2019/09/30 Robert Merendino Additional Insured's Notice of Coverage0
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StafeFaM STATE FARM®
47
AQ Bvx 853919
Richards,,, TX 75085-3919
70A
AT1 23
CITY OF MENIFEE esz ooss
29844 HAUN RD
MENIFEE CA 92586-6539
J,
CITY OF MENIFEE
FINANCE
OCT 15 2019
DATE OF NOTICE: OCT 10 2019
CODE:
A
RECEIVED NOTE: PLEASE NOTIFY STATE FARM AT THE
ADDRESS LISTED AT THE TOP, LEFT CORNER
OF THIS PAGE REGARDING ANY CHANGE OF
ADDRESS INFORMATION.
ADDITIONAL. INSURED'S NOTICE OF COVERAGE
State Farm Mutual Automobile Insurance Company
NAMED INSURED: POLICY NO: 7212-FA2D•A
26816 CMERENINO, ROBERT YR/MAKE/MODEL: 2007 FORD11 7P PICKUP COVERAGE:IAD LIABILITY
26816 CHERRY HILLS BLVD VIN/CAMPER:
SUN CITY CA 92586-2505 AGENT NAME; JOHN GALEA INS AND FIN SVC INC $ 1 MIL /$ 1 MIL /$ 1 MIL
AGENT PHONE: (714)526-3344
ENDORSEMENT NO: 6028BU POLICY EFFECTIVE
POLICY MESSAGES: This policy shown above supersedes policy# 1018131-75F. SEP 30 2019 UNTIL TERMINATED
The policy includes a loss payable clause protecting the addilional insured's interest in the described car to the extent of the insurance
Provided and subject to all policy provisions. The additional insured will be given 20 days notice It the policy is terminated. Until such notice
is provided, it shall be presumed that the required renewal premiums have been paid. Tlie additional insured must notify us within 10 days of
any change of interest or ownership coming to their attention. Failure to do so will render this policy null and void.
FRT