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<br />INSURANCE FACT SHEET <br /> <br />I <br />I <br /> <br />We require a Certificate of Insurance or Declaration Page shown in the name of the Municipal- <br />ity listed below. If more than one insurance company is used, indicate each & for what type <br />coverage. Per the Agreement, we require Liability & Physical Damage on all vehicles, Liability <br />& Property Damage on all other equipment & FORD MOTOR CREDIT COMPANY named as <br />Loss Payee or Additional Insured. RETURN TO: Ford Motor Cred~ Company, P.O. Box 1739, <br />Dearborn, MI 48121-1739 <br /> <br />, <br /> <br />I! <br /> <br />TRANS NO: <br /> <br />3987001 <br /> <br />LIP AGREEMENT NO: 39870 <br /> <br />MUNI: <br />. ADDRESS: <br />CITY: <br /> <br />City of Paris <br />135 First Street S.E. <br />Paris, TX 75461-9037 <br /> <br />,0 <br />l' <br /> <br />CONTACT: <br /> <br />Carol Morgan <br /> <br />PHONE: (903)785-7511 <br /> <br />EQUIP DESC: One Ford New HoJland 5030 Tractor with Terrain King Versa Mower, <br />(S.N.055063B) with 04311 <br /> <br />INSURANCE COMPANY: Texas Municipal League <br /> <br />ADDRESS: 211 East 7th Street, 3rd Floor <br /> <br />CITY: <br /> <br />Austin <br /> <br />STATE: TX ZIP: 78701 <br /> <br />PHONE: (512) 320-1325 <br />POLICY NO: 5823-95 <br /> <br />CONTACT PERSON: Paula Rntthnff <br />EXPIRATION DATE: Q/10/Q7 <br /> <br />LIABILITY AMT: 5,000,000 PROPERTY DAMAGE AMT: ACV <br />PHYSICAL DAMAGE AMT: COMPREHENSIVE DEDUCTIBLE: ACV <br />COLLISION DEDUCTIBLE: $1,000 <br /> <br />INSURANCE COMPANY: <br /> <br />ADDRESS: <br /> <br />CITY: <br /> <br />PHONE: <br />POLICY NO: <br /> <br />STATE: <br /> <br />ZIP: <br /> <br />CONTACT PERSON: <br />EXPIRATION DATE: <br /> <br />LIABILITY AMT: PROPERTY DAMAGE AMT: <br />PHYSICAL DAMAGE AMT: COMPREHENSIVE DEDUCTIBLE: <br />COLLISION DEDUCTIBLE: <br /> <br />...- I~' <br /> <br />SELF-INSURED: <br />IF YOU ARE SELF-INSURED FOR ANY COVERAGE, PLEASE PROVIDE THE NAME OF YOUR <br />INSURANCE POOL/FUND. <br /> <br />NAME OF INSURANCE POOL/FUND: <br /> <br />SELF-INSURED FOR: LIABILITY: $ <br />CONTINUOUS COVERAGE: FROM <br /> <br />PROPERTY: $ <br />TO <br /> <br />PHYSICAL:$ <br /> <br />\ <br />\ <br />'. I <br />I <br /> <br />PLEASE SIGN: <br /> <br />Michael E. Malone City Manager <br /> <br />'! I <br />