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HomeMy WebLinkAbout125758 FULLER LANDSCAPING - INSURANCE CERTIFICATE (8)03/21/2006 13:53 9702215478 DARYL ALEXANDER SF PAGE 02 ACERTIFICATE OF INSURANCE SUCH INSURANCE AS RESPECTS THE INTEREST OF THE CERTIFICATE HOLDER NAMED BELOW WILL NOT BE CANCELED OR OTHERWISE TERMINATED WITHOUT GIVING 10 DAYS PRIOR WRITTEN NOTICE TO THE CERTIFICATE HOLDER, BUT IN NO EVENT SHALL THIS CERTIFICATE BE VALID MORE THAN 30 DAYS FROM THE DATE WRITTEN. THIS CERTIFICATE OF INSURANCE DOES NOT CHANGE THE COVERAGE PROVIDED 13Y ANY POLICY DESCRIBED BELOW. This certifies that: ® STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY of Bloomington, Illinois ❑ STATE FARM FIRE AND CASUALTY COMPANY of Bloomington, Illinois ❑ STATE FARM COUNTY MUTUAL INSURANCE COMPANY OF T'EMS of Dallas, Texas, or ❑ STATE FARM INDEMNITY COMPANY of Bloomington, Imnois has Coverage in force for the following Named Insured as shown below: NAMED INSURED: BRIAN FULLER ADDRE33 OF NAMED INSURED, 4836 KT.VA OR, LAPORTE, Co 80535-9507 POLICY NUMBER 660 9210-C1S-06F EFFECTIVE DATE OF POLICY 4119/00-10/19/06 DESCRIPTION OF 1993 FORD DUMP 1FDKFi /M4YNPL91l3b VEHICLE (Including VIN) I IARII.ITY COVFRAr,F ® YES ❑ NO ❑ YES ❑ NO © YES ❑ NO ❑ YES ❑ NO LIMITS OF LIABILITY a. Bodily Injury Each Person Each Accident b. Property Damage Each Accident c. Bodily Injury & Property Damage Single Limit Each Accident $3001000 PHYSICAL DAMAGE COVERAGES ❑ YES ® MO ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO a. Comprehensive $ Deductible $ Deductible $ Deductible $ Deducnble ❑ YES ® NO ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO b. Colli3ion $ Deductible $ DeductNe $ Deductible $ DedUedble EMPLOYERS NON -OWNED CAR LIABILITY COVERAGE ❑ YES 0 NO ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO HIRED CAN LIAtlILI I Y COVERAGE ❑ YES ® NO ElYES ❑ NO ❑ YES NO [I❑ U YES NO FLEET -COVERAGE FOR ALL eucENeED MOTOROR VEHICLES VE ❑ YES l� NO ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO AGKN'T TiMe Holder Name and Address of 06--2157 CITY OF FORT COLLINS AS ADDITIONAL. INSURED DARYL ALEXANDER PURCHASING DEPARTMENT PO SOX 1922 PO BOX 580 FORT COLLINS, CO 80522 FORT COLLINS, CO 80522 221-6707 970-493-2196 INTERNAL STATE FARM USE ONLY: ❑ Request permanent Certificate of Insurance for liability coverage. 122429.2 Rev. D&IG-2004 ® Request Certificate Holder to be added as an Additional Insured. -06