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Get CO DR 2717 2006-2021

Ber Date of Birth Phone Number ( ) _ EVIDENCE OF PUBLIC LIABILITY INSURANCE MUST BE FILED WITH THIS DEPARTMENT BEFORE YOUR DRIVING PRIVILEGE WILL BE REINSTATED. (ยง42-7-406(2),C.R.S). Name of Insurance Company Address of Insurance Company Policy Number Policy Period (from) (to) I, _________________________________________________________ certify that I am Insured under an automobile liability policy as defined in Colorado motor vehicle statutes affording limits of $25,000/$50,000 bodi.

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