HomeMy WebLinkAbout112297 VINEY TRUCKING INC - INSURANCE CERTIFICATE (8)-a STATE FARM INSURANCE COMPANIES®
free Promontorryy Circle
Greeley CO 80638-0001
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CITY OF FORT COLLINS FINANCIAL
SERVICES PURCHASING DIVISION
LNr�r�: PO BOX 580
FORT COLLINS CO 80522-0580
DATE OF NOTICE: JUL 27 2011
CODE: 33380
NOTE: PLEASE NOTIFY STATE FARM AT THE
ADDRESS LISTED AT THE TOP, LEFT CORNER
OF THIS PAGE REGARDING ANY CHANGE OF
ADDRESS INFORMATION.
NOTICE OF TERMINATION OF AN ADDITIONAL INSURED. INTEREST
Stale Farm Mutual Automobile Insurance Company
2157-F913-G
NAMED INSURED: POLICY NO:
0571122-El7-06L CAR 064 COVERAGE:
VINEY TRUCKING INC YR/MAKE/MODEL:
2006 TRAIL KING TRL
PO BOX 1446 VIN/CAMPER:
1 TKLC412X6w024736
LAPORTE CO 80535-1446 AGENT NAME:
DARYL ALEXANDER INS AGCY INC
AGENT PHONE:
(970)493-2196
3RD PARTY INTEREST TERMINATED
EFFECTIVE AUG 09 2011
POLICY MESSAGES:
Protection of the additional insured's interest provided by this policy is terminated as of the effective date above for the following reason:
Policy cancelled by insured. This advance notice is solely to protect the additional insured's interests as they are affected by the ownership,
maintenance, or use of the car described in the policy.
FRT