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Digital Provenance
Digitized materials: physical originals can be viewed in Special Collections and Archives reading room
Publisher
University of Nevada, Las Vegas. Libraries
Transcription
PACIFIC EMPLOYERS INSURANCE COMPANY Home Office: LOS ANGELES, CALIFORNIA H Location 1033 South Hose at._____ Assured______ ffjltl.. J_A R -Al&l L l f Q _______________ ;________________________ Address______1 0 3 $ __F it .-,''- fliC itirt__ ;, ¥ £.» , __ !tJy&__tfKG A .fij fife V A im Agency____ ___________________________________________________ ______ -Policy No--------UP-1929 _From_____ -To____________3- 2 2 -4 7 Broker_____BaUSffilf? & OHa r OHsR -Policy C O D E N O 3 -4 7 0 D E S C R IP TIO N O F W OR K JOB #1 PA Y R O L L Equipment for laying 2-4* pipeline* new reservoir, Las Vegas, Nevada EXCAVATION-FOB CELLABB OR FOtfNDATIGRS, ETC, (Total aro’t of contract $1,650*00) HO PAIROlLL B O D IL Y IN J U R Y P R E M . m i P R O P E R TY DAMAGE P R E M . inXL Total Earned Premium- Advance or Deposit Premium- Additional Premium_________ Return Premium_____________ Net Premium Additional BXL Return Date- Xl/17/47 A* stARLIli G-633-A 50M 10-47 Auditor
