picture by: Freddy Sosa
PRINCIPAL NAMED INSURED
First Name
Last Name
Home Phone
Work Phone
E-mail Address
Mailing Address
City
State
ZIP Code
Marital Status
Date of Birth
Gender
Motorcycle License
State Filing
Auto Yrs Licensed
Traffic Violns 3yrs
Primary Residence
VEHICLE TYPE
Vehicle Type
Year
Model
CC Size
Garaging ZIP Code
Vehicle Use
Performance
Lo Jack®
Annual Miles
Association Name
COVERAGE INFORMATION
BI PD Coverage
Medical Pay
Collision
UMPD
UM/UIM
Social Network
Newsletter
Information
Los Negociadores
The Negotiators Inc.

T.(310)329-9992
F. (310)329-9876

1900 Marine Ave
Gardena CA 90249



www.thecarnegotiators.com www.losnegociadores.com www.cambiatuprestamo.com
www.lnis.net



Hours M - F: 9am to 7pm Sat: 10am to 5pm
Sun: Closed