HomeMy WebLinkAboutInsurance Certificate: Pasta Piatti - Cancellation Notice
AMERICAN HALLMARK
INSURANCE COMPANY OF TEXAS
P.O. BOX 901089
FORT WORTH, TX 76101-2089
NOTICE OF CANCELLATION DUE
TO NONPAYMENT OF PREMIUM
DATE:
201 0-05-08
MAIL TO:
CITY OF ASHLAND
20 E MAIN ST
ASHLAND OR 97520
INSURED NAME AND ADDRESS
PASTA PIATTIINC
358 E MAIN STREET
ASHLAND, OR 97520
POLICY NUMBER:
POLICY EFFECTIVE DATE:
TYPE OF INSURANCE:
CANCELLATION DATE:
PREMIUM PAST DUE:
TOTAL DUE:
44PB461488
09/10/2009
Businessowners
OS/23/2010
$504.00
$1,497.00
You are hereby notified in accordance with the terms and conditions of the above mentioned Policy, and in accordance
with law, that your Insurance will cease at 12:01 A.M. on the date shown above due to non-payment of premium.
AutomDbile Insurance Plan Information: If the insurance being terminated is automobile insurance, other than
insurance obtained under the Oregon Automobile Insurance Plan, you are possibly eligible for automobile insurance
through another insurer or under the Oregon Automobile Insurance Plan. Please contact your agent or this company for
information on securing insurance through the Automobile Insurance Plan.
Replacement of Property (Fire) Insurance: If this notice of cancellation or nonrenewal pertains to a policy providing
fire, extended coverage and possibly vandalism and malicious mischief insurance and you wish to replace your policy,
you should make an effort to obtain insurance through another company in the normal market. If you have difficulty
procuring replacement coverage in the normal market, you possibly may obtain coverage through the Oregon Fair Plan
Association. For further information, please contact your agent or this Company.
AGENT NAME AND ADDRESS
HART INSURANCE AGENCY
POBOX 1240
GRANTS PASS, OR 97528
03792
X03720R (1095)
MF-CA3-OR
COMMERCIAL LINES
Add'l Interest