The URL can be used to link to this page

2019/05/11 Robert Merendino Certificate of Liability Insurance'"-`-#C" VEHICLE OR EQUIPMENT CERTIFICATE OF rNSURANCE DATE (WYeWYYyri TIi1:5R FICATEC OE IS ISSUED AS A AAELY R OF GATT AAT: I ONLY AND CONFERS HQ RTGHm UPON THE CERTIFICATE HOLDER. THIS CM23/2019 CELOW- THIS CERTIFICATE NOT AFFIRMATIVELY N SU LYE NECiATiVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THI$ CERTIFIGATE OF INSURANCE DOE$ NOT CONSTITUTE CONTRACT REPRESENTATIVE OR PRCiDUCER, AIVD THI=CERTIFICATE R BETWEEN THE ISSUING INSURER(S), AUTHORIZED This fonn Is used to report coverage, provided to a single sPecirsc vetdcle or Provided to multiPle vehicles under a single policy. i nk Do not use this form to report liability coverage USSACORD25torthatpulpose. ER PRODUC Jahn Gafca InswAnce & Financial S"ces Inc "'•• R John Ga Lic #0i45$6G 1102 E Chapman Ave _ Fullerton CA 92631 as UR&; -- - -- -- . --.. _ Robert Merendino 2581E Sandy Lodge Rd Sun City, CA 92SM-2352 _ lee 714-526.3344 State Farm Mutual Automobile Insurance Company 714-526-2262 +,cat;Kfv ION OF VEHICLE OR E0 IPMENT R E: YEgR 11tAliEllirrWUE°ACTUAER P07 =oMODEL osrE ::_ ve MEW*kVA7M NUMsER TioN 150 PAJ 1 FTPX12EE57FA61232 VEIeCLEIMU1PAIENT VALUE SE711AL NUXSE. 25178 .`•"•"_43 CERTIFICATE NUMBER - THIS 15 TD CE12tIFY 71 WT THE AtiLICY{IESj OF INSURANCE LISTEt7 BELOW HASri1RVF BEEN iSSUEU TO THE IH5URISION NUMBER: I NAMEU A OVE FOR THE POLICY 1'ERIMS) INDICATED, Nr]TV4TTHSTANDING ANY REQUIREMEN7. -TERM OR CONUITT4fii OF ANY CONTRACT OR OTHER DOCUMENT IIVITH FtES1'ECT TO WIiICH THIS CERTXCLU E BRAY N ISSUED OR MAY PERTAIN, TTiF INSURANCE AFFORDEl) BYTHE I'tit]CYIIES] ❑CSCRIBED HEREIN ISlARE SUECTT TO ALL THE TERMS. F_7CCLUSipNSANp CONDITIONS OF SUCH POLICY{IESj, wet TYPE Of INSURANCE VEHICLE LIABILrry 05PECiALR LIABILITY OCCURRENCE S MADE OFINSURANCE OILISION SSOUP VEHOTC BROAD L POLICY NUMBER 11D1 8131-E1 i-75B POLICV NUMIBER POUCY EFffCTIVE j POLICY EXPRATIDM DATE {01YfpOtYYYy1 I DAT61M'MlDDJYYYri 05111P2019 I 1111112019 POLICY EFFECTIVE POLICY EXPIRATION AATE IMYIDDIYYYYt DATE IMYIDDffy" WETS SINCIU:UMt=M(Perp" 1 1RYiF�raetj3�} 3 1CNIWIi3E q $ 1 FMX jCOEiEGRTE S LlMtla I DEDUCIBLE 0 ACV © AMT i LgI1R 0 0 AMT T { BED 0 ACV 0 AYT 0 © AMT DED 0 Z AAGREEDAMT 0 RC ❑ STATEC AMT f LIMIT 0 BED REMARKS pNCLUDW a SMCIAt CONDITIONS i OTTNER Cow -RAGES) (Attach ACORD 707, Ad4Tkwmf Remar►a Schodufa; If a sPapl is r�uir� ADDITfONAL INTEREST Seloci one rd'the foMawing: CANCELLATION ha 8fSlitAHI f�efoetda•.Crtboa below has been, adder! 20 #as SHOULD ANY OF THE A6 WE DESCR1BEII POLICIES BE CANCELLED A rc41 nu Eras Exen sutrlN[dd Io add the addksanai h4eeasrdesr, tt n Pdl�ynunlba(s). 9EFORE THE EXPIRATION 3143E 7HEREOp, fiiOTECE WILL Be rsled r�r t�pory� . P��Y[ } i7ELlVEItM IN ACC:OROMCE WITH THE POLICY PROVISIONS. VEHICLE 1EOUlP1A6NT INTEREST; LEASED NAME AND ADDRESS OFADDRIDNALINTEREST DESCROMonL7FTIrEADDn WALyn;REqT -...-�-- CITY OF MENIFEE x-DnWNALINStMED LOSS PAYEE 29844 HALIN ROAD UMMM LMPAVW MENIFEE. CA 92586 LOANtLEASENUMBER ---- ACORD 23 (2016103) The ACORD name atH1 logo are Fe9%Wed marks of ACORD All rights reserved. 1004351 1429873 01-26.Me Binder of Insurance Pending issuance and delivery of a policy pursuant to the application of the insured and to all the terms and conditions of the policy issued by the company the State Farm Mutual Automobile Insurance Company Does hereby insure: ROBERT MERENDINO 25816 SANDY LODGE RD SUN CITY, CA 92586--2352 Policy Number: I01 8131-El -75B Year Make 2007 FORD F150 PICKUP Liability lM/lM/lM Vehicle Identification Number (VIN) 1FTPX12557FA61232 Coverages Comprehensive $100 Collision Ued $250 Effective May 20, 2019, expiring not to exceed thirty (30) days hence and to became void immediately upon the issuance of a policy in place hereof. ANY PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD ANY INSURANCE COMPANY OR OTHER PERSON FILES AN APPLICATION FOR INSURANCE OR STATEMENT OF CLAIM CONTAINING ANY MATERIALLY FALSE INFORMATION OR CONCEALS FOR THE PURPOSE OF MISLEADING, INFORMATION CONCERNING ANY FACT MATERIAL THERETO COMMITS A FRAUDULENT INSURANCE ACT, WHICH IS A CRIME AND SUBJECTS SUCH PERSON TO CRIMINAL AND CIVIL PENALTIES. Datekk _........ ..._�..•�CY�� IMthorized Representative JOHN G&EA INSURANCE AND SyaftF► M FINANCIAL SERVICES, INC. 1102 E. Chapman Ate. Fullerton, Ca. 9mi (714)528-3344 www.johNwea.aom