NOTICE OF CANCELLATON FOR NON PAYMENT
Old Dominion Insurance Co.
PO Box 2004 ...
Keene, New Hamps~e 03431
4It
11/15/00
Busn Policy BPG15254
MORTGAGEE/LIENHOLDER
INSURED
CITY OF CLEARWATER
112 SOUTH OSCEOLA AVE.
CLEARWATER, FL 33756
PICKLES PLUS TOO INC
320 CLEVELAND STREET
CLEARWATER, FL 33758
Dear Policyholder, Thank yoU for your payment. Your insurance
coverage has been reinstated and remains in force. Your
reinstatement is dependent upon timely payment being honored
by the financial institution and if payment is not honored by
the financial institution, the policy will terminate on the date
and time shown on the cancellation notice issued for nonpayment
of premium.
00228
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C~~ d Dominion Insurance Co.
AGENCY
090168003
MITCHELL AGENCY INC.
14290 WALSINGHAM RD.
LARGO, FL 33774
RECEIVED
NO V 2. ti LUO[;
CITY CLERK DEPARTMENT
JAN-19-2001 08:39
CITY ATTORNEY'S OFFICE
7275624021
P. 02.,'02
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I
11
IMPORTANT INFORMATION
Concerning Your Motor Vehicle In$ur~nce
If t~e motor vehicle insurance policy being c~ncelled or nonranewed provides personal injury
protection benefits and property damage liabilitv insurance, Florida law reQuires that we
report such action to the Department of Highway Safetv and Hotor Vehicles within 45 days
from the effective date of the cancellation or nononrenewal.
Failure ~o maintain personal injury protection and property damage liability insurance on a
motor venicla when required by law may result in the loss of your motor vehicle re~i$tration
and driving ~rivileges in this state. Should your registration and driving privileges be
'suspended, the following fee will be charged for the reinstatement of your motor vehicle
registration and/or driver's license (if both your registration and license are suspended.
only one reinstatement fea shall be charged to reinstate the registration and license):
$150 - first reinstatement
'250 - second reinstatement
$500 - ea~h subsequent reinstatement during 3 years following the first reinstatement.
If you do not have a second reinstatement within 3 years after the initial reinstate.ent.
the r~instatement fee will be $150 for the first reinstatement after th~t 3 year period.
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RECEIVED
.IAN 1 9 ?DOl
MI::'I\ Iv1ANAGEMENT
TOTAL P.Q2