee’Ajah L Boyd
1229 1st Street Card Effect. Date 1229 1st Street Card Effect. Date
#4 05/14/2025 #4 05/14/2025
Louisville, KY 40203 Louisville, KY 40203
Card Exp. Date Card Exp. Date
11/13/2025 11/13/2025
Company Name: Liberty Mutual Personal Insurance Company
Company Name: Liberty Mutual Personal Insurance Company
NAIC Number: 12484 Personal lines PMKT 535 04 10 NAIC Number: 12484 PMKT 535 04 10
SEE IMPORTANT MESSAGE ON REVERSE SIDE Personal lines
SEE IMPORTANT MESSAGE ON REVERSE SIDE.
THIS CARD NOT FOR THIS CARD NOT FOR
DISTRIBUTION DISTRIBUTION
SEE IMPORTANT MESSAGE ON REVERSE SIDE. SEE IMPORTANT MESSAGE ON REVERSE SIDE.
Please place the card(s) above in your vehicle(s) and/or Please place the card(s) above in your vehicle(s) and/or
save to your device. save to your device.
SEE IMPORTANT MESSAGE ON REVERSE SIDE. SEE IMPORTANT MESSAGE ON REVERSE SIDE.
If the Vehicle Identification Number on the insurance card
If the Vehicle Identification Number on the motor vehicle or policy and the motor vehicle do not match, please
title and registration and the Vehicle Identification contact your local sales office at the telephone number
Number on the vehicle do not match, you must contact listed on the card to have the Vehicle Identification
the county clerk to have the Vehicle identification on the Number on the identification card or policy corrected.
vehicle title and registration corrected.
This information has been reported electronically to the
Department of Vehicle Regulation.
SEE IMPORTANT MESSAGE ON REVERSE SIDE. SEE IMPORTANT MESSAGE ON REVERSE SIDE.
If you lose a card or trade cars please contact your YOUR SERVICE OFFICE If you lose a card or trade cars please contact your YOUR SERVICE OFFICE
Liberty Mutual service office to secure a new card. PO Box 958416 Liberty Mutual service office to secure a new card. PO Box 958416
Lake Mary FL 32795 Lake Mary FL 32795
Report all accidents promptly, by telephone if the Report all accidents promptly, by telephone if the
accident involves another occupied vehicle (even though ISSUING OFFICE accident involves another occupied vehicle (even though ISSUING OFFICE
no injuries are claimed), a pedestrian, or any personal no injuries are claimed), a pedestrian, or any personal
injury or property damage. PO Box 958416 injury or property damage. PO Box 958416
Lake Mary FL 32795 Lake Mary FL 32795
This card should be presented to a law enforcement This card should be presented to a law enforcement
officer if requested. officer if requested.
THIS CARD NOT FOR THIS CARD NOT FOR
DISTRIBUTION DISTRIBUTION
THIS CARD NOT FOR THIS CARD NOT FOR
DISTRIBUTION DISTRIBUTION
THIS CARD NOT FOR THIS CARD NOT FOR
DISTRIBUTION DISTRIBUTION