Standard Fire Insurance Policy for New Hampshire
No. Type of Company Renewal of Number Space for Company Name, Insignia and Location
Space for Producer's Name and Mailing Address ........ Inception (Mo. Day Yr.) Expiration (Mo. Day Yr.) Years
Subject to Form No(s). attached hereto.
Agency at Countersignature Date. .........................Agent
Insert signatures and
titles of proper officers
Source. 1959, 163:1. 1981, 349:1. 2000, 260:5. 2001, 224:3. 2003, 144:7. 2006, 196:5. 2009, 215:3, eff. Jan. 1, 2010.