HomeMy WebLinkAboutJW TRUCKING - INSURANCE CERTIFICATESTATE FARM INSURANCE COMPANIES®
.�y 1555 Promontorryy Circle
Greeley CO 80638 0001
16A
AT1 20 A
000477
CITY OF FORT COLLINS
PO BOX 580
FORT COLLINS CO 80522-0580
IIiiIJLiiildiiJJiiIJlLrirLlrLdilliiJirlJLriirlJl
DATE OF NOTICE FEB 14 2008
CODE
NOTE PLEASE NOTIFY STATE FARM AT THE
ADDRESS LISTED AT THE TOP, LEFT CORNER
OF THIS PAGE REGARDING ANY CHANGE OF
ADDRESS INFORMATION
ADDITIONAL INSUREDS NOTICE OF COVERAGE
State Farm Fire and Casualty Company
1623 F913 I
NAMED INSURED
POLICY NO
55 7203 D08 06J
COVERAGE
JW TRUCKING INC
YR/MAKE/MODEL
1990 KENWORTH DUMP
BI AND PD LIABILITY
600 LOUISE LN
VIN/CAMPER
1XKADB9X5LJ551242
$ 1 MIL
$1000DED COMP
FORTCOLLINSCO 80521 3037
AGENTNAME
BILLCOFER
$1000DED COLL
AGENT PHONE (970)223 7900
ENDORSEMENT NO 6028BF POLICY EFFECTIVE
POLICY MESSAGES This policy shown above supersedes policyi 0557203 061 JAN 30 2008 UNTIL TERMINATED
The policy includes a loss payable clause protecting the additional insured s interest in the described car to the extent of the insurance
provided and sublect to all policy provisions The additional insured all be given 10 days notice if the policy is termnated Until such notice
is provided it shall be presumed that the required renewal premums have been paid The additional insured must notify us within 10 days of
any change of interest or ownership coming to their attention Failure to do so will render this policy null and void
FEB G 6 2008
RECEIVED
FRT