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CONTRACT HOLDER

CONTRACT NUMBER

VEHICLE (YEAR/MAKE/MODEL/VIN)

COVERAGE TYPE

TERM MONTHS

TERM MILES

ROADSIDE ASSISTANCE

DEDUCTIBLE

EXPIRATION DATE

1. Upon noticing a problem, direct yourself to a safe area.
• DO NOT CONTINUE TO DRIVE THE VEHICLE •

2. Contact GWC’s customer service department at to obtain a preferred repair facility. You must have the repair facility contact us before any work is started on your vehicle.

3. Do not have any work done on your vehicle until an authorization number is issued to the repair facility by GWC.

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