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<br />~ <br />GUldeOne" <br /> <br />Insurance <br /> <br />GuideOne . 'JaJ Insurance Company <br />GuideOnE\....Jlnsurance Company <br />GuideOne me Insurance Company <br />GuideOne Specialty Mutual Insurance Company <br />GuideOne L10yds Insurance Company <br />GuideOne America Insurance Company <br /> <br />FAMILY JACKET <br />__ ACCOUNT NUMBER <br />AGENT 04-607 <br />MARSH ADVANTAGE AMERICA <br />160 SPEAR ST FLOOR # 15 <br />SAN FRANCISCO, CA 94105 <br /> <br />009620305 <br />009620296-01 <br /> <br />"11 Ashworth Road, West Des Moines, Iowa 50265-3538 <br />ADDITIONAL INSURED <br /> <br />(04 ) (866)264-3092 <br /> <br />THE CITY OF SANTA ANA <br />ATTN: LUIS ESTEVEZ <br />20 CIVIC CENTER PLAZA <br />SANTA ANA CA 92701 <br /> <br />INSURED <br />LUTHERAN SOCIAL SERVICES <br />OF SO CALIF % SILVIA ACUNA <br />1501 E ORANGETHORPE AVE #250 <br />FULLERTON CA 92831 <br /> <br />NOTICE OF CANCELLATION <br /> <br />COMMERCIAL PACKAGE <br /> <br />Policy Number 9620-305 <br /> <br />Perhaps you have overlooked your recent insurance statement. We appreciate your business and <br />want to continue your coverage. However, because we have not received premium payment, the <br />policy listed above is canceled, effective at 12:01 a.m. standard time on 08/25/02. <br /> <br />To help us avoid this action and continue your coverage without interruption, please submit the <br />minimum premium due before the cancellation date. A late charge will be included in your next <br />billing statement. <br /> <br />If you have already sent your payment, please accept our thanks. If you have any questions <br />about your policy, please contact your agent listed above. Thank you for insuring with <br />GuideOne Insurance. <br /> <br />Policies Included within this account are: <br /> <br />1133-255 <br /> <br />3878-903 <br /> <br />9620-305 <br /> <br />MEMORANDUM COPY <br /> <br />080502 <br /> <br />. ?PROVED AS TO FORM <br /> <br />;(J{~L cb; <br /> <br />" : 1 "ttorney <br /> <br />UBCl92 <br />