NOTICE OF CANCELLATION OF INSURANCENATIONAL CASUALTY COMPANY
C/O K& K INSURANCE GROUP, INC.
1712 MAGNAVOX WAY
FORT WAYNE IN 46804
NOTICE OF CANCELLATION OF INSURANCE
Named Insured & Mailing Address:
GREENWOOD PANTHERS CULTURE AND SPORTS
ORGANIZATION
ATTN: JOSEPH MARSHALL
1380 S MADISON AVENUE
CLEARWATER FL 33756
Producer: 5778
SADLER 8 COMPANY, INC.
PO BOX 5866, 14 DEVINE ST
SUITE 200
COLUMBIA SC 29250-5866
Policy No.: KR00000004478300/JXS0000026398300
Type of Policy: COMMERCIAL GENERAL LIABILITY
Date of Cancellation: 06/30/2015; 12:01 A.M. Local Time at the mailing address of the Named Insured.
We are cancelling this policy. Your insurance wili cease on the Date of Canceliation shown above.
The reason for cancellation is Failure to provide complete exposure information for underwriting and pricing.
Failure to meet American Youth Football membership process by under reporting the correct number of
teams/squads. Membership is required to be eligible for the insurance program.
Your interest in this policy as an "insured" or other party of interest is being cancelled effective 06/30/2015;
12:01 A.M. Local Time at the mailing address of the named insured.
Additional Insured
CITY OF CLEARWATER
PO BOX 4748
CLEARWATER FL 33758
FORM# CC9697FL51995
ODEN 3.0.15.02a
Copy for Additional Insured
Date Mailed:
22nd day of April, 2015
FLCCI5NONE APP
04222015SYNN
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