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INSURANCE FACT SHEET We require a Certificate of Insurance or Declaration Page shown in the name of the Municipal- ity listed below. If more than one insurance company is used, indicate each & for what type coverage. Per the Agreement, we require Liability & Physical Damage on all vehicles, Liability & Property Damage on all other equipment & FORD MOTOR CREDIT COMPANY named as Loss Payee or Additional Insured. RETURN TO: Ford Motor Credit Company, P.O. Box 1739, Dearbom, MI 48121 -1739 3987001 City of Paris 135 First Street S.E. Paris, TX 75461 -9037 Carol Morgan UP AGREEMENT NO: 39870 PHONE: (903)785 -7511 One Ford New Holland 5030 Tractor with Terrain King Versa Mower, (S.N.055063B) with 04311 INSURANCE COMPANY: Texas Municipal League ADDRESS: 211 Fast 7th Street, 3rd Floor CRY, Austin STATE: Tx ZIP: 78701 PHONE: (512) 320 -1325 CONTACT PERSON: Paula Rntthnff POLICY NO: 5823 -95 EXPIRATION DATE: q / -jn197 LIABILITY AMT: 5,000,000 PHYSICAL DAMAGE AMT: INSURANCE COMPANY: ADDRESS: PROPERTY DAMAGE AMT: Acv COMPREHENSIVE DEDUCTIBLE: Acv COLLISION DEDUCTIBLE: $1,000 CITY: STATE: PHONE: CONTACT PERSON: POLICY NO: EXPIRATION DATE: Wa LIABILITY AMT: PROPERTY DAMAGE AMT: PHYSICAL DAMAGE AMT: COMPREHENSIVE DEDUCTIBLE: COLLISION DEDUCTIBLE: SELF- INSURED: IF YOU ARE SELF - INSURED FOR ANY COVERAGE, PLEASE PROVIDE THE NAME OF YOUR INSURANCE POOL/FUND. NAME OF INSURANCE POOL/FUND: SELF - INSURED FOR: LIABILITY: $ PROPERTY: $ PHYSICAL:$ CONTINUOUS COVERAGE: FROM TO PLEASE SIGN: Michael E. Malone City Manager TRANS NO: MUNI: ADDRESS: CITY: .••''.'h �.AY CONTACT: ' : ► .. EQUIP DESC: 3987001 City of Paris 135 First Street S.E. Paris, TX 75461 -9037 Carol Morgan UP AGREEMENT NO: 39870 PHONE: (903)785 -7511 One Ford New Holland 5030 Tractor with Terrain King Versa Mower, (S.N.055063B) with 04311 INSURANCE COMPANY: Texas Municipal League ADDRESS: 211 Fast 7th Street, 3rd Floor CRY, Austin STATE: Tx ZIP: 78701 PHONE: (512) 320 -1325 CONTACT PERSON: Paula Rntthnff POLICY NO: 5823 -95 EXPIRATION DATE: q / -jn197 LIABILITY AMT: 5,000,000 PHYSICAL DAMAGE AMT: INSURANCE COMPANY: ADDRESS: PROPERTY DAMAGE AMT: Acv COMPREHENSIVE DEDUCTIBLE: Acv COLLISION DEDUCTIBLE: $1,000 CITY: STATE: PHONE: CONTACT PERSON: POLICY NO: EXPIRATION DATE: Wa LIABILITY AMT: PROPERTY DAMAGE AMT: PHYSICAL DAMAGE AMT: COMPREHENSIVE DEDUCTIBLE: COLLISION DEDUCTIBLE: SELF- INSURED: IF YOU ARE SELF - INSURED FOR ANY COVERAGE, PLEASE PROVIDE THE NAME OF YOUR INSURANCE POOL/FUND. NAME OF INSURANCE POOL/FUND: SELF - INSURED FOR: LIABILITY: $ PROPERTY: $ PHYSICAL:$ CONTINUOUS COVERAGE: FROM TO PLEASE SIGN: Michael E. Malone City Manager