STATEMENT OF ACCOUNT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Fire and Lightning Workman’s Compensation
Tourist’s Floater ; Use and Occupancy
Surety Bonds Steam Boiler
oS {[Charlton INSURANCE Agency| on
Burglary baci Plate Glass
Accident : Fly Wheel
Health Phone 689 Liability
Lawrence, Kansas
Forrest C Allen,
801 LOuisiana St.
* Lawrence Kansas.
Date COMPANY Class Policy Number Amount 5 Expiration Debit Credit Balance
Account Rendered. MAR 30.1940. eee z
3 15 40 | PHOENIX INDEMNITY AUTO | A214235 1}35 15 41 18.60 } 18.60 ,.
36 AC A575 VANCANCY PERMIT 60 18.00 °
c. NO NORTH BRIT! SE FIRE) 441342 VACANCY) PERMIT OUOlY 15.00 ts
qecElVay
Ine, "nd
App .”*
PR 7
G 7 Chg 2
A oY
Descriptive Detail On Entries ds ‘iy
AUTO: Auto BURG: Burglary E-L: Employers Liability LIV: Live Stock “«

A-H: Accident & Health
BOIL: Boiler
BOND: Bonds

CAN: Cancelled
COMP: Compensation
COVG: Coverage

EQ: Earthquake

FLTR: Floater

FIN: Financed

FITO: Fire & Tornado
F-T: Fire & Theft

LIAB: Liability
MAR: Marine

P-L: Public Liability

PG: Plate Glass

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e & Occupancy