CANCELLATION REQUEST / POLICY RELEASE DATE …
The above referenced policy is lost, destroyed or being retained. No claims of any type will be made against the Insurance Company, its agents or its representatives, under this policy for losses which occur after the date of cancellation shown above. Any premium adjustment will be made in accordance with the terms and conditions of the policy.
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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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