RESCISSION NOTICENATIONAL CASUALTY COMPANY
CIO K & K INSURANCE GROUP, INC.
1712 MAGNAVOX WAY
FORT WAYNE IN 46804
RESCISSION NOTICE
Named Insured & Mailing Address: Producer: 5583727
CLEARWATER JAZZ HOLIDAY INC
PO BOX 7278
CLEARWATER FL 33758
SOLACE INSURANCE
RUTH NICHOLS
10125 ULMERTON RD STE 200
LARGO FL 33771
Policy No.: KK00000003927400 /XK00000003927600
Type of Policy: COMMERCIAL GENERAL LIABILITY
The CANCELLATION notice issued to be effective 12/28/2013 is hereby rescinded.
Additional Insured
5583735 CJP /11
CITY OF CLEARWATER
PO BOX 4748
CLEARWATER FL 33758
FORM# CSO1 FL22006
ODEN 3.0.13.12a Copy for Additional Insured
Date Mailed:
3rd day of January, 2014
FLCS15RSCN_C
01032014SINY
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