HomeMy WebLinkAbout112297 VINEY TRUCKING INC - INSURANCE CERTIFICATE (10)STATE FARM INSURANCE COMPANIES®
O 1555 Promontorryy Circle
Greeley CO 80638-0001
DATE OF NOTICE: MAY 23 2012
CODE: 33380
19A
AT1 20
OOM91 0093
CITY OF FORT COLLINS FINANCIAL
SERVICES PURCHASING DIVISION
PO BOX
580
FORT COLLINSLI
CO 80522-0580
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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 COVERAGE
State Farm Mutual Automobile Insurance Company 2157-F913-G
NAMED INSURED: C� j POLICY NO: 0571122-E17-06M CAR 013 COVERAGE:
VINEY TRUCKING INC 11 LL I I YR/MAKE/MODEL: 1997 PETERBILT TRACTOR BI AND PD LIABILITY
PO BOX 1446 VIN/CAMPER: 1XP5DB8X2VD433065 $ 2 MIL
LAPORTE CO 80535-1446 AGENT NAME: DARYL ALEXANDER INS AGCY INC
> AGENT PHONE: (970)493-2196
ENDORSEMENT NO: 6028BT POLICY EFFECTIVE
o MAY 17 2012 UNTIL TERMINATED
ry POLICY MESSAGES: This policy shown above supersedes policy# 0571122-06L.
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. Unfit 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.
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ADDITIONAL INSUREWS NOTICE OF COVERAGE
State Farm Mutual Automobile Insurance Company 2157-F913-G
NAMED INSURED: POLICY NO: 0571122-El7-06M CAR 023 COVERAGE:
VINEY TRUCKING INC YR/MAKE/MODEL: 1994 PETERBILT TRACTOR BI AND PD LIABILITY
PO BOX 1446 - VIN/CAMPER: 1XP5DR9X7RD347733 $ 2 MIL
LAPORTE CO 80535-1446 - AGENT NAME: DARYL ALEXANDER INS AGCY INC
AGENT PHONE (970)493-2196 .
- ENDORSEMENT NO*.602tiBT- -- — -__ ._-..-. ;POLICY -EFFECTIVE
MAY 17 2012 UNTIL TERMINATED
POLICY MESSAGES: This policy shown above supersedes policy# 0571122-06L.
The policy includes a lose 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.
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ADDITIONAL INSURED'S NOTICE OF COVERAGE
State Farm Mutual Automobile Insurance Company 2157-F913-G
NAMED INSURED: POLICY NO: 0571122-E17-06M CAR 033 COVERAGE:
VINEY TRUCKING INC YR/MAKE/MODEL: 1996 PETERBILT TRACTOR BI AND PD LIABILITY
PO BOX 1446 VIN/CAMPER: 1XPFDB9X4TD398321 $ 2 MIL
LAPORTE CO 80535-1446 AGENT NAME: DARYL ALEXANDER INS AGCY INC
AGENT PHONE (970)493-2196
ENDORSEMENT NO: 6028BT POLICY EFFECTIVE
MAY 172012 UNTIL TERMINATED
POLICY MESSAGES: This policy shown above supersedes policy# 0571122-06L.
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.
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OSTATE FARM INSURANCE COMPANIES®
1555 Promontorryy Circe DATE OF NOTICE: MAY 23 2012
Greeley CO 80636-0001 CODE: 33380
19A
20 A .
000wl S FINANCIAL
N- NOTE: PLEASE NOTIFY STATE FARM AT THE
CITY OF FORT ADDRESS LISTED AT THE TOP, LEFT CORNER
SERVICES PURCHASING
ASING DIVISION OF THIS PAGE REGARDING ANY CHANGE OF
LW� PO BOX 580 ADDRESS INFORMATION.
Kai FORT COLLINS CO 80522-0580
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ADDITIONALINSURED'S NOTICE OF COVERAGE
State Farm Mutual Automobile Insurance Company 2157-F913-G
NAMED INSURED: POLICY NO: 0571122-EI7-06M CAR 064 COVERAGE:
e VINEY TRUCKING INC YR/MAKE/MODEL: 2001 PETERBILT TRACTOR BI AND PD LIABILITY
PO BOX 1446 VIN/CAMPER: 1XP5DB9X41 D541292 $ 2 MIL
LAPORTE CO 80535-1446 AGENT NAME: DARYLALEXANDER INS AGCY INC
> AGENT PHONE: (970)493-2196
a° ENDORSEMENT NO: 6028BT POLICY EFFECTIVE
m MAY 17 2012 UNTIL TERMINATED
F POLICY MESSAGES: This policy shown above supersedes policy# 0571122-06L.
AThe 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
FNv' any change of interest or ownership coming to their attention. Failure to do so will render this policy null and void.
e
ADDITIONAL INSURED'S NOTICE OF COVERAGE
..
State Farm Mutual Automobile Insurance Company
2157-F913-G
NAMED INSURED: POLICY NO:
0571122-El7-06M
CAR 065 COVERAGE:
VINEY TRUCKING INC YR/MAKE/MODEL:
2003 TRAVIS TRL
$1000 DED. COMP.
PO BOX 1446 VIN/CAMPER:
48X1F382431002603
$1000 DED. COLL.
LAPORTE CO 80535-1446 AGENT NAME:
DARYL ALEXANDER INS AGCY INC
_ AGENT PHONE:
(970)493-2196
- '-' -ENDORSEMENT NO:
6028ST " -
POLICY EFFECTIVE -
MAY 17 2012 UNTIL TERMINATED
POLICY MESSAGES: This policy shown above supersedes policy# 0571122-06L.
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.
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ADDITIONAL INSURED'S NOTICE OF COVERAGE
State Farm Mutual Automobile Insurance Company 2157-F913-G
NAMED INSURED: POLICY NO: 0571122-E77-06M CAR 081 COVERAGE:
VINEY TRUCKING INC YR/MAKE/MODEL: NONOWNED AUTO BI AND PD LIABILITY
PC BOX 1446 VIN/CAMPER: $ 2 MIL
LAPORTE CO. 80535-1446 AGENT NAME: DARYL ALEXANDER INS AGCY INC
AGENT PHONE: (970)493-2196
ENDORSEMENT NO: 6028BT POLICY EFFECTIVE
6164OR 6165BT MAY 172012 UNTIL TERMINATED
POLICY MESSAGES: This policy shown above supersedes policy# 0571122-06L.
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
STATE FARM INSURANCE COMPANIES®
O 1555 Promontorryy Circle
Greeley 00 80636-0001
30A
AT1 20 A
000a94 0093
CITY OF FORT COLLINS FINANCIAL
SERVICES PURCHASING DIVISION
.i PO BOX 580
FORT COLLINS CO 80522-0580
DATE OF NOTICE: MAY 17 2012
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.
ADDITIONAL INSURED'S NOTICE OF.COVERAGE :.
State Farm Mutual Automobile Insurance Company
2157-F913-G
NAMED INSURED: POLICY NO:
0571122-El7-06M CAR 013 COVERAGE:
VINEY TRUCKING INC YR/MAKE/MODEL:
1997 PETERBILT TRACTOR BI AND PD LIABILITY
$2MIL
PO BOX 1446 VIN/CAMPER:
1 XP5DB8X2VD433065
LAPORTE CO 80535-1446 AGENT NAME:
DARYL ALEXANDER INS AGCY INC
AGENT PHONE:
(970)493-2196
ENDORSEMENT NO:
6028BT POLICY EFFECTIVE
u MAY 17 2012 UNTIL TERMINATED
n POLICY MESSAGES: This policy shown above supersedes policy# 0571122-06L.
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.
ADDITIONAL INSURED'S NOTICE OF COVERAGE::.,
State Farm Mutual Automobile Insurance Company 2157-F913-G
NAMED INSURED: POLICY NO: 0571122-El7-06M CAR 023 COVERAGE:
VINEY TRUCKING INC YR/MAKE/MODEL: 1994 PETERBILT TRACTOR 81 AND PD LIABILITY
PO BOX 1446 VIN/CAMPER: 1 XP5DR9X7RD347733 $2MIL
LAPORTE CO 80535-1446 AGENT NAME: DARYL ALEXANDER INS AGCY INC
_ AGENT PHONE: (970)493-2196 - -
-- - -- -- - - ENDORSEMENT NO: 6028BT - --` -- •POLICY EFFECTIVE---- - — - - --- -
MAY 17 2012 UNTIL TERMINATED
POLICY MESSAGES: This policy shown above supersedes policy# 0571122-06L.
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
R' any change of interest or ownership coming to their attention. Failure to do so will render this policy null and void.
m
ADDITIONAL INSURED'S NOTICE OF COVERAGE::.7771
State Farm Mutual Automobile Insurance Company 2157-F913-G
NAMED INSURED: POLICY NO: 0571122-El7-06M CAR 033 COVERAGE:
VINEY TRUCKING INC YR/MAKE/MODEL: 1996 PETERBILT TRACTOR BI AND PD LIABILITY
PO BOX 1446 VIN/CAMPER: 1XPFDB9X4TD398321 $2MIL
LAPORTE CO 80535-1446 AGENT NAME: DARYL ALEXANDER INS AGCY INC
AGENTPHONE: (970)493-2196
ENDORSEMENT NO: 6028BT POLICY EFFECTIVE
MAY 17 2012 UNTIL TERMINATED
POLICY MESSAGES: This policy shown above supersedes policy# 0571122-06L.
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.
Bm FRT
STATE FARM INSURANCE COMPANIES®
O 1555 Promontorryy Circle ..
Greeley CO 8063E-0001
DATE OF NOTICE: MAY 17 2012
CODE: 33380
10100
20
000994 0093
CITY OF FORT COLLINS FINANCIAL
SERVICES PURCHASING DIVISION
PO BOX 580
L FORT COLLINS CO 80522-0580
A
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 COVERAGE
State Farm Mutual Automobile Insurance Company 2157-F913-G
NAMED INSURED: POLICY NO: 0571122-El7-06M CAR 063 COVERAGE:
ge VINEY TRUCKING INC YR/MAKE/MODEL: 2003 KENWORTH TRACTOR BI AND PO LIABILITY
r;+ PO BOX 1446 VIN/CAMPER: 1XKWD89X13J705001 $2MIL
LAPORTE CO 80535-1446 AGENT NAME: DARYL ALEXANDER INS AGCY INC
> AGENT PHONE: (970)493-2196
ENDORSEMENT NO: 6028BT POLICY EFFECTIVE
m MAY 17 2012 UNTIL TERMINATED
F POLICY MESSAGES: This policy shown above supersedes policy# 0571122-06L.
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 it 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.
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n
ADDITIONALINSURED'S NOTICE OF COVERAGE
State Farm Mutual Automobile Insurance Company 2157-F913-G
NAMED INSURED: POLICY NO: 0571122-E17-06M CAR 065 COVERAGE:
VINEY TRUCKING INC YR/MAKE/MODEL: 2003 TRAVIS TRL $1000 DED. COMP.
PO BOX 1446 VIN/CAMPER: 48Xl F382431002603 $1000 DED. COLL.
LAPORTE CO 80535-1446 AGENT NAME: DARYL ALEXANDER INS AGCY INC
AGENT PHONE: (970)493-2196
ENDORSEMENT NO: 6028BT POLICY EFFECTIVE --
MAY 17 2012 UNTIL TERMINATED
POLICY MESSAGES: This policy shown above supersedes policy# 0571122-06L.
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.
m
ADDITIONAL INSURED'S NOTICE OF COVERAGE
State Farm Mutual Automobile Insurance Company 2157-F913-G
NAMED INSURED: POLICY NO: 0571122-E17-06M CAR 070 COVERAGE:
VINEY TRUCKING INC YR/MAKE/MODEL: 2005 PETERBILT TRACTOR BI AND PD LIABILITY
POBOX1446 VIN/CAMPER: 1 XP5DB9Xl 513846500 $2MIL
LAPORTE 0080535-1446 AGENTNAME: DARYL ALEXANDER INS AGCY INC $1000DED. COMP.
AGENT PHONE: (970)493-2196 $1000DED. COLL.
'
ENDORSEMENT NO: 6028ST POLICY EFFECTIVE
MAY 17 2012 UNTIL TERMINATED
POLICY MESSAGES: This policy shown above supersedes policy# 0571122-06L.
The policy includes a lose 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
STATE FARM INSURANCE COMPANIES®
O 1555 Promontorryy Circle
Greeley CO 80636-0001
DATE OF NOTICE: MAY 17 2012
CODE: 33380
30A
20 A
000494 0093
CITY OF FORT COLLINS FINANCIAL
SERVICES PURCHASING DIVISION
PO BOX 580'
FORT COLLINS CO 80522-0580
NOTE: PLEASE NOTIFY STATE FARM AT THE
ADDRESS LISTED AT THE TOP,. LEFT CORNER
OF THIS PAGE REGARDING ANY CHANGE OF
ADDRESS INFORMATION.
ADDITIONAL INSUREDS NOTICE OF COVERAGE
State Farm Mutual Automobile Insurance Company 2157-F913-G
NAMED INSURED: POLICY NO: 0571122-E17-06M CAR 075 COVERAGE:
S VINEY TRUCKING INC YR/MAKE/MODEL: 2005 KENWORTH TRACTOR BI AND PD LIABILITY
�,+ PO BOX 1446 VIN/CAMPER: 1XKWDB9X95R096258 $2MIDED.COMP.
LAPORTE CO 80535-1446 AGENT NAME: DARYL ALEXANDER INS AGCY INC $1000 DED. COLL.
> AGENT PHONE: (970)493-2196
z ENDORSEMENT NO: 6028BT POLICY EFFECTIVE
m MAY 17 2012 UNTIL TERMINATED
& POLICY MESSAGES: This policy shown above supersedes policy# 0571122-06L.
The policy includes a lose 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. Unfit such notice
v� 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.
e
A
ADDITIONALINSURED'S NOTICE OF COVERAGE
State Farm Mutual Automobile Insurance Company 2157-F913-G
NAMED INSURED: POLICY NO: 0571122-E17-06M CAR 076 COVERAGE:
VINEY TRUCKING INC YR/MAKE/MODEL: 2008 TRAIL KING TRAILER $1000 DED. COMP.
PO BOX 1446 VIN/CAMPER: 1TKSC40268W054963 $1000 DED. COLL.
LAPORTE CO 80535-1446 AGENT NAME: DARYL ALEXANDER INS AGGY INC
AGENT PHONE: (970)493-2196 _
ENDORSEMENT NO: 6028ST POLICY EFFECTIVE —
MAY -
MAY 17 2012 UNTIL TERMINATED
POLICY MESSAGES: This policy shown above supersedes policy# 0571122-06L.
The policy includes a lose 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.
m
ADDITIONAL INSURED'S NOTICE OF COVERAGE .::
State Farm Mutual Automobile Insurance Company 2157-F913-G
NAMED INSURED: POLICY NO: 0571122-E17-06M CAR 079 COVERAGE:
VINEY TRUCKING INC YR/MAKE/MODEL: 2001 PETERBILT TRACTOR BI AND PD LIABILITY
PO BOX 1446 VIN/CAMPER: 1XPFD89X41N541260 $2MIL
LAPORTE CO 80535-1446 AGENT NAME: DARYL ALEXANDER INS AGCY INC
AGENT PHONE: (970)493-2196
ENDORSEMENT NO: 6028BT POLICY EFFECTIVE
MAY 17 2012 UNTIL TERMINATED
POLICY MESSAGES: This policy shown above supersedes policy# 0571122-06L.
The policy includes a lose 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 auch 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
a any change of interest or ownership coming to their attention. Failure to do so will render this policy null and void.
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