HomeMy WebLinkAboutCOI - Special K Productions - Expires 2023-10-21State Farm Insurance
PO Box 2915
Bloomington, 1- 61702-2915
02 6868
AT1 000875 1005 01
CITY OF GILROY
ITS OFFICERS EMPLOYEES &
VOLUNTEERS
7351 ROSANNA ST
GILROY CA 95020-6141
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Notice of Reinstatement
Businessowners
Reinstatement date: October 21, 2022, 12:01 a.m. Standard Time
Date processed: October 6, 2022
Amount paid: No Amount Due
AtStateFarm°
State Farm General Insurance Company
Policy number: 97-B8-B286-6
SFPP number: 1086009802
Your State Farm Agent
AI Olseen
3267 S White Road
San Jose, CA 95148-4056
Bus: 408-274-490D
Email: al.olseen.b9ct@statetarm.com
OCT
GILROY CITY CLERK'S OFFICE
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: Location:
ALI, KENYATTA 3687 ROCKY CREEK CT
DBA SPECIAL K PRODUCTIONS SAN JOSE CA 95148-1421
Policy Number: 97-BB-B286.6
Prepared, October O6, 2022
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Page 1 of 1
1009364 2000 152832 200 09-08 2017
State Farm Insurance
PO Box 2915
Bloomington, IL 61702-2915
02 6868
AT1 000870 1005 01
CITY OF GILROY
ITS OFFICERS, OFFICIALS &
r. EMPLOYEES
7351 ROSANNA ST
GILROY CA 95020-6141
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Notice of Reinstatement
State Farm General Insurance Company
Policy number: 97-B8-B286-6
SFPP number: 1086009802
Your State Farm Agent
AI Olseen
3267 S White Road
San Jose, CA 95148-4056
Bus: 408-274-4900
Email: al.olseen.b9ct@statefarm.com
Businessowners L,,LRYITI CLERK'S OFFICE
Reinstatement date: October 21, 2022,12:01 a.m. Standard Time
Date processed: October 6, 2022
Amount paid: No Amount Due
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-BB-B286-6
Prepared. October O6. 2022
av
Location:
3687 ROCKY CREEK CT
SAN JOSE CA 95148-1421
Page 1 of 1
W0870
1009364 2000 152832 200 09-08-2017