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Home My WebLink About112297 VINEY TRUCKING INC - INSURANCE CERTIFICATE (27)StateFarm STATE FARM® AL PO Box 853922 Richardson; TX 75085-3922 14A AT1 20 000828 0093 CITY OF FORT COLLINS FINANCIAL SERVICES PURCHASING DIVISION ,:- PO BOX 580 ��• FORT COLLINS CO 80522-0580 �I��II�IIIIIII�II��I�.... IIl1-1111111111111f111111'1III-1-111111 A DATE OF NOTICE: JUN 07 2017 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-FAF1-A NAMED INSURED: POLICY NO: 057 1122-E17-06R CAR 017 COVERAGE: VINEY TRUCKING INC YR/MAKE/MODEL: 2008 PETERBILT SEMI TRK BI AND PD LIABILITY PO BOX 1446 VIN/CAMPER: 1 XPXD49X78D755529 $10 01 DED. COMP. LAPORTE CO 80535-1446 AGENT NAME: DARYL ALEXANDER INS AGCY INC $1000 DED. COLL. o AGENT PHONE: (970)493-2196 o ENDORSEMENT NO: 6028BT POLICY EFFECTIVE MAY 17 2017 UNTIL TERMINATED POLICY MESSAGES: This policy shown above supersedes policy# 0571122-06Q. The policy includes a loss payable clause protecting the additional insured's interest in the described car to the extent of the insurance o 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 g any change of interest or ownership coming to their attention. Failure to do so will render this policy null and void. 0 N ADDITIONAL INSURED'S NOTICE OF COVERAGE State Farm Mutual Automobile Insurance Company 2157-FAF1-A NAMED INSURED: POLICY NO: 057 1122-E17-06R 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 $1000 DED. COMP. $1000 DED. COLL. AGENT PHONE: (970)493-2196 ENDORSEMENT NO: 6028BT POLICY EFFECTIVE MAY 17 2017 UNTIL TERMINATED POLICY MESSAGES: This policy shown above supersedes policy# 0571122-060. 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. w 0 A ADDITIONAL INSURED'S NOTICE OF COVERAGE { State Farm Mutual Automobile Insurance Company 2157-FAFl-A NAMED INSURED: POLICY NO: 057 1122-E17-06R OAR054 COVERAGE: VINEY TRUCKING INC YR/MAKE/MODEL: 2001 PETERBILT TRACTOR BI AND PD LIABILITY PO BOX 1446 VIN/CAMPER: 1 XP5DB9X41 D541292 $ 2 MIL LAPORTE CO 80535-1446 AGENT NAME: DARYL ALEXANDER INS AGCY INC $1000 DED. COMP. $1000 DED. LOLL. AGENT PHONE: (970)493-2196 ENDORSEMENT NO: 6028BT POLICY EFFECTIVE MAY 17 2017 UNTIL TERMINATED POLICY MESSAGES: This policy shown above supersedes policy# 0571122-06Q. 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 N any change of interest or ownership coming to their attention. Failure to do so will render this policy null and void. OD FRT ADDITIONAL INSURED'S NOTICE OF COVERAGE State Farm Mutual Automobile Insurance Company 2157-FAF1-A NAMED INSURED: POLICY NO: 057 1122-E17-06R CAR 063 COVERAGE: VINEY TRUCKING INC YR/MAKE/MODEL: 2003 KENWORTH TRACTOR BI AND PD LIABILITY PO BOX 1446 VIN/CAMPER: 1 XKWD89X13J705001 $ 2 MIL LAPORTE CO 80535-1446 AGENT NAME: DARYL ALEXANDER INS AGCY INC $1000 DED. COMP. AGENT PHONE: (970)493-2196 $1000 DED. COLL. ENDORSEMENT NO: 6028BT POLICY EFFECTIVE POLICY MESSAGES: This policy shown above supersedes policy# 0571122-06Q. MAY 17 2017 UNTIL TERMINATED 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 m any change of interest or ownership coming to their attention. Failure to do so will render this policy null and void. 0 ADDITIONAL INSURED'S NOTICE OF COVERAGE State Farm Mutual Automobile Insurance Company 2157-FAF1-A NAMED INSURED: POLICY NO: 057 1122-E17-06R CAR 065 COVERAGE: VINEY TRUCKING INC YR/MAKE/MODEL: 2003 TRAVIS TRL $1000 DED. COMP. PO BOX 1446 VIN/CAMPER: 48X1 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 2017 UNTIL TERMINATED POLICY MESSAGES: This policy shown above supersedes policy# 0571122-06Q. 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 N any change of interest or ownership coming to their attention. Failure to do so will render this policy null and void. co 0 m ADDITIONAL INSURED'S NOTICE OF COVERAGE State Farm Mutual Automobile Insurance Company 2157-FAF1-A NAMED INSURED: POLICY NO: 057 1122-E17-06R CAR 075 COVERAGE: VINEY TRUCKING INC YR/MAKE/MODEL: 2005 KENWORTH TRACTOR BI AND PD LIABILITY PO BOX 1446 VIN/CAMPER: 1XKWDB9X95R096258 $ 2 MIL LAPORTE CO 80535-1446 AGENT NAME: DARYL ALEXANDER INS AGCY INC $1000 DED. COMP. AGENT PHONE: (970)493-2196 $1000 DED. COLL. ENDORSEMENT NO: 6028BT POLICY EFFECTIVE MAY 17 2017 UNTIL TERMINATED POLICY MESSAGES: This policy shown above supersedes policy# 0571122-06Q. 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. N O O 10 ADDITIONAL INSURED'S NOTICE OF COVERAGE State Farm Mutual Automobile Insurance Company 2157-FAF1-A NAMED INSURED: POLICY NO: 057 1122-E17-06R CAR 079 COVERAGE: VINEY TRUCKING INC YR/MAKE/MODEL: 2001 PETERBILT TRACTOR BI AND PD LIABILITY PO BOX 1446 VIN/CAMPER: 1 XPFDB9X41 N541260 $ 2 MIL LAPORTE CO 80535-1446 AGENT NAME: DARYL ALEXANDER INS AGCY INC $1000 DED. COMP. AGENT PHONE: (970)493-2196 $1000 DED. COLL. ENDORSEMENT NO: 6028BT POLICY EFFECTIVE MAY 17 2017 UNTIL TERMINATED POLICY MESSAGES: This policy shown above supersedes policy# 0571122-06Q. 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 N any change of interest or ownership coming to their attention. Failure to do so will render this policy null and void. 0 r3CK1