CANCELLATION REQUEST / POLICY RELEASE DATE …
premium $ producer's signature date not taken requested by insured rewritten (complete below) other (identify) company policy number effective date remarks flat short rate pro rata premium calculation subject to audit insured mortgagee company loss payee lien holder finance company the undersigned agrees that:
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ADDITIONAL INSURED-VENDORS BROAD FORM …
www.alleganygroup.comLS-71 Ed. 9/02 LS-71 Ed. 9/02 ADDITIONAL INSURED-VENDORS BROAD FORM Applies to Commercial General Liability Coverage Refer to Supplemental Declarations if information is not shown on this form.
COVERAGES LIMITS - Allegany Insurance Group
www.alleganygroup.comproperty shall accept as evidence of insurance a written binder issued by an authorized insurer or its agent if the binder includes or is accompanied by: the name and address of the borrower; the name and address of the lender as loss payee; a description of the insured real property; a provision that the binder may not be canceled
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Preparing for your Premium Audit - General Liability ...
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Preparing for your Premium Audit Workers Compensation …
www.travelers.comfor the premium audit (see next page for requirements)* Tax Report Option 2. If you do not file any of the above, provide one of the following: For Sole Proprietor, Profit or Loss (Form 1040) Schedule C pages 1 and 2 For a Partnership, U.S. Partnership Return of Income (Form 1065) Page 1 and 1125-A