NON-PAY CANCELLATIONLexisNexis is not the Insurance
Company.
For any and all policy changes you
must contact the Insurance Company,
the Carrier or the Producer listed in
the detail below.
If you are not the intended recipient,
please return this card.
I 0
736681 - 5289887 -3 -A
LexisNexis /FIRSt
Mail Drop B1 /290 -W
1000 Alderman Dr
Alpharetta, GA 30005
Place
Stamp
Here
IMPORTANT: INSURANCE COVERAGE NOTIFICATION(S)
LexisNexis is not the Insurance Company.
-For any and all policy changes you must contact the Insurance Company, Carrier, or Producer listed in the detail below.
-For all cancellation, non - renewal, expiration, and lapse notices - all coverage will cease at 12:01AM local time at the premises, unless
otherwise shown in the item detail provided.
-If you want to receive future notifications electronically, email firstsupport@lexisnexis.com.
-This Insurance notice is sent to you as the Loss Payee /Mortgagee /Additional Interested Party on behalf of the carrier listed.
Policy:48. 394.499 -01 REASON: Non -Pay Cancellation Created: 07/13/2013 Eff. Dte: 08/01/2013 12:01 AM ST
Carrier: Southern - Owners Insurance Co Pol. From: 05/01/2013 Pol. To:
Loss Pay: CITY OF CLEARWATER -PO BOX 4748 - CLEARWATER -FL -33758
Insured: LARRYS CLASSIC AUTO BODY LLC -1910 CALUMET ST UNIT A- CLEARWATER -FL -33765
Insurance: Auto-Owners Insurance Co.
Producer: BROWN 8 BROWN OF FLORIDA INC -83 N PARK PLACE BLVD STE 101 - CLEARWATER -FL -33759 727.461.6044
Add. Ins.: Vehicle:
Notes: You are hereby notified that the insurance under this policy will cease at: 12:01 AM on 08 -01 -2013
FIRSt Id: 10190 -270- 5289887 - 225168916