HomeMy WebLinkAbout292606 STILO ENTERPRISES - INSURANCE CERTIFICATE (3)OSTA"fE FARM INSURANCE COMPANIES`'
1555 Promontoryy Circle
Greeley CO 80638-0001
20 163 A
CITY OF FORT COLLINS
ATTN• PURCHASING
PO BOX 580
FORT COLLINS CO 80522-0580
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NOTICE OF TERMINATION OF AN ADDITIONAL INSURED INTEREST
DATE OF NOTICE DEC 24 2007
CODE
NOTE: PLEASE NOTIFY STATE FARM AT THE
ADDRESS LISTED AT THE TOP, LEFT CORNER
OF THIS PAGE REGARDING ANY CHANGE OF
ADDRESS INFORMATION
DEC 3 1 20�)7
RECEIVED
State Farm Fire and Casualty Company
2349-F625-H
NAMED INSURED.
POLICY NO. 43 3370-Bl7-06J COVERAGE:
S
STILO, ROBERT J JR
YR/MAKE/MODEL 19921NTERNATL DUMP
DBA STILO ENTERPRISES
VIN/CAMPER 2HSFHX6R9NC053708
PO BOX 358
AGENT NAME JERRY SMITH
>
LOVELAND CO 80539-0358
AGENT PHONE (970)686-616I
3RD PARTY INTEREST TERMINAI
m
EFFECTIVE JAN 06 2008
H
POLICY MESSAGES
o
Protection of the additional insured's interest provided by this policy is terminated as of the effective date above for the following reason
Policy cancelled for nonpayment of $1207 70
This advance notice is solely to protect the additional meured's interests as they are affected
by the ownership, maintenance, or use of the car described in the policy
N
O
M
FRT