HomeMy WebLinkAboutROY EDWARDS TRUCKING - INSURANCE CERTIFICATEOSTATE FARM INSURANCE COMPANIES®
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1555 Promontory Circle
Greeley 00 80638-0001
153 A
CITY OF FORT COLLINS
PURCHASING DEPARTMENT
215 N MASON
FORT COLLINS CO 80524-4402
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NOTICE OF TERMINATION OF A THIRD PARTY INTEREST
DATE OF NOTICE: MAR 23 2006
CODE:
NOTE: PLEASE NOTIFY STATE FARM AT THE
ADDRESS LISTED AT THE TOP, LEFT CORNER
OF THIS PAGE REGARDING ANY CHANGE OF
ADDRESS INFORMATION.
State Farm Fire and Casualty Company
NAMED INSURED:
POLICY NO:
113 7925-Al8-06B
EDWARDS, ROY
YR/MAKE/MODEL:
1986 KENWORTH DUMP
7325 S SHIELDS ST
VIN/CAMPER:
1XKWD29X8G5331650
FORT COLLINS CO 80526-9614
AGENT NAME:
JOHN K MARTINEZ
AGENT PHONE:
(970)223-7800
1622-F625-1
COVERAGE:
3RD PARTY INTEREST TERMINATED
i POLICY MESSAGES: EFFECTIVE APR 05 2006
N
Protection of the third party's interest provided by this policy is terminated as of the effective date above for the following reason: Policy
cancelled by insured. This advance notice is solely to protect the third party's interests as they are affected by the ownership, maintenance,
� or use of the car described in the policy.
� P Y•
FRT