HomeMy WebLinkAbout112307 E & LL TRUCKING - INSURANCE CERTIFICATE (10)03/04/2009 09:06 9704930226 PAGE 01/01
INf UGI1NG5 CERTIFICATE 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, Illinois, or
❑ STATE FARM GUARANTY INSURANCE COMPANY of Bloomington, Illinois
has coverage in force for the following Named Insured as shown below:
NAMED INSURED: RICX & SHIRLEY STEFFEN dba E & LL TRDCRING
ADDRESS OF NAMED INSURED: 941 E 4"" ST. ,
LOVELAND
CO 80537-5735
POLICY NUMBER
S55 8277-EI6-06V-
017 6949-D20-060
EFFECTIVE DATE
12/24/08-6/24/09
OF POLICY
12/24/08-6/24/09
DESCRIPTION OF
1968 FETERSUILT
1993 PETERBUILT
VEHICLE (Including VIN)
1XPFD29X3JD264445
1XPFJ)R9X5PD32412$
LIABILITY COVERAGE
® YES ❑ NO
® YES
❑ NO
❑ YES
❑ NO
❑ YES
❑ NO
LIMITS OF LIABILITY
a. Bodily Injury
Each Person
1 MM
1 MM
Each Accident
1 n>M
1 Mm
b. Property Damage
Each Accident
1 MM
1 MM
c. Bodily Injury &
Property Damage
Single Limit
Each Accident
1 MM
1 MM
PHYSICAL DAMAGE
COVERAGES
❑ YES ® NO
❑ YES
® NO
❑ YES
❑ NO
[]YES
❑ NO
s. Comprehensive
$ Deductible
$
Deductible
$
Deductible
$
Deductible
❑ YES ® NO
❑ YES
® NO
❑ YES
❑ NO
❑ YES
❑ NO
b. Collision
$ Deductible
$
Deductible
$
Deductible
$
Deductible
EMPLOYERS NON -OWNED
CAR LIABILITY COVERAGE
❑ YES [3 NO
❑ YES
® NO
[IYES
❑ NO
❑ YES
❑ NO
WIRED CAR LIABILITY
COVERAGE
YES ® NO
❑ YES
® NO
❑ YES
❑ NO
❑ YES
❑ NO
FLEET - COVERAGE FOR
ALL OWNED AND LICENSED
MOTOR VEHICLES
❑ YES NO I
❑ YES
® NO
❑ YES
❑ NO
❑ YES
❑ NO
•� Licensed
Staff 06-1680 03/04/2009
�5 nature of Au orized Reobsentative Title Agent's Code Number Date
ame and dress of Certificate Holder Name and Address of Agent
CITY OF FORT COLLINS
PO BOX 580
FORT COLLINS CO 80522 CRAMER STATE FARM
GARY CRAMER
1275 E MAGNOLIA ST., 41
FORT COLLINS CO 60524
INTERNAL STATE FARM USE ONLY: ❑ Request permanent Certificate of Insurance for liability coverage,
122429.3 Rev. 07-28-2005 N Request Certificate Holder to be added as an Additional Insured,