HomeMy WebLinkAboutNAVO, KIRK & LINDA - INSURANCE CERTIFICATEState&rM STATE FARM®
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PO Box 9009
Tempe, AZ 85281-9709
DATE OF NOTICE: AUG 30 2017
CODE:
AT1 20
FORT COLLINS
PO BOX 580
FORT COLLINS
37A
000880 0093
PURCHASING DEPT
CO 80522-0580
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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
2455-FA65-A
NAMED INSURED: POLICY NO:
198 7914-C28-06H
COVERAGE:
NAVO, KIRK & LINDA YR/MAKE/MODEL:
2011 SUBARU STA WAG
BI AND PD LIABILITY
$100,0Qo0o/$100,000
4690 WISCONSIN AVE VIN/CAMPER:
4S4BRBACI B3404246
ED. COMP.
$50DED.
LOVELAND CO 80538-6833 AGENT NAME:
SHARON E YOUNIE INS AGENCY INC 0
$500 DED. COLL.
AGENT PHONE:
(970)663-7880
ENDORSEMENT NO: 60288T
POLICY EFFECTIVE
AUG 25 2017 UNTIL TERMINATED
POLICY MESSAGES: This policy shown above supersedes policy# 1987914-06G.
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
aeFarm STATE FARM
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PO Box 9009
Tempe, AZ85281-9709
DATE OF NOTICE: AUG 25 2017
CODE:
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AT1 20
FORT COLLINS
PO BOX 580
FORT COLLINS
49A
000832 0093
PURCHASING DEPT
CO 80522-0580
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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
2455-FA65-A
NAMED INSURED: POLICY NO:
198 7914-C28-06G
COVERAGE:
NAVO, KIRK & LINDA YR/MAKE/MODEL:
2011 SUBARU STA WAG
BI AND PD LIABILITY
4690 WISCONSIN AVE VIN/CAMPER:
4S4BRBAC1 B3404246
$100,00,000/$100,000
DED.
$500 ED. COMP.
LOVELAND CO 80538-6833 AGENT NAME:
SHARON E YOUNIE INS AGENCY INC $500 DED. LOLL.
AGENT PHONE:
(970)663-7880
ENDORSEMENT NO:
6028BT
POLICY EFFECTIVE
AUG 21 2017 UNTIL TERMINATED
POLICY MESSAGES: This policy shown above supersedes policy# 1987914-06F.
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
State&rm STATE FARM®
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PO Box 9009
Tempe, AZ 85281-9709
DATE OF NOTICE: AUG 18 2017
CODE:
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FORT COLLINS
PO BOX 580
FORT COLLINS
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000782 0093
PURCHASING DEPT
CO 80522-0580
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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
—71
State Farm Mutual Automobile Insurance Company
2455-FA65-A
NAMED INSURED: POLICY NO:
198 7914-C28-06G
COVERAGE:
NAVO, KIRK & LINDA YR/MAKE/MODEL:
2011 SUBARU STA WAG
BI AND PD LIABILITY
4690 WISCONSIN AVE VIN/CAMPER:
4S4BRBAC1B3404246
$100,I$too,000
$500 DIED.
DED. COOMP.MP.
LOVELAND CO 80538-6833 AGENT NAME:
SHARON E YOUNIE INS AGENCY INC $500 DIED. LOLL.
AGENT PHONE:
(970)663-7880
ENDORSEMENT NO: 6028BT
POLICY EFFECTIVE
AUG 21 2017 UNTIL TERMINATED
POLICY MESSAGES: This policy shown above supersedes policy# 1987914-06F.
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