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Digital Provenance
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Publisher
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Transcription
PACIFIC EMPLOYERS INSURANCE COMPANY Home Office: LOS ANGELES, CALIFORNIA St, m m m M M i c o . -Policy N o.. JdP-1535 Address. Agency_ Broker__ 5860 AVALON 5LVC-, LOS A M S E L E S 3,.CALIF, H.Q.____________________________________ 7-1-45 *-1-46 _u£_LA -Policy Date_ H S l C O D E N O D E S C R IP TIO N O F WORK Jtl- PA Y R O L L B O D IL Y IN J U R Y P R O P E R TY DAMAGE P R E M . 3457 0521 LOCATION* Coen traction of Reservoijr at Las Vegas, Nevada* NEVADA CARPENTRY CONTRACTUAL Total Earned Premium--------- Advance or Deposit Premium- Additional Premium------------- Return Premium------------------ Net Premium 55.679.32 55.679.32 W w 25* Additional H__ *_I _Return- Date- 11/14/47 G-633-A 50M 10-47 A. KAELI8 Auditor
