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HomeMy WebLinkAbout112297 VINEY TRUCKING INC - INSURANCE CERTIFICATE (11)STATE FARM INSURANCE COMPANIESe'
1555 Promontory Circle
Greeley CO 80638-0001
96
AT1 20 A
002949 0055
CITY OF FORT COLLINS FINANCIAL
SERVICES PURCHASING DIVISION
V�..W� PO BOX 580
k'3u FORT COLLINS CO 80522-0580
DATE OF NOTICE: OCT 13 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
State Farm Mutual Automobile Insurance Company 2157-F913-G
NAMED INSURED: ✓ 10 POLICY NO: 0571122-El7.06L CAR 009 COVERAGE:
VINEY TRUCKING INC
PO BOX 1446
LAPORTE CO 80535-1446
1996 LOWBOY TRAILER
4U1 81 DHX1 T1 X33033
DARYL ALEXANDER INS AGCY IND
(970)493-2196
3RD PARTY INTEREST TERMINATED
m EFFECTIVE OCT 26 2011
N 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 oar described in the policy.
N
O
M
YR/MAKE/MODEL:
VIN/CAMPER:
AGENT NAME:
AGENT PHONE:
NOTICE,OF TERMINATION OF AN ADDITIONAL.INSURED INTEREST
State Farm Mutual Automobile Insurance Company 2157-F913-G
NAMED INSURED: POLICY NO: 0571122-El7.06L CAR 019 COVERAGE:
VINEY TRUCKING INC YR/MAKE/MODEL: 1997 RANCO TRAILER
PO BOX 1446 VIN/CAMPER: 1 R9ESH509VL008586
LAPORTE CO 80535-1446 AGENT NAME: DARYL ALEXANDER INS AGCY INC
AGENT PHONE: (970)a93-2196
• - 3RD PARTY INTEREST TERMINATED
EFFECTIVE OCT 26 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 oar described in the policy.
N9
mN
O
R
NOTICE OF TERMINATION OF AN ADDITIONAL.INSUREDINTEREST
State Farm Mutual Automobile Insurance Company 2157-F913-G
NAMED INSURED: POLICY NO: 0571122-El7-06L CAR 021 COVERAGE:
VINEY TRUCKING INC YR/MAKE/MODEL: 2000 RANCO TRAILER
PO BOX 1446 VIN/CAMPER: 1 R9ESB505YL008170
LAPORTE CO 80535-1446 AGENT NAME: DARYL ALEXANDER INS AGCY INC
AGENT PHONE: (970)493-2196
3RD PARTY INTEREST TERMINATED
EFFECTIVE OCT 26 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,
v
maintenance, or use of the car described in the policy.
co
N
FRT
NOTICE OF TERMINATION.OF AN ADDITIONALINSURED INTEREST77771
State Farm Mutual Automobile Insurance Company 2157-F913-G
NAMED INSURED: POLICY NO: 0571122-El7.06L CAR 027 COVERAGE:
VINEY TRUCKING INC YR/MAKE/MODEL: 2000 CLEMENT TRAILER
PO BOX 1446 VIN/CAMPER: 5C2683213XYM002671
LAPORTE CO 80535.1446 AGENT NAME: DARYL ALEXANDER INS AGCY INC
AGENT PHONE: (970)493-2196
3RD PARTY INTEREST TERMINATED
POLICY MESSAGES: EFFECTIVE OCT 26 2011
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.
N
N
:. .. .. .
NOT tC (?F TERMINATION OF AN ADDITIONAL' INSURED, INTEREST
State Farm Mutual Automobile Insurance Company 2157-F913-G
NAMED INSURED: POLICY NO: 0571122-El7-06L CAR 038 COVERAGE:
VINEY TRUCKING INC YR/MAKE/MODEL: 1999 CMC TRAILER
PO BOX 1446 VIN/CAMPER: 1 T91 F3925X1247361
LAPORTE CO 80535-1446 AGENT NAME: DARYL ALEXANDER INS AGCY INC
AGENT PHONE: (970)493-2196
3RD PARTY INTEREST TERMINATED
EFFECTIVE OCT 26 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,
v
maintenance, or use of the car described in the policy.
N '
mN
O
R
NOTICE OF TERMINATION OF AN. ADDITIONAL INSURED. INTEREST
State Farm Mutual Automobile Insurance Company
NAMED INSURED:
POLICY NO:
VINEY TRUCKING INC
YR/MAKE/MODEL:
PO BOX 1446
VIN/CAMPER:
LAPORTE CO 80535-1446
AGENT NAME:
AGENT PHONE:
2157-F913-G
0571122-El7-06L CAR 060 COVERAGE:
1999 RANCO TRL
1R9ES6507XL008976
DARYL ALEXANDER INS AGCYINC
(970)493.2196
3RD PARTY INTEREST TERMINATED
EFFECTIVE OCT 26 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.
9
N
N
A
NOTICE OF_TERMINATION:OF AN ADDITIONAL INSURED. INTEREST
State Farm Mutual Automobile Insurance Company
NAMED INSURED:
POLICY NO:
VINEY TRUCKING INC
YR/MAKE/MODEL:
PO BOX 1446
VIN/CAMPER:
LAPORTE CO 80535.1446
AGENT NAME:
AGENT PHONE:
2157-F913-G
057 1122-El7.06L CAR 064 COVERAGE:
2006 TRAIL KING TRL
1TKLC412X6W024736
DARYL ALEXANDER INS AGCY INC
(970)493-2196
3RD PARTY INTEREST TERMINATED
EFFECTIVE OCT 26 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,
0
maintenance, or use of the car described in the policy.
n
N
O
O
N
_a
STATE FARM INSURANCE COMPANIES®
�s
• 1555 Promontory Circle
Greeley CO 80638-0001
96
20 A
002949 0055
CITY OF FORT COLLINS FINANCIAL
SERVICES PURCHASING DIVISION
PO BOX
580
FORT COLLINSLI
CO 80522-0580
DATE OF NOTICE: OCT 13 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
State Farm Mutual Automobile Insurance Company 2157-F913-G
NAMED INSURED:
POLICY NO: 0571122-El7-06L CAR 066 COVERAGE:
VINEY TRUCKING INC
YR/MAKE/MODEL: 2006 TRAIL KING TRAILER
N PO BOX 1446
VIN/CAMPER: 1TKLO41246WO54556
IAPORTE CO 80535-1446
AGENT NAME: DARYL ALEXANDER INS AGCY INC
>
AGENT PHONE: (970)493-2196
3RD PARTY INTEREST TERMINATED
m
EFFECTIVE OCT 26 2011
N 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,
ui maintenance, or use of the car described in the policy.
NOTICE OF TERMINATION OF AN ADDITIONAL INSUREWNTEREST
...
State Farm Mutual Automobile Insurance Company
2157-F913-G
NAMED INSURED: POLICY NO:
0571122-Ell-061- CAR 067 COVERAGE:
VINEY TRUCKING INC YR/MAKE/MODEL:
2006 RANCO TRL DUMP
PO BOX 1446 VIN/CAMPER:
1 R9BSE50561-008848
LAPORTE CO 80535.1446 AGENT NAME:
DARYL ALEXANDER INS AGCY INC
AGENT PHONE:
(970)493-2196
- - -
- 3RD PARTY INTEREST TERMINATED -
EFFECTIVE OCT 26 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,
0
maintenance, or use of the car described in the policy.
m
FRT