Insurance NOTIFICATIONS UNITED STATES LIABILITY INSURANCE COMPANY
1190 DEVON PARK DRIVE
P.O. BOX 6700
WAYNE PA 19087-2191
NOTICE OF CANCELLATION OF INSURANCE
Named Insured&Mailing Address: Producer:3294
TRIDATA, LLC AHT INSURANCE
10605 VANTAGE CT 20 SOUTH KING STREET
POTOMAC MD 20854 LEESBURG VA 20175
Policy No.: PPP 1554052A
Type of Policy: PROFESSIONAL PACKAGE
Date of Cancellation: 03/29/2021; 12:01 A.M. Local Time at the mailing address of the Named Insured.
We are cancelling this policy. Your insurance will cease on the Date of Cancellation shown above.
The reason for cancellation is Nonpayment of Premium
The amount of premium overdue is$483.20
Excess premium, if not tendered, will be refunded upon demand.
Your interest in this policy as an "insured" or other party of interest is being cancelled effective 03/29/2021;
12:01 A.M. Local Time at the mailing address of the named insured.
Date Maile
10th of arch, 20 1
Additional Insured
CITY OF SALINA
300 W.ASH STREET
BAVARIA KS 67401 FATIN ALAM
MDCCI9NONPMNT
FORM#CC969711MD51995 03102021MYNY
ODEN 3.0.21.02a Copy for Additional Insured Page 1 of 1
i
UNITED STATES LIABILITY INSURANCE COMPANY
1190 DEVON PARK DRIVE
P.O. BOX 6700
WAYNE PA 19087-2191
REINSTATEMENT NOTICE
Named Insured&Mailing Address: Producer:3294
TRIDATA, LLC AHT INSURANCE
10605 VANTAGE CT 20 SOUTH KING STREET
POTOMAC MD 20854 LEESBURG VA 20175
Policy No.: PPP 1554052A
Type of Policy: PROFESSIONAL PACKAGE
You recently received a notice advising this policy was being cancelled effective 01/30/2021 .
This notice is to advise that the policy is being reinstated without lapse in coverage.
Date Mail
3rd d f F ruary, 2 1
Additional Insured t�
CITY OF SALINA
300 W. ASH STREET
BAVARIA KS 67401 FATINALAM
MDCT19
FORM#CT969897MD51995 02032021SNNY
ODEN 3.o 20 12a Copy for Additional Insured Page 1 of 1
UNITED STATES LIABILITY INSURANCE COMPANY
1190 DEVON PARK DRIVE
P.O. BOX 6700
WAYNE PA 19087-2191
NOTICE OF CANCELLATION OF INSURANCE
Named Insured&Mailing Address: Producer:3294
TRIDATA, LLC AHT INSURANCE
10605 VANTAGE CT 20 SOUTH KING STREET
POTOMAC MD 20854 LEESBURG VA 20175
Policy No.: PPP 1554052A
Type of Policy: PROFESSIONAL PACKAGE
Date of Cancellation: 01/30/2021; 12:01 A.M. Local Time at the mailing address of the Named Insured.
We are cancelling this policy. Your insurance will cease on the Date of Cancellation shown above.
The reason for cancellation is Nonpayment of Premium
The amount of premium overdue is $483.20
Excess premium, if not tendered, will be refunded upon demand.
Your interest in this policy as an "insured" or other party of interest is being cancelled effective 01/30/2021;
12:01 A.M. Local Time at the mailing address of the named insured.
Date Maile
11th of J nuary, 0 1
Additional Insured
CITY OF SALINA
300 W. ASH STREET
BAVARIA KS 67401 FATIN ALAM
MDCC19NONPMNT
FORM#CC969711 MD51995 01112021 MYNY
Page 1 of 1
ODEN 3.0.20.12a Copy for Additional Insured