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HomeMy WebLinkAbout127666 MICHAEL TRUCKING - INSURANCE CERTIFICATE (11)0 0 0 0 OSTATE FARM INSURANCE COMPANIES® 1555 Promontory Circle Greeley CO 80638-0001 22A AT1 20 A 000473 CITY OF FORT COLLINS ATTN: PURCHASING PO BOX 580 FORT COLLINS CO 80522-0580 DATE OF NOTICE: APR 22 2009 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 C©VERAGE State Farm Fire and Casualty Company 1680-F913-1 NAMED INSURED: POLICY NO: 55 2176-DO8-06L COVERAGE: ' MICHAEL, DWIGHT YR/MAKE/MODEL: 1997 PETERBILT DUMP BI AND PD LIABILITY DBA MICHAEL TRUCKING VIN/CAMPER: D374171GL $500,000/$500,000/$500,000 2450 W ELIZABETH ST AGENT NAME: GARY CRAMER $2000 DED. COMP. $2000 DED. COLL. FORT COLLINS CO 80521-4120 AGENT PHONE: (970)484-1374 ENDORSEMENT NO: 6028BF POLICY EFFECTIVE APR 08 2009 UNTIL TERMINATGn POLICY MESSAGES: This policy shown above supersedes policy# 0552176-06K. 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