Auto Policy Change automobile

Policy Number: 00146815630

TD General Insurance Company

Thank you for choosing us to insure your vehicle.

Summary of your insured vehicle.

1. 2014 BMW TRUCK/VAN X6 35i 4DR AWD
For complete details, please refer to the enclosed
Certificate of Automobile Insurance.

As a result of the change, your

total premium payable is now:
$4,198.00
RANIA OUESLATI
1141 ROYAL YORK RD APT 703 Taxes and fees, if applicable, are not included.
ETOBICOKE ON M9A 4A9 For complete details, please refer to your invoice.

Enclosed are your policy documents

confirming recent changes to your policy.
Please review them and contact us with any
questions - we’re here to help you!

Changes? Remember to contact us.

To make sure your coverage continues to fit your
needs, keep us informed if, for example:
• Your address is changing;
• There's a change in the usage of your vehicle; or
• There's a change in drivers for your vehicle.

Policy Term:
December 11, 2023, to December 11, 2024
Change effective date:
December 11, 2023

Questions about your coverage or need advice? To report or file a claim, or simply to
Register online and make changes obtain advice before reporting a claim,
Call 1-888-588-5999
Our offices are open weekdays from 8:00 a.m. to your policies, 24/7, at call our toll-free claims service number:
to 8:00 p.m. and Saturdays from 9:00 a.m. to myinsurance.td.com
4:00 p.m. or visit www.tdinsurance.com 1-866-454-8910.
At your service, 24/7.

See over for highlights of the changes.

Page 1 of 12
>
AUMACA002E-800598-20170701
HIGHLIGHTS of changes - review your policy documents for details

Veh No. Description Action

1 Collision Added
1 Comprehensive Added
All Added

The TD Insurance home and auto policies are underwritten by TD General Insurance Company and distributed by TD Insurance Direct Agency Inc.

Page 2 of 12
 TD Insurance
Direct Agency Inc.
101 McNabb Street, 2nd Floor
Markham, ON L3R 4H8

Automobile Insurance Policy Change Details Invoice

Policy no.: 00146815630 Account no.: 0462008208
Invoice date: December 11, 2023
Insured by: TD General Insurance Company
Policy term: December 11, 2023 to December 11, 2024 You're benefiting
Change effective date: December 11, 2023
from these savings.
Payment Summary ü Buy online discount
ü Anti-Theft Discount
Total term premium prior to change: $2,874.00 ü Winter Tire Discount
TD MyAdvantage Discount-Principal
New term premium following change: $4,198.00 ü
Operator
Premium adjustment as of effective date of change ü Online quote discount
to end of policy term: $1,324.00 ü Claims Free Reward

Total remaining balance excluding fees: $4,198.00

Questions?
No taxes applicable If you have questions about your invoice,
visit us online at
Credit Card Payment Details tdinsurance.com/myinsurance.
Your monthly credit card payments, including installment fees, will be charged in 11 You can view billing and payment details,
installments on the dates below. modify your payment plan or chat with an
advisor. You can also access MyInsurance
Date & Premium Installment Total Amount by scanning this QR code:
Fees Including Fees

December 12, 2023 $381.70 $4.97 $386.67

January 11, 2024 $381.63 $4.96 $386.59
February 11, 2024 $381.63 $4.96 $386.59
March 11, 2024 $381.63 $4.96 $386.59
April 11, 2024 $381.63 $4.96 $386.59
May 11, 2024 $381.63 $4.96 $386.59
June 11, 2024 $381.63 $4.96 $386.59
July 11, 2024 $381.63 $4.96 $386.59
August 11, 2024 $381.63 $4.96 $386.59
September 11, 2024 $381.63 $4.96 $386.59 You can also call us at 1-800-268-8955.
October 11, 2024 $381.63 $4.96 $386.59

Please verify your credit card information below and contact us promptly if any Reminder
changes are required due to its loss, theft, cancellation, expiry or other reason. The first When it's time to renew your policy, rest
digits of your credit card have been concealed to protect your personal information. assured that your coverage will not be
interrupted and your payments could be
Name of cardholder: rania oueslati
automatically charged up to 45 days prior
Type of card: MasterCard
to the renewal date. We will be sure to
Credit card account: ************1871 send you details of your payments before
your renewal date.
Please note that payments received are applied to oldest charges first on any
balance owing. Please also note, if you choose to cancel your policy before its expiry
date, a cancellation fee will be charged based on your policy's cancellation table. See
reverse side for information about monthly credit card payment agreement.

Page 3 of 12 ARINCA200E-801534-20190701
 Important information about your
Monthly Credit Card Payment Agreement

You have elected to pay monthly using a credit card, authorizing us to store this information on file and for the insurance company
underwriting your policy to charge the insurance premium (including applicable taxes and fees) for this policy to your credit card
account. Your first payment was charged to your credit card upon completion of your purchase and your next payment will be
charged, monthly, based on your selected payment frequency.

• You agree that there will be no pre-notification period for any changes to the amount or date of your payments.
Note: Changes to your insurance coverage may result in changes to the monthly premium charged to the associated credit
card and/or the date upon which the associated credit card is charged.

• You also agree that this authorization will remain in effect until you cancel it. You may cancel this Agreement by advising us
in writing, over the phone or through MyInsurance and by giving us at least fifteen (15) days' notice before the next scheduled
monthly payment.

You may modify your credit card information related to this monthly payment at least fifteen (15) days before the next scheduled
payment, by advising us in writing, over the phone or through MyInsurance. In such cases, the terms of the present Agreement will
continue to apply until the end of the policy term and to subsequent renewals, but to the credit card replacing the original credit
card.

Please verify the credit card information you entered and contact us promptly if any changes are required due to its loss, theft,
cancellation, expiry or other reason. The digits of your credit card have been concealed to protect your personal information.

Page 4 of 12 BIFACA005E-802234-20200101
 TD General Insurance Company
Certificate of Automobile Insurance - Ontario

Agency TD Insurance Direct Agency Inc. Replacing

Policy No. 00146815630 Policy No.
101 McNabb Street
2nd Floor This is your Certificate of Automobile Insurance. Contact your Broker/Agent with any questions or if you require
Markham, ON L3R 4H8 1-888-588-5999 clarification regarding your coverage choices.

Insurer TD General Insurance Company

66 Wellington St W., 39th FL
TD Bank Tower
Toronto, ON M5K 1A2

Name Insured

rania oueslati Lessor(s) (if applicable)

1141 Royal York RD APT 703 Auto No.
Etobicoke ON M9A 4A9

Policy Period
Y M D Y M D
2023-12-11 < From To > 2024-12-11*
Y M D
Policy Change Effective Date > 2023-12-11 at 5:08 p.m.
* 12:01 a.m. All times are local times at the Named insured's primary address shown on this
Certificate.

Particulars of Described Automobiles

Automobile(s) Year - trade name - model or cc - cyl - body type - VIN (serial number) Purchased price List price new

1 2014 - BMW TRUCK/VAN - X6 35i 4DR AWD - 5UXFG2C57E0H10837

Lienholders

Automobile(s) Name of Lienholders to whom loss may be jointly payable

1 Lendcare Capital Inc

Insurance Coverages Automobile No. 1 Automobile No.

Liability Limit Premium Premium for Limit Premium Premium for

Occasional Drivers Occasional Drivers

Bodily Injury 700

1,000,000
Property Damage 33

Accident Benefits (Standard Benefits) As stated in As stated in

1,406
Section 4 of Policy Section 4 of Policy

Optional Increased Accident Benefits Limit Premium Premium for Limit Premium Premium for
Occasional Drivers Occasional Drivers
Income replacement ($600/$800/$1,000) (up to $ per week) Not purchased (up to $ per week)

Medical, Rehabilitation & Attendant Care Not purchased

($130,000/$1,000,000)
Optional Catastrophic Impairment As stated in Not purchased As stated in
(additional $1,000,000 added to Standard Section 4 of Policy Section 4 of Policy
Benefit or Optional Medical, Rehabilitation
& Attendant Care Benefit)
Caregiver, Housekeeping & Home Not purchased
Maintenance

Death & Funeral Not purchased

Dependant Care Not purchased

Indexation Benefit (Consumer Price Index) Not purchased

Uninsured Automobile As stated in As stated in

40
Section 5 of Policy Section 5 of Policy

Page 5 of 12 AUCEON001E-800690-20171101
 Insurance Coverages (continued) Automobile No. 1 Automobile No.
Direct Compensation - Property Damage*

*This policy contains a partial payment Deductible Premium Premium for Deductible Premium Premium for
of recovery clause for property damage Occasional Drivers Occasional Drivers
if a deductible is specified for direct
compensation - property damage. 0 684

Loss or Damage** Deductible Premium Premium for Deductible Premium Premium for
Occasional Drivers Occasional Drivers
Specified Perils
Included
(excluding Collision or Upset)
Comprehensive
2,000 536
(excluding Collision or Upset)

Collision or Upset 2,000 698

All Perils Not covered

** This policy contains a partial payment of loss clause. A deductible applies for each claim except as stated in your policy.

Policy Change Forms (OPCF No. and Premium Premium for Premium Premium for
Name, including limit if applicable) Occasional Drivers Occasional Drivers
Grand Touring Solution® 90
OPCF 44R Family Protection Coverage 11
OPCF No. 23A Lienholder Protection No cost

Premium $4,198
Subtotals

*Total Premium for each Automobile $4,198

*Premium Subtotal + Occasional Driver Subtotal

Additional
Total Policy Premium $4,198 Premium or $1,324
Refund
Total Policy Cost
Minimum Non-Refundable Premium $50.00 Tax $4,198.00

Rating Information
Driver Marital Yrs Driver's Assignment to Auto Convictions
No. Driver Name Age Status Lic. Training Principal Secondary Occasional Excluded Serious Major Minor

1 rania oueslati 29 S 3 X 1

Chargeable Claims Surcharges Discounts

Auto Date
No. yyyy/mm/dd BI PD AB COLL/AP % Description % Description

Buy online discount - included

Anti-Theft Discount - included
Winter Tire Discount - included
1
TD MyAdvantage Discount-Principal Operator -
included
Online quote discount - included

Kilometres Driven Class Description

Auto To Work Gross Vehicle Weight Rating

No. Annually (One Way) (Commercial vehicles only) Class Description

1 5,000 01 Pleasure

Driving Record Rate Group

Terr. Rating Territory
Auto No. 1 1 Auto No. Code Description
BI 3
PD 3 1 717 METROPOLITAN TORONTO DISTRICT, MARKHAM, RICHMOND HILL, VAUGHAN PEEL DISTRICT
AB 3 9
DCPD 3 33
COLL/AP 3 25
COMP/SP 36
Methods of Payment (See details on the enclosed invoice)
Remarks

Page 6 of 12
 TD General Insurance Company
Certificate of Automobile Insurance - Ontario

This Certificate is proof of a contract of insurance between the Named Insured and the Insurer, subject in all respects to the
Ontario Automobile Policy (OAP 1). In return for the premium charged and the statements contained in the Application, the
contract provides the coverage outlined in this Certificate. You only have a particular coverage for a specific automobile if this
Certificate shows a premium for it, or shows the coverage is provided at no cost. All other terms of the Policy remain the same
unless stated otherwise in this Certificate. Your Insurer will provide you with a copy of the Policy if you request it. This
Certificate is only valid if it is signed by an authorized representative of the Insurer.

President and Chief Executive Officer

For purposes of the Insurance Companies Act (Canada), this document was issued in the course of the Insurer’s insurance
business in Canada.

Warning: The Insurance Act provides that where (a) an Applicant for a contract, (i) gives false particulars of the
described automobile to be insured to the prejudice of the Insurer, or (ii) knowingly misrepresents or fails to disclose
in the application any fact required to be stated therein; or (b) the Insured contravenes a term of the contract or
commits a fraud; or (c) the Insured wilfully makes a false statement in respect of a claim under the contract, a claim
by the Insured, for other than such statutory accident benefits as are set out in the Statutory Accident Benefits
Schedule, is invalid and the right of the Insured to recover indemnity is forfeited.

Cancellation Request Policy No. 00146815630

(fill out and sign if you are requesting to cancel your policy)

In return for the unearned portion of the premium, if any, this policy is cancelled. Any interim and renewal certificates are no
longer valid.

Effective Date of Cancellation Time of Cancellation a.m.

p.m.

Signature of Named Insured Signature of Lienholder/Lessor

Page 7 of 12 AUCEON001E-800690-20171101
 TD General Insurance Company
Certificate of Automobile Insurance - Ontario

This is a brief explanation of the insurance outlined in this Certificate.

Liability Loss or Damage

Provides coverage for you or other insured persons if someone else is Provides a selection of optional coverages for your own automobile.
killed or injured or their property is damaged in an automobile accident. Payments cover direct and accidental loss of, or damage to, a described
It will pay for legitimate claims against you or other insured persons up automobile and its equipment. There is usually a deductible amount
to the limit of your coverage, and the cost of settling claims. indicated for each coverage and this amount is either paid by you toward the
cost of repairs or is deducted from the loss settlement. Higher deductibles
Accident Benefits may reduce your premium. There are four types of coverages:
Your insurance company is obligated to explain details of Accident
Benefits coverage to you. • Specified Perils: Covers the described automobile against loss
or damage caused by certain specified perils. They are: fire;
Provides benefits that you and other insured persons are entitled to theft or attempted theft; lightning; windstorm; hail or rising water;
receive if injured or killed in an automobile accident. These benefits may earthquake; explosion; riot or civil disturbance; falling or forced
include: income replacement for persons who have lost income; landing of aircraft or parts of aircraft; or the stranding, sinking,
payments to non-earners who suffer complete inability to carry on a burning, derailment or collision of any kind of transport in or
normal life; payment of medical, rehabilitation and attendant care upon which the described automobile is being transported.
expenses; payment of certain other expenses; payment of funeral
expenses and payments to survivors of a person who is killed. You may • Comprehensive: Covers a described automobile against loss
also purchase optional benefits to increase the standard level of or damage other than those covered by Collision or Upset,
benefits provided in the policy. The optional benefits your Insurance including perils listed under Specified Perils, falling or flying
company must offer are: income replacement; medical, rehabilitation objects, missiles and vandalism.
and attendant care; optional catastrophic impairment; caregiver
housekeeping and home maintenance; death and funeral; dependant • Collision or Upset: Covers damage when a described
care; and an indexation benefit. automobile is involved in a collision with another object or tips
over.
Uninsured Automobile
Provides coverage if you or other insured persons are injured or killed • All Perils: Combines the Collision or Upset and Comprehensive
by an uninsured motorist or by a hit-and-run driver. It covers damage to coverages.
your automobile and its contents caused by an identified uninsured
motorist.

Direct Compensation - Property Damage

Provides coverage in Ontario, under certain conditions, for damage to
your automobile and to property it is carrying, when another motorist is
responsible. It is called Direct Compensation because you will collect
from us, your insurance company, even though you are not at fault for
the accident. There may be a deductible amount, and this amount is
either paid by you toward the cost of repairs or is deducted from the
loss settlement. Higher deductibles may reduce your premium.

Warning – Offences

It is an offence under the Insurance Act to knowingly make a the intent it be acted on as genuine and the offence is
false or misleading statement or representation to an punishable, on conviction, by a maximum of 10 years
Insurer in connection with the person’s entitlement to a imprisonment.
benefit under a contract of insurance, or to wilfully fail to
inform the Insurer of a material change in circumstances It is an offence under the federal Criminal Code for anyone, by
within 14 days, in connection with such entitlement. The deceit, falsehood or other dishonest act, to defraud or to
offence is punishable on conviction by a maximum fine of attempt to defraud an insurance company. The offence is
$250,000 for the first offence and a maximum fine of punishable, on conviction, by a maximum of 14 years
$500,000 for any subsequent conviction. imprisonment for cases involving an amount over $5,000 or
otherwise a maximum of 2 years imprisonment.
It is an offence under the federal Criminal Code for anyone
to knowingly make or use a false document with

This Certificate contains important information about your automobile insurance.

Page 8 of 12
 Automobile Insurance Policy
Appendix
Attached to and forming part of this policy
(Any ambiguity in this document and the individual CAE forms,
the individual CAE form wordings will prevail)

Policy no. Effective date (yyyy-mm-dd) Insurer

00146815630 2023-12-11 at 5:08 p.m. TD General Insurance Company

Insured
Rania Oueslati

Grand Touring Solution® in the event of loss or damage to the automobile occurring during
In consideration of the premium charged, the Policy is a trip, to pay an amount up to $1,500 for:
amended as follows: (a) additional travel expenses not insured above, including
The insurance provided by: the cost of meals and accommodation and the cost of
• OPCF 20, Coverage for Transportation Replacement; and transportation of the Insured's personal effects, incurred
• OPCF 27, Liability for Damage to Non-Owned by the Insured either to continue the trip or to return to
Automobile(s), and Other Coverages When Insured his or her domicile or to the location where the
Persons Drive, Rent or Lease Other Automobiles; automobile is usually kept;
as well as the Loss of Use Extension, Coverage for (b) additional expenses similar to those outlined in (a)
Emergency Road Service, and Deductible Waiver in case of above incurred by the Insured or someone selected by
hit-and-run are added as follows: the Insured to retrieve the automobile where it was
COVERAGE FOR TRANSPORTATION repaired and return it either to the place reached by the
REPLACEMENT (OPCF 20) Insured but not beyond the scheduled destination or to
1. Purpose of This Change the Insured's domicile or to the location where the
This change is part of your Policy. It provides coverage for you automobile is usually kept.
when you need to pay for other means of transportation because The word Insured as used includes the Insured's spouse and any
of loss or damage to your automobile caused by a peril for which person whose domicile is the same as the Insured's.
you are insured. It replaces coverage by Section 7.4.4 of your
No indemnity is provided unless the loss or damage to the
Policy, "Loss of Use Due to Theft".
automobile exceeds any applicable deductible amount specified in
2. What We Will Pay the Policy for such loss or damage.
2.1 In return for the premium charged, we will reimburse LIABILITY FOR DAMAGE TO NON-OWNED
you for the reasonable expenses of renting a similar
AUTOMOBILE(S), AND OTHER COVERAGES WHEN
substitute automobile. This includes the reasonable
expenses of taxicabs or public transportation. INSURED PERSONS DRIVE, RENT OR LEASE OTHER
AUTOMOBILES (OPCF 27)
2.2 The most we will pay is $5,000 per occurrence.
1. Purpose of This Change
2.3 If the loss of use is because of theft of your entire
automobile, this change replaces Section 7.4.4 of your This change is part of your Policy. It extends coverage:
Policy, "Loss of Use Due To Theft". But, we will not • for loss or damage to a non-owned automobile including
pay less than the limits described in that Section. its equipment resulting from the care, custody or control
3. Limitations on Your Coverage of that non-owned automobile by an insured person, and
3.1 We will only pay if the costs for loss or damage to • when persons who are covered drive other automobiles
your automobile exceed any applicable deductible or rent or lease other automobiles.
amount shown on your Certificate of Automobile
Insurance. 2. Who is Covered
2.1 If the Certificate of Automobile Insurance is in the name
3.2 We will reimburse you from the time the loss or
damage occurs if your automobile cannot be operated of an individual or individuals, an insured person in this
under its own power; or 12:01 a.m. of the day change form means you, your spouse and all drivers
following your report to us or the police that your listed in the Policy.
automobile has been stolen. 2.2 If the Certificate of Automobile Insurance is in the name
In all other cases, we will reimburse you from the time your of a corporation, unincorporated association, partnership,
automobile is delivered for repair due to loss or damage. sole proprietorship or other entity, an insured person in
3.3 Your coverage ends on the date that your automobile is this change form means the principal driver(s) declared
repaired or replaced; or we offer you a payment to settle as such to us, the spouse of each and all drivers listed in
the claim. the Policy. (continued on reverse)
LOSS OF USE EXTENSION
In addition to coverage provided above, the Insurer also agrees,
Page 9 of 12 AUAPON27SE-800712-20230617
3. Liability for Damage to Non-Owned Automobiles • is not owned, hired or leased by an insured person's
employer or by an employer of anyone living in the same
3.1 What We Will Cover
dwelling as the insured person; and
In return for the premium charged, we will provide
• is not being used to carry paying passengers or to make
coverage for the liability imposed by law or assumed by
commercial deliveries at the time of the loss.
any written agreement for loss or damage to a non-owned
automobile including its equipment resulting from the Any automobile with a GVWR of more than 4,500
care, custody or control of that non-owned automobile by kilograms, other than the described automobile, while driven
an insured person. This loss or damage must result from a by an insured person referred to in 2, when the other
peril described under Section 7, Loss or Damage automobile is being used for personal purposes and only if it
Coverage, Subsection 7.1.2, paragraph D, All perils, of the is rented for no more than 7 days.
Policy OAP 1.
For Direct Compensation - Property Damage Coverage the
A deductible of $300 applies for each claim.
other automobile cannot be a described automobile in a motor
3.2 Limitations on This Coverage vehicle liability policy.
3.2.1 The coverage applies only to an automobile with a 4.3 Limitations on This Coverage
Gross Vehicle Weight Rating (GVWR) of 4,500
This coverage does not apply to anyone who owns an insured
kilograms or less.
automobile or leases an automobile covered by OPCF 5,
3.2.2 We will not cover loss or damage to any automobile "Permission to Rent or Lease Automobile(s) and Extending
which is: Coverage to the Specified Lessee(s)", or a similar
• owned or licensed in the name of any person endorsement.
insured by this change or by any person living in the
same dwelling as these persons, or ADDITIONAL FEATURE - COVERAGE FOR MOTOR
HOME AND TRAILER
• owned or leased by the employer of these persons.
3.2.3 Where applicable, Sections 3.3.1, 3.3.2 and 3.3.3 of Coverage under the OPCF 27 above is extended to also apply to
your Policy will apply to this change. the following vehicles:
3.2.4 We will not pay more than $100,000 under this • Under Section 3.2.1, to motor home type
change for any one occurrence plus the costs vehicles and trailers used in connection with
provided for in 3.2.3 above. automobiles described in Section 3.2.1 herein,
while used for private or pleasure purposes.
3.2.5 The automobile must be used with the owner's or
lessee's consent. • Under Section 4.2, to motor home type vehicles
and trailers used in connection with automobiles
4. Providing Other Coverage When Insured Persons Drive, described in Section 4.2 and herein, while used for
Rent or Lease Other Automobiles private or pleasure purposes, other than the described
4.1 What We Will Cover automobile, while driven by an insured person referred
to under Section 2.
In return for the premium charged, we will provide the
Liability, Accident Benefits, Uninsured Automobile and REIMBURSEMENT OF EMERGENCY ROAD SERVICE
Direct Compensation - Property Damage coverage EXPENSES
described in your Policy when the insured persons drive
other automobiles. However, we will not provide Liability 1. Purpose of This Change
coverage to persons who are excluded drivers under this This change is part of your Policy. It adds coverage for
Policy when they drive, in Ontario, an automobile which emergency service expenses because your automobile is disabled.
is rented or leased for a period of less than 30 days. We 2. What We Will Pay
will also provide Liability coverage to insured persons
who rent or lease automobiles for periods of not more We will reimburse you for up to $100 for each time your
than 30 days, but only with respect to the liability of the automobile is disabled and as a result you require emergency
insured persons for the negligence of the drivers of the service. You must provide us with acceptable evidence of loss
rented or leased automobiles, and we will not provide this and receipts for any towing and emergency service.
additional Liability coverage if the driver of the rented or 3. What is Not Covered
leased automobile is an excluded driver under this Policy. This change does not apply to:
4.2 Definition of Other Automobile • cost of parts or supplies
For the purposes of Section 3, "Liability Coverage", • oil
Section 4, "Accident Benefits Coverage", Section 5, • gasoline
"Uninsured Automobile Coverage", and Section 6, "Direct • batteries
Compensation - Property Damage", of your Policy, other • tires
automobile also means: ADDITIONAL FEATURE - DEDUCTIBLE WAIVER IN
Any automobile with a GVWR of 4,500 kilograms or less, CASE OF HIT-AND-RUN
other than the described automobile, while driven by an The Insurer agrees that following a covered loss under Section 7,
insured person referred to in 2, when the other automobile: "Loss or Damage Coverages" of the Policy, the deductible
• is not being driven by an insured person in connection amount will be waived should the loss or damage to your insured
with the business of selling, repairing, maintaining, automobile arise from an accident being reported as a hit-and-run
storing, servicing or parking automobiles; to the police force as soon as practicable following its occurrence.
• is not owned or frequently used by an insured person
or anyone living in the same dwelling as the insured All other terms and conditions of the Policy remain the same.
person;

Page 10 of 12
 Automobile Insurance Policy
Appendix

Attached to and forming part of this policy

Policy no. Effective date (yyyy-mm-dd) Insurer

00146815630 2023-12-11 at 5:08 p.m. TD General Insurance Company

Insured
Rania Oueslati

OPCF No. 23A

Lienholder Protection
1. Purpose of This Change 2. Joint Payment
If we are settling a claim with you and your automobile is not
1.1 This change is a part of your Policy. It protects the repaired or the lost or damaged parts are not replaced, we will jointly
lienholder's interest in your automobile if you have a pay you and the lienholder for any loss covered under Section 6 of
claim for a loss covered under Section 6 "Direct your Policy, "Direct Compensation - Property Damage" and Section 7
Compensation - Property Damage" and Section 7 of of your Policy, "Loss or Damage Coverages."
your Policy, "Loss or Damage Coverages."
3. Notifying the Lienholder
Lienholder Name and Address (the "Lienholder") If any coverage in Section 6 and/or in any subsection of Section 7 of
Lendcare Capital Inc
your Policy is cancelled, we must notify the lienholder in writing at
1315 Pickering PKY SUITE 400
least fifteen days before the cancellation. However, this obligation
4th Floor
ends on the expiry date shown on this form.
Pickering ON L1V 7G5

to the extent of the lienholder's interest. If you have purchased any coverage under Section 7 but do not
cooperate with any reasonable arrangements we make to inspect your
automobile, we must notify the lienholder in writing. The lienholder's
rights under the coverage will not be affected except after 15 days
1.2 This change applies to the following automobile(s): following the date of mailing of such notice.

Automobile # Model Year Trade Name (Make) Serial #

1 X6 35i 4DR AWD 2014 BMW TRUCK/VAN 5UXFG2C57E0H10837

Insurance provided under Section 6 and/or Section 7 of your Policy.

Direct Compensation - Property Damage $0 Deductible

Specified Perils Included
Comprehensive $2,000 Deductible
Collision $2,000 Deductible
All Perils Not covered

All other terms and conditions of your Policy remain the same.

Page 11 of 12 AUAPON23AE-800730-20171101
Page 12 of 12