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Statefarm STATE FARM® <br /> c;'<;® DATE OF NOTICE: JUL 15 2026 <br /> PO Box 2368 CODE: <br /> Bloomington IL 61702-2368 <br /> 30A <br /> AT1 02 A <br /> 0000so oosa NOTE: PLEASE NOTIFY STATE FARM AT THE <br /> CITY OF PLEASANTON ADDRESS LISTED AT THE TOP, LEFT CORNER <br /> mi. PLEASANTONPO BOX 520OF THIS PAGE REGARDING ANY CHANGE OF <br /> ,•• •. CA 94566-0802 <br /> ADDRESS INFORMATION. <br /> II"III'IIII'IIIII"Ili' IIIIII(II'IIIII'11, II II'IiIIII'IIihII <br /> 0 <br /> L <br /> s <br /> INSURED'S NOTICE OF(COVERAGE <br /> [ DITIONAL <br /> State Farm Mutual Automobile Insurance Company 378F-FA57-A <br /> NAMED INSURED: POLICY NO: 331 8286-A01-05U COVERAGE: <br /> D&D COMMERCIAL& YR/MAKE/MODEL: 2026 FORD PICKUP BI AND PD LIABILITY <br /> eRESIDENTIAL PAINTING INC VIN/CAMPER: 1FT8W2BN8TEE22692 $1 MIL <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 /> JUL 01 2026 UNTIL TERMINATED <br /> rm POLICY MESSAGES: This policy shown above supersedes policy#3318286-05T. <br /> co <br /> T, 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 /> gany change of interest or ownership_coming to their attention. Failure to do so will render this policy null and void. <br /> N <br /> FRT <br />