853-American Dental Plan-Cancel CompBenefits
CORPORATION
· ~ · ' The dental and vision benefits company of choice
Sep 25, 2003
City of Sanford
Attn: Joyce Riggins
PO Box 1788
Sanford, FL 32772-1788
American Dental Plan, Inc. (FL)
AGENT:McLain, Pierce & Associates
P. O. Box 1419
Sanford, FL 32772-1419
Te1~:407-328-8142
Notice of Cancellation
Gmup~. 70279 PEffective: 10/01/2003
This confirms a request for cancellation for the dental/vision benefits of your plan with us effective 10 / 01 / 2003
TOTAL DUE IMMEDIATELY: $. 0 0
ff you have questions regarding this notice of cancellation, please contact Account Services
at (800) 633-1262 ext: 7812
Remit payment to:
CompBenefits Corp.
100 Mansell Court East, Suite 400
Roswell, GA 30076
Fax: (770) 998-6871
·Subs: 207 SmnDate: 10/01/1999 Region:001:Florida-Orlando