Lutf 11
Lutf 11
or Office
F
use Only
LOSS PAYEE
☐ OTHER
COVERAGES AND LIMITS INDICATED BELOW BY AN “X” IN THE INCLUDED COLUMN IS AFFORED FOR ABOVE DESCRIBED VEHICLE:
IMITS OF
L IMITS OF
L
COVERAGES LIABILITY INCLUDED COVERAGES LIABILITY INCLUDE
D
A/AABODILY INJURY LIABILITY
Each Person $100,000/$300,000 X Med Pay NA
Each Occurrence
B/BBPROPERTY DAMAGE LIABILITY JTOWING
J 100
$
Each Occurrence $50,000 X UU RENTAL REIMBURSEMENT $900 X
The Loss Payable Clause of such policy provides: The Additional Interest Endorsement of such policy, in part, provides:
This Certificate of Insurance neither affirmatively nor negatively amends, extends, or alters the coverage afforded by the policy referred to above.
“ The company reserves the right to cancel such policy at any time as provided by its terms, but in such case “ …such insurance as is afforded by the policy” for automobile liability insurance listed …hereof applies also
the company shall notify the Lienholder when not less than ten days thereafter such cancellation shall be to the person or organization named as Additional Interested Party. “As respects such …interest, no
effective as to the interest of said Lienholder therein and the company shall have the right, on like notice, to cancellation…and no endorsement…adversely affecting such additional interest, shall be effective until ten
cancel this agreement.” (10) days following the mailing of written notice (to the person or organization) of such cancellation or
endorsement…”
This Certificate of Insurance neither affirmatively nor negatively amends, extends, or alters the coverage afforded by the policy referred to above.