Transportation Carrier Information

The information below reflects the content of the TMIS
information system as of the close of the previous business day.
Carrier ID CA 0145634
Carrier Status Exempt - 10/16/03
Carrier Name INTERNATIONAL CHURCH OF THE FOURSQUARE GOSPEL
Phone Number (209) 267-1263
Primary DBA JACKSON FOURSQUARE CHURCH

Contact
Address
PASTOR JAY DONNELLY
P O BOX 515
JACKSON, CA 95642

Physical
Address
87 WEST RIDGE ROAD
SUTTER CREEK, CA 95685

INSURANCE POLICIES
Policy Type Policy Number Insurance Company Address
PL and PD Policy F5D00836000 LUMBERMENS MUTUAL CASUALTY CO
ONE KEMPER DR
LONG GROVE, IL 60049-0001