HomeMy WebLinkAbout357006 LYNNETTE KEIM DBA ALL AMERICAN BACKFLOW - INSURANCE CERTIFICATE (3)ALLSTATE LIENHOLDER SERVICE CENTER
PO BO.0 660349
DALLAS, TV 75266-0349
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CITY OF FORT COLLINS
PO BOX 580
FORT COLLINS CO 80522-0580
CERTIFICATE OF INSUILINCE
ALLSTATE INSURANCE COMPANY
Northbrook,lllinois, certifies that the following insurance is in force:
POLICYHOLDER POLICY NUMBER
LYNNETTE KEIM 9 76 517567 06/01
3912 W EISENHOWER BLVD
LOVELAND CO 80537-7904
Date: 10!22/14
EFFECTIVE DATE
OF CERTIFICATE
DECEMBER 1, 2014
POLICY PERIOD
DECEMBER I, 2014 At 12.01 A.M.
JUNE1,2015 Slud.mTi,s�
The person or organization designated below is described in the policy as:
CITY OF FORT COLLINS LIENHOLDER
PO BOX 580 (Loss Payable Clause)
FOWI'COLLINSCO 80522-0580
RX ADDITIONAL
INTERESTED PARTY
AGENT SECURITY INS GROUP
PHONE (970) 378-4818
Coverages designated below are afforded for each described vehicle:
BI $300,000 EA.PERS.- $500,000 EA.00C. 1995 JIMMY
PI) $300,000EA.00C. IGKDT13W7S2554999
Collision- DF,D. Comprehensive -No Comprehensive Coverage
See reverse side for provisions concerning Loss Payable Clause and Additional Interested Party.
This Certificate of Insurance neither affirmatively nor negatively amends, extends or alters the coverage
afforded by the policy referred to above.
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The Loss Payable Clause of such policy provides
"The company reserves the right to cancel such policy at any time as provided by its terms, but in such
case the company shall notify the Lienholder when not less than ten days thereafter such cancellation shall
be effective as to the interest of said Lienholder therein and the company shall have the right, on like
notice, to cancel this agreement."
The Additional Interest Endorsement of such policy, in part, provides:
"...such insurance as is afforded by the policy" for automobile liability insurance listed on the reverse side
hereof applies also to the person or organization named as Additional Interested Party.
"As respects such... interest, no cancellation ... and no endorsement... adversely affecting such additional
interest, shall be effective until ten (10) days following the mailing of written notice (to the person or
organization) of such cancellation or endorsement..:'
601952486827P