REINSTATEMENT NOTICE (2)
e.OUCYNUMSER CA R H 0 Q 1
bUU OjUj-D17-59
fEa-11-91
~~~W:E~ANCE ~ RICHARD OBA
JIMMIES..HECKER
1105 SEMINOLE ST
CLEARWATEa fL 34615-4344
ADDRESSEE
CITY Of CLEARWATER
PO BOX 47413
CLEARwATER fL 34618
~j~~;f~J.~~\i~~~f~~.~~~~~{':~~~~.r~~~~~~~~~~~ 75647
GQVERAGI;S
bl ANO PO LIABILITY
CAI'IPESCRIPTION (~JU<E-:YEAFl-BODY STYLE)
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~N 1FDJF37190NA46496
AGENT 9099
STATE FARM MUTUAL AUTOMOBILE INSURANCE CO.
WINTER HAVEN fL 338&8-0007
gOllCY /llUMSER CAR 00 5
tsuu l:uu~-D17-59
. ~--~ ":":--.--:-.:'::"'---'----
DATE Of NOTICE
fES-11-91
~S~~RU:E~ANC E & RI CHARD OBA
JIMMIE;) .RECKER'
1105 SEMINOLE ST
CLEARWATER fL 34615-4344
ADDRESSEE
CITY Of CLEARWATER
PO BOX 4748
CLEARwATER fL 34618
g<}VE'Jr&bS POL lAB I Ll TY
lWf~~fij'A1fiN (~YE--rif~-B.piYttTYLE)
~N 1HTCF26703G812471
AGENT 9099
75647
STArE fARM MUTUAL AUTOMOBILE INSURANCE CO
wINTER HAVEN fL 33888-0007 ·
"
WE ARE PLEASED TO INFORM YOU
THAT THIS POLICY HAS BEEN
PLACED BACK IN FORCE AS OF
OCT-17-90 .
"
THE ~D3RESSEE WILL BE GIVEN
10 DAYS NOTICE IF THE POLICY
IS TERMINATED. UNTIL SUCH
NOTICE IS PROVIDED, IT SHALL
BE PRESUMED THAT THE REQUIRED -
RENEWAL PREMIUMS HAVE BEEN
PAID.
ADDRESSEE MUST NOTIFY US
WITHIN 10 DAYS Of ANY CHANGE
OF INTEREST OR OWNERSHIP
CO~ING TO THEIR ATTENTION.
FAILURE TO DO SO ~ILL RENDER
THIS POLICY NULL AND VOID.
NOTICE Of INSURANCE COVERAGE
WE ARE PLEASED TO INFOR~ YOU
THAT THIS POLICY HAS 8E~N
PLACED BACK IN FORCE AS-OF
OCT-17-90 .
THE ADDRESSEE WILL SF GIV~N
10 OAYS NOTICE IF THE POLICY
.IS TERMINATED. UNTIL SUCH
NOTICE IS PROVIDED, IT SHALL
BE PRESUMED THAT THE REQUIRED _
RENEWAL PREMIUMS HAVE BEEN'
PAID.
ADDRESSEE MUST NOTIFY US
WITHIN 10 DAYS OF ANY CHANGE
OF INTEREST OR OWNERSHIP
COMIN~ TO THEIR ATTENTION.
fAILURE TO 00 SO WILL RENDER
THIS POLICY NULL AND VOID.
~/-/cJO-