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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 Location___ 1Q33 Sotittl Hope St»_____ ROBERTS HOOFING COMPANY______________ ___ Address. 921 a* MSI« $T., LAS VEGAS, IfgV-DA .Policy No. .From____ UP-1864 8-1-16 Agency- Broker— H, 0 . -To_ ; E.WETT i CHANDLER -Policy Date____ 1 2 —2 1 —45/<46 C O D E N O . 5 5 5 1 D E S C R IP TIO N OP W OR K job n All roofin'" at n«w reservoir, Las Vegas, Nevada* ROOFIRG - AL|i KINDS, etc, PA Y R O L L 7 9 8 , 3 5 B O D IL Y IN J U R Y • 5 5 4 4 42 P R O P E R TY DAMAGE . 7 8 5 P R E M . 27 Total Earned Premium- Advance or Deposit Premium- Additional Premium_______ Return Premium__________ Net Premium Date. 1 / 1 4 / 4 7 lG-633-A 50M 10-47 ~ 7 T A ddition al 1 ^ * 9 ] } f tiirn A • M AKLltl .. Audi tor
