HomeMy WebLinkAbout168310 SCHRADER OIL CO - INSURANCE CERTIFICATE (3)CANCELLATION/TERMINATION NOTICE
Third Party Copy
CERTHOLDER
Page 1 of 1
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Insured:
SCHRADER OIL CO
PO BOX 495
FORT COLLINS, CO 80522
G"Uj
Account No. 314-627-1
Date: 07/18/2012
Cancel Iation/Termination of each policy listed below was requested by the insured.
Place of Issue,
FEDEMED
INSUR9NCEv
121 East Park Square
PO Box 328
Owatonna, MN 55060
According to contract language in the policies listed below, we will continue to protect your interest as a
mortgagee, additional insured, or a loss payee through the date and time of day shown below.
Policy
Time of
Policy
CancellationfTermination
Policy
Number
Policy Type
Date
Cancellation/Term i nation*
9802184
Commercial Package Policy
06/30/2012
12:01 a.m.
9802192
Liquor Liability Coverage
06/30/2012
12:01 a.m.
9802185
Umbrella
06/30/2012
12:01 a.m.
` Standard time at the designated business premises.
CITY OF FORT COLLINS
PO BOX 580
FORT COLLINS CO 80522
Loss Payee/
Mortgagee/
Additional Insured/
Certificate Holder
FEDERATED MUTUAL INSURANCE COMPANY. FEDERATED LIFE INSURANCE COMPANY. FEDERATED SERVICE INSURANCE COMPANY.
MFO-00 )07-09) HOME OFFICE: OWATONNA, MINNESOTA 55060 1-888-333A949
CANCELLATION/TERMINATION NOTICE
Third Party Coey
LOSS PAYEE/MORTGAGEE
Page 1 of 1
Account No. 314-627-1
Date: 07/18/2012
Insured:
SCHRADER OIL CO
PO BOX 495
FORT COLLINS, CO 80522
Cancel Iation/Term ination of each policy listed below was requested by the insured.
Place of Issue:
FEDEAUZED
INSURANCE
121 East Park Square
PO Box 328
Owatonna, MN 55060
According to contract language in the policies listed below, we will continue to protect your interest as a
mortgagee, additional insured, or a loss payee through the date and time of day shown below.
Policy
Time of
Policy
Cancellation/Termination
Policy
Number
Policy Type
Date
Cancellation/Termination'
9802184
Commercial Package Policy
06/30/2012
12,01 a.m.
9802192
Liquor Liability Coverage
06/30/2012
12:01 a.m.
9802185
Umbrella
06/30/2012
12:01 a.m.
' Standard time at the designated business premises.
CITY OF FORT COLLINS
300 LAPORTE AVE
FORT COLLINS, CO 80521
Loss Payee/
Mortgagee/
Additional Insured/
Certificate Holder
FEDERATED MUTUAL INSURANCE COMPANY. FEDERATED LIFE INSURANCE COMPANY. FEDERATED SERVICE INSURANCE COMPANY.
MF040 (07-09) HOME OFFICE: OWATONNA, MINNESOTA 55060 1-888-3334949