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Transcription
W&sm POLICY NO. m m 5 1 ^ 0 w R E P O R T O F i^UDn%kM A D D R E S S A G E N T INDEMNITY INSURANCE COMPANY OF NORTH AMERICA PH ILAD E LPH IA d r i l l i n g c o r p ., l t 3020 Empire St., Emett & Chandler Burbank, Calif. C O D E NO. PO LIC Y PERIOD LOCATION OF WORK AU D IT PERIOD BEGDSTS " " 10-15-52 E N D S""' 11-19-52 10-15-52 11-19-52 l&J CLASS KIND BUSINESS COVERAGE STATE CITY CLASS LIMITS C LA SSIFIC ATIO N PA YR O LL RATE EARNED PREMIUM OSH #1 P r o d m b i o n t e s t o n f i v e w ati r w e l l i i t L a e Y e s a s * Y e v a d a . . M a e . J a l 3 2 0 4 J J r l l l i n j z ~ , 5 C - 1 1 1 l t 8 4 W W " If , 5 C 1 0 . i f - H m i C o n t r a c t n 8 1 * P S 2 7 ~rt i* » .19* i t - 16 A B S T R A C T No. EARNED PREMIUM P. L. P. D. TO TA L STATE ADVANCE < £ f PREMIUM ADDITIONAL PREMIUM 2 2 . 2 2 1 C-Z073 PREMIUMS DUE THE INDEMNITY INSURANCE COM PANY OF NORTH AM ERICA ARE PAYABLE IMMEDIATELY UPON PRESENTATION OF TH IS REPORT
