Laserfiche WebLink
INVOICE NUMBER <br /> No 42037 *0*1 SS 10,V f Midwest Area, Inc. <br /> PLEASE RETURN INSURANCE <br /> THIS PORTION WITHz N"' <br /> 6900 HUMBOLDT AVENUE NORTH <br /> YOUR PAYMENT 4ANCBROOKLYN CENTER, MINNESOTA 55430 <br /> 612 - 566-8100 <br /> F City of St. Anthony <br /> 3301 Silver Lake Road <br /> St. Anthonyg Minnesota 55418 <br /> CUSTOMER NO. INSUREWS NAME IF DIFFERENT FROM CUSTOMER FILE DATE <br /> SAI 55 7T7783::] <br /> EFFECTIVE DATE RENEWAL DATE <br /> POLICY NUMBER MO.-DAY,YR- MO.-DAY-YR. INVOICE NUMBER <br /> IST61701 8 1 83 9/1/83 N o 42037 <br /> • <br /> BUSINESS w COMPANY PREMIUM <br /> CODE „ CODE DESCRIPTION OF COVERAGE <br /> 60'17 30 Package Policy 2,930-00 <br /> 2nd Installment <br /> On <br /> BALANCE <br /> PREMIUMS ARE DUE ON <br /> EFFECTIVE DATE OF POLICY <br /> Midwest Area, Inc. <br /> J <br />