HomeMy WebLinkAboutBICYCLE RACING ASSO OF CO DBA AMERICAN CYCLING ASS - INSURANCE CERTIFICATEPHILADELPHIA INDEMNITY INSURANCE COMPANY
1-877-438-7459
ONE BALA PLAZA, SUITE 100
BALA CYNWYD PA 19004
NOTICE OF CANCELLATION OF INSURANCE
Named Insured &Mailing Address Producer: 0003563
BICYCLE RACING ASSOCIATION OF COLOR TAGGART AND ASSOCIATES INC
DBA AMERICAN CYCLING ASSOCIATION 1600 CANYON BOULEVARD STE 109
1010 WASHINGTON AVE STE 200 PO BOX 147
GOLDEN CO 80401 BOULDER CO 80306
Reference:
N/A
Policy No.:
PHPK666387
Type of Policy:
PACKAGE
Date of Cancellation:
12/28/2011; 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 NONPAYMENT OF PREMIUM $ 8335.00.
Excess premium, if not tendered, will be refunded no more than forty-five days after the effective date of the
termination.
Your interest in this policy as an "insured" or other party of interest is being cancelled effective 12/28/2011;
12:01 A.M. Local Time at the mailing address of the named insured.
Other Party of Interest
CITY OF FORT COLLINS
PO BOX 580
FORT COLLINS CO 80522
Date Mailed:
14th day of December, 2011
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FRAN DEEMING
COCC19NONPMNT
FORM# CC969711 C0520D1 12132011 MYNY
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