HomeMy WebLinkAboutInsurance Certificate: Morgan, William & Pacific Crane Certification Co (2) OHO® DATE OF NOTICE: MAY 03 2022
PO Box 2368 CODE
Bloomington IL 61702-2368
45A
AT1 12 A
000an 0093CINOTE: PLEASE NOTIFY STATE FARM AT THE
IT'S MS OF CASERAND ADDRESS LISTED AT THE TOP, LEFT CORNER
OFFICERS, AGENTS, ISAOA OF THIS PAGE REGARDING ANY CHANGE OF
20 E MAINIIST ADDRESS INFORMATION.
•��:' ASHLAND OR 97520-1849
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State Farm Mutual Automobile Insurance Company 1355-FA96-A
NAMED INSURED: POLICY NO: 266 7181-F24-55J COVERAGE:
MORGAN,WILLIAM& YR/MAKE/MODEL: NONOWNED AUTO B1 AND PD LIABILITY
• PACIFIC CRANE CERTIFICATION CO VIN/CAMPER: $t MIL
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 DEC 24 2021 UNTIL TERMINATED
POLICY MESSAGES: This policy shown above supersedes policy#2667181-551.
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 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
any change of interest or ownership coming to their attention. Failure to do so will render this policy null and void.
FRT