NOTICE OF NON RENEWAL OR INTENT TO CANCEL
Notice of Non-Renewal or Intent to Cancel
'-.~-'
. Some of the Companies named below are not licensed In every state
U Hartford Fire Insurance Company CJ Newlork Underwriters Insurance Company :::: Hartford Insurance COEny 01 the Midwest
~artford Accident and Indemnity Company IJ Twi ity Fire Insurance Company :::: Hartford Insurance Co any 01 Alabama
IJ Hartford Casualty Insurance Company i::J Ha d Insurance Company 01 Illinois ~ Hartford Insurance Co I ny 01 the Southeast
Hlrtford PIUI, Hlrtford, CetlHCtIClll 06115
Date of this Notice
1-27-86
Expiration Date
Name and Address of Regional Office
~.. bpu.
3-26-86
1.1 .. .lX6827
CltJ .rCleanat:_
tit,. IIa11 """
~. I'L. 33516
L
-, __ ~ ~.iIwed Insured and Address
I 181.. IIDIlZl
Qeoqe L. Tftjl1.lo c-..thetioa Co.
P.o. .. 1681
~"""'J4~ fL. 33U3
-.J L
J
~
This is to notify you that the Company, designated on policy number
81 UD UA27
cJ Will not renew ;he above numbered POIi~y be~ond the Expiration Date shown. All coverages pro;ided will terminate on that date
D Intends to cancel the above numbered policy.
This is an advance notice sent to you
days' warning before the date of the Notice of Cancellation.
D Will be unable to continue your coverage beyond the Expiration Date shown because your agent no lon~r represents this Company. AI
coverage provided by the policy will terminate on that date. H E eEl V E D
D
JAN 30 1986
CITY CLERK
You may wish to avail yourself of the services of the Facility indicated below either through your present agent or broker or directly by application to
the Facility lor continued insurance coverage.
Name and
Address of
Facility
We hope this advance notice will enable you to arrange lor replacement insurance and avoid any interruption in your insurance protection. We
suggest you contact your agent or broker immediately.
I
~rB.JJy.
By......................................................................................
I
Producer's Name and Address
David Chapuu Agcy lac. 152160
Property and Casualty Department
df 1/21/& HO
-.J
~
(exp.3-26-86)
Form PPF-554-4 Printed in U.S.A.
THE HARTFORD