HomeMy WebLinkAboutCHUCK HOFFMAN - INSURANCE CERTIFICATE,$tate Farm Fire and Casualty Company 14086-2-R FIRE OVL
1555 Promontory Circle Greeley CO 80638-0001 Y' 'COPY' DECLARATIONS PAGE 'coP
06-1680-22RR POLICY NUMBER S50 6852-C21-06K
CITY OF FT COLLINS POLICY PERIOD SEP 21 2003 to MAR 21 2004
PURCHASING DEPT
256 W MOUNTAIN ST
FORT COLLINS CO 80521-2711
NAMED INSURED: HOFFMAN, CHUCK
DO NOT PAY PREMIUMS SHOWN ON THIS PAGE.
SEPARATE STATEMENT ENCLOSED IF AMOUNT DUE.
AGENT
GARY CRAMER
2038 S COLLEGE AVE
FORT COLLINS, CO 80525-1425
PHONE: (970)484-1374
s
. el.i}, ' i,�s: ��'�<. $.� �� ti, �m ��6. �E `'•F o r a Y-b�h,.�m � s E ' i 4 '. � 1�y� e
c� � r ^.d�a��a. s..•xz+5 n$�z=� u:knks'n,�.,m,$a�.aA.m . �.,ne ��p ;A r: ru, .�u1 ,93�a�r n1
0600000
1988
See policy for coverage details. MACK
Limit of Liabilitv-Coveraae A
U Uninsured Motor Vehicle $27 60
v
Each Person, Each Accident
Your policy consists of this declarations page, the policy booklet - form 9906.5, and any endorsements that apply, including
those issued to you with any subsequent renewal notice.
Replaced policy number S506852-06J.
11T COLLINS, PURCHASING DEPT 256 W
MOBILE NORTHERN INC, 1800 N TAFT HILL
FORT COLLINS SNOW REMOVAL, 256 W
711.
MIDT EARTH BUILDERS, 7250 GREENRIDGE
6102G AMENDMENT OF DEFINED WORDS, LIABILITY AND PHYSICAL DAMAGE
COVERAGES.
6289AH SINGLE LIMIT OF LIABILITY.
6906.2 AMENDMENT OF INSURED S DUTIES• LIABILITY NO-FAULT UNINSURED
MOTOR VEHICLE & PHYSICAL DAMAGE COVERAGES; AND CONDITIONS.
USE -COMMERCIAL.
FE-6999 TERRORISM INSURANCE COV NOTICE.
Named Insured- HOFFMAN, CHUCK DBA CHUCK HOFFMAN TRUCKING 1901 LONGWORTH RD FORT COLLINS CO
80526-1516