REINSTATEMENT NOTICE (4)A FLORIDA WORKERS COMPENSATION
JOINT NNDERWRIDNC ASSOCIATION, INC.
03322 -AM
2420 LAKEMONT AVE STE 200
ORLANDO FL 32814
CP 01 6640 G6640P0S 14158 03322 P1
CITY OF CLEARWATER
P.O. BOX 4748
CLEARWATER
REINSTATEMENT NOTICE
FL 33758
F;
RECEIVED
JUN 1 6 2014
Customer Service
Please take notice that the Policy designated below has been reinstated as of the effective date of the reinstatement
stated below, notice of cancellation heretofore issued being hereby withdrawn as null and void.
POLICY NUMBER: ( 6FR1 3UB-7D74823-6-1 3 )
ISSUE DATE: 06 -06 -14
NAME AND ADDRESS OF INSURED
MIDFLORIDA ARMORED & ATM
SERVICES INC
4314 WEST DR MLK BLVD
TAMPA FL 33614
PRODUCER OR AGENT
ADCOCK - ADCOCK PROPERTY &
2284N
ISSUING OFFICE
FLORIDA WC JUA 821
EFFECTIVE DATE OF THIS NOTICE
07 -01 -1 4
LOCATION
(Complete for Fire Policies or Fire Coverages ONLY)
VEHICLE IDENTIFICATION
(Complete for Auto Policies or Coverages Only)
WRITTEN NOTICE IS HEREBY GIVEN TO YOU AS:
THE PERSON TO WHOM AN INSURANCE CERTIFICATE WAS ORIGINALLY ISSUED OR A BANK
OR FINANCE COMPANY;
AN ADDITIONAL INSURED UNDER THE TERMS OF THE POLICY;
A MORTGAGEE
X
CN003C0394
THIS NOTICE IS GIVEN ONLY BY THE
COMPANY OR COMPANIES WHICH ISSUED
THE POLICY DESIGNATED ABOVE.
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