REINSTATEMENT NOTICE (3)
PHILADELPHIA INDEMNITY INSURANCE COMPANY
ONE BALA PLAZA
SUITE 100
BALA CYNWYD PA 19004
REINSTATEMENT NOTICE
RECEIVED
JUN 02 2008
Named Insured & Mailing Address:
Producer: 0018418 OFFiCIAL RECORDS AND
LEGISLATIVE SRVCS DEPT
LOCKTON COMPANIES, LLC
525 WEST MONROE,
SUITE 600
CHICAGO IL 60661
CHILDREN'S HEART FOUNDATION
PO BOX 244
LINCOLNSHIRE IL 60069
Policy No.: PHPK282080
Type of Policy: PACKAGE INCLUDING AUTO
You recently received a notice advising this policy was being cancelled effective 06/02/2008.
This notice is to advise that the policy is being reinstated without lapse in coverage.
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MA'I27 RklO:49
CITY OF CLEARWATER
112 S OSCEOLA AVE
CLEARWATER FL 33756
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Date Mailed:
20th day of May, 2008
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Additional Insured
i
i MAUREEN O'BRIEN
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FORM# CT9698971L51995
aDEN 3.0.08.02.
Copy for Additional Insured
ILCT36
05202008SINY
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PHILADELPHIA INDEMNITY INSURANCE COMPANY
ONE BALA PLAZA
SUITE 100
BALA CYNWYD PA 19004
NOTICE OF CANCELLATION OF INSURANCE
Named Insured & Mailing Address:
Producer: 0018418
CHILDREN'S HEART FOUNDATION
PO BOX 244
LINCOLNSHIRE IL 60069
LOCKTON COMPANIES, LLC
525 WEST MONROE,
SUITE 600
CHICAGO IL 60661
Reference: N/A
Policy No.: PHPK282080
Type of Policy: PACKAGE INCLUDING AUTO
Date of Cancellation: 06/02/2008; 12:01 A.M. Local Time at the mailing address of the Named Insured.
We are cancelling this policy. Your insurance will cease on the Date of Cancellation shown above.
The reason for cancellation is NONPAYMENT OF PREMIUM $ 186.57.
You may request we provide you and/or your insurance producer with information about losses under this policy
and previous policies, which we have issued to you not to exceed three years. The information will give you
details of closed claims, open claims and reserves for occurrences which mayor may not be concluded as a
claim. We will provide the information to you within 30 days from the date we receive your request.
Your interest in this policy as an "insured" or other party of interest is being cancelled effective 06/02/2008;
12:01 A.M. Local Time at the mailing address of the named insured.
E'CFllED
MAY 23 2008
OFF:(';;IL RECORDS AND
LEGJ$u.tJIVE SRVCS DEPT
CITY OF CLEARWATER
112 S OSCEOLA AVE
CLEARWATER FL 33756
Date Mailed:
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Additional Insured
.
FRAN DEEMING
FORM# CC9697011L72003
ODEN 3.0.08.028
Copy for Additional Insured
ILCC36NONPMNT
05142008MYNY
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