HomeMy WebLinkAbout113967 PROJECT SELF SUFFICIENCY - INSURANCE CERTIFICATENOTICE OF CANCELLATION, NONRENEWAL OR CONDITIONED RENEWAL
NAMEAND.
ADDRESS
OFINSURANCE
COMPANY
NAMEAND.
ADDRESS
OF INSURED
Ohio Casually Insurance
10700 E Geddes Ave Ste 300
Englewood CO
80112
(Colorado)
PROJECT SELF-SUFFICIENCY OF LOVELAND-FORT COLLIN
375 W 37TH ST STE 150
LOVELAND CO 80538-8435
KIND OF POLICY:
Package Policy
POLICY/APPLICATIONBINDERNO.: BKO 11 52256750
EFFECTIVE DATE OF NOTICE:
4/25/2011 12:01 AM
(DATE) (HOURSTANDARDTIME AT THE ADDRESS OF THE INSURED)
DATE OF MAILING: 2/2512011
NAME AND ADDRESS OF AGENTBROKER:
FLOOD AND PETERSON INSURANCE INC 05-0582
PO BOX 270370
FORT COLLINS CO 80527-0370
(Specific information concerning the cancellation
or nonrenewal has been given to the Insured.)
TO THE ADDITIONAL INTEREST:
You are notified that the above policy is cancelled or nonrenewed effective on and after the hour and date mentioned above. This notice is being provided to you as you have
been provided with a certificate of insurance on the above policy. Any interest you may have in the above policy is terminated.
NAMEAND. CIT OF FT COLLINS
ADDRESS OF PO BOX 580
ADDITIONAL
INTEREST FORT COLLINS
CO
80522
(E)GU 402c (Ed, 7.02) UNIFORM INFORMATION SERVICES, INC., 01M ADDITIONAL INTERESTS COPY Page 1 of t