HomeMy WebLinkAboutJW TRUCKING - INSURANCE CERTIFICATE (2)STATE FARM INSURANCE COMPANIES9
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1555 Promontory Circle
Greeley CO 80636 0001
DATE OF NOTICE FEB 20 2008
CODE
AT1 20
CITY OF FORT
PO BOX 580
FORT COLLINS
21A
000399
COLLINS
CO 80522-0580
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A
ADDITIONAL INSURED S NOTICE OF COVERAGE
State Farm Fire and Casualty Company
NAMED INSURED
JW TRUCKING INC
600 LOUISE LN
FORT COLLINS CO 80521 3037
NOTE PLEASE NOTIFY STATE FARM AT THE
ADDRESS LISTED AT THE TOP, LEFT CORNER
OF THIS PAGE REGARDING ANY CHANGE OF
ADDRESS INFORMATION
1623 F913I
COVERAGE
$BI' IND PD LIABILITY
WOODED COMP
WOODED COLL
POLICY EFFECTIVE
POLICY MESSAGES This policy shown above supersedes policy* 0557203 06J FEB 14 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 subject to all policy provisions The additional insured will be given 10 days notice it 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
POLICY NO
YR/MAKE/MODEL
VIN/CAMPER
AGENT NAME
AGENTPHONE
ENDORSEMENT NO
55 7203 D08 06K
1990 KENWORTH DUMP
1XKADB9X5W551242
BILL GOFER
(970)223 7900
6028BF
FnT