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Get Canada OEF 28A 1993-2024

OEF 28A Excluded Driver Endorsement Except for those accident benefits required to be paid as outlined in Part B it is agreed that all insurance provided by this policy is eliminated while drives the following automobile s including any temporary substitute automobile and any newly acquired automobile as defined in the policy. Vehicle Model Year Make VIN Acknowledgment of excluded driver I acknowledge that if I drive the above automobile s there is no coverage for i property damage and bodily injury caused to others ii damage to the above automobile s and iii accident benefits except for those accident benefits required to be paid* Signature of excluded driver Note By signing this form you will be without some insurance for some accidents. drives any of the automobile s defined in the policy there is no coverage for i property damage and bodily injury caused to others ii damage to any of the automobile s and iii accident benefits except for those accident benefits required to be paid* Signature of named insured Except as otherwise provided in this endorsement all limits terms conditions provisions definitions and exclusions of the policy shall have full force and effect. Attached to and forming part of Policy Issued to This endorsement shall be effective from from local time or as Y M D A. M. P. M. stated in the Certificate of Insurance to which this endorsement is attached* ONTARIO INSURANCE COMMISSION MARCH 1993 Version fran aise disponible. Vehicle Model Year Make VIN Acknowledgment of excluded driver I acknowledge that if I drive the above automobile s there is no coverage for i property damage and bodily injury caused to others ii damage to the above automobile s and iii accident benefits except for those accident benefits required to be paid* Signature of excluded driver Note By signing this form you will be without some insurance for some accidents. drives any of the automobile s defined in the policy there is no coverage for i property damage and bodily injury caused to others ii damage to any of the automobile s and iii accident benefits except for those accident benefits required to be paid* Signature of named insured Except as otherwise provided in this endorsement all limits terms conditions provisions definitions and exclusions of the policy shall have full force and effect. drives any of the automobile s defined in the policy there is no coverage for i property damage and bodily injury caused to others ii damage to any of the automobile s and iii accident benefits except for those accident benefits required to be paid* Signature of named insured Except as otherwise provided in this endorsement all limits terms conditions provisions definitions and exclusions of the policy shall have full force and effect. Attached to and forming part of Policy Issued to This endorsement shall be effective from from local time or as Y M D A. Attached to and forming part of Policy Issued to This endorsement shall be effective from from local time or as Y M D A. M. P. M. stated in the Certificate of Insurance to which this endorsement is attached* ONTARIO INSURANCE COMMISSION MARCH 1993 Version fran aise disponible. .

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