HomeMy WebLinkAbout549678 ROCKY MOUNTAIN FENCE INC - INSURANCE CERTIFICATEStateFarm STATE FARM®
PO Box 9009
Tempe, AZ 85281-9709
DATE OF NOTICE: DEC 12 2016
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AT1 20
CITY OF FORT
PO BOX 582
FORT COLLINS
17A
A
000728 0093
COLLINS
CO 80522-0582
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
2258-FAF1-A
NAMED INSURED: POLICY NO:
211 9133-E11-06E
COVERAGE:
ROCKY MOUNTAIN DECK & FENCE YR/MAKE/MODEL:
2016 RAM PICKUP
BI AND PD LIABILITY
$ i MIL 1 MIL I$ 1 MIL
INC VIN/CAMPER:
3C63R3DL2GG127984
E
DED.
3167 HUDSON CT AGENT NAME:
THE BEST INSURANCE AGENCY INC $1000 COLL.
LOVELAND CO 80538-4935 AGENT PHONE:
(970)330-1100
ENDORSEMENT NO:
6028BT
POLICY EFFECTIVE
DEC 01 2016 UNTIL TERMINATED
POLICY MESSAGES: This policy shown above supersedes policy# 2119133-06D.
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.