HomeMy WebLinkAboutCOI - Applied Survey Research, Inc. - Until terminatedStateFarm STATE FARM®
O"U
PO Box 2368
Bloomington IL 61702-2368
DATE OF NOTICE JUL 09 2024
CODE:
r
121000.8 {o1a0821f) 06-06-2014
63A
AT1 02
000117 0093
CITY OF GILROY ISAOA
7351 ROSANNA ST
GILROY CA 95020-6196
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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 &
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 POLICY EFFECTIVE
6164DP 6165CS JUN 20 2024 UNTIL TERMINATED
POLICY MESSAGES: This policy shown above supersedes policy# 3352611-05Z.
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.
2551-FC05-A
499 0630-B06-05
COVERAGE:
BI AND PD LIABILITY
$ 1 MIL
FRT