HomeMy WebLinkAboutW/C AFFIDAVIT 8/22/24 28AP 1233 ED 02-15
28-271
A R B E L L A' P.O. Box 55392
Boston, MA 02205-5392
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Policy Number Policy Type Policy Term Date of Notice
7520094518 Businessowners 04/01/2024-04/01/2025 08/22/2024
Mail To: Insured: Agent:28-271
TOWN OF YARMOUTH THE PANCAKE MAN, LTD NO COMMONWEALTH INS PARTNERS
1146 MAIN ST MARSHALL FARLEY LLC
YARMOUTH, MA 02664 FO BOX 148 2 HERITAGE DR
HYANNISPORT, MA 02647 SUITE 301
NORTH QUINCY, MA 02171
617-847-0005
RESCISSION NOTICE
Thank you for making your payment prior to the effecive date of cancellation. This Notice of Rescission is to inform you
that a valid payment made prior to the effective date means this policy will not be cancelled. Assuming such payment is
honored by your financial institution, the company hereby nullifies the notice of cancellation with the effective date of
08/29/2024 and your policy will continue in force unaffected by the notice of cancellation.
However, if your payment is ultimately dishonored by your financial institution, the original cancellation date of 08/29/2024
will continue to apply and you should consider your policy cancelled as of that date. This Notice of Rescission is only
applicable if a valid payment is made.
By I �/ 1170' ,.
/ Authorized Repr entative
RF^CEIVCD
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BUILDING DEPARTMENT
By:
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Additioial Interest Copy
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