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Sbte&M STATE FARM® <br />® PO Box 2368 <br />Bloomington IL 61702-2368 <br />41A <br />AT1 02 <br />000039 0093 <br />CITY OF PLEASANTON <br />PO BOX 520 <br />PLEASANTON CA 94566-0802 <br />111111111Jill <br />1�11��1��n����l4nlnllllll��llllllllll�n�lllll�l <br />A <br />DATE OF NOTICE: JUN 02 2025 <br />CODE: <br />NOTE: PLEASE NOTIFY STATE FARM AT THE <br />ADDRESS LISTED AT THE TOP, LEFT CORNER <br />OF THIS PAGE REGARDING ANY CHANGE OF <br />ADDRESS INFORMATION. <br />ANDITIONAL INSUREQ'a NOTICE CSF COVERAGE <br />State Farm Mutual Automobile Insurance Company <br />378F-FA57-A <br />NAMED INSURED: POLICY NO: <br />331 8286-AO1-05G <br />COVERAGE: <br />D & D COMMERCIAL & YR/MAKE/MODEL: <br />2021 FORD PICKUP <br />BI AND PD LIABILITY <br />RESIDENTIAL PAINTING INC VIN/CAMPER: <br />1 FTFW1 RGOMFC64059 <br />$1 MIL <br />0 <br />$ DED. COMP. <br />AND RICE, DAVID AGENT NAME: <br />JILL CASH <br />00 DED. COLL, <br />PO BOX 1149 AGENT PHONE: <br />(925)892-8000 <br />.$1100 <br />PLEASANTON CA 94566-0114 ENDORSEMENT NO: 6028BU <br />POLICY EFFECTIVE <br />MAY 05 2025 UNTIL TERMINATFn <br />POLICY MESSAGES: This policy shown above supersedes policy# 3318286-05F. <br />The policy includes a loss payable clause protecting the additional insured's interest in the described car to the extent of the insurance <br />provided and subject to all policy provisions. The additional insured will be given 20 days notice if the policy is terminated. Until such notice <br />is provided, it shall be presumed that the required renewal premiums have been paid. The additional insured must notify us within 10 days of <br />any change of interest or ownership coming to their attention. Failure to do so will render this policy null and void. <br />FRT <br />