INSURANCE COVERAGE NOTIFICATIONDO NOT RETURN UNLESS YOUR
ADDRESS HAS CHANGED. In an
effort to improve the accuracy of our
mailings LexisNexis continually
works to update inaccurate mailing
addresses. To help in that effort we
have included this return postcard to
allow you to send us updated
address information. Please only
return it if you are still the Loss
Payee and the notices should be
sent to a different address than what
we currently have on file for you.
Place
11111 Stamp
Here
10.1.1906 1 AS 0.220 33643P11.p01
283385.5289887-1-A
LexisNexis/FIRSt
Mail Drop 91 H
1200 Bluegrass Lake Parkway
Alpharetta, GA 30004
IMPORTANT: INSURANCE COVERAGE NOTIFICATION(S)
The insurance notification below indicate that lhe'Adion'
listed in'REASON' was taken by 'Carrier' on 'Effective Date' in reference to 'Policy' for'Insured' covering 'Vehicle',
Instructions:
1) If you are no longer the Additional Insured or Loss Payee contact the Carrier or Producer.
2) Contact the Carrier or Producer for all policy related questions or additional inquiries.
3) Contact LexisNexis/FIRS1 by EMAIL at firstsupport@LexisNexis.com or FAX at (866) 293.1863 to change your mailing address.
4) To receive future notifications electronically, EMAIL firstsupport®LexisNexis.com.
Policy: BPG97272 REASON: Cancellation Rescind Notice Created: 0805/2009 Eff. Dte: 06/05/2009
Carrier: NGM Insurance Company Pol. From: 06/02/2009 Pol. To: 06/02/2010
Loss Pay: City Of Clearwater-Drew Street-Clearwater, FL 33755
insured:Jpk Clearwater Enterprises Inc Dba Callyogurt-519 Cleveland Street Ste 105-Clearwater, FL 33755
Add. Ins.:
Insurance: NGM Insurance Company-P O Box 2004-Keene, NH 03431
Producer: Bb&T-Iler Wall & Shonter-Po Box 14448-St. Petersburg, FL 33733 P: (727) 327.7070
Deducts: Comp: Coll: State Reg:
Vehicle:
End.No.: 090189004
taozes: BUSN Ol9NER
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