HomeMy WebLinkAboutSTATE COMPENSATION INSURANCE FUND - INSURANCE CERTIFICATESTATE
COMPENSATION
INSURANCE
FUND
IN REPLY REFER TO:
DECEMBER 22, 2005
CITY OF FORT COLLINS, CO
PO BOX 580
FORT COLLINS
CO 80522
CERTIFICATE OF WORKERS'
COMPENSATION INSURANCE
----------------------
CANCELLATION NOTICE
-------------------
RE: CERTIFICATE DATED APRIL 1, 2005
THE WORKERS' COMPENSATION INSURANCE POLICY FOR THE EMPLOYER
NAMED BELOW HAS BEEN CANCELLED EFFECTIVE JANUARY 25, 2006 AT
12:01 A.M.
IF YOU HAVE ANY QUESTIONS REGARDING THIS NOTICE, PLEASE
CONTACT THE EMPLOYER NAMED BELOW
EMPLOYER:
ECONOLITE CONTROL PRODUCTS, INC
3360 E LA PALMA AVE
ANAHEIM, CA 92806
POLICY 1603984-05
POLICYHOLDER SERVICES
SANTA ANA DISTRICT OFFICE
(714) 565-5995
1275 Market Street •San Francisco, CA 94103-1410
Mailing Address: P.O. Box 420807 • San Francisco, CA 94142-0807
SCIF 19102