HomeMy WebLinkAboutMIDDLEBEAR SPRINKLERS - INSURANCE CERTIFICATENATIONAL AMERICAN INSURANCE COMPANY
POST OFFICE BOX 9
CHANDLER OK 74834
NOTICE OF CANCELLATION OF INSURANCE
Named Insured & Mailing Address: Producer: 17006
MIDDLEBEAR SPRINKLERS & HADDOCK INSURANCE AGENCY INC
LANDSCAPING LLC 287 CENTURY CIRCLE #101
PO BOX 272113 LOUISVILLE CO 80027
FORT COLLINS CO 80527-2113
Policy No.: MP05550205
Type of Policy: GENERAL LIABILITY OCCURRENCE
Date of Cancellation: 01/22/2009; 12:01 A.M. Local Time at the mailing address of the Named Insured.
We are cancelling this policy. Your insurance will cease on the Date of Cancellation shown above.
The reason for cancellation is INSURED'S REQUEST - PREMIUM FINANCE DEFAULT
Your interest in this policy as an "insured" or other party of interest is being cancelled effective 01/22/2009;
12:01 A.M. Local Time at the mailing address of the named insured.
Additional Insured
CID
CITY OF FORT COLLINS
PO BOX 580
FORT COLLINS CO 80522
Date Mailed:
22nd day of January�009
SENIOR VICE PRESIDENT
COCC15NONEAPP
FORM# CC9697CO51995 01222009SYNN
ODEN 3.0.08.12a Copy for Additional Insured Page 1 of 1