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Notice of Cancellation
This notice
is issued by: MID—CENTURY INSURANCE COMPANY
Dale: 05/20/05
Property
Location:
(If other than shown ow)
try Or (erti icafe Num er(s) Agent Num er [once afion Date
04594-74-39 07-17-321 06/02/05
Named Insured And Mailing Address:
R T INSTALLATIONS INC
1649 E 83RD DR
DENVER CO 80229
Notice of Cancellation Of
Mortgagee Or Otller Interest
® You are hereby notified, that all coverage extended to you under the above listed policy is cancelled effective
on the cancellation date shown above at the time specified in the Declarations of this policy, unless you
have been notified of a more recent cancellation under other provisions of the policy.
❑ You are hereby notified that all coverage extended to you under the above policy(ies) or certificate(s) on:
is cancelled effective on the cancellation date shown above at the time specified in the Declarations of this
policy, unless you have been notified of a more recent cancellation under other provisions of the policy.
Note to Mortgagee: Your loan with this policyholder may have expired, however, this notice complies with
the provision of our policy.
Loan Number:
Mortgagee or Other Interest:
CITY OF FT COLLINS
PO BOX 580
FT COLLINS CO 80522
25-5096 5-02 MORTGAGEE, BUREAU, COMMISSIONS A5096131
OR OTHER INTEREST CON