HomeMy WebLinkAboutInsurance Certificate: Thomas Giordano
ALLSTATE LIENHOLDER SERIICE CENTER
PO BOX 660349
DALLAS, TX 75266-0349
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CITY OF ASHLAND Date: 07/26!14
20 E MAIN ST
ASHLAND OR 97520-1850
CERTIFICATE OF INSURANCE
EFFECTIVE DATE
OF CERTIFICATE
ALLSTATE INSURANCE COMPANY AUGUST 22, 2014
Northbrook, Illinois, certifies that the following insurance is in force:
POLICYHOLDER POLICY NUMBER POLICY PERIOD
THOMAS R GIORDANO 9 76 986806 08/22 AUGUST 22, 2014 At 12.01 A.M.
105A LINCOLN ST FEBRUARY 22, 2015 Standard Time
ASHLAND OR 97520-2284
The person or organization designated below is described in the policy as:
CITY OF ASHLAND LIENHOLDER
20 E MAIN ST (Loss Payable Clause)
ASHLAND OR 97520-1850 X ADDITIONAL
INTERESTED PARTY
AGENT ROBERT N BUCKMISTER
PHONE (541) 488-2516
Coverages designated below are afforded for each described vehicle:
BI $100,000 EA.PERS.- $300,000 EA.OCC. 2006 SOLSTICE
PD $100,000 EA.000. 1G2MB33B76Y110178
Collision- $500 DED. Comprehensive- $100 DED.
See reverse side for provisions concerning Loss Payable Clause and Additional Interested Party.
This Certificate of Insurance neither affirmatively nor negatively amends, extends or alters the coverage
afforded by the policy referred to above.
DI696
*0000036060107241875401II01*
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The Loss Payable Clause of such policy provides:
"The company reserves the right to cancel such policy at any time as provided by its terms, but in such
case the company shall notify the Lienholder when not less than ten days thereafter such cancellation shall
be effective as to the interest of said Lienholder therein and the company shall have the right, on like
notice, to cancel this agreement."
The Additional Interest Endorsement of such policy, in part, provides:
"...such insurance as is afforded by the policy" for automobile liability insurance listed on the reverse side
hereof applies also to the person or organization named as Additional Interested Party.
"As respects such... interest, no cancellation ...and no endorsement... adversely affecting such additional
interest, shall be effective until ten (10) days following the mailing of written notice (to the person or
organization) of such cancellation or endorsement..."
601072418754P