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Evergreen Insurance Managers Inc
Evergreen Evergreen Independent Insurance Marketing
C4) CA License 80G35858
insurance C1C2 managers 5293 NE Elam Young Pkwy Ste 160,Hillsboro,OR97124
Ph.503.259.3060 I Toll Free 866.450.1150 I Fx 503.259.3065
- www.evergreenins.com
NOTICE OF NONRENEWAL
INSURED NAME&ADDRESS:
Rogue Farm Corps
PO Box 533
Ashland,OR 97520
POLICY NUMBER: DATE OF EXPIRATION:
CL00106695 6/9/2020,12:01A.M.Standard Time at the Address of the Insured
TYPE OF POLICY: DATE OF MAILING:
General Liability April 6,2020
INSURANCE COMPANY: ISSUED THROUGH GENERAL AGENCY OFFICE:
Acceptance Casualty Insurance Company Hillsboro,OR 97124
You are hereby notified in accordance with the terms and conditions of the above mentioned policy, and in accordance with the law; that your
insurance will cease at and from the hour and date mentioned above and that no offer of renewal will be made available. This is your only Notice of
Nonrenewal,therefore,please take the necessary action to remarket this account. This notice supersededs any and all prior notices.
REASON FOR NONRENEWAL: Market no longer available through Evergreen Insurance Managers
GENERAL AGENCY NAME&ADDRESS: I hereby certify that I personally prepared and mailed through the United States Post Service a
Evergreen Insurance Managers Inc notice of nonrenewal to the Insured an exact opy of which appears above.
Evergreen Independent Insurance Marketing,CA Lic#0G35858
5293 NE Elam Young Pkwy Ste 160
Hillsboro,OR 97124 Authorized Representative:
Signed: 4/6/2020 1:13:35 PM lI �jl
RETAIL AGENCY/RETAIL PRODUCER:
Redwoods Leavitt Insurance Agency Phone:(541)479-2667
122 NE Beacon Dr
Grants Pass,OR 97526
, ADDITIONAL INTEREST:
Northwest Youth Corps
2621 Augusta St
Eugene,Or 97403
ADDITIONAL INTEREST:
Th'e City of Ashland
"Finance Dept,Attn:Tuneberg,Director
20 E Main St
Ashland,OR 97520
ADDITIONAL INTEREST:
Ecotrust
721 NW 9th Ave
Portland,OR 97209
ADDITIONAL INTEREST:
Two Rivers Farm
89190 Old Mohawk Rd
Springfield,OR 97478
ADDITIONAL INTEREST:
Clackamas Community College
7738 SE Harmony Rd
Milwaukie,OR 97222