HomeMy WebLinkAboutInsurance Certificate: Morgan, William & Pacific Crane Certification Co (5) asagurdrm STATE FAI.1M"
O-O® DATE OF NOTICE: MAY 10 2022
PO Box 2368 CODE:
Bloomington IL 61702-2368
41A
AT1 12 A
000azs oossCINOTE: PLEASE NOTIFY STATE FARM AT THE
IT'S OFFICERS,
OF ASHLAND DDRESS LISTED AT THE TOP, LEFT CORNER
CSRS, AGENTS, ISAOA
20 E MAIN ST r";
OF THIS PAGE REGARDING ANY CHANGE OF
ASHLAND OR 97520-1849 ADDRESS INFORMATION.
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NAL INS R 'S tdOTICE i�F Ct�VERAGE ,
State Farm Mutual Automobile Insurance Company • 1355-FA96-A
NAMED INSURED: POLICY NO: 266 7181-F24-55K •
COVERAGE:
MORGAN,WILLIAM& YR/MAKE/MODEL: NONOWNED AUTO BI AND PD LIABILITY
v PACIFIC CRANE CERTIFICATION CO VIN/CAMPER: $1 MIL
• 1394 DENTON WAY AGENT NAME: JEFF AVERY INSURANCE AGCY INC $50o DED.coMPlcoLL.
REDDING CA 96002-3621 AGENT PHONE: (530)243-4600
o ENDORSEMENT NO: 6028BU POLICY EFFECTIVE
6164DP 6165CS MAR 25 2022 UNTIL TERMINATED
§• POLICY MESSAGES: This policy shown above supersedes policy#2667181-55J.
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
03 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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