|
�
<br />' � �'• Pw.-.�:�:z:e-..:....y%:.,si�r.�c�:J.:�c:3iiiS>;•s.'.§3t:,::k4.Svi�.:.vu:�.:..:'�.�.%:i�c:li..�b.i�e,;�:s.;v�t.c:.;✓Jai:..-»_ .�::i�L........,.avi��..i � -�;. f :� t'. .�.5
<br /> �i: • +t,n'J
<br /> i � t
<br />�
<br /> .- '��� ACIFIC EMPLOYERS INSURANCE C MPA'NY
<br /> QX CANCELLATION NOTICE ! ❑ REINSTATEMENT NOTICE
<br /> Office at P.O. Box C-90025 Date August 28, lg 85
<br /> llellevue, WA 98009 �p� � � � � � � D
<br /> lJ� v�O•U� GU�S Fo.C' ,d
<br /> � _-� �: ; 198 5 %�.ed iLE�C ,d T J�/-i3'�.St
<br /> __......... ................. ...........__ fo,� `io��
<br /> CI1Y OF EVERETT
<br /> 'L
<br /> � Pub!ic Works Dept� �
<br /> -1
<br /> City of Everett PLCASG CONP'IRPf �
<br /> Permit Department � m
<br /> Everett, WA 98201 �'S'� C�OF �U_F/'F/7
<br /> L � h�as �rro c�,�c�.c.�✓s = �
<br /> /ir/iT// T�YE- f.00�' T.�/GT �n x
<br /> You are hereby notified that this Company elects to cancel X�4Yr1fX3t� r'/. ��) m
<br /> X❑ a) Individual Bond No.K9 9°i 87 25 4 /�/S ���'JD ��`L �v"`� m o
<br /> covering P1icl-piountain Contractor. Inc. �� ��ti�C�LL`-��. -� c
<br /> �Name& Addressl i Q � '
<br /> �j�„�%�d�y -� z
<br /> � b) Bond or Policy No. �/ �/!//�� m �
<br /> � c) Covera9e under Bond or Policy No. T '�e `
<br /> insofar as the acts of are concemed. r =
<br /> � d) Insuring Agreement(s) of Policy No. � ��
<br /> �
<br /> o �
<br /> Thi; cancellation is to take effect on [he 28th day of September , 19 85 , � D
<br /> in acr.ordance with the [erms of said Bond or Policy. i m
<br /> mN
<br /> ❑X INSURANCE COMPANY OF NORTH AMERICA ��
<br /> CC: Nasman & Associates ❑ PACIFIC EMPLOYERSINSURA CE COMPANY m �
<br /> CC: Mid-Muuntain Contractor, Inc. ��
<br /> � . m
<br /> , By � � i
<br /> A[rorncy�m�Fact
<br /> Pfa sha D vis-Thomsen, -+ �
<br /> _.
<br /> _ BS�SCG3 PTO. IN U.S.A. �
<br /> Z .
<br /> ; OBLIGEE CGPY = �
<br /> .Yni� , �� , r. —T ,+r•-� -i� •F� T --n-� e"C._r—�c^.�r.. .� t. ^r--r'.+�'.—'_+...T^„ f..�.�. �--�
<br /> 1� � n� i(,�• ] �. J �$�`��_ � s t t ln
<br /> �,�., .I. t � " F � �,1� � } ' .. i �y s �✓��
<br /> � ' .� � � � f�� ' t � ° �� i A �' � } a � - p i
<br /> g � v'/4\:V I C ♦ j i � � ,
<br /> � ''Gp�t�i: � S � �.�� �y 1 �ff ,�i r�� �� .�:� 1 � i �� �y� � w � i �..
<br /> � ,•j , �
<br /> S�Yi. td� „ .tit ,. r t'� �� -. � i 1 � � � �-' ♦�y �a � 4i . i K�; ��
<br /> i Y ' � � r:. ^• �•^ r i � �� t 7 � . / ,-A� � r��. � � . +d,i i' � � ` {4 R� r" ,
<br /> �� � ryt , } �l� i (� 7', Y '� �� � � ��t F se� i p�,5y 1 a, 7r i
<br /> �'�' v . y y� ��i£rl i e. '�A : � �� s � q . � . Y � .
<br /> � l , �H �:
<br /> ; '�,1,' ' , . , J '.:I Fj� ..` 5 , . i � i f � L 2�<��'� . i N '�.
<br /> 1 / e
<br /> i �'.Y� � r� �'� f S' ��� :. � I t � T � < K �� � yr-�
<br /> �.+r!� �y � V � 1 a � . � . R � -t � i .4 �} � a' Y'f
<br /> ��'"�h5 x � � t � t��j M►• � ; '•; . � !i � ii. , � '�' � t }.t
<br /> < '�`i.t�, rt Y - i i PT 1 +�g � ..'�> o � - ^S . t� r . `� � � .. y, \ : }`�
<br /> ,[�[ i I �.. ^� � 'x��� >�;.r r" �. r � { ' i � 1 t� <� �S� t .k t� �F.- I .n �
<br /> ,*�,}+ f. i � 2 � : vy "� T �, 1 . r� � � r, \ � � k�'-
<br /> yY. ?1 ( �. . t � � rv ..1 . .C-. � .f�'' ¢ � �� 1 eh ��
<br /> � � "{�jjl,ri . �:�.� N �ti��} . e y � � � .f 2� t R�.:. l VI � �..f'� y f¢ 1't ,
<br /> i ! I •p ! t `- 1 . � 1 1 !
<br /> tiB'� 1 5 . . � i ��i( �f;.i i (i � l^ : r r S., �. 1
<br /> 4, y� i�'j ' f'� Y� ir`e Rr�ti � �'�.'.� t� i � �K..� � i�. � �a ,,.,j {�t' . �, r �; � .
<br /> �V i
<br /> � ' � � , . � s � ,�r: ° P ,�, ' , r� , , t r"� , �.
<br /> ��< �', w�t��{� ' ,� , � , r - al x�.r
<br /> Y7 �� � -Fv, p , � SI � � � (.� � � l� I �t i�� � �y �1"
<br /> 1 d� a �$��. h t � t u g
<br /> �, t '�r`J �� �� ` i�. "� t( F�`11. ; � 1 � { �` � if . � ���'J / � i� f� � . !:.
<br /> l�t f t r . 1 �Ce: r.: ..hf �1_ ��., � }y�^, � , + ,,.. �',
<br /> � ` y11 4 t '•, � f' �Y.� � 1 � �. f � � �Y
<br /> " et'�'�y. ,. } ; ' y +` ' i �,� '� 14 , > ��`:, � , . ''}i te. '
<br /> I � "1,(1µ J t .... . �f. 1 -�/'' � ' � ' � �t �? . � #M1� n �f� � r �i� l � � i 1ef � � k i� t . ... ,� V}a',-
<br /> 7�.bt„�.r [�i �.��j L � i �.'#� }� � .t� � ;j .•�� rit Y- S � � � �v,�.t � � � � 1 i�, + t� ;`?
<br /> � 9�'� � - � �atl(�l f����.�� l� 1 � i ��' rtYVi.. y �:
<br /> t
<br /> +-,• � 1•. � .�+`� . ��� . � .. . ���.. � . • � . � .�5�� . � .�.t �. .
<br /> i — —
<br />
|