HomeMy WebLinkAbout384033 J J'S TRUCKING - INSURANCE CERTIFICATE (2)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 BY
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 TEXAS of Dallas Texas
❑ STATE FARM INDEMNITY COMPANY of Bloomington Illinois or
❑ STATE FARM GUARANTY INSURANCE COMPANY of Bloomington Illinois
has coverage In force for the followlno Named Insured as shown helnw
NAMEDINSURED PFLIPSEN, STAN DBA JJ S TRUCKING
ADDRESS OF NAMED INSURED 221
W DOUGLAS RD LOT 17
POLICY NUMBER
Pending
EFFECTIVE DATE
OF POLICY
02/04/2008
DESCRIPTION OF
VEHICLE (including vlN)
R686ST8447
LIABILITY COVERAGE
E YES
❑ NO
❑ YES
❑ NO
❑ YES
❑ NO
❑ YES
❑ NO
LIMITS OF LIABILITY
a Bodily Injury
1 000,000
Each Person
1 000 000
Each Accident
1 000 000
b Property Damage
Each Accident
c Bodily Injury 8
Property Damage
Single Limit
Each Accident
PHYSICAL DAMAGE
COVERAGES
❑ YES
E NO
❑ YES
❑ NO
❑ YES
[]NO
❑ YES
❑ NO
a Comprehensive
$
Deductible
$
Deductible
$
Deductible
$
Deductible
❑ YES
ENO
❑ YES
❑ NO
❑ YES
❑ NO
❑ YES
❑ NO
b Collision
$
Deductible
$
Deductible
$
Deductible
$
Deductible
EMPLOYERS NON -OWNED
CAR LIABILITY covERAGE
[I YES
ENO
YES
❑ NO
YES
❑ NO
❑ YES
[]NO
HIRED COVVERAGELIABILITY
E YES
❑ NO
❑ YES
❑ NO
❑ YES
❑ NO
❑ YES
❑ NO
FLEET C RAGE FOR
ALLM MOTOR 41CLES��D
ENO
❑ YES
❑ NO
❑ YES
❑ NO
❑ YES
❑ NO
ly
_)is
Agent 1680-06 02/04/2008
i9 re of ° Title Agents Code Number Dale
Na Address of Certificate Holder Name and Address of Anent
C ty 0 Fort Collins Gary Cramer
215 N Mason St 1275 E Magnoila St #I
Fort Collins Co 80524 Fort Collins Co 80524
INTERNAL STATE FARM USE ONLY ❑Request permanent Certificate of Insurance for Isabdity coverage
122429 3 Rev 07 26 2005 00 Request Certificate Holder to be added as an Additional Insured