HomeMy WebLinkAboutINDEPENENT SALT COMPANY - INSURANCE CERTIFICATE�, 01948 -AM
TRAVELERS)
2420 LAKEMONT AVE STE 100
ORLANDO FL 32814
CP 01 6640 GLL40POS 08327 01948 P1
CITY OF FORT COLLINS
ATTN: PURCHASING DIVISION
PO BOX 580
FORT COLLINS CO 80522-0580
[_Xj CANCELLATION NOTICE. Please take notice that the Policy designated below, issued to the insured named
below, has been canceled. Your interest under the Policy is canceled effective on the date stated below.
NOT TAKEN NOTICE. Please take notice that the Insured named below has not accepted the Policy designated
below and therefore no insurance has come into force thereunder.
❑ AMENDMENT NOTICE. Please take notice that, effective on the date stated below, the Policy designated below
has been amended as follows:
❑ NON -RENEWAL NOTICE. Please take notice that we have advised the insured that this Policy will not be
renewed.
REWRITE NOTICE. Please take notice that the Policy designated below has been canceled; however, it is being
rewritten.
POLICY NUMBER: (GKUB-0839C97-7-08 )
NAME AND ADDRESS OF INSURED
INDEPENDENT SALT COMPANY
P 0 BOX 36
KANOPOLIS KS 67454
EFFECTIVE DATE OF THIS NOTICE
1 1 -1 8-08
LOCATION
(Conilxete for Fire Policies or Fire Coverages ONLY)
ISSUE DATE: 11 -21 -08
PRODUCER OR AGENT
SUNFLOWER INSURANCE GRP 747GF
ISSUING OFFICE
ST LOUIS/NCCI O1I
(Comliete for Auto Policies or Coverages Only)
WRITTEN NOTICE IS HEREBY GIVEN TO YOU AS:
F XI 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
THIS NOTICE IS GIVEN ONLY BY THE
COMPANY OR COMPANIES WHICH ISSUED
THE POLICY DESIGNATED ABOVE.
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