HomeMy WebLinkAboutJ D KERBS - INSURANCE CERTIFICATENOTICE OF CANCELLATION/NONRENEWAL DATE 11/24/03
WILSHIRE INSURANCE COMPANY
P.O. BOX 7006 • LANCASTER, CALIFORNIA 93539-7006
TO ALL INSURED(S), LOSS PAYEES, AND OTHER INTERESTS IF ANY, NAMED IN THE POLICY DESCRIBED
BELOW: TAKE NOTICE THAT THE SAID POLICY IN ITS ENTIRETY WILL CEASE AS TO ALL INTERESTS INSURED.
THE EFFECTIVE DATE SHALL BE AS SHOWN BELOW.
r JASON KERBS
Named DBA: J.D. KERBS ENTERPRISES
Insured 856 21ST SW
LOVELAND CO 80537
L
Countersigned at LANCASTER, CALIFORNIA
POLICY NUMBER
1
DA2492000-57-02
J
this day 11/24/03
Authorized Representative
AGENT'S CODE NUMBER
CANCELLATION ERMINATION
000300000
12 24 03
Countersignature
at the hour of 12:01 A.M. Standard Time
You are hereby notified in accordance with the terms and conditions of the above mentioned policy that your insurance will cease at and
from the hour and date mentioned.
Policy r l
Issued TRUCKWRITERS OF COLORADO INC Reason:
through 1410 CARR STREET
(Agent)
L LAKEWOOD CO 80214-610
PREMIUM ADJUSTMENT: If this policy is cancelled and the premium has not been paid, the earned premium due and payable shall
be computed as provided in the policy, and demand is hereby made for payment thereof. If premium has been paid, the excess paid
premium, if any, above the earned premium, if not tendered with this cancellation notice, will be refunded as soon as practicable after
cancellation becomes effective.
The following (when applicable) have also been notified (by separate
notice): Certificate Holder(s), State Commission(s), Additional Insured(s), or
other interests.
Should your policy contain form MCS-90, Endorsement for Motor Carriers, it
shall also be cancelled at the hour and date mentioned above.
I- -1
CITY OF FORT COLLINS
Loss Payee 256 W . MOUNTAIN AVE.
PO BOX 580
L FORT COLLINS CO 80524 J
AVAILABILITY OF OTHER INSURANCE
You have been notified herewith that this Company does
not desire to carry your Commercial automobile insur-
ance any longer. Other insurance is possibly available
through your agent, another insurer or through the
Automobile Insurance Plan. For additional information,
please contact your Insurance Agent.
11/24/03
DB NOC (6/91)
INSURED
NOTICE OF CANCELLATION/NONRENEWAL DATE �-11/24/03
WILSHIRE INSURANCE COMPANY
P.O. BOX 7006 • LANCASTER, CALIFORNIA 93539-7006
TO ALL INSURED(S), LOSS PAYEES, AND OTHER INTERESTS IF ANY, NAMED IN THE POLICY DESCRIBED
BELOW: TAKE NOTICE THAT THE SAID POLICY IN ITS ENTIRETY WILL CEASE AS TO ALL INTERESTS INSURED.
THE EFFECTIVE DATE SHALL BE AS SHOWN BELOW.
POLICY NUMBER
F JASON KERBS
Named DBA: J.D. KERBS ENTERPRISES BA2492000-57-02
Insured 856 21ST SW
LOVELAND CO 80537
L J
Countersigned at LANCASTER, CALIFORNIA
this day 11/24/03 ,, ,gQ�' /}
Authorized Representative
AGENT'S CODE NUMBER
CANCELLATION ERMINATION
000300000
12 24 03
Countersignature
at the hour of 12:01 A.M. Standard Time
You are hereby notified in accordance with the terms and conditions of the above mentioned policy that your insurance will cease at and
from the hour and date mentioned.
Policy F
Issued TRUCKWRITERS OF COLORADO INC Reason:
through 1410 CARR STREET
(Agent)
L LAKEWOOD CO 80214-GI0
PREMIUM ADJUSTMENT: If this policy is cancelled and the premium has not been paid, the earned premium due and payable shall
be computed as provided in the policy, and demand is hereby made for payment thereof. If premium has been paid, the excess paid
premium, if any, above the earned premium, if not tendered with this cancellation notice, will be refunded as soon as practicable after
cancellation becomes effective.
The following (when applicable) have also been notified (by separate
notice): Certificate Holder(s), State Commission(s), Additional Insured(s), or
other interests.
Should your policy contain form MCS-90, Endorsement for Motor Carriers, it
shall also be cancelled at the hour and date mentioned above.
r
CITY OF FORT COLLINS
Loss Payee 256 W . MOUNTAIN AVE.
PO BOX 580
L FORT COLLINS CO 80524 J
AVAILABILITY OF OTHER INSURANCE
You have been notified herewith that this Company does
not desire to carry your Commercial automobile insur-
ance any longer. Other insurance is possibly available
through your agent, another insurer or through the
Automobile Insurance Plan. For additional information,
please contact your Insurance Agent.
11/24/03
DB NOC 16/91)
INSURED