HomeMy WebLinkAboutFORT COLLINS CONVENTION & VISITORS BUREAU - INSURANCE CERTIFICATE 2023-2024iteFarm STATE FARM�
��
PO Box 2368
Bloomington IL 6i702-2368
AT1 20
CITY OF FORT
PO BOX 580
FORT COLLINS
17A
A
003007 0093
COLLINS
CO 80522-0580
�iiin�li�l�illiil�ilnlii�i��ni��i�i�in�ii��iil����i�iii�ii�i�
DATE OF NOTICE: AUG 29 2023
CODE:
NOTE: PLEASE NOTIFY STATE FARM AT THE
ADDRESS LISTED AT THE TOP, LEFT CORNER
OF THIS PAGE REGARDING ANY CHANGE OF
ADDRESS INFORMATION.
4DDITIONAL INSURED'S NOTICE OF COVERAGE
late Farm Mutual Automobile Insurance Company 1817-FAF1-A
AMED INSURED: POLICY NO: 487 4274-E04-066 COVERAGE:
�RT COLLINS CONVENTION & YR/MAKE/MODEL: 202o SUBARU STA WAG BI AND PD LIABILITY
SITORS BUREAU VIN/CAMPER: 4S4BTACCXL3201009 $ � MIU$ 1 MIL /$ 1 MIL
3A VISIT FORT COLLINS AGENT NAME: MARY BIGGERS $500 DED. COMP.
�LD TOWN SQ STE 107 AGENT PHONE: $soo �E�. co��.
(970)493-9336
�RT COLLINS CO 80524-2464 ENDORSEMENT NO: 6028BT POLICY EFFECTIVE
AUG 15 2023 UNTIL TERMINATED
�LICY MESSAGES: This policy shown above supersedes policy# 4874274-06A.
ie policy includes a loss payable clause protecting 1he additional insured's interest in the described car to the extent of the insurance
ovided and subject to all policy provisions. The additional insured will be given 10 days notice if the policy is terminated. Until such notice
provided, it shall be presumed that the required renewal premiums have been paid. The additional insured must notify us within 10 days of
iy change of interest or ownership coming to their attention. Failure to do so will render this policy null and void.
FRT