HomeMy WebLinkAboutIns Cancellation Notice: RW Hays CANCELLATION/TERMINATION NOTICE Page 1 of 1
Third Party Cody
ADDITIONAL INSURED
Account No. 314-757-6
Date: 07/11/2011
Place of Issue:
FEDEMIZAD
INSURANCE?
Insured: 121 East Park Square
RW HAYS COMPANY PO Box 328
PO BOX 1220 Owatonna, MN 55060
MEDFORD, OR 97501
Cancel Iation/Termination of each policy listed below was requested by the insured.
According to contract language in the policies listed below, we will continue to protect your interest as a
mortgagee, additional insured, or a loss payee through the date and time of day shown below.
Policy Time of
Policy Cancellation/Termination Policy
Number Policy Type Date CancellationfTermination'
9802189 Commercial Package Policy 07/01/2011 12:01 a.m.
9802191 Liquor Liability Coverage 07/01/2011 12:01 a.m.
9802190 Umbrella 07/01/2011 12:01 a.m.
Standard time at the designated business premises.
CITY OF ASHLAND Loss Payee/
90 N MOUNTAIN AVE Mortgagee/
ASHLAND, OR 97520 Additional Insured/
Certificate Holder
FEDERATED MUTUAL INSURANCE COMPANY. FEDERATED LIFE INSURANCE COMPANY. FEDERATED SERVICE INSURANCE COMPANY.
MFO-40(07-09) HOME OFFICE:OWATONNA, MINNESOTA 55060 1-888-333-0949