HomeMy WebLinkAboutSTEVEN J WINICK SJW TRUCKING - INSURANCE CERTIFICATESTATE FARM INSURANCE COMPANIES®
1555 Promontorryy Circle
Greeley CO 80638-0001
15A
AT1 20 A
000485
CITY OF FT COLLINS
PO BOX 580
FORT COLLINS CO 80522-0580
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DATE OF NOTICE: JUN 12 2008
CODE:
NOTE: PLEASE NOTIFY STATE FARM AT THE
ADDRESS LISTED AT THE TOP, LEFTCORNER
OF THIS PAGE REGARDING ANY CHANGE OF
ADDRESS INFORMATION.
ADDITIONAL INSURED'S NOTICE OF COVERAGE
State Farm Fire and Casualty Company 1623-F913-1
NAMED INSURED: POLICY NO: 102 2241-D25.06G COVERAGE:
WINICK, STEVEN J YR/MAKE/MODEL: 1978 PETERBILT DUMP BI AND PD LIABILITY
11083 HIGHWAY 14 VIN/CAMPER: 112296N $1 MIL
AULT CO 80610-9717 AGENT NAME: BILL COFER $1000 BED. COMP.
.
AGENT PHONE: (970)223-7900 $1000 DEDCOLL.
ENDORSEMENT NO: 6028BF POLICY EFFECTIVE
POLICY MESSAGES: This policy shown above supersedes policy# 1022241-06F. JUN 02 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 if the policy is terminated. Until such notice
is provided, it shall be presumed thatthe required renewal premiums have been paid. The additional insured must notify its 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.
IRT