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Home My WebLink About292606 STILO ENTERPRISES - INSURANCE CERTIFICATE (8)PACE 1 of 2 FOR LIENHOLDER USE 1870-4392-01 FAMILY CAR POLICY NON -ASSESSABLE POLICY ISSUED BY AMERICAN FAMILY MUTUAL INSURANCE COMPANY A MEMBER OF THE AMERICAN FAMILY INSURANCE GROUP MADISON, WI PLEASE READ YOUR POLICY POLICY NUMBER 1870-4392-01-63-FPPA-CO POLICYHOLDER/NAMED INSURED STILO, ROBERT PO BOX 358 LOVELAND, CO 80539-0358 1992 INTL 940 VEHICLE SYMBOL 26 . CLASS CITY 2 COVERAGES AND LIMITS PROVIDED TERRITORY 78 BODILY INJURY LIABILITY $250,000 EACH PERSON $500,000 EACH OCCURRENCE PROPERTY DAMAGE LIABILITY $250,000 EACH OCCURRENCE EFFECTIVE FROM 03-18-2010 TO 08-21-2010 /TK4911MI&I01113 11/7 VIN 2HSFHX6R9NC053708 ADDITIONAL ENDORSEMENTS THAT APPLY TO YOUR POLICY: END 10 SPECIAL PROVISION FOR AFMIC POLICYHOLDERS END 300 COLORADO AMENDATORY END 45 CANCELLATION AND NON -RENEWAL *END 83 MEDICAL EXPENSE $5,000 EACH PERSON *END 90 EMERGENCY ROAD SERVICE COVERAGE *UNINSURED MOTORISTS - BODILY INJURY ONLY ONLY $250,000 EACH PERSON $500,000 EACH ACCIDENT *UNDERINSURED MOTORISTS COVERAGE - BODILY INJURY ONLY $250,000 EACH PERSON $500,000 EACH ACCIDENT *END 50 ACCIDENTAL DEATH & SPECIFIC DISMEMBERMENT BENEFITS COV $20,000 EACH PERSON City of Fort Collins: Listed as Additional Insured 215 N Mason Street PO Box 580 Fort Collins, CO. 80522 MULTIPLE VEHICLE DISCOUNT HAS BEEN APPLIED NOTE: THE PERCENTAGE OF FAULT IN AN AUTO ACCIDENT MAY IMPACT THE EXTENT OF RECOVERABLE DAMAGES BASED ON COLORADO LAW. NOTE: COLORADO LAW REQUIRES AN INSURER TO COLLECT A $1.00 FEE PER MOTORVEHICLE PER YEAR. THE FEE IS SENT TO THE COLORADO AUTO THEFT PREVENTION FUND. Declarations effective on the date shown above. These declarations form a part of this policy and replace all other declarations which may have been issued previously for this policy. If this declarations is accompanied by anew policy, the policy replaces any which may have been issued before with the same policy number. A 4W I - AUTHORIZED REPRESENTATIVE President secretary AGENT 157-309 PHONE (970)669-0007 ROY A CHRISTMAN 1402 W 28TH ST STE 1 LOVELAND, CO 80538-3169 USER ID RAC014 TYPE DE ENTRY DATE 03-18-2010 INCEPTION DATE 01-25-2008 Form No. U1A1(b) Stock No. 05095 PAGE 2 OF 2 AGREEMENT 1870-4392-01 We agree with you, in return for your premium payment, to insure you subject to all terms of this policy. We will insure you for coverages and die limits of liability as shown in the declarations of this policy. DEFINITIONS 1. We. us and our mean the company providing this insurance. 2. You and your mean the policyholder named in the declarations and spouse, if living in the same household. LOSS PAYABLE CLAUSE Loss or damage shall be paid to you and the lienholder shown in the declarations. The insurance covering the interest of the lienholder shall apply unless invalidaled by the lienholder's fraudulent acts or omissions. We have the: right, however, to cancel this policy as shown in the General Provisions. Cancelation shall tenninate this agreement with respect to the lienrholder's interest. When we cancel, we will give the lienholder at least 10 days (30 days in Illinois) notice. When we pay the lienholder we are entitled, to the extent of the payment, to the licnholder'.s rights of recovery. INTERLINE WI 00 98 07 06 DATE: 03/1 1 /2010 WILSHIRE INSURANCE COMPANY P.O. Box 7006, Lancaster, California 93539-7006 NOTICE OF REINSTATEMENT To ALL Insureds, Loss Payees, and Other Interests, if any, named in the Policy described below: Additional Interest FORT COLLINS, CITY OF DIRECTOR OF PURCHASING 215 N MASON, 2ND FLR FORT COLLINS, CO 80522-0000 Policy Number: BA2494623 57 02 We are notifying you that the policy shown below is reinstated effective at 12:01 a.m. Standard time at the First Named Insured's mailing address on the date shown below. This Notice of Reinstatement does not vary, waive, alter or extend any of the Terms, Conditions, Agreements or' Declarations of the policy other than herein stated. DATE OF CANCELLATION REINSTATEMENT EFFECTIVE 04/01 /2010 04/01 /2010 Countersigned at Lancaster, California on 03/1 1 /10 Authorized Representative Policy Issued through Agency: TRUCKWRITERS OF COLORADO INC 1510 GLEN AYR DR STE 6 LAKEWOOD, CO:.80215-3051 Named Insured: SAINTS TRUCKING, LLC 4502 HIBISCUS ST FORT COLLINS, CO 80526-0000 Countersignature Producer Code: 000300001 WI 00 98 07 06 Page 1 of 1 ADD'L INSURED 0 03/1 1 /2010