HomeMy WebLinkAboutInsurance Certificate: Kencairn, Kerry srarerairm STATE FARM°
0c>2® DATE OF NOTICE: SEP 15 2020
PO Box 853922 CODE:
Richardson, TX 75085-3922
40A .
AT1 15 A .
000818 0093 ! • NOTE:,PLEASE,NOTIFY'STATE FARM'•AT THE
AND OF ASHLAND AND THEIR .
ELECTED! OFFICIALS OFFICERS & ADDRESS LISTED AT THE TOP, LEFT CORNER
EMPLOYEE'S ' . . OF THIS PAGE REGARDING ANY CHANGE 'OF •
20 E MAIN ST ADDRESS INFORMATION.
•.' ASHLAND OR 97520-1850 • ' •
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'' ;ADDITIONAL INSUREDS NOTICE OF COVERAGE
State,Farm'Mutual Automobile Insurance Company :' : ; 097C-FAESA
NAMED INSURED: :POLICY nit): " 330 3415-A14-37D - . •COVERAGE:.. `
KENCAIRN,KERRY YR/MAKE/MODEL: 2014 SUBARU. SPORT WG BI AND'PD LIABILITY
Tr 147 CENTRAL AVE VIN/CAMPER: JF2SJAHCOEH433306 $1 MIL/$1 MIL/5 1 MIL
o $250 DED.COMP.
cli ASHLAND OR 97520-1714 AGENT NAME: JACOB FINCH ' • $1000-DED.COLL.
to
b AGENT,PHONE:. (541)482-8470
o ENDORSEMENT NO: 6028BJ POLICY EFFECTIVE
c• • SEP 02 2020 UNTIL TERMINATED
i POLICY MESSAGES: This policy shown.above supersedes policy#3303415-37C. .
m The policy includes a loss payable clause protecting the additional insured's 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-10 days notice-if-the.policy-is-terminated.'Until_such_notice_:___ _ • _ _ _ __ ..„
ro is provided,it shall be presumed that the required renewal premiums have beerrpaid. The additional insured must notify us within 10 days of
i 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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