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Digital Provenance
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Publisher
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Transcription
I PACIFIC EMPLOYERS INSURANCE COMPANY Home Office: LOS ANGELES, CALIFORNIA Location____103-3_8t. ___________________ Assured- W- -Policy No. -HP-2018 Address- Agency— Broker__ ttsn a ? M'C'Tf ^ ri« & & — V ? & * * & & f — _From_ .8-19-46 Ha 0. _To_ 8-70,7,6 n ft -Policy Date-------LTf C O D E N O . 5213 Date. D E S C R IP TIO N O F W O R K Laying concrete blocks at reservoir near West Charlesnteown Blvd. t Las Vegas, Nevada. CONCRETE CONSTRUCTION- R.0.C. PA Y ROLL. 160.00 Total Earned Premium- Advance or Deposit Premium- Additional Premium_________ Return Premium____________ B O D IL Y IN J U R Y *739 P R E M . 18 P R O P E R TY D AM AGE .393 P R E M . N et P rem ium 11/14/47 AdditionaL ..31 63 53 -Return. G-6J3-A 50M 10-47 Auditor
