HomeMy WebLinkAbout127666 MICHAEL TRUCKING - INSURANCE CERTIFICATE (4)09/29/2008 16 13 3704930226 PAGE 02/02 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, IIIlnOw Or ❑ STATE FARM GUARANTY INSURANCE COMPANY of Bloomington Illinois hat crwnraea in force for the fellowlnd Named Inured as Mom DBIM NAMEDINSURED Dwight Michaels DBA Micbael Trucking ADDRESS OF N MED 2450 N £kTZA9&TH ST POLICY NUMBER 055 2176-D08-063- S55 9543-A26-0611- ^, EFFECTIVE DATE OF POLICY 04/08/2008 01/26/2008 1983 Feterbilt DESCRIPTION OF 1997 Peterbi.lt DUWtruck D=Wtruck lxP91)29R0DP161015 t 1 V" D374171GL -VEHICLE LIABILITY COVERAGE ® YES ❑ NO ® YES ❑ NO ❑ YES © NO ❑ YES ❑ NO LIMITS OF LIABILITY a Soddylnpey Each Poison 500,000 500,000 ECM 500 000 500,000 b Prgmty Damage Each Accident 500 000 500,000 c Bodily INury & Property Damage Single Laren Each A Cadent PHYSICAL DAMAGE COVERAGES ® YES ❑ NO ® YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO a henae9 $ 2000 Dedtr Oft $ 2000 Deducible $ De&Ktl* $ DOdVdbla ® YES ❑ NO ® YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO b Collision $ 2000 Dedudwis $ 2000 Deductil* $ Dedcule $ Deductit)le CMLvA" . ❑ YES ® NO ❑ YES ® NO © YES ❑ NO ❑ YES ❑ NO HIRED PAGE IurY ❑ ® NO ❑ YES ® NO ❑ YES ❑ NO ❑ YES ❑ NO FLEET ALLO1AHM=#kr S ® NO ❑ YES ® NO ❑ YES ❑ NO ❑ YES ❑ NO M07 City Of Fort Collins Attn Purchasing PO Box 580 215 N Mason Fort Collins CO 8D522 1275 £ Magnolia 41 Fort Collins, CO 80524 USE ONLY 0 Request Mend CmWk;g a of IMWWIM for FspRy *Wwage