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Text File  |  1995-12-30  |  2KB  |  41 lines
  1.  
  2.                    INSURANCE BINDER
  3.  
  4. Effective Date and Hour__________________________
  5.  
  6. Insured__________________________________________
  7.  
  8. Address__________________________________________
  9.  
  10. Company__________________________________________
  11.  
  12. Premium__________________________________________
  13.        __________________________________________
  14.  
  15. Coverage___________________________________________________
  16.         ___________________________________________________
  17.         ___________________________________________________
  18.         ___________________________________________________
  19.  
  20. This binder is evidence that ___________________________has
  21. placed the described insurance with the above Company for
  22. the amount set forth.  This binder shall remain in force
  23. for ____days from the date of commencement of liability
  24. hereunder or when, if earlier, it is replaced by a policy
  25. of the Company, and is subject to all the terms and
  26. conditions of said policy as customarily issued by the
  27. Company.  This binder may be cancelled by the Insured by
  28. mailing to the Company written notice stating when
  29. thereafter such cancellation shall be effective.  This
  30. binder may be cancelled by the Company by mailing to the
  31. named insured at the address shown in this binder written
  32. notice stating when not less than ten days hereafter such
  33. cancellation shall be effective.
  34.  
  35.                           _______________________________
  36.  
  37.                           By_____________________________
  38.  
  39.                           Dated__________________________
  40.  
  41.