HomeMy WebLinkAboutInsurance Certificate: Morgan, William & Pacific Crane Certification Co awwrarur ,1,41C r'omli -
CD-C)„,, DATE OF NOTICE: MAY 20 2022
PO Box 2368 CODE:
Bloomington IL 61702-2368
12A
AT1 12 A
000430 0093
CITY OF ASHLAND NOTE: PLEASE NOTIFY STATE FARM AT THE
IT'S OFFICERS, AGENTS, ISAOA ADDRESS LISTED AT THE TOP, LEFT CORNER
•• 20 E MAIN ST OF THIS PAGE REGARDING ANY CHANGE OF
1= ASHLAND OR 97520-1849 ADDRESS INFORMATION.
til
II��'IIII���II��III�IIIhhI1"11 hIIIIhIIIIII1hI 1111111'111
8
0
s
s
/4nn1TL:ONAL.iNSUREDS:NICE::�dF:.��3..ERAGE.... ... ..... ..:::::::..::::::::.::::..:::..::::...: .... ... .. ..... .. . .......... ...... ...:::....::.:.. . ... .....::..
State Farm Mutual Automobile Insurance Company 1355-FA96-A
NAMED INSURED: POLICY NO: 266 7181-F24-55L COVERAGE:
MORGAN,WILLIAM& YR/MAKE/MODEL: NONOWNED AUTO BI AND PD LIABILITY
PACIFIC CRANE CERTIFICATION CO VIN/CAMPER: $1 MIL
2 1394 DENTON WAY AGENT NAME: JEFF AVERY INSURANCE AGCY INC $500 DED.COMP/COLE.
REDDING CA 96002-3621 AGENT PHONE: (530)243-4600
ENDORSEMENT NO: 6028BU POLICY EFFECTIVE
6164DP 6165CS MAR 25 2022 UNTIL TERMINATED
POLICY MESSAGES: This policy shown above supersedes policy#2667181-55K.
co
m The policy includes a loss payable clause protecting the additional insured's interest in the described car to the extent of the insurance
5 provided and subject to all policy provisions.The additional insured will be given 20 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
gany change of interest or ownership coming to their attention. Failure to do so will render this policy null and void.
•
•
FRT