HomeMy WebLinkAboutCORRESPONDENCE - GENERAL CORRESPONDENCE - INSURANCE CERTIFICATECERTIFICATE 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: RICK & SHIRLEY STEFFEN dba E & LL TRUCKING
ADDRESS OF NAMED INSURED: 941
E 4Te ST. ,
LOVELAND
CO 80537-5735
POLICY NUMBER
S55 8277-E16-06V-
017 6949-D20-06Q
EFFECTIVE DATE -
12/24/08-6/24/09
OF POLICY
12/24/08-6/24/09
DESCRIPTION OF
1988 PETERBUILT
1993 PETERBUILT
VEHICLE (Including VIN) '
1XPFD29X3JD264445
1XPFDR9X5PD324128
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 MM
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
a. Comprehensive 7
$
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-
FN NO -
E]-YES
M NO-
❑ YES
❑ NO
❑ YES
❑ NO
HIRED CAR LIABILITY
❑ YES
® NO
❑ YES
® NO
❑ YES
❑ NO
[:1YES
[:1NO
COVERAGE
FLEET - COVERAGE FOR
ALL OWNED LICENSED
MOTOR VEHICLES
❑ YES
® NO
❑ YES
® NO
El YES
❑ NO
[_1 YES
[-INOMO
Name and Address of Certificate Holder
CITY OF FORT COLLINS
PO BOX 580
FORT COLLINS CO 80522
Licensed
Staff 06-1680 03/04/2009
Title
Name and Address of
CRAMER STATE FARM
GARY CRAMER
1275 E MAGNOLIA ST., #I
FORT COLLINS CO 80524
INTERNAL STATE FARM.USE ONLY:- D. Request permanent Certificate of insurance -for --liability coverage. --
122429.3 Rev. 07-26-2005 ® Request Certificate Holder to be added as an Additional Insured.
Date