HomeMy WebLinkAboutInsurance Certificate: Morgan, William & Pacific Crane CertificationCo. DATE OF NOTICE: OCT 01 2021
®PO Box 853922 • CODE:
Richardson, TX 75085-3922 .
36A
' AT1 12 A .
000545•0093
CITY OF ASHLAND NOTE: PLEASE NOTIFY STATE FARM AT THE
'IT'S OFFICERS, AGENTS, ISAOAADDRESS'LISTED AT THE TOP, LEFT CORNER
v��• 20 E MAIN ST . . OF.THIS PAGE REGARDING ANY CHANGE OF
• ASHLAND OR 97520-1849 • ADDRESS INFORMATION.
1111"1111111111111111111_111111111111111111111"111111111111" .
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ADDITIONAL::INSURED'S NOTICE OFC 3VERAAGE
State.Farm-Mutual Automobile Insurance Company . • . • • 1355-FA96-A.
NAMED INSURED: • . POLICY NO:.. • .266 71.81-F24-551 COVERAGE:
MORGAN,WILLIAM& - YR/MAKE/MODEL: .NONOWNED AUTO • BI AND PD LIABILITY
a PACIFIC CRANE CERTIFICATION CO VIN/CAMPER: $1 MIL
N 1394 DENTON WAY AGENT NAME: JEFF AVERY INSURANCE AGCY INC $500 DED.COMP/COLE.
o REDDING CA 96002-3621 • AGENT PHONE:• (530)243-4600 '
8 ENDORSEMENT NO:.6028BU POLICY EFFECTIVE
c . ' 6164DP 6165CS. SEP 22 2021 UNTIL;TERMINATED
POLICY MESSAGES: This policy shown above supersedes policy#2667181=55H.
7, The policy includes a loss payable clause protecting the additional insureds 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
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
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g 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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