NOTICE OF CANCELLATION OR NONRENEWAL (2)
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NOTICE OF CANCELLATION
1- OR NONRENEWAL
Dale Mailed
?/:l.2/93
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> II NDEMNI TY UNI:i[hl...JF~ I TEF;:~:) I N~:)UF:ANCE COMPANY
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: MIAMI, OKLAHOMA
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fAMPA, FLORIDA 336:1.4
PoliCY
Number
UL.O 0 1 ~',.iJ/t:l.
INC.
Issued Through
PYogqm Undefwrlten, Inc. Coconut Creek, FI.
Termination
Will take effect at 12:01 A.M. (Standard Time)
4 / :::.~9 / 93
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RECEIVED
FEB 1 7 1993
On
(Date)
CITY CLERK DEPT.
Applicable item(s) marked (x) below
) CANCELLATION 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. 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.
Reason(s) for cancellation:
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X) NONRENEWAL You are hereby notified in accordance wi!hfhe-terms and conditions ofthe abovementioned policy that thecmo~\le-
mentioned policy will expire effective at and from the hour and date mentioned above and the policy will not. be renewed. .
Reason(.) for nonrenewal:
CClMF'ANY NO t..DNLJEF{ WHITING THU; CI...AGG OF BLJSINE~:;S
INFORMATION ( ) below ( ) attached pertains to this cancellation or nonrenewal. and. requirements of State Insurance Codes.
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~ HEHBERT LEONHARDT INSURANCE
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g 5100 EAST BAY DRIVE SUITE 500
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~~ 470 N. GUlFVIEW BLVD.
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LIEN HOLDER OR MORTGAGEE
.,.. YOU ARE HEREBY NOTIFIED THAT MORTGAGE OR
A. 1 . .r + M. "'OAN AGREEMENT. PAYABLE TO YOU AS MORT-
GAGEE OR LIEN HOLDER. WHICH IS A PART OF THE
ABOVE POLICY. ISSUED TO THE ABOVE INSURED.
IS H El'lE BY CANCELLED IN ACCORDANCE WITH
THEi POLICY, SAID CANCELLATION TO BE EFFEC-
TIVE ON AND AFTER THE HOUR AND DATE MEN-
TIONED ABOVE,
DWNEF{S,
INC.
CERTIFICATION
I hereby certify that I perlonaHy mailedi" the U,S, POlt
Oflice at the place andti me stamped heron. a notice 01
cancellation or nonrenew.1 to the Inlured and. il re-
quired. to the lien holder. an exact carbon copy "f which
app.a.r. above. and at said time received Irom the U,S,
Post Office the receipl(Form 3817) made. part hereof
or a"ached,
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