HomeMy WebLinkAboutInsurance Cancellation Notice: Cascade Airport Shuttle
AMERICAN SERVICE INSURANCE
(847) 472-6700
150 NORTHWEST POINT BLVD., SUITE 300
ELK GROVE VILLAGE IL 60007-1040
NOTICE OF CANCELLATION OF INSURANCE
Named Insured & Mailing Address: Producer: 19345
CASCADE AIRPORT SHUTTLE OSWALD INSURANCE AGENCY, INC
3295 HWY 66 2225 PACIFIC BLVD., SE, STE. 209
ASHLAND OR 97520 ALBANY OR 97321
Policy No.: OR 400000000100
Type of Policy: AUTO LIABILITY AND PHYSICAL DAMAGE
Date of Cancellation: 12/22/2014; 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 NON PAYMENT OF PREMIUM - $1,515.30 (INCLUDES $9.00
REINSTATEMENT FEE).
Your interest in this policy as an "insured" or other party of interest is being cancelled effective 12/22/2014;
12:01 A.M. Local Time at the mailing address of the named insured.
Date Mailed:
17th day of No mber, 2014
Additional Insured
OR 400000000100
CITY OF ASHLAND
20 E MAIN ST - -
ASHLAND OR 97520 SCOTT WOLLNEY
ORCCINONPMNT
FORM# CC96970R51995 11172014MY
1
ODEN 3.0.14.10a Copy for Additional Insured Page 1 of f 1