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HomeMy WebLinkAbout112297 VINEY TRUCKING INC - INSURANCE CERTIFICATE (32)StateFarm STATE FARM® PO Box 853922 Richardson, TX 75085-3922 28A 20 000752 0093 CITY OF FORT COLLINS FINANCIAL SERVICES PURCHASING DIVISION PO BOX 580 FORT COLLINSLI CO 80522-0580 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. ADDITIONAL INSURED'S NOTICE OF COVERAGE State Farm Mutual Automobile Insurance Company 2157-FAF1-A NAMED INSURED: POLICY NO: 057 1122-E17-06R CAR 072 COVERAGE: e VINEY TRUCKING INC YR/MAKE/MODEL: 2008 TRAIL KING TRAILER $1000 DED. COMP. PO BOX 1446 VIN/CAMPER: 1TKLC41258WO38627 $1000 DED. COLL. LAPORTE CO 80535-1446 AGENT NAME: DARYL ALEXANDER INS AGCY INC 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. co I 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 co is provided, it shall be presumed that the required renewal premiums have been paid. The additional insured must notify us within 10 days of c 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 075 COVERAGE: VINEY TRUCKING INC YR/MAKE/MODEL: 2005 KENWORTH TRACTOR BI AND PD LIABILITY PO BOX 1446 VIN/CAMPER: iXKWDB9X95R096258 $2MIL 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. o 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. $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 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 ADDITIONAL INSURED'S NOTICE OF COVERAGE State Farm Mutual Automobile Insurance Company 2157-FAF1-A NAMED INSURED: POLICY NO: 057 1122-E17-06R CAR 081 COVERAGE: VINEY TRUCKING INC YR/MAKE/MODEL: NONOWNED AUTO BI AND PD LIABILITY PO BOX 1446 VIN/CAMPER: $ 2 MIL LAPORTE CO 80535-1446 AGENT NAME: DARYL ALEXANDER INS AGCY INC AGENT PHONE: (970)493-2196 ENDORSEMENT NO: 6028BT POLICY EFFECTIVE 6164CR 6165BT 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. W 0 m ADDITIONAL INSURED'S NOTICE OF COVERAGE State Farm Mutual Automobile Insurance Company 2157-FAFl-A NAMED INSURED: POLICY NO: 057 1122-E17-06R CAR 097 COVERAGE: VINEY TRUCKING INC YR/MAKE/MODEL: 2005 PETERBILT SEMI TRK BI AND PD LIABILITY PO BOX 1446 VIN/CAMPER: 1XP5DB9X55D856513 $ 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# 0571122-06Q. 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-FAFl-A NAMED INSURED: POLICY NO: 057 1122-E17-06R CAR 098 COVERAGE: VINEY TRUCKING INC YR/MAKE/MODEL: 2004 PETERBILT SEMI TRK BI AND PD LIABILITY PO BOX 1446 VIN/CAMPER: 1 XP5DB9X94D818538 $ 2 MIL LAPORTE CO 80535-1446 AGENT NAME: DARYL ALEXANDER INS AGCY INC $1000 DIED. 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. 0 0 co ADDITIONAL INSURED'S NOTICE OF COVERAGE State Farm Mutual Automobile Insurance Company 2157-FAF1-A NAMED INSURED: POLICY NO: 057 1122-E17-06R CAR 099 COVERAGE: VINEY TRUCKING INC YR/MAKE/MODEL: 2014 SIDUMP R TRL DMP $1000 DED. COMP. PO BOX 1446 VIN/CAMPER: 1 D9FS4026EC688179 $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. 0 m BCK1