CANCELLATION REQUEST / POLICY RELEASE DATE …
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: The above referenced policy is lost, destroyed or being retained. No claims of any type will be made …
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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.
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