HomeMy WebLinkAboutInsurance Certificate: Polaris Land Surveying LLC I .awcvra►w► *1 A 1 t I-iuiiul" • '
O O® DATE OF NOTICE: OCT 13 2020
PO Box 853922 CODE:
Richardson, TX 75085-3922
85A
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000s . osa NOTE: PLEASE.NOTIFY STATE FARM AT THE
THE CITYOF ASHLANDD & ISAOA I ADDRESS LISTED AT THE TOP, LEFT CORNER
20 E MAIN ST OF THIS. PAGE REGARDING ANY CHANGE OF
ASHLAND OR 97520-1850 ADDRESS INFORMATION:
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A{?DITIONAL:1[�1SURED S N } IGE IrtF�t7VERAGE
• •.:State.Farm'Mutual Automobile Insurance Company • • • • •- 090B-FAE6A:.
NAMED INSURED: POLICY NO: • L23 4521-D30-371 COVERAGE:'
POLARIS LAND SURVEYING LLC YR/MAKE/MODEL: 2001 TOYOTA ; PICKUP •BI AND PD LIABILITY
nr PO BOX 459 VIN/CAMPER: •' 5TEWN72N21Z728384 $1 MI . 1 MIL/$1 MIL
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ASHLAND OR 97520-0016 AGENT NAME: JON SNOWDEN INSURANCE AGCY INC $50 DDED.. OLL
� $200 DED.C .
AGENT PHONE: (541)482-2461
ENDORSEMENT NO: 60286) POLICY EFFECTIVE
OCT 07 2020 UNTIL TERMINATED
CV POLICY MESSAGES: This policy shown above'supersedes policy#L234521-37H. .
, 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
co is provided,it shall be presumed that the required renewal premiums have been paid. The additional insuredmust notify us within'10 days of _"
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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