HomeMy WebLinkAbout22ND CENTURY TECHNOLOGIES INC - INSURANCE CERTIFICATE* SELECTiVV
Date Of Mailing: 12i06i2012
SELECTIVE WAY INSURANCE COMPANY
WANTAGE AVENUE
BRANCHVILLE, NJ 07890
Name and CITY OF FORT COLLINS
Address 215 NORTH MASON ST, 2ND FLR
Of Certificate FORT COLLINS, CO 80524
Holder
Name and SUYDAM INSURANCE AGENCY LLC
Address 1743 STATE ROUTE 27
Of Agent SOMERSET, NJ 08873-3907
Name and 22ND CENTURY TECHNOLOGIES INC
Address 1 EXECUTIVE DR
Oflnsured SUITE 285
SOMERSET, NJ 08873-4003
Policy No.: S 2000140
To Certificate Holder:
You are hereby notified that the above mentioned policy for the above mentioned insured will be reinstated at
and from the following hour and date:
Effective Date of Reinstatement: DFCEMBER 12, 2012 12:01 AM
(Date) (Hour -Standard Time at the address of the Insured)
Certificate Holder Reinstatement Notice
FORM 2137 10 10