HomeMy WebLinkAboutSTEVEN J WINICK - INSURANCE CERTIFICATE (2)STATE FARM INSURANCE COMPANIES®
1555 Prornonforryy Circle
Greeley CO 80638-0001
15A
AT1 20 A
000469
CITY OF FORT COLLINS
PO BOX 580
FORT COLLINS CO 80522-0580
DATE OF NOTICE: NOV 05 2008
CODE:
NOTE: PLEASE NOTIFY STATE FARM AT THE
ADDRESS LISTED AT THE TOP, LENT CORNER
OF THIS PAGE REGARDING ANY CHANGE OF
ADDRESS INFORMATION.
ADDITIONAL INSURED'S NOTICE OF COVERAGE
State Farm Fire and Casualty Company
NAMED INSURED:
POLICY NO:
132 3874-DO2-06E
WINICK, STEVEN J
YR/MAKE/MODEL:
1990 PETER13ILT DUMP
11083 HIGHWAY 14
VIN/CAMPER:
1 XPOD29XOLD293391
AULT CO 80610-9573
AGENT NAME:
BILLCOFER
AGENT PHONE:
(970)223-7900
ENDORSEMENT NO:
6028BF
1623-F913.1
COVERAGE:
BI AND PD LIABILITY
$ 1 MIL
$1000 DED. COMP.
$1000 DED. COLL,
POLICY EFFECTIVE
OCT 28 2008 UNTIL TERMINATED
POLICY MESSAGES: This policy shown above supersedes policy# 1323874-06D.
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