REINSTATEMENT NOTICE
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REINSTATEMENT NOTICE
o NATIONAL INDEMNITY COMPANY
o NATIONAL FIRE & MARINE INSURANCE COMPANY
o COLUMBIA INSURANCE COMPANY
nNATIONAL INDEMNITY COMPANY OF FLORIDA
Gulfcoast Limo, Inc.
450 S. Gulfview Blvd. '~03
Clearwater, Florida 34630
December 15,
19
88
Please take notice that Policy No.
7AP II 30 93
,issued to you by this Company and canc~lIed
by notice dated
November 15,
, 19~ , said notice to take effect at twelve and one
minute o'clock A.M. on the
4th
day of
January
, 19 89
is hereby reinstated and that the insurance hereunder is in full force and effect from twelve and one minute o'clock
A.M.onthe
4th
day of
January
, 19 ~, standard time.
Countersigned at St. Petersburg, Fl.
cc: Orlando Office
cc: Poe & Associates
cc: City of Clearwater
t~per~e~~
Secretary
(!~. (!k~-..
M.1860b i12/83)
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L._..v/ /....,{_..J
I 3/81
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..;;'.....-7.."'r,'''T''"'''''''1f'.'m~'...~':-.-_9"'" '
:;-,""-11".,.----
Signed this
/ .-."
,/ ,..
day of
"
19_
FOR ORDINARY MAIL
CANCELLATION NOTICE
Ui;l'1l o~lloPy to the Company without delay and I
Complete Certification of Melling Below _~
FOR REGISTERED MAIL
CANCELLATION NOTICE
,.. sturn one copy to the Company without delay and
. .. Attach both tissue paper Registered Mall Receipt
and Registered Letter Receipt Card
] NATIONAL INDEMNITY COMPANY
J NATIONAL INDEMNITY COMPANY OF FLORIDA
] NATIONAL INDEMNITY COMPANY OF MINNESOTA
] NATIONAL FIRE & MARINE INSURANCE COMPANY
] NATIONAL LIABILITY & FIRE INSURANCE COMPANY
] COLUMBIA INSURANCE COMPANY
U-l0l1f l7IB61
3024 HARNEY STREET, OMAHA, NEBRASKA 68131
NOTICE OF CANCELLATION
F
!mmF.JtCIAL Auto
POLICY
lUCY NO.
KINO OF POLICY
ISSUED THROUGH AGENCY OR OFFICE AT:
IS CANCELLED TO TAKE EFFECT AT:
12:01 A. M.
1/4/89
iAP113091
.flS NOTICE MAl LED TO:
ST. PETERSBURG. fL
HOUR - STANDARD TIME. DATE
r
-,
GULFCOAST LIMO, INC.
450 S. GULlVl1-. BLVD. 1803
CLEARWATKR BRACH, FL 34630
-I
AMOUNT OF POLICY $
PREMIUM $
EXPIRATION
RETURN PREMIUM
PREMIUM DUE
2/24/89
L
$
$----
You ere hereby notified that in accordance with the terms and conditions of the above mentioned policy your insurance will cease at and
from the hour and date mentioned above.
UNDERWRITING RY.QUIREMENT-CANNOT OBTAIN DRIVERS F.XCLUSION ON JOSEPH MURNAN
If the premium has been paid, premium edlustment will be made IS soon as practicable after cancellation becomes effective. Excess
premium paid, If any, will be refunded on demand.
If the premium has not been paid, a bill for the premium earned to the time of cancellation will be forwarded In due course.
....
NATIONAL INDEMNITY eOMrA"~Y or FLORIDA
COMPANY
AUTHORIZED REPRESENTATIVE
DANA ROEHRIG' ASSOCiATES, INC.
eel IUca or PL
eel CITY or CLEARWAtER
cc; IMPETUAL PUKIUM rIftANC!, IRC.
cc; PO! " AS8OCIAYI':S
eCI ORLANDO OFFICE
JUBt Ql)ffitt Jl1tpnr1tntut
Received from
AFFIX STAMP
AND
POSTMARK
CERTIFICATION
. One piece of ordinary.. __ _________class
mail addressed to-
I hereby certify that I personally mailed in the U.S. Post Office
at the place and time stamped hereon, a notice of cancellation,
an exact carbon. copy of which appears above, and at said time
received from the U. S. Post Office the re.:eipt (Form 38171 hereto
attached.
--- - - -- - - -- - - - ...-- - - --- ----------- ----------------
THIS RECEIPT DOES NOT PROVIDE FOR INDEMNIFICATION
FORM 3817
FACSIMILE
POSTMASTER
Signature \
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