NOTICE OF NONRENEWAL OF INSURANCELLOYDS OF LONDON
18302 HIGHWOODS PRESERVE PARKWAY
SUITE 310
TAMPA FL 33647
NOTICE OF NONRENEWAL OF INSURANCE
Named Insured & Mailing Address:
CLEARWATER NEIGHBORHOOD HOUSING
SERVICES, INC.
608 N GARDEN AVE
CLEARWATER FL 33755
Producer: BWCU01
BURNS 8� W�LCOX-TAMPA
18302 HIGHWOODS PRESERVE PKWY
SUITE 310
TAMPA FL 33647
Policy No.: 455369
Type of Palicy: COMMERCIAL PROPERTY
Date of Expiration: 03/31/2013; 12:01 A.M. Local Time at the mailing address of the Named Insured.
We are nonrenewing this policy. Caverage will cease on the Expiration Date shown above.
Our records indicate you are an "insured" or other party of interest under this policy. This is your notice that thE:�
named insured's coverage under this policy is being nonrenewed on the Expiration Date indicated in the above
box.
Martgagee/Lienholder
CITY OF CLEARWATER
112 S. OSCEOLA AVE
CLEARWATER FL 33756
Date Mailed:
12th day af February, 2013
7rina F: Swartz
AUTHORIZEO REPRESENTATIVE
FLCN27NI�NE APP
FORM# CN9697FL51995 01172Q13MYNN
ODEN 3.0.12.12a Copy for Mortgagee/Lienholder F'age 1 of 1