HomeMy WebLinkAboutSTEVEN J WINICK - INSURANCE CERTIFICATESTATE FARM INSURANCE COMPANIES®
1555 Promontorryy Circle
Greeley CO 80638-0001
20A
Art 20
000486
CITY OF FORT COLLINS
PO BOX 580
FORT COLLINS CO 80522-0580
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ADDITIONAL INSURED'S NOTICE OF COVERAGE
DATE OF NOTICE: JUN 13 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.
State Farm Fire and Casualty Company 1623-F913-I
NAMED INSURED: POLICY NO: 132 3874-DO2-060 COVERAGE:
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WINICK, STEVEN J YR/MAKE/MODEL: 1990 PETERBILT DUMP BI AND PC LIABILITY
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11083 HIGHWAY 14 VIN/CAMPER: 1 XPOD29XOLD293391 $ 1 MIL
AULT CO 80610-9717 $1000 DED. COMP.
AGENT NAME: BILLCOFER $1000 DED. COLL.
AGENT PHONE: (970)223-7900
ENDORSEMENT NO: 6028BF POLICY EFFECTIVE
POLICY MESSAGES: This policy shown above supersedes policyC 1323874-066. JUN 02 2008 UNTIL TERMINATED
The policy includes a loss payable clause protecting the additional insured'& 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 that the required renewal premiums 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.
ADDITIONAL INSURED'S NOTICE OF COVERAGE
State Farm Fire and Casualty Company 1623-F913-I
NAMED INSURED: POLICY NO: 557203-DO8-06L COVERAGE:
JW TRUCKING ]NO YR/MAKE/MODEL: 1990 KENWORTH DUMP BI AND PD LIABILITY
600 LOUISE LN VIN/CAMPER: 1XKADB9X5LJ551242 $1 MIL
FORT COLLINS CO 80521-3037 AGENT NAME: BILL GOFER $1000 DED. COMP.
AGENT PHONE: (970)223-7900 $1000 DED. COLL.
ENDORSEMENT NO: 6028BF POLICY EFFECTIVE
POLICY MESSAGES: This policy shown above supersedes policy* 0557203-06K. 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 that the required renewal premiums 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.
FRT