HomeMy WebLinkAboutCOI - Susan B & Peter Connery, Applied Survey Research - ExpiresStateFarm STATE FARM®
0
O'C>
0
0
121000.8 (o1a0821f) 06-06-2014
PO Box 853922
Richardson, TX 75085-3922
41A
AT1 02
000126 0093
CITY OF GILROY ISAOA
7351 ROSANNA ST
GILROY CA 95020-6196
IIIIIIiILIIII,i11111111111111iir. l'Ii'II''IIIIIII111
A
DATE OF NOTICE: JUN 18 2020
CODE:
NOTE: PLEASE NOTIFY STATE FARM AT THE
ADDRESS LISTED AT THE TOP, LEFT CORNER
OF THIS PAGE REGARDING ANY CHANGE OF
ADDRESS INFORMATION.
ADDITIONALINSURED'S NOTICE OF COVERAGE
State Farm Mutual Automobile Insurance Company
NAMED INSURED:
CONNERY, SUSAN B & PETER &
APPLIED SURVEY RESEARCH IN
PO BOX 1927
WATSONVILLE CA 95077-1927
POLICY NO:
YR/MAKE/MODEL: NONOWNED AUTO
VIN/CAMPER:
AGENT NAME: JILL JUDD
AGENT PHONE: (831)462-1666
ENDORSEMENT NO: 6028BU
6164DP 6165CS
335 2611-B06-05P
2551-FC05-A
COVERAGE:
BI AND PD LIABILITY
$ 1 MIL
POLICY EFFECTIVE
JUN 11 2020 UNTIL TERMINATED
POLICY MESSAGES: This policy shown above supersedes policy# 3352611-050.
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
is provided, it shall be presumed that the required renewal premiums have been paid. The additional insured must notify us within 10 days of
any change of interest or ownership coming to their attention. Failure to do so will render this policy null and void.
FRT
StateFarm STATE FARM®
0
0
0
121000.8 (o1a0821f) 06-06-2014
00
PO Box 853922
Richardson, TX 75085-3922
42A
AT1 02
000127 0093
CITY OF GILROY ITS OFFICERS,
EMPLOYEES AND REPRESENTATIVES
7351 ROSANNA ST
GILROY CA 95020-6196
11111 I I I I l i l I1111111111111I 11111111111111111I11111111' 11111111111
A
DATE OF NOTICE: JUN 18 2020
CODE:
NOTE: PLEASE NOTIFY STATE FARM AT THE
ADDRESS LISTED AT THE TOP, LEFT CORNER
OF THIS PAGE REGARDING ANY CHANGE OF
ADDRESS INFORMATION.
ADDITIONAL INSURED'S NOTICE OF COVERAGE
State Farm Mutual Automobile Insurance Company
NAMED INSURED:
CONNERY, SUSAN B & PETER
DBA APPLIED SURVEY RESEARCH
PO BOX 1927
WATSONVILLE CA 95077-1927
POLICY NO:
YR/MAKE/MODEL:
VIN/CAMPER:
AGENT NAME:
AGENT PHONE:
446 0758-C16-05C
2001 CHEVROLET SPORT WG
3GNEC16T71G160093
JILL JUDD
(831)462-1666
ENDORSEMENT NO: 6028BU
2551-FC05-A
COVERAGE:
BI AND PD LIABILITY
$ 1 MIL
$250 DED. COMP.
$250 DED. COLL.
POLICY EFFECTIVE
JUN 11 2020 UNTIL TERMINATED
POLICY MESSAGES: This policy shown above supersedes policy# 4460758-05B.
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
is provided, it shall be presumed that the required renewal premiums have been paid. The additional insured must notify us within 10 days of
any change of interest or ownership coming to their attention. Failure to do so will render this policy null and void.
FRT