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HomeMy WebLinkAboutInsurance Certificate: Walter, Mark & Christine (2) ....."•••••.41... .7 I Oi I G. r-/Aratin- 0 0-00 DATE OF NOTICE: FEB 04 2021 PO Box 853922 Richardson, TX 75085-3922 • CODE: . • 24A AT1 15 A 000973 CITY OF ASHLAND 0093 , NOTE: PLEASE NOTIFY STATE FARM. AT THE 20, E MAIN ST ADDRESS LISTED AT THE TOP, LEFT CORNER •..zy_t. ASHLAND OR 97520-1849 . ' • • OF THIS PAGE REGARDING ANY CHANGE OF• '...'1-15. • . . . ADDRESS INFORMATION. . 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' State Farm:Mutual Automobile Insurance Company - " ' ::• • . ..• • ‘•• " •• 95FA-RB62-A „ , • ,• NAMED. INSURED: . , . , ' • POLICY NO: . '- 254 2884-D03-37Y ' , COVERAGE: •• WALTER,MARK D&CHRISTINE L YR/MAKE/MODEL: • 2013 VOLVO ' 4DR BI AND PD.LIABILITY vr $2 MIL •••• 13290 S SQUIRE DR VIN/CAMPER: YV1612FS1D1218342 0 $250 DED.COMP. 2 OREGON CITY OR 97045-5911 AGENT NAME: JEFF LANDSTROM $500 DED.coLL. ; AGENT PHONE: (503)518-7100 ENDORSEMENT NO: 6028BJ . POLICY EFFECTIVE • . JAN 13 2021 UNTIL TERMINATED &NJ:, POLICY MESSAGES: This policy shown above supersedes policy#2542884-37X. ?, The policy includes a loss payable clause protecting the additional insured's interest in the described car to the extent of the insurance 13 provided and subject to all policy provisions.The additional insured will be given 10 days notice if the policy is terminated. Until such notice -03 -is provided,'iishall be'or-IS-Dined thatitie-reqUirea-renewal proltifunis haVe-been-Paid--.-TheadOiti-onal'insiire-d-rniist•notifyusiVithilil•O-days of -'-'.-- - --;- - -•• - - g any change of interest or ownership coming to their attention. Failure to do so will render this policy null and void. 0 N ,...:•,,...,•:•:,_:.:•:•;•.,..,•,•:,,,:•••:•:.,...,•,.....,•,•:•,......,....,•:•:•,,„,:•,•:......:•,•,,,,•:•:,....:•:•:_•:-:•:.•:... ;; . _:•:.: ::;;;., ...: :•:•:•,.. ._•:•:•: :•:::::::::::::::: ::,i,i:i:i:i:ii:i*ii:i:ii:i:i:i:i:i:i:i::i:i:::i:::i:::::i:i,i,:i:i:i:i:i:i:ii:K:i:i:i:i;i:i:i:i*i:i:ii:i:i:i:i:i:i:i:i:i,:i* : :: :i::i:i: :i*::i:i:i:::i:i: ::]:::::: : :i:i:m:::ii:i:i: :kkljUll:IVNALLINMAjrir;LtiiNkj:liLik,riii;;UVAllriALi :i:i:i::i*:::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::,::::::::::::::::::::::::::::::::::::::: .:::•:•:.:•:-:.:.:•:.:.:.:.:.:.:,:•:.:•:.:::::.:.:::::.:.:.:::.:.:.:,:.:.:.:.:.:.:-:::.:.:::.:.:•:•:.:•:•:•:•:•:•:•:.:•:•:•:•:•:•:•:•:•:•:•:•:•:::•:•:::.:•:•:::::. ...:.:.:.:.:::.:.:.:.:•:•:•::::::::::::::::::::::::::::::::::::::::::::::::::z.:::::::::::::::::::::::::i:::::::::i:::::::::::::::::i:i::::::::::::::::::::::::::::::::::::::::::::::::::::::i::::::*::::i:i::::::::::::::i:::::i::: ::* : : :::::::::::::::::i::: :::::::::::::::::: State Farm Mutual Automobile Insurance Company 95FA-FB62-A NAMED INSURED: POLICY NO: 254 2884-D03-37Y . COVERAGE: WALTER,MARK D&CHRISTINE L _ ' .,YR/MAKE/MODEL:. 2013 VOLVO ,4DR .- , . ,.• , .. -.. BI AND PD-LIABILITY 13290 S SQUIRE DR ' , - : • 2. • . VIN/CAMPER:, ...' YV1612FS1•D1218342-. •' .•• - - • • S-2 MIL . • • ... , . • $250•DED.COMP. ' •OREGON CITY OR 97045-5911' .. . -AGENT NAME: ' .JEFF LANDSTROM• • • - .. . - • -2.- -'. . .. • • ,' .. • •. ‘ -,-. ' -, ''...„ AGENT-PHONE: '•,(503)518-7100 • %, - ......:. • •••,_ • '' • •, ' • ' ,'. • ''• 1, : :.."':-• " - ' ' T.N ENDORSEMENO: 6028BJ ' . ',:' :'• . •..' . POLICY EFFECTIVE - .- :- •• .. • .,-••- •• • „ , • • , .., . , ,., , . , . . . ,JAN.13 2021 UNTIL TERMINATED . • -. POLICY MESSAGES: fiiispolicy shown above supersedes pOlicy#2542884-37X.:, , • - • -, • . • •- •• • , ' , • . '• . • - The policy includes a loss payable clause protecting the additional insureds,interest in the described car to the extent of the insurance •'.' . 2, .:.- . ;- provided and subject to•allpolicyprovisionS.The additional insured will be given 10 days notice if•the.policyla terminated Until such notice • ...- • • '• ,.,•is proVided,it shall be Oresurtied that the required renewal prenliumS have been paid. The additional insured must notify Us within 10 days of '• , '' '' h.. any change of interest or ownership coming to their attention. -Failure to do so will render this policy null and void. .1 . . . . . . . . . • • - • • , . . . . • . . . . . . . . • ' ' • • . . • • . . . . • . . • , . . . , . . . , . . • . • • - . . . . . • • . . FRT