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M STATE FARM INSURANCE COMPANIES® <br />b DATE OF NOTICE. JUL 15 2014 <br />900 Old River Road <br />Bakersfield CA 93311 -9501 CODE: 67472 <br />52A <br />AT1 23 A <br />000977 0093 <br />CITY OF RIVERSIDE NOTE: PLEASE NOTIFY STATE FARM AT THE <br />3900 MAIN ST ADDRESS LISTED AT THE TOP, LEFT CORNER <br />00, RIVERSIDE CA 92522 -0002 OF THIS PAGE REGARDING ANY CHANGE OF <br />ADDRESS INFORMATION. <br />I�I���II�I��I��I���II�I�I��II�II��I�I�II�IIII��III�II 'I�IIIII��" <br />n <br />S <br />0 <br />State Farm Mutual Automobile Insurance Company <br />7501 -FA4 &M <br />NAMED INSURED: POLICY NO: <br />092 0880- E25 -75G <br />COVERAGE: <br />W ERIC ANDERSON CURB DESIGN YR /MAKE/MODEL: <br />2004 FORD FLATBED <br />BI AND PD LABILITY <br />INC VIN /CAMPER: <br />3FRNX65244V619716 <br />$ 1 MIL <br />715 VIA CONCEPCION AGENT NAME: <br />SKALA INSURANCE AGENCY INC HOODED 00 DED COMP <br />COLL <br />RIVERSIDE CA 92506 -3631 AGENT PHONE: <br />(909)883 -8861 <br />ENDORSEMENT NO: 6028BU <br />POLICY EFFECTIVE <br />JUL 02 2014 UNTIL TERMINATED <br />ADDITIONAL INSURED'S NOTICE OF COVERAGE <br />State Farm Mutual Automobile Insurance Company <br />7501- FA48 -M <br />NAMED INSURED: POLICY NO: <br />256 2352 - 018 -75E <br />COVERAGE: <br />g <br />W ERIC ANDERSON CURB DESIGN YRIMAKE/MODEL: 2006 FORD STAKE <br />BI AND PD LIABILITY <br />N <br />INC VINICAMPER: <br />1 FDXF46P86EC93663 <br />$ 1 MIL <br />500 DED COMP <br />715 VIA CONCEPCION AGENT NAME: <br />SKALA INSURANCE AGENCY INC <br />500 DIED COLL <br />> RIVERSIDE CA 92506 -3631 AGENT PHONE: (909)883 -8861 <br />ENDORSEMENT NO: 6028BU POLICY EFFECTIVE <br />m JUL 01 2014 UNTIL TERMINATED <br />POLICY MESSAGES: This policy shown above supersedes policy# 2562352 -75D. <br />The policy includes a loss payable clause protecting the additional insured's interest In the described oar to the e)dent of the insurance <br />n 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 />cc <br />0 <br />ADDITIONAL INSURED'S NOTICE OF COVERAGE <br />State Farm Mutual Automobile Insurance Company <br />7501 -FA4 &M <br />NAMED INSURED: POLICY NO: <br />092 0880- E25 -75G <br />COVERAGE: <br />W ERIC ANDERSON CURB DESIGN YR /MAKE/MODEL: <br />2004 FORD FLATBED <br />BI AND PD LABILITY <br />INC VIN /CAMPER: <br />3FRNX65244V619716 <br />$ 1 MIL <br />715 VIA CONCEPCION AGENT NAME: <br />SKALA INSURANCE AGENCY INC HOODED 00 DED COMP <br />COLL <br />RIVERSIDE CA 92506 -3631 AGENT PHONE: <br />(909)883 -8861 <br />ENDORSEMENT NO: 6028BU <br />POLICY EFFECTIVE <br />JUL 02 2014 UNTIL TERMINATED <br />POLICY MESSAGES: This policy shown above supersedes policy# 0920880 -75F. <br />The policy includes a loss payable clause protecting the additional insured's Interest in the described car to the e)dent 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 />9 any change of interest or ownership coming to their attention. Failure to do so will render this policy null and void. <br />A <br />FR? <br />