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Please Remit Payment To: <br />NAU COUNTRY INSURANCE COMPANY <br />PO BOX 488 <br />N� ANOKA, MN 55303 -0488 <br />" -' IIIIIIIIIiIIIII) II IIIIIIIIII I VIII IIII IIIIII <br />Page 1 of 2 <br />NAU Country Insurance Company <br />7—r,,L.-4 o8¢7 <br />Premium Statement of Accounts 1012009 Statement #21067861 <br />Account# 46067861 <br />25293 1 AT 0.357 <br />* * * * * * * * * * * * * * * ** *AUTO * *3 -DIGIT 680 091 <br />PLATTE RIVER RECOVERY <br />IMPLEMENTATION FOUNDATION <br />522 MICHAEL DR <br />GRETNA NE 68028 -8002 <br />�illrrlllllll��nll�llr�l���llllilllnllilllllllllrllllln��l�l <br />Premium Statement of Accounts 10/2009 <br />PLATTE RIVER RECOVERY Account Balance <br />IMPLEMENTATION FOUNDATION <br />522 MICHAEL DRIVE Current Due <br />GRETNA, NE 68028 <br />$ 2,811.00 <br />$ 2,811.00 <br />Statement Date <br />Current Due <br />Amount Enclosed <br />10101/2009 <br />$ 2,811.00 <br />=o <br />10/01/2009 <br />Detailed policy information is provided on the <br />following pages showing the charges by CROP and <br />BILLING DATE. The "Current Due" shown is what is <br />owed at this time. <br />f r <br />T. <br />'charges �� <br />Payments <br />Date Insurance Premium Fees <br />- -- -- - -- -- - - - - -- --- - - - - -- -- -- <br />Other <br />Interest <br />Charges" * <br />-- -- - - - - -- - -- <br />Total Current <br />Charges <br />-- <br />Loss <br />Payments * Balance <br />- ----- --= -- <br />- - <br />10/01/09 MPCI 2,232.00 30.00 <br />- - <br />2,262.00 <br />- - 2,262.00 <br />110/01/09 Hail /Fire 549.00 - <br />- - <br />549.00 ! <br />- 549.00 I <br />* Includes payments and adjustments received since your previous statement. Account activity after the statement date is not reflected on this statement. <br />** Other charges column includes overpaid losses, premium taxes if applicable and miscellaneous account fees; such as NSF charges. <br />to report policyholders who have unpaid debt on any MPCI policy. Once reported, RMA / FCIC may put the <br />ihibits them from participating in the crop insurance program until the debt is paid. <br />1 .25% per month (15% APR) will be charged on unpaid fees and premium balances not paid <br />billing date on the amounts listed above, regardless if the account has a pending claim. <br />Please contact your agent if you have any questions regarding either this statement or claims filed with our company. You may disregard this notice <br />if your payment has been mailed. <br />A &O* Note: This amount may increase by 1.15 percent of net book premium (except for group plans of insurance) if the loss ratio in the State <br />exceeds 1.20. However, the amount of premium the producer must pay will not change. <br />Thank you for doing business with NAU Country Insurance Company <br />Statement # 21074252 NAU COUNTRY INSURANCE COMPANY A &o* Subsidy Provided by FCIC: $917.42 <br />Account # 46067861 7333 SUNWOOD DRIVE NW RAMSEY, MN 55303 5119 Risk Subsidy Provided by FCIC: $2,727 <br />763 - 427 -3770 MPCI Gross Premium: $4,959 <br />