CANCELLATION NOTICE (010)
lOERATEO MUTUAL INSURANCE COM4._NY
5887 Glenridge Dr NE
Atlanta, GA 30358
Certificateholder
Insured
CITY OF CLEARWATER
POBOX 4748
CLEARWATER FL 34618
059-620-5
SOUTHERN PLUMBING
R & K SOUTHERN PLUMBING
CORP DBA
POBOX 387
PORT RICHEY FL 34673
CANCELLATION NOTICE
CANCELLATION of the following policy was requested by the insured,
Cancellation as respects any named mortgagee, certificateholder, additional insured, or loss payee interest shall be
effective ten days after receipt of this notice,
Policy
Number
Coverage
Cancellation
Date
9040117
COMMERCIAL PACKAGE POLICY
11/22/90
.'
This Notice was mailed on February 7,1991.
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MF0.40 106-87 Cl
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