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o:d•c <br />Employers insurance of Wausau <br />7450 FRANCE AVENUE SOUTH • P.O. BOX 1357 • MINNEAPOLIS, MINNESOTA 55440 • PHONE (672) 831 -4723 <br />CERTIFIED MAIL <br />RETURN RECEIPT REQUESTED <br />City of Little Canada <br />515 Little Canada Road <br />Little Canada, MN 55117 <br />Workers' Compensation Policy No.: 0318 -00- 053598 <br />Combination Casualty Policy No.: 0328 -02- 053598 <br />NOTICE OF CANCELATION <br />October 18, 1977 <br />Our sales representative, Robert McPherson, has discussed with you <br />placing your automobile and workers' compensation insurance with <br />another carrier. <br />This is formal notice that cancelation of the above numbered combination <br />casualty policy shall be effective as of 12:01 a.m. January 23, 1978 <br />and accordingly no coverage will be afforded after the cancelation <br />date. <br />This cancelation notice is in accordance with policy cancelation <br />provisions. The final premium adjustment, if any, on this cancelation <br />will be made on your account as soon as possible. <br />If you are unable to obtain replacement workers' compensation insurance <br />on a direct basis with another company, you may make application <br />to the Minnesota Bureau for Assigned Risk insurance. Enclosed are <br />the applications. <br />We thank you for having allowed us the opportunity of providing <br />this insurance in the past. <br />Kent Volz <br />Reg. Casualty <br />Underwriter <br />TC /1 <br />Enclosure <br />OCT, 19 1977 <br />CITY OF <br />LITTLE CANADA <br />Employers Mutual Liability Insurance Company of Wisconsin • Employers Life Insurance Company of Wausau • Home Office: Wausau, Wisconsin <br />Illinois Employers Insurance of Wausau • Principal Office: River Forest, Illinois <br />32 <br />■ <br />