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awrerarm STATE FARM' <br /> - < ® DATE OF NOTICE: MAR 31 2026 <br /> PO Box 2368 <br /> Bloomington IL 61702-2368 CODE: <br /> 39A <br /> AT1 02 A <br /> 0000ss 0093 <br /> CITY OF PLEASANTON NOTE: PLEASE NOTIFY STATE FARM AT THE <br /> PO BOX 520 ADDRESS LISTED AT THE TOP, LEFT CORNER <br /> D. PLEASANTON CA 94566-0802 OF THIS PAGE REGARDING ANY CHANGE OF <br /> • ADDRESS INFORMATION. <br /> 'I''II"I'II'IIIII-111'III I1101411411111101IV0 <br /> 8 <br /> 0 <br /> s <br /> s <br /> ADDITIONAL INSURED'S NOTICE OF COVERAGE <br /> • <br /> State Farm Mutual Automobile Insurance Company 378F-FA57-A <br /> NAMED INSURED: POLICY NO: 331 8286-A01-05S COVERAGE: <br /> D&D COMMERCIAL& YR/MAKE/MODEL: 2021 FORD PICKUP BI AND PD LIABILITY <br /> • RESIDENTIAL PAINTING INC VIN/CAMPER: 1 FTFW1 RG0MFC64059 $1 miL D <br /> $250 DED.COMP. <br /> 61 AND RICE,DAVID AGENT NAME: JILL CASH $1000 DED.COLL. <br /> PO BOX 518 AGENT PHONE: (925)892-8000 <br /> • EAGLE ID 83616-0461 ENDORSEMENT NO: 6028BU POLICY EFFECTIVE <br /> MAR 26 2026 UNTIL TERMINATED <br /> E POLICY MESSAGES: This policy shown above supersedes policy#3318286-05R. <br /> • The policy includes a loss payable clause protecting the additional insureds 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 /> co 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 /> 25 any change of interest or ownership coming to their attention. Failure to do so will render this policy null and void. <br /> FRT <br />