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Home My WebLink About112297 VINEY TRUCKING INC - INSURANCE CERTIFICATE (31)StafeFaM STATE FARM® PO Box 853922 Richardson, TX 75085-3922 28A AT1 20 000752 0093 CITY OF FORT COLLINS FINANCIAL SERVICES PURCHASING DIVISION PO BOX 580 FORT COLLINS CO 80522-0580 I l 1, l l l l JillI I I I I I' l l l l l l l l l' l l l l 1,111"1"I 1111111111"Ill Jill I DATE OF NOTICE: MAY 17 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. 'ADITIONAL 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 $ 2 MIL LAPORTE CO 80535-1446 AGENT NAME: DARYL ALEXANDER INS AGCY INC $1000 DED. COMP. o $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# 0571122-06Q. 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 W 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. 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. 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. R ADDITIONAL INSURED'S NOTICE OF COVERAGE State Farm Mutual Automobile Insurance Company 2157-FAF1-A NAMED INSURED: POLICY NO: 057 1122-E17-06R CAR 054 COVERAGE: VINEY TRUCKING INC YR/MAKE/MODEL: 2001 PETERBILT TRACTOR BI AND PD LIABILITY PO BOX 1446 VIN/CAMPER: 1XP5DB9X41 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 any change of interest or ownership coming to their attention. Failure to do so will render this policy null and void. FRT I N co R N I`o I � N 1v0 ADDITIONAL INSURED'S NOTICE OF COVERAGE State Farm Mutual Automobile Insurance Company 2157-FAF1-A NAMED INSURED: POLICY NO: 057 1122-E17-06R CAR 059 COVERAGE: VINEY TRUCKING INC YR/MAKE/MODEL: 2006 TRAVIS TRL DUMP $1000 DED. COMP. PO BOX 1446 VIN/CAMPER: 48X1 F392861004289 $1000 DED. COLL. LAPORTE CO 80535-1446 AGENT NAME: DARYL ALEXANDER INS AGCY INC AGENT PHONE: (970)493-2196 ENDORSEMENT NO: 6028BT POLICY EFFECTIVE POLICY MESSAGES: This policy shown above supersedes policy# 0571122-06Q. MAY 17 2017 UNTIL TERMINATED The policy includes a loss payable clause protecting the additional insured's interest in the described car to the extent of the insurance provided and subject to all policy provisions. The additional insured will be given 10 days notice if the policy is terminated. Until such notice is provided, it shall be presumed that the required renewal premiums have been paid. The additional insured must notify us within 10 days of any change of interest or ownership coming to their attention. Failure to do so will render this policy null and void. ADDITIONAL INSURED'$ 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 $t o00 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. 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 F362431002603 $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 any change of interest or ownership coming to their attention. Failure to do so will render this policy null and void. ADDITIONAL INSURED'S NOTICE OF COVERAGE State Farm Mutual Automobile Insurance Company 2157-FAF1-A NAMED INSURED: POLICY NO: 057 1122-E17-06R CAR 070 COVERAGE: VINEY TRUCKING INC YR/MAKE/MODEL: 2005 PETERBILT TRACTOR BI AND PD LIABILITY PO BOX 1446 VIN/CAMPER: 1 XP5DB9X15D846500 $ 2 MIL LAPORTE CO 80535-1446 AGENT NAME: DARYL ALEXANDER INS AGCY INC $1000 DED. COMP. AGENT PHONE: (970)493-2196 $1000 DED. LOLL. 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. BCK1