HomeMy WebLinkAboutCOI - Special K Productions - Expires 2024-01-21State Farm Insurance
PO Box 2915
Bloomington, IL 61702-2915
WINW StateFarm°
02 W68
AT1 011848 1005 01
CITY OF GILROY
ITS OFFICERS, OFFICIALS &
EMPLOYEES
7351 ROSANNA ST
GILROY CA 95020-6141
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Notice of Reinstatement
State Farm General Insurance Company
Policy number: 97-138-B286-6
SFPP number: 1086009802
Your State Farm Agent
Al Olseen
3267 S White Road
San Jose, CA 95148-4056
Bus: 408-274-4900
Email: al.olseen.b9ct@statefarm.com
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Businessowners
Reinstatement date: January21, 2023,12:01 a.m. Standard Time JAN 17 2023
Date processed: January 5, 2023
Amount paid: No Amount Due GILROY CITY CLERICS OFFlCE
Please keep for your records
We are pleased to acknowledge receipt of the premium due on this policy. This policy will be continued in force subject to its printed
terms and conditions upon the payment check clearing through your bank.
Insured:
ALI, KENYATTA
DBA SPECIAL K PRODUCTIONS
Policy Number. 97-B8-B286.6
Prepared: January 05, 2023
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Location:
3687 ROCKY CREEK CT
SAN JOSE CA 95148-1421
Page 1 of 1
1009364 2000152832 200 09o8.2017
State Farm Insurance
PO Box 2915
Bloomington, IL 61702-2915
02 M68
AT1 011853 1005 01
y., CITY OF GILROY
ITS OFFICERS EMPLOYEES &
VOLUNTEERS
7351 ROSANNA ST
GILROY CA 95020-6141
s
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ys
Notice of Reinstatement
Businessowners
Reinstatement date: January 21, 2023, 12:01 a.m. Standard Time
Date processed: January 5, 2023
Amount paid: No Amount Due
Please keep for your records
^StateFarm'
State Farm General Insurance Company
Policy number: 97-BS-B286-6
SFPP number: 1086009802
Your State Farm Agent
All Olseen
3267 S White Road
San Jose, CA 95148-4056
Bus:408-274-4900
Email: al.olseen.b9ct@statefarm.com
We are pleased to acknowledge receipt of the premium due on this policy. This policy will be continued in force subject to its printed
terms and conditions upon the payment check clearing through your bank.
Insured: Location: '��` fig[HO
ALI, KENYATTA 3687 ROCKY CREEK CT JAN 177
DBA SPECIAL K PRODUCTIONS SAN JOSE CA 95148-1421
GILROY Cm' CLERK
Policy Number: 97-BB-B286-6
Prepared. January 05, 2023
u-v
Page 1 of 1
1009364 2000 152832 200 09 08 2017