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2009-05340 Ins Cert 05-2010
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2009-05340 Ins Cert 05-2010
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Last modified
4/7/2011 11:46:04 AM
Creation date
5/14/2010 12:09:08 PM
Metadata
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Template:
PW_Contract
COE_Contract_Number
2009-05340
PW_Document_Type_Contract
Insurance & Bonds
Organization
Dreamland Skateparks LLC
PW_Department
Public Works
Contract_Administrator
Aanderud
External_View
No
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~. <br />Named Insured 8 Mailing Address: <br /> <br />WESTERN NATIONAL ASSURANCE COMPANY <br />9706 4TH AVENUE NE <br />STE 200 <br />SEATTLE WA 98115 <br />REINSTATEMENT NOTICE <br />Producer: 631 <br />DREAMLAND SKATEPARKS LLC <br />PMB 334 <br />960 SE HWY 101 <br />LINCOLN CITY OR 97367 <br />KPD INSURANCE INC <br />PO BOX 784 <br />SPRINGFIELD OR 97477 <br />Reference: CPP 0012567 CID 262201 <br />Policy No.: CPP 0012567 <br />Type of Policy:. PACKAGE <br />- -- <br />You recently received a notice advising that this policy was being cancelled effective 04/25!2010 . <br />This notice is to advise you that the policy is being reinstated without lapse in coverage. <br />Certificate Holder <br />CPP 0012567 CID 262201 <br />CITY OF EUGENE <br />ATTN HEATHER NELSON <br />1820 ROOSEVELT BLVD <br />EUGENE OR 97402 <br />Date Mailed: <br />11th day of May, 2010 <br />RICHAROa, STEVE <br />ORCT19 <br />c7 5112010SINY <br />FORM# CT9698970R51995 `~`' `' ~ ~ ~5~~ page 1 of 1 <br />ooEH a.o.io ae Copy for Certifcate Holder <br />
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