HomeMy WebLinkAboutADVANCED PEST MANAGEMENT COLORADO MOSQUITO CONTROL - INSURANCE CERTIFICATE (12)OSTATE FARM INSURANCE COMPANIES®
1555 Promontory Circle
Greeley CO 80638-0001
DATE OF NOTICE DEC 07 2007
CODE
20 183 A
CITY OF FORT COLLINS
CITY HALL WEST
300 LAPORTE AVE
FORT COLLINS CO 80521-2719
IIIrIIIIrIrrLLrlldrlJLlIIIIIrdrlrllllLrILIIILrIrLIII
NOTE PLEASE NOTIFY STATE FARM AT THE
ADDRESS LISTED AT THE TOP, LEFT CORNER
OF THIS PAGE REGARDING ANY CHANGE OF
ADDRESS INFORMATION.
NOTICE OF TERMINATION OF A THIRD PARTY INTEREST
State Farm Mutual Automobile Insurance Company 1983-F626-8
NAMED INSURED. POLICY NO F601683-COI-061 CAR 077 COVERAGE
S ADVANCED PEST MANAGEMENT INC YR/MAKE/MODEL: 2003 FORD PICKUP BI AND PD LIABILITY
DBA COLORADO MOSQUITO CONTROL VIN/CAMPER- 1 MRIOD93PS48953
695 N 7TH AVE AGENT NAME: DORIS STIPECH
> BRIGHTON CO 80601-1559 AGENT PHONE: (303)421-2191
¢ 3RD PARTY INTEREST TERMINATED
m EFFECTIVE DEC 20 2007
& POLICY MESSAGES:
AProtection of the third party's Interest provided by this policy Is terminated as of the effective date above for the following reason
Cancellation of Liability Coverage This advance notice is solely to protect the thud party's Interests as they are affected by the ownership,
maintenance, or use of the car described In the policy
N
O
M
FRT