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HomeMy WebLinkAboutCRA-R-12-0062 09-24-2012 Backupre erne GOVERNMENTAL INSURANCE TRUST Workers Compensation Southeast Overtown Park Community Redevelopment Agency 49 NW 5th Street, Suite 100 Miami, FL 33128 • Client: Southeast Overtown Park Community Redevelopment Agency �Gei ID�8�2 LAW Invoice i P. O. Box 2416 'Daytona Beach, FL 32115 WC FL1 0134004 12-09 09/13/2012 10/01/2012 - 10/01/2013 o, $2e I'�"fo'ia 328.00 �Qpn�, n o h ' 'a , u,- Da e Ago c.�1 _ yo�tcarg m b'�"e , r 37486 a.,,..-. 1(U, i t I�" J JI hY19 iR L "kKy� i�•J � � ��EF� + ��' a`w s " iMIG sa bot ®escrtpt�op1.'�yxz>>� � 1 Agreement # WC FL1 0134004 12-09 (10/01/2012 through 10/01/2013) Current Billed Premium Expense Constant Due Annual Annual payment of $2,328.00 is due 10/01/2012. Printed on Date - ti Thank You $2,128.00' $200.00 $2,328.00 Preferred Governmental Insurance Trust (PGIT ) Administered by Public Risk Underwriters of FL, Inc. P.O. Box 958455, Lake Mary, FL 32795-8455 Phone (321) 832-1456 Fax (321) 832-1489 09/13/2012 Public Risk Insurance Agency P. O. Box 2416 Daytona Beach, FL 32115 Southeast Overtown Park West CRA Southeast Overtown Park West Community Redevelopment Ass( 49 NW 5th St Suite 100 Miami, FL 33128 Please detach and return with payment Customer: Southeast Overtown Park West CRA � r INVOICE traMio In; .oL�e u ma y. IMEVIEWMKGEN 29,277.00 Invoice#25762 PK FL1 0134033 12-05 Thank You ©es r, pin nx� 25762 10/01/2012 Renew policy Policy #PK FL1 0134033 12-05 10/01/2012-10/01/2013 Preferred Gov Insurance Trust General Liability - Renew policy Inland Marine - Renew policy Commercial Property - Renew policy 9,557.00 598.00 19,122.00 29,277.00 Public Risk insurance Agency P.C. Box 2416 Daytona Beach, FL 32115 (386)252-6176 09/17/2012 Thank You