Code Alarm ca6554 Przewodnik Instalacji Pobierz pdf (Strona 64)

MAXIMUM INSURANCE DISCOUNT AUTHORIZATION

Dear

Insurance

Agent,

The installation of my Code-Alarm automatic (passive) arming security system

the vehicle indicated below qualifies me for the maximum discount

mandated by

law

some states and by insurance company option

other~.

This

vehicle security system automatically arms itself

after the doors are

closed and includes at least one engine disabling relay to prevent the engine from being started.

Insured

Signature:

_______________________

Name(pleaseprint

______________

Street Address:

__________________

State:

__________

Zip:

___________

Insurance

Company:,

________________________________________

Policy#:--------------------------------------------

Vehicle

Year/Make/Model:

_______________________________________

Vehicle Identification

---------------------------------------------------

The signature

below

certifies that

Code-Alarm

automotive security system

was

installed

___________

_ (date)

Installer

Signature:-------------------------------------------

Company:

____________________

·---~---------------------

Address:

---------------------------------Telephone:

________

PLEASE COMPLETE AND

MAIL

TO YOUR INSURANCE COMPANY

1026673

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Code Alarm ca6554 Przewodnik Instalacji Strona 64

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