Auto-Owners Executive Umbrella Insurance Statement

--- ## Page 1 The user wants me to transcribe all visible text from the invoice/statement image into clean markdown format. I need to: 1. Capture all text exactly as it appears 2. Use ### for sections 3. Use **bold** for labels 4. Use markdown tables for tabular data 5. Use - bullets for lists 6. Preserve all numbers, dates, and values exactly Let me go through the document systematically: Top left: 12-0025-00 Top right: 32130 (5-23) Left side header: HUB INTERNATIONAL FLORIDA 4830 W KENNEDY BLVD STE 850 TAMPA FL 33609-2593 INVOICE Left side vertical text: 0001287 (appears to be a barcode number) QR code in upper left area Agency phone: (727) 797-0441 Policyholder info: JOHAN JONGSMA TATYANA JONGSMA 851 BRIGHTWATERS BLVD NE SAINT PETERSBURG FL 33704 Right side - Auto-Owners header: Auto-Owners INSURANCE LIFE · HOME · CAR · BUSINESS 1-800-288-8740 www.auto-owners.com Auto-Pay (EFT) Statement date: 11/22/2024 EXECUTIVE UMBRELLA 50-989154-01 see reverse side Account: 015413721 Right side info block: Payment Plan Full Pay Current Balance $1,793.76 Minimum Due Auto-Pay Box with text: An automatic payment of $1,793.76 will be initiated on 12/12/2024. No action is required. Bottom left: QR code Bottom right: 5029474 Now let me format this properly in markdown. I should organize it by sections. Let me think about the layout: The document has a header area, left column with agency info, right column with insurer info, middle area with policyholder info, and bottom area with payment details. Let me structure it: ### Header - Top left reference numbers - Top right form numbers ### Agency Information (Left) HUB INTERNATIONAL FLORIDA address and invoice label ### Insurer Information (Right) Auto-Owners branding, contact info ### Policyholder Information Johan and Tatyana Jongsma address ### Policy Details Account number, policy type, statement date ### Payment Information Table with payment plan, balance, minimum due ### Important Notice Box about automatic payment ### Footer Bottom numbers and QR codes Actually, looking at the layout more carefully, I should try to preserve the spatial relationships where possible while making it clean markdown. Let me try a different approach - transcribe exactly as it appears from top to bottom, left to right. Top line: 12-0025-00 (left) 32130 (5-23) (right) Then left side: HUB INTERNATIONAL FLORIDA 4830 W KENNEDY BLVD STE 850 TAMPA FL 33609-2593 INVOICE (There's a number 0001287 vertically on the left) Agency phone: (727) 797-0441 JOHAN JONGSMA TATYANA JONGSMA 851 BRIGHTWATERS BLVD NE SAINT PETERSBURG FL 33704 Right side: Auto-Owners INSURANCE LIFE · HOME · CAR · BUSINESS 1-800-288-8740 www.auto-owners.com Auto-Pay (EFT) Statement date: 11/22/2024 EXECUTIVE UMBRELLA 50-989154-01 see reverse side Account: 015413721 Then the payment info section. Let me format this as clean markdown: ``` 12-0025-00                                                                                             32130 (5-23) **HUB INTERNATIONAL FLORIDA** 4830 W KENNEDY BLVD STE 850 TAMPA FL 33609-2593 **INVOICE** Agency phone: (727) 797-0441 **JOHAN JONGSMA** **TATYANA JONGSMA** 851 BRIGHTWATERS BLVD NE SAINT PETERSBURG FL 33704 **Auto-Owners** **INSURANCE** LIFE · HOME · CAR · BUSINESS 1-800-288-8740 www.auto-owners.com **Auto-Pay (EFT)** Statement date: 11/22/2024 **EXECUTIVE UMBRELLA 50-989154-01** see reverse side Account: 015413721 | Payment Plan | Full Pay | | Current Balance | $1,793.76 | | Minimum Due | Auto-Pay | > An automatic payment of $1,793.76 will be initiated on 12/12/2024. No action is required. 5029474 ``` Wait, I need to check if there are any QR codes or other elements that should be noted. The user said "transcribe ALL visible text". QR codes don't have visible text to transcribe, but there are numbers near them. There's a number "0001287" vertically on the left side. There's a number "5029474" at the bottom right. Let me look more carefully at the image. The number 0001287 appears to be printed vertically along the left margin. Actually, looking at the image again, I see: - Top left: "12-0025-00" - Top right: "32130 (5-23)" Left side agency block: "HUB INTERNATIONAL FLORIDA" "4830 W KENNEDY BLVD STE 850" "TAMPA FL 33609-2593" "INVOICE" There's a vertical string "0001287" on the far left. There's a QR code. "Agency phone: (727) 797-0441" Policyholder: "JOHAN JONGSMA" "TATYANA JONGSMA" "851 BRIGHTWATERS BLVD NE" "SAINT PETERSBURG FL 33704" Right side: "Auto-Owners" (logo) "INSURANCE" "LIFE · HOME · CAR · BUSINESS" "1-800-288-8740" "www.auto-owners.com" "Auto-Pay (EFT)" "Statement date: 11/22/2024" "EXECUTIVE UMBRELLA 50-989154-01" "see reverse side" "Account: 015413721" Then the payment table: "Payment Plan" - "Full Pay" "Current Balance" - "$1,793.76" "Minimum Due" - "Auto-Pay" Box: "An automatic payment of $1,793.76 will be initiated on 12/12/2024. No action is required." Bottom left: QR code Bottom right: "5029474" Now, how to format this cleanly in markdown? I think I should use a layout that captures the main sections. Option 1: Single column flow Option 2: Two-column representation where appropriate Since the user wants clean markdown and the document has a clear layout, I'll organize it logically by sections. Actually, looking at the request again: "Transcribe ALL visible text on this page as clean markdown." This means I need to capture every piece of text. Let me do it section by section from top to bottom, left to right. ``` 12-0025-00                                                                                             32130 (5-23) **HUB INTERNATIONAL FLORIDA** 4830 W KENNEDY BLVD STE 850 TAMPA FL 33609-2593 **INVOICE** 0001287 Agency phone: (727) 797-0441 **JOHAN JONGSMA** **TATYANA JONGSMA** 851 BRIGHTWATERS BLVD NE SAINT PETERSBURG FL 33704 **Auto-Owners** **INSURANCE** LIFE · HOME · CAR · BUSINESS 1-800-288-8740 www.auto-owners.com **Auto-Pay (EFT)** Statement date: 11/22/2024 **EXECUTIVE UMBRELLA 50-989154-01** see reverse side Account: 015413721 | | | |:---|:---| | Payment Plan | Full Pay | | Current Balance | $1,793.76 | | Minimum Due | Auto-Pay | > An automatic payment of $1,793.76 will be initiated on 12/12/2024. No action is required. 5029474 ``` Wait, I need to check if "0001287" is actually text or just part of a barcode. Looking at the image, it appears to be printed vertically on the left side, so it is visible text. Also, I should note that there are QR codes, but they don't contain readable text to transcribe. Let me refine the formatting. The user wants: - ### for sections - **bold** for labels - markdown tables for tabular data - - bullets for lists Let me reorganize: ``` 12-0025-00                                                                                             32130 (5-23) ### Agency Information **HUB INTERNATIONAL FLORIDA** 4830 W KENNEDY BLVD STE 850 TAMPA FL 33609-2593 **INVOICE** 0001287 Agency phone: (727) 797-0441 ### Policyholder **JOHAN JONGSMA** **TATYANA JONGSMA** 851 BRIGHTWATERS BLVD NE SAINT PETERSBURG FL 33704 ### Insurance Company **Auto-Owners** **INSURANCE** LIFE · HOME · CAR · BUSINESS 1-800-288-8740 www.auto-owners.com ### Policy Details **Auto-Pay (EFT)** Statement date: 11/22/2024 **EXECUTIVE UMBRELLA 50-989154-01** see reverse side Account: 015413721 ### Account Summary | **Payment Plan** | Full Pay | | **Current Balance** | $1,793.76 | | **Minimum Due** | Auto-Pay | ### Payment Notice An automatic payment of $1,793.76 will be initiated on 12/12/2024. No action is required. 5029474 ``` Hmm, but the user said "Output ONLY the transcribed text — no commentary, no analysis, no preamble". So I shouldn't add my own section headers like "Agency Information" unless they are in the original document. The original document doesn't have section headers like "### Agency Information". So I should just transcribe the text as it appears, using formatting conventions for layout. Let me try again, being more faithful to the original text while using markdown for structure: ``` 12-0025-00                                                                                             32130 (5-23) **HUB INTERNATIONAL FLORIDA** 4830 W KENNEDY BLVD STE 850 TAMPA FL 33609-2593 **INVOICE** 0001287 Agency phone: (727) 797-0441 **JOHAN JONGSMA** **TATYANA JONGSMA** 851 BRIGHTWATERS BLVD NE SAINT PETERSBURG FL 33704 **Auto-Owners** **INSURANCE** LIFE · HOME · CAR · BUSINESS 1-800-288-8740 www.auto-owners.com **Auto-Pay (EFT)** Statement date: 11/22/2024 **EXECUTIVE UMBRELLA 50-989154-01** see reverse side Account: 015413721 | Payment Plan | Full Pay | | Current Balance | $1,793.76 | | Minimum Due | Auto-Pay | An automatic payment of $1,793.76 will be initiated on 12/12/2024. No action is required. 5029474 ``` Wait, I need to check the box. The text "An automatic payment..." is in a box/shaded area. In markdown, I could use a blockquote or just leave it as text. The user wants clean markdown. Also, I need to check: is "Auto-Owners" bold or is it a logo? In the image, it's clearly a stylized logo font, but in text, I should probably bold it as it's a company name header. Let me look one more time at the vertical number "0001287". It appears on the left side, running vertically. This is likely a form or document control number. Also, there are QR codes. Since the user wants "visible text", and QR codes are images, I don't transcribe them, but if there are numbers next to them, I should include those. Actually, looking at the top left area, there's a QR code near the agency info. The number "0001287" is to the left of that QR code, printed vertically. Let me check the bottom. There's a QR code at the bottom left, and "5029474" at the bottom right. Now, regarding the table: the original has two columns - labels on left, values on right. I should format this as a markdown table. Let me verify the exact text once more: Top: "12-0025-00" and "32130 (5-23)" Agency: "HUB INTERNATIONAL FLORIDA" "4830 W KENNEDY BLVD STE 850" "TAMPA FL 33609-2593" "INVOICE" Left vertical: "0001287" Agency phone: "Agency phone: (727) 797-0441" Insured: "JOHAN JONGSMA" "TATYANA JONGSMA" "851 BRIGHTWATERS BLVD NE" "SAINT PETERSBURG FL 33704" Insurer header: "Auto-Owners" "INSURANCE" "LIFE · HOME · CAR · BUSINESS" "1-800-288-8740" "www.auto-owners.com" Payment method: "Auto-Pay (EFT)" "Statement date: 11/22/2024" Policy: "EXECUTIVE UMBRELLA 50-989154-01" "see reverse side" Account: "Account: 015413721" Summary table: "Payment Plan" / "Full Pay" "Current Balance" / "$1,793.76" "Minimum Due" / "Auto-Pay" Notice box: "An automatic payment of $1,793.76 will be initiated on 12/12/2024. No action is required." Footer: "5029474" I think the cleanest way is to present it as: ``` 12-0025-00                                                                                             32130 (5-23) **HUB INTERNATIONAL FLORIDA** 4830 W KENNEDY BLVD STE 850 TAMPA FL 33609-2593 **INVOICE** 0001287 Agency phone: (727) 797-0441 **JOHAN JONGSMA** **TATYANA JONGSMA** 851 BRIGHTWATERS BLVD NE SAINT PETERSBURG FL 33704 **Auto-Owners** **INSURANCE** LIFE · HOME · CAR · BUSINESS 1-800-288-8740 www.auto-owners.com **Auto-Pay (EFT)** Statement date: 11/22/2024 **EXECUTIVE UMBRELLA 50-989154-01** see reverse side Account: 015413721 | Payment Plan | Full Pay | |:---|:---| | Current Balance | $1,793.76 | | Minimum Due | Auto-Pay | An automatic payment of $1,793.76 will be initiated on 12/12/2024. No action is required. 5029474 ``` Actually, looking at the layout again, the Auto-Owners section is on the right side, and the agency info is on the left. The policyholder info is on the left below the agency. In my transcription above, I've put them in order from top to bottom, which is correct for a text transcription. One detail: "Auto-Owners" is in a stylized script font. In plain text, I should just write it as "Auto-Owners". Another detail: the payment box. The text starts with "An automatic payment..." and is in a shaded box. I'll just transcribe the text. Let me check if there are any other text elements. The QR codes themselves don't have visible text. The number "0001287" is visible and should be included. I think my transcription is complete. Let me format it one more time to make sure it's clean. Actually, I want to double-check the policy number: "50-989154-01" And the account number: "015413721" And the statement date: "11/22/2024" And the auto-pay date: "12/12/2024" And the amount: "$1,793.76" All look correct. Final check on the vertical number: It looks like "0001287" or "0001287" - I think it's "0001287". Wait, looking more carefully at the image, the vertical text on the left side near the agency address appears to be "0001287". Let me confirm... yes, --- ## Page 2 ### Policies on Account 015413721 | Policy | Current Balance | Minimum Due | |--------|-----------------|-------------| | EXECUTIVE UMBRELLA 50-989154-01 - effective 12/12/2023 | $0.00 | $0.00 | | EXECUTIVE UMBRELLA 50-989154-01 - effective 12/12/2024 | $1,793.76 | $1,793.76 | ### Access your account online View policy documents, payments, claim status and more. Visit **customercenter.auto-owners.com** to enroll in online access. ### Important Billing Information - A fee of up to $15.00 may be charged if a cancellation bill is issued (except IL, IA, MI, ND, NC, & VA). - IL, IA, MI, ND, NC, & VA only - A fee of $15.00 is charged if a cancellation bill is issued and your insurance is continued or reinstated. No fee is charged if your insurance is cancelled and not reinstated. - A fee of up to $15.00 may be charged for returned items. Returned items may be represented as an electronic ACH transaction. - A fee of up to $0.00 may be charged when making a payment by phone. - A billing fee of up to $3.00 may be charged for each bill. No fee is charged for accounts on the full pay payment plan, or accounts on other payment plans when fully paperless and set up for automatic EFT payments. The fee is reduced to $2.00 for accounts receiving paper bills when set up for automatic EFT payments.