HomeMy WebLinkAboutSTEVEN J WINICK - INSURANCE CERTIFICATE (3)STATE FARM INSURANCE COMPANIES@
O 1555 Promontorryy Ci Cie
Greeley
CO 80638-0001
16A
AT1 20 A
000483
CITY OF FT COLLINS
PO BOX 580
FORT COLLINS CO 80522-0580
DATE OF NOTICE: NOV 19 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.
ADDITIONAL INSURED'S NOTICE OF COVERAGE
State Farm Fire and Casualty Company
1623-F913-1
NAMED INSURED:
POLICY NO:
102 2241-D25-06J
COVERAGE:'
`
WINICK, 8TEVEN J
YR/MAKE/MODEL:
1978 PETERBILT DUMP
BI AND PU LIABILITY
"
11083 HIGHWAY 14
VIN/CAMPER:
112296N
$1 MIL
$1000 DE D. COMP.
'
AULT CO 80610-9573
AGENT NAME:
BILL COFER
$1000 DED. COLL.
AGENT PHONE:
(970)223-7900
ENDORSEMENT NO: 6028BF
POLICY EFFECTIVE
OCT 31 2008 UNI IL TERMINATED
POLICY MESSAGES: This policy shown above supersedes policy& 1022241-061.
The policy includes a loss payable clause protecting the additional ineured'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 clays notice if the policy is terminated. Until such notica
is provided, it &hail be preaumed that the required renewal premiums have been paid. The additional insured must notify us within 10 days of
any change of interest ur ownership coming to their attention. Failure to do so will render this policy null and void.
FRT
OA STATE FARM INSURANCE COMPANIES®
1555 Promontorryy Circle
Greeley CO 80638-0001
15A
AT1 20 A
000482
CITY OF FORT COLLINS
PO BOX 580
FORT COLLINS CO 80522-0580
DATE OF NOTICE: NOV 19 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.
ADDITIONAL INSURED'S NOTICE OF COVERAGE
1
State Farm Fire and Casualty Company
1623-F913-1
NAMED INSURED:
POLICY NO:
1323874-1302-06F
COVERAGE: r
WINICK, STEVENJ
YR/MAKE/MODEL:
1990 PETERBILT DUMP
BI AND PD LIABILITY
11083 HIGHWAY 14
VIN/CAMPER:
IXPOD29XOLD293391
$ 1 MIL
$1000 DED. COMP.
AULT CO 80610.9573
AGENT NAME:
BILL COFER
$1000 DED. COLL,
AGENT PHONE:
(970)223-7900
ENDORSEMENT NO:
6028BF
POLICY EFFECTIVE
OCT 31 2008 UNTIL TERMINATED
POLICY MESSAGES: This policy shown above supersedes policy# 1323874-06E.
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.
FRF