HomeMy WebLinkAboutInsurance Certificate: Kencairn Landscape Architecture LLC O ...^.` , ^..... DATE OF NOTICE: JUL 05 2023
PO Box 2368 CODE:
Bloomington IL 61702-2368
67A
AT1 15 A
001633 0093
AND FICIR NOTE: PLEASE NOTIFY STATE FARM AT THE
CITY OF ASHLAND
ELECTED OFFICIALS OFFICERS & ADDRESS LISTED AT THE TOP, LEFT CORNER
EMPLOYEE'S OF THIS PAGE REGARDING ANY CHANGE OF
r.151 WINBURN WAY ADDRESS INFORMATION.
• ASHLAND OR 97520-1849
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State Farm Mutual Automobile Insurance Company 097C-FAE6A
NAMED INSURED: POLICY NO: 330 3415-A14-37H COVERAGE:
KENCAIRN LANDSCAPE YR/MAKE/MODEL: 2022 SUBARU I SPORT WG BI AND PD LIABILITY
Ncb ARCHITECTURE LLC VIN/CAMPER: JF2GTHMC6N8273706 $1 MIL/$1 MIL/$1 MIL
147 CENTRAL AVE AGENT NAME: JACOB FINCH $200 DED.
$1000 DED..COLL.
g ASHLAND OR 97520-1714 AGENT PHONE: (541)482-8470
o ENDORSEMENT NO: 6028BJ POLICY EFFECTIVE
JUL 14 2023 UNTIL TERMINATED
g POLICY MESSAGES: This policy shown above supersedes policy#3303415-37G.
cc The policy includes a loss payable clause protecting the additional insured's interest in the described car to the extent of the insurance
I; provided and subject to all policy provisions.The additional insured will be given 10 days notice if the policy is terminated. Until such notice
co 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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