HomeMy WebLinkAboutInsurance Cancellation: Ashland Independent Film
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NOTICE TO L1ENHOLDER/MORTGAGEE/
ADDITIONAL INSURED/CERTIFICATE HOLDER
MARYLAND CASUALTY COMPANY
(Refer to envelope for insurance company address)
CITY OF ASHLAND, ITS AGENTS, DIRECTORS,
EMPLOYEES
20 E MAIN STREET
ASHLAND OR 97520-
POLICY NO, rSURED SOUTHERN OREGON FILM SOCIETY
PPS 42329442 DBA: ASHLAND INDEPENDENT FILM
AGENT
REINHOLDT & O'HARRA INSURANCE
INSURING COMPANY
MARYLAND CASUAL TV COMPANY
REFERENCE
TO LIENHOLDER
You are hereby notified that the agreement under the Loss Payable Clause payable to you as
Lienholder which is part of the above policy, issued to the above insured, has been or will be
cancelled or nonrenewed in accordance with the conditions of the policy. Your interest under this
policy ceases effectiVe
TO MORTGAGEE
The Mortgagee Agreement in the above mentioned policy has been or will be cancelled or
nonrenewed. Your interest under this policy ceases effective
TO ADDITIONAl INSURED:
..x.. This is to notify you that the above captioned policy which names you as an Additional Insured has
been or will be cancelled in accordance with the conditions of the policy. Your interest under this
policy ceases effective 07/01/2009
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TO CERTIFICATE HOlDER
This is to notify you that the above captioned policy for the above named insured has been or will
be cancelled. Your interest in this policy ceases effective
04/25/2009
Date of Mailing
990028 (3/94)
l1llRD PARTY copy