HomeMy WebLinkAboutPark Engineering, Inc. 04.01.2024 V2aTRAVELERSJ�
PO Box 64095
St. Paul, NIN 55102-0095
000185- 01
CITY OF LOS ALTOS ATTN RICHARD CHIU
26379 FREMONT RD
LOS ALTOS HILLS CA 94022
CANCELLATION NOTICE. Please take notice that the Policy designated below, issued to the insured named
below, has been canceled. Your interest under the Policy is canceled effective on the date stated below
❑) NOT TAKEN NOTICE. Please take notice that -the Insurednamed-below-has not accepted -the Policy designated
below and therefore no insurance has come into force there under.
FIAMENDMENT NOTICE. Please take notice that, effective on the date stated below, the Policy designated nated below
has been amended .as follows:
❑ NON -RENEWAL NOTICE. Please take notice that we have advised the insured that this Policy will not be
renewed.
❑ Please take notice that the Policy desi nated below has been canceled; however, it is being
REWRITE NOTICE. y g g
rewritten.
POLICY NUMBER: 680-1P219042-23-47 ISSUE DATE: 03/12/2024
NAME AND ADDRESS OF INSURED PRODUCER OR AGENT.
---PARK -ENGINEERING INC,- - --- ---- ---- ----- -- - = - ---
372 VILLAGE SQ BRICK INSURANCE. AGENCY DMT47
ORINDA CA 94563
ISSUING OFFICE
RETAIL A&E 21W
co EFFECTIVE DATE OF THIS NOTICE VEHICLE IDENTIFICATION
04/01/24N (Complete for Auto Policies or Coverages Only)
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LOCATION
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(Complete for Fire Policies or Fire Coverages ONL Y)
000
WRITTEN NOTICE IS HEREBY GIVEN TO YOU AS:
❑ THE PERSON TO WHOM AN INSURANCE CERTIFICATE WAS ORIGINALLY ISSUED OR A BANK
OR FINANCE COMPANY;
. .r 0 AN ADDITIONAL INSURED UNDER THE TERMS OF THE POLICY;
n
❑ A MORTGAGEE `
THIS NOTICE IS GIVEN ONLY BY THE
COMPANY OR COMPANIES WHICH ISSUED
THE POLICY DESIGNATED ABOVE.
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