NOTICE OF CANCELLATION OR NONRENEWAL
NOTICE OF CAN~LLATION OR NONRENEWAL
STAT FLORIDA
I
POLlCY#
RCA 200373
ISSUEO THROUGH AGENCY
OR OFFICE A T:
CLIFTON, NEW JERSEY
CANCELLA TION OR TERMINA nON
DA TE OF NOTICE
0712012001
05/09/2001
12:01 A.M.
INSURANCE
COMPANY
FIRE & CASUALTY INS. COMPANY OF CT
TYPE OF POLICY:
COMMERCIAL LINES POLICY
NAME AND
ADDRESS
OF INSURED
CLEARWATER BEACH SEAFOOD, INC.
TIA CRABBY BILL'S CLEARWATER BEACH REST.
37 CAUSEWAY BLVD.
CLEARWATER, FL 33767
teasonlsl for Cancellation (ADDlicable item marked XI
-2L- You are hereby notified in accordance with the terms and conditions of the above mentioned po~cy, and in accordsncewith law, that your insurance will caase
from !he hour and date mentioned above for !he reason(s) stated in !he "IMPORTANT NOTICES" section below.
---'If your insurance rs being-am:ellJed -cflJe 'to n(1npaymi:lnrotpremiUn'--'-'cancellation can ljif avoidelffiY 'paYing'1tie prem"iu-rTi"due prior to the effec'trvedi:ite orcanceilalio-n.
x
NON RENEWAL. You are hereby notified in accordance with the terms and conditions of the above mentioned policy, and in accordance with taw, that the above
mentioned policy will expire effective at and from the hour and date mentioned above and the policy will NOT be renewed for the rasson(s} stated in the "Important
Notices" section below.
-2L- IMPORTANT NOTICES - Reason(s) for cancellation or nonrenewal:
LOSS OF REINSURANCE.
'0 LIENHOLDER:
XX
You are hereby notified that the, agreement under the Loss Payable Clause payable to you as Uenholder, which is a part of the above po/icy, issued to
\he above insured, is hereby cancelled or nonrenewed in accordance with the conditions of the policy, said cancellation or nonrenewaJ to be effective
on and after the hour and date mentioned above.
'0 MORTGAGEE/LOSS PA YEElADDITlONAL INSURED:
07/2012001
Effective at 12:01 A.M. (Standard Time), we hereby canceVnonrenew the Mortgagee Agreement which is made part of the above mentioned policy
;sued to the insured named above covering on
COMMERCIAL LINES POLICY
37 CAUSEWAY BLVD., CLEARWATER, FL 33767
It
Ind made payable to you as mortgagee (or trustee),in the event of loss.
~SURANCE
:OMPANY
FIRE & CASUALTY INS. COMPANY OF CT
RECEIVED
AME AND
,DDRESS
IF MORTGAGEE:
lR LOSS PAYEE:
lR ADDITIONAL
~SURED:
THE CITY OF CLEARWATER
CIO RISK MANAGEMENT
MAY 1 1 ?nn,
P.O. BOX 4748
CLEARWATER, FL 33758
RISK MANAGEMENT
THIS DOCUMENT WAJJ CREATED USING 'WORDFu' BY MIPS OATAUNE AMERICA, wc.
To REMove THIS MESSAGE ORDER THE p~ BY CAU.ING 1-800~9US60 OR CONTACT YOUR LOCAl MIPS OATAUNE AMERICA REPRESENTAT1VE.
lia Certified Return Receipt l \
:onfirmation#: 70001670000718860~3~
Form RCA 05/1998
R~'. "J'",\
CC~'':6 \;: Cu
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Kt s Ie
MAYl :~ l(lU't
CITY CLERK DEPARTMENT
.