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<br /> <br />I <br /> <br />~ r~ij~op!~sec:E~~~~m~~t,bOidf.ce-lype:'~~~~E'~''-83::Cio 27-m~ <br />H;==~=W&:~=;:rl~:m:~:~~:~S:~~!!~:~T~~;(:a!:!;t1~fcf~2rr!~': ,Z <br /> <br />underthls'contract.l;,"".' -".',',\:':,,' : "" :":"'" <br />. Ac;lalm Is 8 legally valid reason fOLS\.Ilng the: SelIfj...~'Aidefense Is 81eg81ly valid reason. for not paying, n <br />"tl\eSeller"AJhcI""J8'anyone trying'to collect for t~,~ur~h~~. .'. ; i <br /> <br />ce lothi. purehase,imayc";~ suehrequesr for in~~...nce for any reason withinfifteeoJl~) !laY'l\'Omth~* <br />tin wri!ing. I know that ~e cancel~,~,on~ of:mtcover:ag~ ~i11 be arranged with the insura'nce--~ar9~t{~);arn;t i <br />arge wdlbe'cred!redto th.s contracL'. . '.. . '.', , ' ',; <br />r" :LEj\SENOTE: If! have reqUeste~rinsu-~e:~n~~iS'p,urcha~.-' J will receive within-thirty (30) days a certificate ofinsurance,mp~ fullyd'escribihg the insiIrance cove~~:~ <br />~-: ~-know_,that if th~re is-any co~flict-in. the cdttetage at tbe>lan'glUlge of the ce~ific3te o~ insurance _and the fono~ng Notice of PiOpose~t?~nsuranq~;that I am covered,on~y-tQ'~ <br />i -~ extent stated-m the followmg Notice-of Proposed-Insurance. I also k:nowthatlhave msurance-coverag~ onlY'IfJ have:bee'n charg--etl:for tt; <br />, , NOTICE OFPROPQSEPilNsI)RAN'CE <br /> <br />'~"1>(.~jt~~jW#II:liJidRAA1l!!'1:'l:sjf(lU@;,1lillQllrr\\1lt~app~le;iiit1jjs$li1eiC6iiW~f()il:t/iOl'e.v~~Icl<onl~l(f!liiY~R)\O'Sen .., <br />-. .: Th'is insuranCe will only cover the ~rson signirig-the uestat the cost ,fOT eac~ type ofi~surance s~wn,- SubJectt~;'1l(:C_ep~c:e <br />fJO!iay;and will, . berofiQlonths a.fIerll>>'eff~li~ _ "9"llI;tj)\t!!e'~ber<of <br />payments,. anl!t!>al.dunng,1hll\:penndoftiJ!le LwUL,!1Ol'have,,!!yi <br />on'Or:abank lhtpurchases lI!e',sal~,ContracHO:tI1e:extehtoh18 <br />me. The initial' amount of edifLtfe Insul'3rice is the amount required to repay t}\e Totatof.~~Y~I1tS;{lh~,~_~,in~~ <br />.~S;hl\~'WKl\llltof,ea\:!\!\lontl\ly"pay,menl on", scl1.edu1ed30,day ,has!s. If 1 amjointly obligated 9n lheSllIeli ,Contra<;! with,!! GO-Illlyer; a!l(!cwe-baJ(e<l!otl1.$iglll'd <br />the~r ' uest-f6rCfe4it'Dfe In~nmce: d~aih benc.;fitS wiB'be' pa -able only wi.th res - t to the first one'ufns lodie. Subject t . <br /> <br /> <br />The.foregoing instrument was acknowledged before. me Q-P...... <br />, . . ...;.'.r,I:3/ <br />~-..../- <br />...- <br />_~_ _ _' _ .;;.._t' <br />b~ the authorized agent oLS~~..~@,_~~_.LC-:~ r;-"J __.t':_-~ .~<~ <br />My cO~lission expires:. . <br /> <br />PACEs~ER PRODUCTS,;JblC2 ls.1iter) <br /> <br />/ <br />,./7-c--t.-i "'-:::"'-<-. <br /> <br />'7 <br />. 19 L") <br />c~ <br /> <br />~~_/~1, c ~ _A _ ~._ <br /> <br />,/ . ,/ <br />Br :__,f/d~,~-/l..{ <br />,. <br /><{ , <br />~ -.;;...., <br /> <br /> <br />~ 11~ <br />( C. . rJ r-' <br />I; o..-t'fulIr,<<-) ,. 1'--0 . <br />(, , .'--"-'~,".--~""'~ <br />V , .t"1tAAJ'I'I! "~ I!, \ <br />. ":i~:~~~~~ 'ii" ~:,,~t.j,:;~ <br /> <br /> <br />~ <br /> <br />L <br /> <br />L <br /> <br />-1 <br /> <br />L <br />