No preview available
HomeMy WebLinkAbout112297 VINEY TRUCKING INC - INSURANCE CERTIFICATE (33)3 atee&rm STATE FARM® W PO Box 853922 Richardson, TX 75085-3922 28A 20 000752 0093 CITY OF FORT COLLINS FINANCIAL SERVICES PURCHASING DIVISION _ PO BOX 580 FORT COLLINS CO 80522-0580 ADDITIONAL INSURED'S NOTICE OF COVERAGE State Farm Mutual Automobile Insurance Company 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. 2157-FAF1-A NAMED INSURED: POLICY NO: 057 1122-E17-06R CAR 100 COVERAGE: VINEY TRUCKING INC YR/MAKE/MODEL: 2014 SIDUMP R TRL DMP $1000 DED. COMP. c PO BOX 1446 VIN/CAMPER: 1 D9FS4026EC688117 $1000 DED. COLL. N LAPORTE CO 80535-1446 AGENT NAME: DARYL ALEXANDER INS AGCY INC to 9 AGENT PHONE: (970) ENDORSEMENT NO: 6028BT3 2196 POLICY EFFECTIVE MAY 17 2017 UNTIL TERMINATED POLICY MESSAGES: This policy shown above supersedes policy# 0571122-06Q. g 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 00 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 103 COVERAGE: VINEY TRUCKING INC YR/MAKE/MODEL: 2001 PETERBILT SEMI TRK BI AND PD LIABILITY PO BOX 1446 VIN/CAMPER: 1 XP5D49X11 D550799 $ 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-FAF1-A NAMED INSURED: POLICY NO: 057 1122-E17-06R CAR 108 COVERAGE: VINEY TRUCKING INC YR/MAKE/MODEL: 2008 TRAIL KING BTM TRLR $1000 DED. COMP. PO BOX 1446 VIN/CAMPER: 1T8LC412X8W071896 $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. FRT vco A I co N 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 112 COVERAGE: VINEY TRUCKING INC YR/MAKE/MODEL: 2016 TRAIL KING BTM TRLR $1000 DED. COMP. PO BOX 1446 VIN/CAMPER: 1TKLO4124GWO31546 $1000 DED. COLL. LAPORTE CO 80535-1446 AGENT NAME: DARYL ALEXANDER INS AGCY INC AGENT PHONE: (970)493-2196 ENDORSEMENT NO: 6028BT POLICY EFFECTIVE POLICY MESSAGES: This policy shown above supersedes policy# 0571122-06Q. MAY 17 2017 UNTIL TERMINATED The policy includes a loss payable clause protecting the additional insured's interest in the described car to the extent of the insurance provided and subject to all policy provisions. The additional insured will be given 10 days notice if the policy is terminated. Until such notice is provided, it shall be presumed that the required renewal premiums have been paid. The additional insured must notify us within 10 days of any change of interest or ownership coming to their attention. Failure to do so will render this policy null and void. ADDITIONAL INSURED'$ NOTICE OF COVERAGE State Farm Mutual Automobile Insurance Company 2157-FAF1-A NAMED INSURED: POLICY NO: 057 1122-E17-06R CAR 116 COVERAGE: VINEY TRUCKING INC YR/MAKE/MODEL: 2004 KENWORTH SEMI TRK BI AND PD LIABILITY PO BOX 1446 VIN/CAMPER: 1 XKWDB9X04RO65303 $ 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# 0571122-060. 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. ADDITIONAL INSURED'S NOTICE OF COVERAGE State Farm Mutual Automobile Insurance Company 2157-FAF1-A NAMED INSURED: POLICY NO: 057 1122-E17-06R CAR 117 COVERAGE: VINEY TRUCKING INC YR/MAKE/MODEL: 1994 PETERBILT TRACTOR BI AND PD LIABILITY PO BOX 1446 VIN/CAMPER: 1 XP5DR9X7RD347733 $ 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 poiicy# 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