HomeMy WebLinkAboutInsurance Certificate: Southern Oregon communicatinsStateFa►m STATE FARM®
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PO Box 853922
Richardson, TX 75085-3922
DATE OF NOTICE: JAN 08 2020
CODE:
a
52A
AT1 15
000932 0093
CITY OF ASHLAND
20 E MAIN ST
ASHLAND OR 97520-1850
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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 INSUREDS NOTICE OF COVERAGE
State Farm Mutual Automobile Insurance Company
2372-FAE6A
NAMED INSURED: POLICY NO:
352 3755-Ao2.37C
CAR 024 COVERAGE:
SOUTHERN OREGON COMMUNICATONS YR/MAKE/MODEL:
2004 CHEVROLET BUKT TRK
BI AND PD LIABILITY
LLC VIN/CAMPER:
1GDMBC1C44F505848
$1 MIL/$1 MIL/$1 MIL
$500 DED. COMP.
747 SUMMER GLEN DR AGENT NAME:
SPOON INS AND FIN SVCS INC $500 DED. COLL.
MEDFORD OR 97501-4500 AGENT PHONE:
(541)884-6265
ENDORSEMENT NO:
6028BJ
POLICY EFFECTIVE
JAN 02 2020 UNTIL TERMINATED
POLICY MESSAGES: This policy shown above supersedes policy# 3523755-37C017.
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