NOTCE OF CANCELLATION OR NON RENEWAL
POLICY NO.
ISSUED THROUGH AGENCY OR OFFICE AT:
AVIATION OFFICE OF AMERICA INC.
Nt" TICE OF CANCELLATION OR NONRENErA, L
I AIRPORT LIABILITY _,
KIND OF POLICY
CANCELLATION OR TERMINATION WILL TAKE EFFECT AT:
(DATE) (HOUR-STANDARD TIME)
LOVE FIELD TERMINAL
BUILDING
DALLAS. TEXAS 75235
OF
DATE OF NOTICE
BINDER
AGENCY MARKETING SERVICES, INC.
ST. PETERSBURG FL. 33743-1786
OCTOBER 28 198
OCTOBER ~6 1986
INSURANCE
COMPANY
UNITED STATES FIRE INSURANCE COMPANY
NAME AND .
ADDRESS
OF INSURED .
CITY OF CLEARWATER
P.O. BOX 4748
CLEARWATER, FLORIDA 33518
D
(Applicable item marked IZJ)
r;-;] You are hereby notified in accordance with the terms and conditions of the above mentioned policy that your insurance will cease at and from the hour
LJU and date mentioned above.
If the premium has been paid. premium adjustment will be made as soon as practicable after cancellation becomes effective.
If the premium has not been paid, a bill for the premium earned to the time of cancellation will be forwarded in due course.
You are hereby notified in accordance with the terms and conditions of the above mentioned policy that your insurance will cease at and from the hour
and date mentioned above due to nonpayment of premium.
A bill for the premium earned to the time of cancellation will be forwarded in due course.
CANCEL.
-LATlON
NON-
RENEWAL
D
You are hereby notified in accordance with the terms and conditions of the above mentioned policy that the above mentioned policy will expire effective
at and from the hour and date mentioned above and the policy will NOT be renewed.
IMPORTANT D In compliance with the Fair Credit Reporting Act (Public Law 91.508), you are hereby informed that the action taken above is being taken Wholly or partly
NOTICE because of information contained in a consumer report from the following consumer reporting agency:
AVIATION OFFICE OF AMERICA
5780 PEACHTREE DUNWOODY, N.E. (N~UfTE 470. ATLANTA. GA. 30342
(ADDRESS)
INSURED'S COpy
17 ('
G~n'n I
Authorlze~
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GU 8811b (Ed. 3-73) I"'"",,",-:'::~,..cr-'
@ 1983