HomeMy WebLinkAboutInsurance Certificate: Pacific Crane Certification Co. -----•-•-• ,..p...._ . AI IIVI
C>® DATE OF NOTICE: JUL 08 2022
PO Box 2368 CODE:
Bloomington IL 61702-2368
26A
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000asz 0093CINOTE: PLEASE NOTIFY STATE FARM AT THE
IT'SY OF ASHLAND ADDRESS LISTED AT THE TOP, LEFT CORNER
IT'S AGENTS, ISAOA OF THIS PAGE REGARDING ANY CHANGE OF
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20 E MAIN ST ASHLAND OR 97520-1849 ADDRESS INFORMATION.
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State Farm Mutual Automobile Insurance Company - 1355-FA96-A .
NAMED INSURED: , NO: . • 266 7181l-F24-55M • COVERAGE: •
MORGAN,WILLIAM& YR/MAKE/MODEL: NONOWNED AUTO BI AND PD LIABILITY
PACIFIC CRANE CERTIFICATION CO VIN/CAMPER: $t MIL
9 1394 DENTON WAY AGENT NAME: JEFF AVERY INSURANCE AGCY INC $500 DED.COMP/COLE.
REDDING CA 96002-3621 AGENT PHONE: (530)243-4600
o • ENDORSEMENT NO: 6028BU POLICY EFFECTIVE
w 6164DP 6165CS JUN 24 2022 UNTIL TERMINATED
POLICY MESSAGES: This policy shown above supersedes policy#2667181-55L.
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14 The policy includes a loss payable clause protecting the additional insured's interest in the described car to the extent of the insurance
provided and subject to all policy provisions.The additional insured will be given 20 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
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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