HomeMy WebLinkAboutPOTTER COMMERCIAL WALLS AND CEILINGS - INSURANCE CERTIFICATEPINNAA COL
ASSURANCE
CITY OF FORT COLLINS
P.O. BOX 580
FORT COLLINS CO 80522
7501 E Lowry Blvd
Denver, CO 80230-7006
Phone: (303) 361-4000 / (800) 873-7242
Fax: (303) 361-5000 / (888) 329-2251
www.r)innacol.com
June 1, 2009
Policy #: 4102271
INSURED: AGENT:
POTTER COMMERCIAL WALLS AND CEILINGS WESTERN GROUP, INC - PUEBLO
43600 HWY 50E PO BOX 1958
AVONDALE CO 81022 PUEBLO, CO 81002
(719) 543-3604
Notice To Certificate Holder Of Pending Cancellation
Pinnacol Assurance would like to inform you that the workers' compensation insurance policy through our
company for:
Policy #: 4102271
Insured: POTTER COMMERCIAL WALLS AND CEILINGS INC
for whom you currently hold a certificate of workers' compensation insurance, is scheduled to terminate as of
June 17, 2009.
If the insured listed above elects to maintain the policy, we will send you a notice rescinding the cancellation.
As always, Pinnacol Assurance continues to be Colorado's premier workers' compensation insurance company.
If you have any questions regarding this letter, or if I can be of further help, please contact me at the numbers
listed below.
Sincerely,
Ryan Lanter, Underwriter
Phone: (303) 361-4524 / (888) 852-2263
Fax: (303) 361-5500 / (888) 329-2209
Pinnacol Assurance' 7501 E Lowry Blvd' Denver, CO 80230
Page 1 of 1 UB4018 - 06/01/2009 18:46:50 4102271 Updated: 12/13/2006 P719