HomeMy WebLinkAbout112307 E & LL TRUCKING - INSURANCE CERTIFICATE (9)S T��TI \I♦MM
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®® CERTIFICATE OF INSURANCE
INSU MANCi
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: E &
LL TRUCKING INC
ADDRESS OF NAMED INSURED: 941
E 4TH ST
LOVELAND
CO 80537-5735
POLICY NUMBER
153 5987-F24-06F
153 5990-F24-06E
EFFECTIVE DATE
OF POLICY
12-24-2009
12-24-2010
93 PETERBILT 378
DESCRIPTION OF
88 PETERBILT
378
1XPFDR9X5PD324128
VEHICLE (Including VIN)
1XPFD29X3JD264445
LIABILITY COVERAGE
® YES
❑ NO
® YES
❑ NO
❑ YES
❑ NO
❑ YES
❑ NO
LIMITS OF LIABILITY
a. Bodily Injury
Each Person
100,000
100,000
Each Accident
300,000
300,000
b. Property Damage
Each Accident
100,000
100,000
c. Bodily Injury &
Property Damage
Single Limit
Each Accident
PHYSICAL DAMAGE
COVERAGES
❑ YES
❑ NO
® YES
❑ NO
❑ YES
[]NO
❑ YES
❑ NO
a. Comprehensive
$
Deductible
$ 1000
Deductible
$
Deductible
$
Deductible
❑ YES
❑ NO
❑ YES
❑ NO
❑ YES
❑ NO
❑ YES
❑ NO
b. Collision
$
Deductible
$
Deductible
$
Deductible
$
Deductible
EMPLOYERS NON -OWNED
CAR LIABILITY COVERAGE
❑ YES
❑ NO
❑ YES
❑ NO
❑ YES
❑ NO
❑ YES
❑ NO
HIRED CAR LIABILITY
E] YES YES
NO
[:1 YES
ElNO
❑ YES
❑ NO
E]YES
E]NO
COVERAGE
FLEET - COVERA E FOR
MOALL O R EDA D4b
MOTOR VEH , ES
YES
❑ NO
❑ YES
❑ NO
❑ YES
El NO
❑ YES
❑ NO
Name and'Addrq$ of Certificate Holder
City of Fort ollins
215 N. Madison St
Fort Collins, CO 80522
ent 970-484-1374 03-11-2010
Title
Name and Address of
Gary Cramer
1275 E Magnolia
Fort Collins, Co
Agent's Gode Number Date
ent
unit I
80524
INTERNAL STATE FARM USE ONLY: ❑ Request permanent Certificate of Insurance for liability coverage.
122429.3 Rev. 07-26-2005 ® Request Certificate Holder to be added as an Additional Insured.