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HomeMy WebLinkAboutInsurance Certificate: Table Rock Masonry (2) i WORLD OF INS LLC 1091 MEDFORD CENTER PRO4GRE.FRYED MEDFORD, OR 97504 COMA ERC/AL EFREN REGALADO Policy Number: 03976300-0 Underwritten by: EFREN REGALADO Artisan and Truckers Casualty Co TABEL ROCK MASONRY Date of Mailing: February 28, 2017 7782 HARLAN DR WHITE CITY, OR 97503 Policy Period: Nov 4, 2016 Nov 4, 2017 Page 1 of 1 WORLD OF INS LLC 1-541-770-3383 Online Service progressiveagent.com Customer Service 1-800-444-4487 Final Bill Please note that you no longer have insurance with us, effective February 27, 2017. Although your policy canceled, there is still a balance due. Please see your payment summary below for more information. If you already sent your payment, thank you, but please know that your payment will not reinstate your policy. Failure to pay the amount owed by the due date may result in your referral to a collections agency. If you have questions about your cancellation, or would like to learn how to keep this policy or purchase a new one, please call your Agent. Policy premium for coverage until February 27, 2017 $320.00 Installment fee 12.00 Late fee 20.00 Other fees 20.00 Total $372.00 Total amount paid -254.75 Total amount due $117.25 Due date March 16, 2017 . . . . . . . . . . . . . . . . . . . • • • • • • • • • • • • • • • • • • • • • . . • • • • • • • • • • • • • • • • • • • • • • • • Policy Number: 03976300-0 Payment Coupon EFREN REGALADO For immediate payment, please go to . Total . . amou . . . . . . . . . . . . . nt due $117.25 progressiveagent.com or call 1-877-278-1615. Due date March 16, 2017 If you pay by check, please allow five to Amount enclosed $ seven days for your payment to reach us. Write your policy number on the check and make it payable to Artisan and Truckers Casualty Co. PROGRESSIVE PO BOX 105428 ATLANTA GA 30348-5428 Do not write below this section of coupon. CA-68299 Form 6269(10/10) 525703976300 36397 0011725 0011725 5000443 4717401 000011041605