Receipt for Supplies

Front:
----------- ----------- 1018-D. RECEIPT FOR SUPPLIES MR FRED A.WRIGHT, AGENT, 5590 ---- Agency VIRGINIA ,----- ----- Agent Shipped'.. ------ vià... -------N-E-BRA---Express Co., Charges Paid Received of the Springfield Fire and Marine Insurance Company the following ------Commission --- ---- Register, with Prohibited List Attached ----Sign ----- --------Loss Reports Fire Policies inclusive Tornado Policies--- inclusive Dwelling Policies -inclusive Comb. F. & T. Policies:----- Linclusive Auto Policies F. & T. ---- ---: -inclusive ------inclusive Certificates ---Tornado O-8-9 tryinclusive Received: 2 - / .191. Pred O w right Agent Please verify, sign and mail to us at once. Do not use Rubber Stamp or Typewriter for Signature

Back:
US POSTAGE SE POST C JUL-13 90 Ely S.F.& Springfield Fire and Marine Insurance Co. 209 WEST JACKSON BOULEVARD CHICAGO, ILL.