HomeMy WebLinkAboutJ D KERBS ENTERPRISES - INSURANCE CERTIFICATEREINSTATEMENT NOTICE
DATE
12/01/03
WILSHIRE INSURANCE CQMPAMV
P.O. BOX 7006 a LANCASTER, CALIFORNIA 93539-7006
TO ALL INSUREDS, LOSS PAYEES, AND OTHER INTERESTS IF ANY, NAMED IN THE POLICY DESCRIBED BELOW: You are hereby notified that the
Policy numbered below is issued to you by WILSHIRE INSURANCE COMPANY and cancelled by the insurer on the date shown is hereby reinstated
effective the date shown and the Policy to which this endorsement is attached is reinstated and remains in full force and effect without lapse in
coverage.
Nothing herein contained shall be held to vary, waive, alter, or extend any of the terms, conditions, agreements or declarations of the un-
dermentioned Policy other than as above stated.
POLICY NUMBER
F JASON KERBS
DBA: J.D. KERBS ENTERPRISES BA2492000-57-02
Named 856 21ST SW
Insured LOVELAND CO 80537
L J
Countersigned at LANCASTER, CALIFORNIA
this day 12/01/03
WILSHIRE INSURANCE COMPANY
Authorized Representative
Countersignature
AGENT'S CODE NUMBER
DATE CANCELLED
REINSTATED EFFECTIVE
000300000
12 24 03
12 24 03
Policy r TRUCKWRITERS OF COLORADO INC
Issued 1410 CARR STREET
through
(Agent) LAKEWOOD CO 8 0 214 - 610
L I
CITY OF FORT COLLINS
Loss Payee 256 W . MOUNTAIN AVE.
PO BOX 580
L FORT COLLINS CO 80524 J
DB RN (e/91) INSURED