NOTICE OF CANCELLATION (11)NOTICE OF CANCELLATION
Third Party Copy
CERTHOLDER
Producer: MATTHEW J ALBANI 6 -243
FLORIDA AIR SYSTEMS INC
6600 E BROADWAY AVE
TAMPA, FL 33619
Account No. 344-925-3
Date: 10/31/2013
:Insured
Page 1 of 1
Reason for Cancellation:
Nonpayment of Premium
Place of Issue:
FEDERrATED
INSURANCEI
121 East Park Square
PO Box 328
Owatonna, MN 55060
Policy Time of
Policy Cancellation Policy
Number Policy Type Date Cancellation* Issuing Company
9365408 Business Owners Package 10/22/2013 12:01 a.m. Federated Mutual
9365409 Commercial Package Policy 10/22/2013 12:01 a.m. Federated Mutual
Each policy described above is cancelled as of the date and time above, according to the terms of the policy. No
coverage will be provided to any party under a policy described above as of the cancellation date and time shown above.
NO FURTHER CANCELLATION NOTICE WILL BE SENT.
Standard Time at the designated business premises.
CITY OF CLEARWATER Loss Payee/
PO BOX 4748 Mortgagee/
CLEARWATER, FL 33758 -4748 Additional Insured/
Certificate Holder
BY
FEDERATED MUTUAL INSURANCE COMPANY. FEDERATED LIFE INSURANCE COMPANY. FEDERATED SERVICE INSURANCE COMPANY.
F10 -90C (04 -13) HOME OFFICE: OWATONNA, MINNESOTA 55060 1- 888 - 333 -4949