HomeMy WebLinkAboutCOI - Salazar Transportation, Inc. - Expires 2020-09-08COASTAL BROKERS INSURANCE
License No. 0600570
Pleasanton, CA 94588-3300
Notice of Rescission
Producer:
CALPLU
CALIFORNIA PLUS INSURANCE SERVICE
2111 CENTRAL AVENUE
CERES, CA 95307
Provider Number: SCINS
Provider Name: Scottsdale Insurance Company
Address:
Insured:
14930
Salazar Transportation, Inc.
PC Box 1526
Lodi, CA 95241
Policy Number:
Policy Inception Date:
Policy Expiration Date:
Notice Number:
Notice Effective Date:
Processed on:
LTS0004744-01
09/08/2019
09/08/2020
1
03/04/2020
02/10/2020
United States Postal Service
Provider Name: Scottsdale Insurance Company
Address:
Insured Name: Salazar Transportation, Inc.
Address: PO Box 1526
Lodi, CA 95241
Affix
postage and
postmark.
For use as a "Certificate of Mailing" as provided in part 155 of the Postal Service Manual.
May be used for Domestic or International Mail. Does not provider for Insurance.
Date Of Mailing: 1/29/2020
In accordance with the terms and conditions of the above mentioned policy, the Cancellation Notice or Notice of Non -Renewal
that you received is hereby rescinded. Your coverage remains in force without interruption.
Rescission Reason: PAYMENT RECEIVED BY COASTAL BROKERS
(Duplicate of Notice Of Rescission to Lienholder)
Received From:
Provider Name: Scottsdale Insurance Company
Address:
One piece of ordinary mail addressed to:
Leinholder Name: CITY OF GILROY
Address: 7351 ROSANNA STREET
GILROY, CA 95020
Affix
postage and
postmark.
For use as a "Certificate of Mailing" as provided in part 155 of the Postal Service Manual.
May be used for Domestic or International Mail. Does not provider for Insurance.
Authorized Signature
For Registered Mail or Certified Mail Notice of Cancellation or Nonrenewal to
the Insured and, if required, to the Lienholder, the appropriate U.S. Postal
Service Receipt must be attached hereto and no postage stamp should be
affixed to the receipt reproduced hereon.
CERTIFICATION
I hereby certify that I personally mailed in the U.S. Post Office at the place and
time stamped hereon, a notice of cancellation or nonrenewal to the Insured if
required, to the Leinholder, an exact copy of which appears above, and at said
time received from the U.S. Postal Service the receipt made a part hereof or
attached hereto.
Signed this day of 20
Signature
Generated by: David Joven
Generated on: 02(10/2020 01:23 PM
Created By: David Joven
PPS-NOR1
Producer Copy
Page 1 of 1
Authorized Signature
COASTAL BROKERS INSURANCE
License No. 0600570
Pleasanton, CA 94588-3300
Producer:
CALPLU
CALIFORNIA PLUS INSURANCE SERVICE
2111 CENTRAL AVENUE
CERES, CA 95307
Copy of Notice Sent to Named Insured
Insured:
14930
Salazar Transportation, Inc.
PO Box 1526
Lodi, CA 95241
Notice of Rescission
Provider Number: SCINS
Provider Name: Scottsdale Insurance Company
Address:
Policy Number:
Policy Inception Date:
Policy Expiration Date:
Notice Number:
Notice Effective Date:
Processed on:
LTS0004744-01
09/08/2019
09/08/2020
1
03/04/2020
02/10/2020
Date Of Mailing: 1/29/2020
In accordance with the terms and conditions of the above mentioned policy, the Cancellation Notice or Notice of Non -Renewal
that you received is hereby rescinded. Your coverage remains in force without interruption.
Rescission Reason: PAYMENT RECEIVED BY COASTAL BROKERS
You are hereby notified that the agreement under the Loss Payable Provisions payable to you as a Lienholder, which is a part of the above policy,
issued to the above insured, is hereby rescinded in accordance with the conditions of the policy. The coverage remains in force without
interruption.
Provider Name: Scottsdale Insurance Company
Address:
Additional Interest: CITY OF GILROY
Address: 7351 ROSANNA STREET
GILROY, CA 95020
Generated by: David Joven
Generated on: 02/10/2020 01:27 PM
Created By: David Joven
PPS -NOR 1
Additional Interest Copy
Page 1 of 1
Authorized Signature
COASTAL BROKERS INSURANCE
License No. 0600570
Pleasanton, CA 94588-3300
Notice of Cancellation
Producer:
CALPLU
CALIFORNIA PLUS INSURANCE SERVICE
2111 CENTRAL AVENUE
CERES, CA 95307
Provider Number: SCINS
Provider Name: Scottsdale Insurance Company
Address:
Copy of Notice Sent to Named Insured
Insured:
14930
Salazar Transportation, Inc.
PO Box 1526
Lodi, CA 95241
Policy Number: LTS0004744-01
Policy Inception Date: 09/08/2019
Policy Expiration Date: 09/08/2020
Notice Number: 2
Notice Effective Date: 03/31/2020
Processed on: 02/25/2020
IS CANCELLED AT 12:01 a.m. STANDARD TIME ON: 3/31/2020
Date Of Mailing: 2/25/2020
You are hereby notified in accordance with the terms and conditions of the above mentioned policy, and in accordance with the
law, that your insurance will cease at and from the hour and date mentioned above.
Reason for Cancellation: NON-PAYMENT TO FINANCE COMPANY
You are hereby notified that the agreement under the Loss Payable Provisions payable to you as a Lienholder, which is a part of the above policy,
Issued to the above Insured, is hereby cancelled in accordance with the conditions of the policy, said cancellation to be effective on and after the
hour and date mentioned above.
Provider Name: Scottsdale Insurance Company
Address:
Additional Interest: CITY OF GILROY
Address: 7351 ROSANNA STREET
GILROY, CA 95020
Generated by: David Joven
Generated on: 02/26/2020 01:40 PM
Created By: David Joven
PPS-NOC1
Additional Interest Copy
Page 1 of 1
-et
Authorized Signature