HomeMy WebLinkAboutInsurance Certificate: Pilot Rock Excavation
THE CINCINNATI CASUALTY COMPANY
P 0 BOX 145496
CINCINNATI OH 45250-5496
NOTICE OF NONRENEWAL OF INSURANCE v,,
Named Insured & Mailing Address: Producer: 36015~~~`. ~.a--.•
PILOT ROCK EXCAVATION INC BOB HART INSURANCE INC
DBA HART INSURANCE AGENCY
5 S STAGE RD P 0 BOX 1240
MEDFORD OR 97501-8729 GRANTS PASS OR 97528
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Policy No.: EPP0151857/EBA0151857
Type of Policy: PACKAGE INCLUDING AUTO
Date of Expiration: 07/20/2016; 12:01 A.M. Local Time at the mailing address of the Named Insured.
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We will not renew this policy when it expires. Your insurance will cease on the Expiration Date shown above.
This policy provides auto liability coverage. You should contact your agent or any agent concerning your
possible eligibility for replacement coverage through another insurer or through the Oregon Automobile
Insurance Plan, PO Box 6530, Providence, RI 02940-6530.
This policy provides fire and extended coverage insurance on your property. You should contact your agent
concerning coverage through another insurer or your possible eligibility for coverage through the Oregon Fair
Plan Association, 8705 S.W. Nimbus Ave., Suite 360, Beaverton, OR 97008-7157. If no agent exists, we will
directly assist in submission of the application.
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JUN - 7 2016
Date Mailed:
3rd day of une, 2 6
Other Party of Interest
EPP/EBA0190151857/NORTH
CITY OF ASHLAND AND ITS EMPLOYEES,
OFFICERS AND AGENTS
20 E MAIN ST ELIZABETH STEPHENS 513-870-2048
ASHLAND OR 97520-1814
ORCN36NONE APP
FORM# CN96970102OR52014 06032016MYNN
ODEN 3.0.16.02a Copy for Other Interests Page 1 of 1