HomeMy WebLinkAboutExplanation of ShortTerm PolicyEXPLINATION OF SHORT-TERM POLICY
The 08/06/02 policy renewal was issued by Kemper Insurance thru SPECIALTY NATIONAL
INSURANCE COMPANY
The A.M. Best rating fell to below A, thus the reason for the roll-over of the business to ARCH
INSURANCE with an A rating.
The premium difference is re-insurance on high property values.= $1,683.00.
INCLUDED is a binder for the 08/06/03 renewal and the premium statemem.= $342,890.00
Thank you, June Wilson
CLARK GENERAL INSURANCE
7/24)03
CANCELLATION REQUEST / POLICY RELEASE D^TE
ACORD,,
.R?DDCSR' ~C .o ~.,¥ 1-800-838-5299
~mTAaA ~C~. ~S~C~ A~.T.~C~
C/O ~ZC~ ~S~C~ ~C~
1700 o~ co~
AUBURN BTLL$, MI 48326
CODE: / SUB CODE:
INSURED NAME AND ADDRESS
CTTZ OF
501 EAST COORT
J-E~ffJ~.SO~ILLE, II~ 47130
CANCELLATION REQUEST (Policy at~ached)
COMPANY NAME AND ADDRESS I NArC CODE:
SPECIALTY NATIONAL INSITRANCE
POLICY
~PE PACKAGE
CANCel ~ FO POLICY INFORMATION
POLICY
NUMSE. 3ZZ12057001
CANCELLATION DATE TiME ~ AM
EFFECTIVE DATE AND 5/14/2003
HOUR OF CANCELLATION 12:01
/ EF~ECTIVE DATE ~PI~TION DATE
POLICY TER~ 8/6/2002 8/612003
POLICY RELEASE [Complete Statement Section Below)
POLICY RELEASE STATEMENT
The undersigned agrees that;
The above reterenced policy is lost. destroyed or being retained.
NO clalrns of ~ny type wt[I be maae against the insurance Corr3any. [ts agents or [ta representatives,
~nder thru policy for losses which occar after the date of canceltst[bo shown above
Any premium adjustment wilt be made m accoraance wdh the terms an~ conditions of the polic
DATE SIGNATURE OF NAMED INSORED . ~/ DATE
FOR AGENCY/COMPANY USE
TITLE DATE
REASON FOR CANCELLATION
NOT T,~(EN L~ OTHER (identify)
REQUESTED BY INSURED *
]~l $0't~C~.. C0~1~
-:FFECT]VE DATE
.U.EER t~'l~EG00071 5/14/2003
REMARKS
METHOD OF CANCELLATION
New York Only: If you do not keep your auto insurance n force dur ng the entire registration period, your motor vehicle ·
registration will be suspended f your vehicle is still uninsured after 90 days, your dryer's license will be susp. ended.
To avoid these penalties, you must surrender your registration certificate and plates before your insurance expires, uy law,
We must report the termination of auto insurance covera,qe to the Department of Motor Vehicles.
NAME AND ADDRESS
REQUESTIRELEASE DISTRIBUTION