HomeMy WebLinkAbout129614 PROFESSIONAL DOCUMENT SOLUTIONS INC - INSURANCE CERTIFICATE (5)StateF&M STATE FARM@
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PO Box 853922
Richardson, TX 75085-3922
DATE OF NOTICE: MAY 01 2018
CODE:
AT1 20
CITY OF FORT
PO BOX 590
E-1 FORT COLLINS
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130
003491 0055
COLLINS
CO 80522-0590
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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.
NOTICE OF THIRD PARTY'S COVERAGE
State Farm Mutual Automobile Insurance Company
1478-FAF1-A
NAMED INSURED: POLICY NO:
446 4337-DO3-06
COVERAGE:
PROFESSIONAL DOCUMENT YR/MAKE/MODEL:
2010 FORD CRGO VAN
$1000 DED. COMP.
SOLUTIONS INC VIN/CAMPER:
NMOLS6AN6ATQ07455
$1000 DED. COLL.
TAFOYA, TROY AGENT NAME:
DAVE LAWSER
4114 S TIMBERLINE RD UNIT 100 AGENT PHONE:
(970)226-1306
FORT COLLINS CO 80525-6026
POLICY EFFECTIVE
APR 03 2018 UNTIL TERMINATED
POLICY MESSAGES:
The policy includes a loss payable clause protecting the third party's interest in the described car to the extent of the insurance provided and
subject to all policy provisions. The third party 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 third party 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