HomeMy WebLinkAboutInsurance Certificate: Southern Oregon CommunicationsStateFarm STATE FARM®
•
®PO Box 853922
Richardson, TX 75085-3922
26A
AT1 15
000857 0093
CITY OF ASHLAND
20 E MAIN ST
UM ASHLAND OR 97520-1850
[III 111111111111111111111111111111111111"111111111111111111[111
DATE OF NOTICE: JAN 03 2020
CODE:
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 2372-FAE6-A
NAMED INSURED: POLICY NO: 352 3755-Ao2-37C CAR 001 COVERAGE:
SOUTHERN OREGON COMMUNICATONS YR/MAKE/MODEL: 2004 FORD BUKT TRK BI AND PC LIABILITY
a $ 1 MIL/$ 1 MIL/$ 1 MIL
S LLC VIN/CAMPER: 3FRNF65N44V681419 $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
o ENDORSEMENT NO: 6028BJ POLICY EFFECTIVE
JAN 02 2020 UNTIL TERMINATED
m POLICY MESSAGES: This policy shown above supersedes policy# 3523755-37B.
m The policy includes a loss payable clause protecting the additional insured's interest in the described car to the extent of the insurance
b 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
o any change of interest or ownership coming to their attention. Failure to do so will render this policy null and void.
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ADDITIONAL INSURED'S NOTICE OF COVERAGE'.
State Farm Mutual Automobile Insurance Company 2372-FAE6-A
NAMED INSURED: POLICY NO: 352 3755-AO2-37C CAR 003 COVERAGE:
SOUTHERN OREGON COMMUNICATONS YR/MAKE/MODEL: 2000 FORD PICKUP BI AND PD LIABILITY
LLC VIN/CAMPER: 1 FTSX31 177YEB68872 $1 MIL/$1 MIL/$1 MIL
747 SUMMER GLEN DR AGENT NAME: SPOON INS AND FIN SVCS INC $500 DED. COMP.
MEDFORD OR 97501-4500 AGENT PHONE: (541)884-6265 $500 DED. COLL.
ENDORSEMENT NO: 6028BJ POLICY EFFECTIVE
JAN 02 2020 UNTIL TERMINATED
POLICY MESSAGES: This policy shown above supersedes policy# 3523755-37B.
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
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ADDITIONAL INSURED'S NOTICE OF COVERAGE
State Farm Mutual Automobile Insurance Company 2372-FAE5A
NAMED INSURED: POLICY NO: 352 3755-Ao2-37C CAR 004 COVERAGE:
SOUTHERN OREGON COMMUNICATONS YR/MAKE/MODEL: 1991 INTERNATIO UTIL TRK BI AND PD LIABILITY
LLC VIN/CAMPER: 1HTSHNZR4MH362634 $ 1 MIL/$ 1 MIL/$ 1 MIL
747 SUMMER GLEN DR AGENT NAME: SPOON INS AND FIN SVCS INC $500 DED. COMP.
MEDFORD OR 97501-4500 AGENT PHONE: (541)8e4-6265 $500 DED. COLL.
ENDORSEMENT NO: 6028BJ POLICY EFFECTIVE
JAN 02 2020 UNTIL TERMINATED
POLICY MESSAGES: This policy shown above supersedes policy# 3523755-37B.
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
H any change of interest or ownership coming to their attention. Failure to do so will render this policy null and void.
m
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ADDITIONAL INSURED'S NOTICE OF COVERAGE
State Farm Mutual Automobile Insurance Company 2372-FAE6-A
NAMED INSURED: POLICY NO: 352 3755-Ao2-37C CAR 005 COVERAGE:
SOUTHERN OREGON COMMUNICATONS YR/MAKE/MODEL: 2000 FORD BUKT TRK BI AND PD LIABILITY
LLC VIN/CAMPER: 1 FDXF46F3YEA44200 $ 1 MIL /$ 1 MIL /$ 1 MIL
747 SUMMER GLEN DR AGENT NAME: SPOON INS AND FIN SVCS INC $500 DED. COMP,
MEDFORD OR 97501-4500 AGENT PHONE: (541)884-6265 $500 DED. COLL.
ENDORSEMENT NO: 6028BJ POLICY EFFECTIVE
POLICY MESSAGES: This policy shown above supersedes policy# 3523755-37B. JAN 02 2020 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'S NOTICE OF COVERAGE
State Farm Mutual Automobile Insurance Company 2372-FAE6-A
NAMED INSURED: POLICY NO: 352 3755-Ao2-37C CAR 006 COVERAGE:
SOUTHERN OREGON COMMUNICATONS YR/MAKE/MODEL: 1992 INTERNATIO BUKT TRK 81 AND PD LIABILITY
LLC VIN/CAMPER: 1 HTSDPCN8NH431775 $ 1 MIL /$ 1 MIL /$ 1 MIL
747 SUMMER GLEN DR AGENT NAME: SPOON INS AND FIN SVCS INC $500 DED. COMP.
MEDFORD OR 97501-4500 AGENT PHONE: (541)884-6265 $500 DED. COLL.
ENDORSEMENT NO: 6028BJ POLICY EFFECTIVE
JAN 02 2020 UNTIL TERMINATED
POLICY MESSAGES: This policy shown above supersedes policy# 3523755-37B.
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 2372-FAE6-A
NAMED INSURED: POLICY NO: 352 3755-Ao2-37C CAR 007 COVERAGE:
SOUTHERN OREGON COMMUNICATONS YR/MAKE/MODEL: 2001 STERLING BUKT TRK BI AND PD LIABILITY
LLC VIN/CAMPER: 2FZAAKAK51AJ20186 $ 1 MIL /$ 1 MIL /$ 1 MIL
747 SUMMER GLEN DR AGENT NAME: SPOON INS AND FIN SVCS INC $500 DED. COMP.
MEDFORD OR 97501-4500 AGENT PHONE: (541)884-6265 $500 DED. COLL.
ENDORSEMENT NO: 6028BJ POLICY EFFECTIVE
JAN 02 2020 UNTIL TERMINATED
POLICY MESSAGES: This policy shown above supersedes policy# 3523755-37B.
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 2372-FAE6-A
NAMED INSURED: POLICY NO: 352 3755-A02-37C CAR 009 COVERAGE:
SOUTHERN OREGON COMMUNICATONS YR/MAKE/MODEL: 1993 INTERNATIO BUKT TRK BI AND PD LIABILITY
LLC VIN/CAMPER: 1 HTSDPPNl PH52325 $ 1 MIL /$ 1 MIL /$ 1 MIL
747 SUMMER GLEN DR AGENT NAME: SPOON INS AND FIN SVCS INC $50DED, COMP,
MEDFORD OR 97501-4500 AGENT PHONE: (541)884-6265 $500 DED, COLL.
ENDORSEMENT NO: 6028BJ POLICY EFFECTIVE
JAN 02 2020 UNTIL TERMINATED
POLICY MESSAGES: This policy shown above supersedes policy# 3523755-37B.
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.
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StateFamt STATE FARM®
•
PO Box 853922
Richardson, TX 75085-3922
26A
15
000857 W93
CITY OF ASHLAND
20 E MAIN ST '
UM ASHLAND OR 97520-1850
A
DATE OF NOTICE: JAN 03 2020
CODE:
NOTE: PLEASE NOTIFY STATE FARM AT THE
ADDRESS LISTED AT THE TOP, LEFT CORNER
OF THIS PAGE REGARDING ANY CHANGE OF
ADDRESS INFORMATION.
ADDITIONALINSURED'S NOTICE "OF COVERAGE
State Farm Mutual Automobile Insurance Company 2372-FAEB-A
NAMED INSURED: POLICY NO: 352 3755-Ao2-37C CAR 010 COVERAGE:
SOUTHERN OREGON COMMUNICATONS YR/MAKE/MODEL: NONOWNED AUTO BI AND PD LIABILITY
LLC VIN/CAMPER: $ 1 MIL/$ 1 MIL/$ 1 MIL
747 SUMMER GLEN DR AGENT NAME: SPOON INS AND FIN SVCS INC
MEDFORD OR 97501-4500 AGENT PHONE: (541)884-6265
ENDORSEMENT NO: 6028BJ POLICY EFFECTIVE
6164DG 6165CJ JAN 02 2020 UNTIL TERMINATED
POLICY MESSAGES: This policy shown above supersedes policy# 3523755-37B.
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
2372-FAE6A
NAMED INSURED: POLICY NO:
352 3755-Ao2.37C
CAR 012 COVERAGE:
SOUTHERN OREGON COMMUNICATONS YR/MAKE/MODEL:
19991NTERNATIO UTIL TRK
BI AND PD LIABILITY
LLC VIN/CAMPER:
1HTSCABNXXH670183
$1 MIL/$1 MIL/$1 MIL
747 SUMMER GLEN DR AGENT NAME:
SPOON INS AND FIN SVCS INC $500 DED. COMP.
$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# 3523755-37B.
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 2372-FAE6A
NAMED INSURED: POLICY NO: 352 3755-AO2-37C CAR 014 COVERAGE:
SOUTHERN OREGON COMMUNICATONS YR/MAKE/MODEL: 2001 STERLING UTIL TRK BI AND PD LIABILITY
LLC VIN/CAMPER: 2FZAAKAK91AJ43325 $ 1 MIL/$ 1 MIL/$ 1 MIL
747 SUMMER GLEN DR AGENT NAME: SPOON INS AND FIN SVCS INC $500 DED. COMP.
MEDFORD OR 97501-4500 AGENT PHONE: (541)884-6265 $50o DED. LOLL.
ENDORSEMENT NO: 6028BJ POLICY EFFECTIVE
JAN 02 2020 UNTIL TERMINATED
POLICY MESSAGES: This policy shown above supersedes policy# 3523755.37B.
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.
m
a FRT
ADDITIONALINSURED'S NOTICE OF COVERAGE
State Farm Mutual Automobile Insurance Company 2372-FAE6.A
NAMED INSURED: POLICY NO: 352 3755-Ao2-37C CAR 015 COVERAGE:
SOUTHERN OREGON COMMUNICATONS YR/MAKE/MODEL: 2000 INTERNATL BUKT TRK BI AND PD LIABILITY
LLD VIN/CAMPER: IHTSCABNOYH225582 $ 1 MIL/$ 1 MIL/$ 1 MIL
747 SUMMER GLEN DR AGENT NAME: SPOON INS AND FIN SVCS INC $500 DED. COMP.
MEDFORD OR 97501-4500 AGENT PHONE: (541)884-6265 $500 DED. COLL.
ENDORSEMENT NO: 6028BJ POLICY EFFECTIVE
POLICY MESSAGES: This policy shown above supersedes policy# 3523755-37B. JAN 02 2020 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
m
any change of interest or ownership coming to their attention. Failure to do so will render this policy null and void.
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ro
ADDITIONAL INSURED'S NOTICE OF COVERAGE
State Farm Mutual Automobile Insurance Company 2372-FAEGA
NAMED INSURED: POLICY NO: 352 3755-A02-37C CAR 016 COVERAGE:
SOUTHERN OREGON COMMUNICATONS YR/MAKE/MODEL: 2000 FORD BUKT TRK BI AND PD LIABILITY
LLC VIN/CAMPER: 3FDXF75H1YMA04941 $1 MIL/$1 MIL/$1 MIL
747 SUMMER GLEN DR AGENT NAME: SPOON INS AND FIN SVCS INC $500 DED. COMP.
MEDFORD OR 97501-4500 AGENT PHONE: (541)884-6265 $500 DED. COLL.
ENDORSEMENT NO: 6028BJ POLICY EFFECTIVE
JAN 02 2020 UNTIL TERMINATED
POLICY MESSAGES: This policy shown above supersedes policy# 3523755-37B.
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 t0 do so will render this policy null and void.
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ADDITIONAL INSUREDS NOTICE OF COVERAGE
State Farm Mutual Automobile Insurance Company 2372-FAESA
NAMED INSURED: POLICY NO: 352 3755-A02-37C CAR 017 COVERAGE:
SOUTHERN OREGON COMMUNICATONS YR/MAKE/MODEL: 2004 GMC BCKT TRK BI AND PD LIABILITY
LLC VIN/CAMPER: 1GDM8C1C44F505848 $ 1 MIL/$1 MIL/$ 1 MIL
747 SUMMER GLEN DR AGENT NAME: SPOON INS AND FIN SVCS INC $500 DED. COMP.
MEDFORD OR 97501-4500 AGENT PHONE: (541)884-6265 $600 DED. COLL.
ENDORSEMENT NO: 6028BJ POLICY EFFECTIVE
POLICY MESSAGES: This policy shown above supersedes policy# 3523755-37B. JAN 02 2020 UNTIL TERMINATED
The policy includes a loss payable clauseprotecting 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.
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ADDITIONAL INSURED'S NOTICE OF COVERAGE
State Farm Mutual Automobile Insurance Company 2372-FAE6A
NAMED INSURED: POLICY NO: 352 3755-A02-37C CAR 021 COVERAGE:
SOUTHERN OREGON COMMUNICATONS YR/MAKE/MODEL: 1997 FORD BUKT TRK BI AND PD LIABILITY
LLC VIN/CAMPER: 1FDXF80C0VVAD2813 $1 MIL/$1 MIL/$1 MIL
747 SUMMER GLEN DR AGENT NAME: SPOON INS AND FIN SVCS INC $500 DED. COMP.
MEDFORD OR 97501-4500 AGENT PHONE: (541)884-6265 $500 DED. COLL.
ENDORSEMENT NO: 6028BJ POLICY EFFECTIVE
JAN 02 2020 UNTIL TERMINATED
POLICY MESSAGES: This policy shown above supersedes policy# 3523755-37B.
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.
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