No preview available
HomeMy WebLinkAbout130144 POTTER COMMERCIAL WALLS AND CEILINGS - INSURANCE CERTIFICATEP/NN/1COL ASSURANCE CITY OF FORT COLLINS P.O. BOX 580 FORT COLLINS CO 80522 \)Owl INSURED: Potter Commercial Walls and Ceilings 43600 Hwy 50e Avondale, CO 81022 7501 E Lowry Blvd Denver, CO 80230-7006 Phone: (303) 361-4000 / (800) 873-7242 Fax: (303) 361-5000 / (888) 329-2251 September 6, 2012 Policy #: 4102271 AGENT: Western Group, Inc - Pueblo PO Box 1958 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 o ou currently Id a certificate of workers' compensation insurance, is scheduled,tCo aDasf /eptember 27, 2012 It t the j nsured 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 UB4001 - 09/06/201220:05:47 4102271 Updated 12/13/2006 P719