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Fitness and Wellness Insurance <br /> A Member of Philadelphia Insurance Companies <br /> Tel:877-438-7459 - Fax:866-847-4046 - CA License#0377645 <br /> Name: Connie Winstead Account#: 78940267 <br /> Address: 3000 Montgomery St Expiring Policy#: PHPK561270-003 <br /> Durham, NC 27705- Renewal Date: 04/30/2014 <br /> Policy Type: General and Professional Liability <br /> Policy Limits: $2,000,000/$4,000,000 <br /> Total Balance Due*: $125.00 <br /> Total charge includes insurance premium,applicable taxes,and a$50 Risk Purchasing Group administration fee that is fully earned and non- <br /> refundable. If you have made changes to your operations,such as producing videos, leasing or purchasing a facility, or hiring employees, <br /> please call customer service for a revised premium. <br /> This payment notice is being sent thirty(30)days prior to the expiration of your current policy.Your policy has been automatically renewed and <br /> issued and is enclosed. If payment is not received by your policy expiration date, your renewal will be automatically canceled. Available <br /> payment options are below. <br /> Questions? Please call customer service 877-438-7459 <br /> If payment has already been made, please disregard this notice. If you do not wish to renew your current coverage, <br /> please send an email to custserv(a)phlyins.com specifying the insured name and address, policy number, policy term, <br /> effective date of cancellation and reason for cancellation. If this is brokered business please contact your agent to <br /> cancel. <br /> Please note the following payment options for renewal of your insurance coverage: <br /> 1. You can renew via Visa or MasterCard on-line at www.fitnessandweliness.com or by contacting our <br /> customer service department at 877-438-7459. <br /> 2. You can renew via check made payable to Fitness and Wellness Insurance by mailing your <br /> payment notice and check to: <br /> Fitness and Wellness insurance <br /> P.O. Box 70251 <br /> Philadelphia, PA 19176-0251 <br /> Note: If you have a landlord, facility owner, or other party to be listed as an additional insured, <br /> please attach a list including name and mailing address. <br /> All correspondence should be sent to: <br /> Philadelphia Insurance Companies <br /> Attention: Customer Service <br /> One Baia Plaza, Suite 100 <br /> Bala Cynwyd, PA 19004 <br /> Please detach here <br /> Fitness and Wellness Insurance <br /> If you are an IDEA member and your membership has lapsed, please go to www.ideafitcom to activate <br /> your membership prior to making payment. <br /> Membership#: Membership Expiration Date: <br /> Phone: Email: <br /> Name: Connie Winstead <br /> Account#: 78940267 <br /> Expiring Policy#: PHPK561270-003 <br /> Expiration Date:04/30/2014 <br /> Total Balance Due:$125.00 <br />