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HomeMy WebLinkAbout127666 MICHAEL TRUCKING - INSURANCE CERTIFICATE (19)AASTATE FARM INSURANCE COMPANIES®
1555 Promontorryy Circle
Greeley CO 80638-0001
23A
AT1 20 A
000542 0093
CITY OF FORT COLLINS
215 N MASON ST
FORT COLLINS CO 80524-4402
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DATE OF NOTICE: APR 24 2014
CODE:
NOTE: PLEASE NOTIFY STATE FARM AT THE
ADDRESS LISTED AT THE TOP, LEFT CORNER
OF THIS PAGE REGARDING ANY CHANGE OF
ADDRESS INFORMATION.
State Farm Fire and Casualty Company 1680-FAFi-I
NAMED INSURED: POLICY NO: 279 3128-C18.06C COVERAGE:
S MICHAEL, DWIGHT YR/MAKE/MODEL: 19971NTERNATIO DUMP BI AND PD LIABILITY
2450 W ELIZABETH 8T VIN/CAMPER: 1 HT8HADR5VH473601 $ 1 MIL
FORT COLLINS CO 80521.4120 AGENT NAME: GARV CRAMER $2000 DED. COMP.
$2000 DED. COLL.
> AGENTPHONE: (970)484-1374
ENDORSEMENT NO: 6028BT POLICY EFFECTIVE
r APR 18 2014 UNTIL TERMINATED
POLICY MESSAGES: This policy shown above supersedes policyi 2793128-066.
The policy includes a loss payable clause protecting the additional insured's Interest in the described oar to the e)dent 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
u� Is provided, it shall be presumed that the required renewal premiums have been paid. The additional Insured must notlfy us within 10 days of
vt 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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