HomeMy WebLinkAboutInsurance Cancelation Notice: Peruvian Point
CANCELLATION CONFIRMATION OF CERTIFICATE
RED SHIELD INSURANCE COMPANY@ OF INSURANCE OR LOSS PAYABLE CLAUSE
1411 SW Morrison St, Ste 400, Portland, OR 97205
Additional Insured: Reference No.
THE CITY OF ASHLAND, OREGON: PARKS
COMMISSION, ITS OFFICERS, EMPLOYEES, AND
AGENTS
ATTN: RACHEL DIAZ
20 E MAIN ST
ASHLAND, OR 97520
You hold a Certificate of Insurance, or there is a Loss Payable Clause under which you are an additional interest
or a Payee, in connection with the Policy of Insurance descrbed below. Your Interest was cancelled for such
Certificate or Loss Payable Clause effective as of the date and hour indicated.
TERMINATION EFFECTIVE DATE: 6/22/2016 at 12:01 AM local time POLICY NUMBER
CLP024299
Named Insured:
CHRISTIAN AINZUAIN
DBA: PERUVIAN POINT
139 CASEY WAY
CENTRAL POINT, OR 97502
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Producer: 6398
RED SHIELD INSURANCE COMPANY
THE INSURANCE CENTER
PO BOX 6
JACKSONVILLE, OR 97530
Authorized Representative
Date Prepared At
6/29/2016 PORTLAND, OREGON
UN 00 04 08 05