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JOLLY BOUNCERS, INC. (2)
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JOLLY BOUNCERS, INC. (2)
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Last modified
10/17/2019 2:35:37 PM
Creation date
10/17/2019 2:29:40 PM
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Contracts
Company Name
JOLLY BOUNCERS, INC.
Contract #
N-2019-217
Agency
COMMUNITY DEVELOPMENT
Expiration Date
10/27/2019
Insurance Exp Date
4/8/2020
Destruction Year
2024
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AGENCY CUSTOMER IG: 000 <br />VEHICLE SCHEDULE <br />NAIC CODE <br />POLICY NUMBER I EFFECTIVE DATE I NAMED INSUREDIS) <br />I MAKE 1 V 7 V H LYP� YIGK !O I VEHICLE TYPE SYMI AGE OiC 6YM 6VM <br />1 i 2008, MODELTUNDRA 4_X2 CREWMAX vLN 5TFEV58138XO63825_i_LP_PijSPre DM1„ <br />GgRA01NG� STREET (Roy d In KY) CITY COUNTY STATE IZIP <br />ADDRESS 14758 Promenade St 1 Slml Valley_ CA 1 93063 041 <br />STATE TERR I ELM IGCW CLASS SIC FACTOR BEAT RADIUS FARTHEST TERMINAL COSTNEW <br />_ - 1000 Q _-_ _ _ 100 { $ 39,010 <br />'r "'J GHHCK Ar]G'L No -"- uN__N_E ti Nf� DsoucTlGLEs -I' ! ToMPrj' 7SPl:c USE OOMM'L FOR HIREg,�ERgGES _ FAULT __ MOTOR r LSP X REIMU X 1 ACV! K.I prC 4 ,C t1F <br />PLEASURE !RETAIL X LIAR MED PAY yTg00R FT COMPI FG I s <br />i._ _ X oTc AN I { STAMr s 500 <br />NO- UNINS SPEC <br />FARM SERVICE I QQF� _ FPN X COLL $ _ _ g SOOCDL <br />._ 1 ( AU6T_.L MC2S2Lr_�.-_ <br />-OR}VETp --- e15 MIf EB 15MILE8« NETa, TOTAL FRM: <br />R C 00 <br />VEH0 YEAR I MAKE: RAM rypp; T r u CIS VEHICLE TYPE SYMI AGE CO <br />QTCSYMCOMPJ I SYM <br />2 _2015 MGOEL:RAM TRUCK 1500 ST ry 1C6RR6FTXFS762581 _ PP ��sPEb COME <br />GARAGING STREET(R q l od lr KY) CITY COUNTY STATE ZIP <br />ADOREfi. 4758 Promenade St ( Simi Valley CA 193Cs3-D411 <br />a no <br />TERR GVW lGCW CLASS sic FACTOR (SEAT CPI RADIUS 1 FARTHEST TERMINAL I COST NEW <br />_ 10,000 _ 100 3 s 29,6A5 <br />USE TX COMM'L T 1 FOR NIRE [ CHECK ApOL NU i UNORINs T F L5P R� 02OUCTIGLEB f TCOMFII 61 <br />I- CUVC1iAPF&.,__J FAULT 1,_I MOTOR ( X REIMS } X ACV X� OTC 1 IC OF <br />PLEASUIE RETAIL 1 10WINb E 40MPI <br />1 ' X LIgS 1 . a MED PAY i .� R LABOR E X Orc G I A ( ST ANT $ 500 <br />FARM SERVICE NO' X UNINS j SPEC 33 I--- " - <br />uLi L...- .htazsu.+_.---Lcg€lv [ FDuv X Gou s -- s _-SOOCOL <br />DRIVEV 15 MILES 16MILES+ NEI'YEH <br />R: TOTAL PROM. <br />VEHR YEAR ',MAKE DODGEfi.Other VEHICLE TYPE SYMIAGE OTP srM srmL <br />3 2011�MooEL RAM 3500 PICKUP l6 MN 3D73M4CLXBG624553 .) �PP �sPEccoML <br />GARAGING i STREET IR q d it KY) CITY COUNTY STATE 21P <br />ADDRESS 4758 Promenade St _LSlm--lCl-VVaa11� _ __ CA 93063-04.1.1 <br />STATEI TERR '� GVWIGCW CLAS$ 1 61C FACTOR SEATCP RADIUS FARTHEST TERMINAL COSTNEW <br />_ 20,000 _ 1 100 y s 52,405 <br />USE COMML� TFORIIIRCrQ ANL7RAOS�Le>,MRTtDAtw� � FOR �. .q FT yl 1C IFUR� SEUUv110F ISTAMTV GO C'15�QCOF <br />PA I CDLI <br />PLEAS ltETML 1 tJ� WING Y/\ COMPI <br />t FARM 1 SERVICE FPN b COIL <br />... __. ,....,._. ,._ ,... . L�. <br />kRNE'O (( 15 MILES I 15 MILES NET VEK <br />W�RK�SCNbDL i { D{uDR 10TAt,r REM' $ <br />VEMN ! YEAR MAKE. NISSAN OdQY PICICU VEHICLE 7YPE SYM IAGEI OTC SCOMPI COLL SYM YMI <br />4 L2004 MaDEL FRONTIER CREW CAQ SC I vIN 1N6MD27T84C451907 PP� �sPEr I COM1. 11 E ; <br />GARAGING ?STREET (R qu d NV) -CITY I COUNTY STATE � ZIP <br />P°DHE55 ' 4758 Promenade St ._ - Siml Valle l 93063 0411 <br />-- <br />6TATE TERR GVWIGCW CLASS eIC I FACTOR (SEATCP RADIUS r FARTHEST TERMINAL COSTNEW <br />10 000 _ 100 I __ a 24,420 <br />UBE COMML FDR HIRE CHECK "- AGi3I AQ` llNi]RINS F LSP RENT DEDUCTIBLES t 1GbMPl1 SPFC <br />&OYERAOE9 __{ gULT I MOTOR e REIMG _ , ACv _ OTC C OF I <br />PLEASURE RETAIL qy LIAR MET PAY TOWING ; FT COMP? FO { <br />&LAGOR AA -.., 9TAMT $__ None <br />FARM BE IC NN'O I _.. UNINS t SPFC FIW DOLL <br />fALR.T X MOTOR _ !COPE _ ,,... S S NOneCOLI <br />C0 KTO I ifiMILES i MILES T PTVER <br />VEH6 YEAR I MAKE DODGE I yF Pickup VEHICLE TYPE ;SYM IAOE S i L <br />._ __ ___ �. TV — — ._ OTCSYM SYM <br />20031 MODEL RAM 1500 PICKUP V8 I vl N 1 D71HA16D53J635509 ] Pr ��sPE �coML <br />GARAGING STREET Req b din KY) ITT COUNTY STATE ZIP <br />ADDRESS 4758 Promenade St Simi Valley _ �CA 9300 0411 <br />S IA1E TERR GVWIGCW CLASS SIC FACTOR SEAT CP� RADIUS PAR7HPST TF.RMiNh4 COST NEW <br />_ 10,000 i 1 100_ 1 _ _ s 2_2,040 <br />USE GOMML I FORHIRE CHECK ARYL NO- jUNDRINS F LSF BENT DLDUCTIDL ON tj CMOMP/ 6Prc <br />I_ rgfl CRAGES __z FAULT MOTOR F REIMU ACV .. OTC .i:!)FL <br />PLEASURE RETAIL �r LIAR MED PAY TOWING FT COMPI PC + S LABOR I OTC I AA I ST AM7 I $ None <br />FARM SERVICE h0• DRI G NSPCC FTW COLL 1 <br />] 1lNVLI .X. MWOA .DOFL .._.... t_ 1 ,s NonecaL <br />911VE r9-...„.. I < 15 MILES I i 15 MILFS NETV@H y ,_ <br />- ACORD <br />fRV II,,D OO 1993,2009 ACORD CORPORATION. Ali rights reserved, <br />. <br />B The ACORD name and logo are registered marks of ACORD <br />Printed by JAB on July 03, 2019 at 01 29PM <br />Risk Management Division <br />
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