HomeMy WebLinkAboutInsurance Certificate: Morgan, William & Pacific Crane Certification Co (3) <) DATE OF NOTICE: MAY 04 2022
PO Box 2368 CODE:
Bloomington IL 61702-2368
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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
EaASHLAND OR 97520-1849 ADDRESS INFORMATION.
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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 BI AND PD LIABILITY
° PACIFIC CRANE CERTIFICATION CO VIN/CAMPER: • $1 MIL
Y 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
5 POLICY MESSAGES: This policy shown above supersedes policy#2667181-551.
The policy includes a loss payable clause protecting the additional insureds interest in the described car to the extent of the insurance •
o provided and subject to all policy provisions.The additional insured will be given 20 days notice if the policy is terminated. Until such notice
a is provided,it shall be presumed that the required renewal premiums have been paid. The additional insured must notify us within 10 days of
3 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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