NOTICE OF CANCELLATION FOR NON PAYMENT
...
I
o NATIONAL INDEMNITY COM;~Y
o NATIONAL FIRE & MARINE INSURANCE COMPANY
o NATIONAL LIABILITY & FIRE INSURANCE COMPANY
o COLUMBIA INSURANCE COMPANY
~NATIONAL INDEMNITY COMPANY OF FLORIDA
o NATIONAL INDEMNITY COMPANY OF MINNESOTA
... ",.... (l ~li
1! "'~ '.'
. .,~ r~ '~"'.
.( ":;
IjCi 9.,Q 1~
3024 Harney Street, Omaha, Nebraska 68131 . (402) 346.7400
Cir\.
Date: 10-19-88
To: City of Clearwater
P.O. Box 4748
Clearwater, Florida 34618-4748
Insured's Name:
Classic Limos of Tampa Bay, Inc.
700 Spottis Woode Lane
Clearwater, Fl. 34615
Insured's Address:
Policy Number.:
7AP 11 41 47
Dear Sir(s):
C\.;r:I~K
This is to notify you that the above insured's policy (Number as shown above). has been canceled
effective 10-/1-88
This notice is being given in accordance with the following: (check the appropriate box)
~1::ertificate of Insurance, Form M-l00, that was sent to you in connection with this policy.
o Your being indicated as a loss payee on the captioned policy.
o Other
Yours truly,
Dana Roehrig & Associates, Inc.
,
~k/ ;j~7~P;
. I
f 1 (Signature)
cc: Nico 0 F,
cc: Horne Shopping INs.
cc: Insured
M-1627a 111/761
c--e~~-*@~
II.'"