HomeMy WebLinkAboutInsurance Certificate: Morgan, William & Pacific Crane Certification Co O
O'O® DATE OF NOTICE: OCT 05.2021
• PO Box 853922 •
, Richardson, TX 75085-3922 CODE: •
42A
AT1 12 • A '
000599 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
e.iii: ASHLAND OR 97520-1849 • ADDRESS INFORMATION.
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• >::ADI):TI NAL:INSURED`S NOTICEOF:.CC3VER1AGIa : ::<,: :: .. . . ..:::::.::::;; , ::::.:; ;:.:.
State Farm Mutual Automobile Insurance Company • . •• •.. - 1355 FA96 A
NAMED INSURED: - POLICY NO: ' 266 7181-F24-551 . COVERAGE:
MORGAN,WILLIAM& YR/MAKE/MODEL:. NONOWNED AUTO- BI AND PD LIABILITY
c PACIFIC CRANE•CERTIFICATION CO , ' VIN/CAMPER: $1 MIL
O, 1394 DENTON WAY • AGENT NAME: • ' JEFF AVERY INSURANCE AGCY INC $500 DED.COMP/COLE.
c REDDING CA 96002-3621 .AGENT PHONE: • (530)243-4600
8 ENDORSEMENT.NO: 6028BU POLICY EFFECTIVE
•= 6164DP 61.65CS SEP 22 2021 UNTIL TERMINATED
Fi POLICY MESSAGES: This policy shown above supersedes policy#2667181-55H.
1 The policy includes a loss payable clause protecting the additional insured's interest in the described car to the extent of the insurance
S. provided and subject to all policy provisions.The additional insured will be given 20 days notice if the policy is terminated. Until such notice
e, is provided,it shall be presumed that the required,renewal premiums have been paid. The additional insured must notify us within 10 days of
-S 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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