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,iawwrarm STA Et FARM:" <br /> c-, <br /> < DATE OF NOTICE: DEC 31 2025 <br /> PO Box 2368 <br /> Bloomington IL 61702-2368 CODE:: <br /> 30A <br /> AT1 02 A <br /> 000026 0093 <br /> CITY OF PLEASANTON NOTE: PLEASE NOTIFY STATE FARM AT THE <br /> PO BOX 520 ADDRESS LISTED AT THE TOP, LEFT CORNER <br /> PLEASANTON CA 94566-0802 OF THIS PAGE REGARDING ANY CHANGE OF <br /> ADDRESS INFORMATION. <br /> IIIijiIIIIIIIIuiIIIInIIIInIIIIIIIIIiIIuIIiiuiIIIiiiiifIiIIIIIII <br /> ADDITIONAL INSURED'S NOTICE OF COVERAGE <br /> State Farm Mutual Automobile Insurance Company 378F-FA57-A <br /> NAMED INSURED: POLICY NO: 331 8286-A01-05M COVERAGE: <br /> D&D COMMERCIAL& YR/MAKE/MODEL: 2021 FORD PICKUP BI AND PD LIABILITY <br /> RESIDENTIAL PAINTING INC VIN/CAMPER: 1 FTFW1RGOMFC64059 $1 MIL <br /> $250 DED.COMP. <br /> b AND RICE,DAVID AGENT NAME: JILL CASH $1000 DED.COLL. <br /> 5 PO BOX 518 AGENT PHONE: (925)892-8000 <br /> EAGLE ID 83616-0461 ENDORSEMENT NO: 6028BU POLICY EFFECTIVE <br /> DEC 22 2025 UNTIL TERMINATED <br /> n• POLICY MESSAGES: This policy shown above supersedes policy#3318286-05L. <br /> I The policy includes a loss payable clause protecting the additional insured's interest in the described car to the extent of the insurance <br /> o 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 />