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2022/10/18 Act 1 Construction, Inc.StiteErrn STATE FARM@&.DATE OF NOTICE: NOV 15 2022 CODE: NOTE: PLEASE NOTIFY STATE FARM AT THE ADDHESS LISTED AT THE TOP, LEFT COBNER OF THIS PAGE REGARDING ANY CHANGE OF ADDRESS INFORMATION. PO gox 2368 Blooni ng ton I L 6 I 702- 2368 554ATT 23 001140 0093CITV OF I.IEN I FE E29844 HAUN RD HENrFEE CA 9?5A6-6539Pt,i)it tss* iltr,ltrtl,illilltt,tl,l[il,tt,il[l,,l,,lil,,lt,illtqrillt,t ADDITIONAL INSUBED'S NOTICE OF COVEBAGE Stale Farm Mutual Aulomobilo lnsuranco Company 1045-FACEA NAMED INSUBED: POLICY NO: 636 1132.A02.75G COVERAGE: - ACT 1 CONSTBUCTTON INC YR/MAKE/MODEL: 2019FORD UTTLTRK ElANDPDLrAElLlw! +aa orr St VIN/CAMPER: r FDew3ET 1 KEC52394 s I MIL I r.ronbo ce s2860.]758 AGENr NAME: roNy FREEMAN 33333BEB.33llli AGENT PHONE: (e0e)e42-6464t ENDORSEMENT NO: 6o28BU PoLICY EFFECTIVE€ OCT 18 2022 UNTIL TEHMINATED POLICY MESSAGES: This policy shown above supersedes policy# 6361 132-75F.E The policy includes a loss payable clause prolecting the additional insured's inleresl in lhe described car to the extenl ol the insurance5 provided and subject 10 all policy provisions. The addilional insured will be given 30 days notice il the policy is terminatod. Until such notice @ is provided, ii shall be presumed that the required r€newal premiums have been paid. The addilional insured musl notity us within 10 days oft any change ol interesl or ownership coming to lh6ir att€ntion. Failure to do so will render this policy null and void. & ADDITIONAL INSUBED'S NOTICE OF COVEBAGE State Farm Mulual Aulomobilo lnsurance Company 1045-FACEA NAMED INSURED: POLICY NO: 614 31ot.E1s.75E COVERAGE: ACT 1 ooNSTBUCTIoN INC YR/MAKE/MODEL: 2019 FORD PICKUP BI AND PD LIABILITY 444 6TH ST VIN/CAMPER: 1FTEW1CP0KKD27914 $ 1 [4rL NoBcocA e2s6o-17s8 AGENTNAME: roNy FREEMAN lSlPl RER 99llPAGENTPHONE:, (eoe)e42.6464 ENDORSEMENT NO: 6O26BU POLICY EFFECTIVE OCT 26 2022 UNTIL TERI\,4INATED POLICY MESSAGES: This policy shown above sup€rsedes policy# 6143101-750. The policy includes a loss payable clause prolecting the additional insured's inlerest in the described car to the extent ol the insurance provided and subjecl to all policy provisions. The additional insured will b6 given 30 days notice il the policy is terminaled. Until such notice ^ is provded, rt shall be presumed lhal lhe required r€newal premiums have been paid. The additional insured must noliry us within 10 days ol N any change ol inleresl or ownership coming lo lheir ahenlion. Failure 1o do so will render lhis policy null and void.I.!t ADDITIONAL INSURED'S NOTICE OF COVEHAGE Stale Farm Mutual Automobile lnsurancs Company 1045"FACEA NAMED INSUHED: POLICY NO; 593 7394.811.75G COVERAGE: ACT 1 CONSTRUCTIoN INC YR/MAKE/ MODEL: 2017 FORD UTIL TRK 8I AND PD LIABILITY 444 6rH sr VIN/CAMPEF: 1FD8W3ET7HEEo781s $ 1 l\rll NoRCocA s2860.r758 acetli ruaraE: roNy FREEMAN 33333 BEB.33illAGENTPHONE: (9os)942-6464 ENDORSEMENT NO: 6O28BU PoLICY EFFECTIVE OCl 26 2022 UNTIL TERMINATED POLICY MESSAGES: This policy shown above supersedes policy# 5937394-75F. The policy includes a loss payabie clause prolecliog lhe addilional insured s interesl irl ihe described car lo lhe exlenl ol lhe insurance provided and subjecl to all policy provisions. The addilional insured will be given 30 days notice il lhe policy is terminated. Until such notice ^ is provided, rl shall be presumed that the required renewal premiums have been paid. The addilional insured musl notily us wiihin 10 days ol I any change ol rnteresl or ownershrp coming to lheir aitention. Failure lo do so will render this policy null and void. I ADDITIONAL INSURED'S NOTICE OF COVERAGE Stato Farm Mulual Automobile lnsurance Company 1045-FACEA NAMED INSURED: pOLtCy NO: ?11 4a74.A23-7bc COVERAGE: ACT 1 CONSTRUCTION INC YR/MAKE/MOOEL: 2013INTL TANKTRK BIAND PB LIABILIW 444 6TH ST VIN/CAMPER: 1 HTMMAAL9DJ2S4O37 $ 1 MIL NoRco cA 92860-1750 IGEHi HaME: ToNy FBEEMAN $2000 DEo colrP' AGENT PHONE: igog)e42-6464 $2000 DED coLL' ENDOHSEMENT NO: 6ozdeu poLtcy EFFECIyE OCI 18 2022 UNTIL TEBMINATEDPOLICY MESSAGES: This policy shown above supersedes policy* 7114074-758. The policy includes a loss payable clause proleclinO the addilional insured's rnleresl in lhe described car lo the exlenl ot lhe insurance provided and subjecl to all policy provisions. The addilional insured \^/ill be Oiven 30 days nolice i, ihe policy is lerminaled. Until such noilce is provided, il shall be presumed lhal lhe required renewa premiums have been paid. The addltional insured mLrst nolily us wllhin 10 days ol any chang€ o, interesl or ov,/nership coming lo lheir attention. Fallure lo do so will render this policy nuli and void. ADDITIONAL INSURED'S NOTICE OF COVERAGE Slats Farm MutuBl Aulomobile lnsurance Company 1045-FACEA NAMED INSURED: PoLIcY No: 569 1347.817.75C covERAGE: ACT 1 CONSTRUCTION INC YR/MAKE/MODEL: 2007 FORD PICKUP Bl AND PD LlABlLlrY 444 6TH ST VIN/CAMPER: 1FTPX12537K042145 $ 1 MIL NoRCocA 92860-'1758 AG-iilt iialitE: roNy FREE|TAN $2000 DED CoMP' acENT PHoNE: (909)s42-6464 $2000 DED coLL ENDORSEMENT NO: 6O28BU POLICY EFFECTIVE OCr 26 2022 UNIIL TERt\,{INATEOPOLICY MESSAGES: This policy shown above supersedes policy# 5691347-758. The policy includes a loss payable clause prolecling the additional insured's inleresl in lhe described car lo lhe ext€nl oi lhe insurance provided and subjecl to all policy provisions. The addilional insured will be given 30 days notice il the policy s terminaled. Llnlil such notice ^ is provided, ii shall be pr€sumed that the required renewal premiums have been paid. The addilional insured musi notily uswiihin l0daysol I any chang€ ol rnteresl or ownershrp coming to therr atteniion. Failure 10 do so will render this policy null and void. g ADDITIONAL INSUFED'S NOTICE OF COVERAGE Stals Farm Mutual Automobils lnsuranco Company 1045-FAoEA NAMED INSURED: POLICY NO: 568 9544-816.75E COVERAGE: ACT 1 CONSTBUCTION INC YR/MAKE/MODEL: 2OO5 FORD PICKUP BIAND PD LIABILIW 444 6TH ST VIN/CAMPER: 1 FTRXI 2w2sN 828065 $ 1 MrL NoRcocA s2e60,1758 aOeHrHauE: roNY FREET\IAN *3::: RER 9:l1PAGENTPHONE: (9os)942-6464 ENDORSEMENT NO: 60288U POLICY EFFECTIVE OCl 18 2022 UNTIL TERIVINATED POLICY MESSAGES: This policy shown above supersedes policy# 5689544-750. The policy includes a loss payable clause prot€clinO lhe additional insured's inlerosi in the described car to the exlent ol the insurance provided and subjsct 10 all policy provisions. The addilional insured will be given 30 days notice i, the policy is terminated. Unlil such notice ^ is provided, it shall be presumed lhal the required rene\4al premiums have been paid. The addilional insured musi nolify us within 10 days oi E any change of inleresl or ownership coming to their allention. Failure 10 do so will render lhis policy null and void.Ig AODITIONAL INSURED'S NOTICE OF COVERAGE State Farm Mulual Automobile lnsurance Company 1045-FACEA NAMED INSUEED: pOLlCy NO: 56e 40r2-817-7sF COVERAGE: ACT 1 CONSTRUoTIoN INC YR/MAKE/MODEL: 1997 FORD PICKUP BIAND PD LIABILITY 444 6TH ST VIN/CAMPER: 3FTHF25F3VMA5935o $ 1 MIL NoRcocA s2860-i758 AGENTNAME: iorv rRpeuaru 333338EB.33[AGENTPHONE: (909)942-6464 ENDORSEMENT NO: 6O28BU POLICY EFFECTIVE OCT 26 2022 UNTIL TEBM]NATED POLICY MESSAGES: This policy shown above supersedes policy# 5694012'75E. The policy includes a Ioss payable clause prolecting lhe addilional insured s int€rest in lhe described car lo the exlenl ol the rnsurance provided and subject lo all policy provisions. The additional insured will be given 30 days nollce it the pollcy is lermlnaled. Until such notice is provided, il shall be presumed lhal lhe required renewal premiurns have been paid. The additional insured musl noliry us wilhin 10 days ol any change ol interesl or ownershlp coming to lheir atlenlion. Failure to do so will render this policy null and void. B(]K1 StaleElm STATE FABM@&.PO Box 2368Bloomington lL 6t 702-2368 DATE OF NOTICE: NOV 15 2022 CODE: NOTE: PLEASE NOTIFY STATE FARM AT THE ADORESS LISTED AT THE TOP, LEFT CORNER OF THIS PAGE REGAROING ANY CHANGE OF AOORESS INFORMATION. 554 ZJ oo1tao ms3 CITY OF I4EN I FEE29844 HAUN RD iIENI FEE CA 9?545-6539Ii:trffiait si ADDITIONAL INSURED'S NOTICE OF COVEBAGE Stale Farm Mulual Aulomobils lnsuranco Company 1045'FACEA NAMED INSUFED: PoLIcY No: 501 7554.E27.75M covEBAGE: ACT 1 CONSTRUCTION INC YR/i,IAKE/MODEL: 2016 FOHD PICKUP Bl ANo P0 LIABIL TY 444 6TH ST VIN/CAMPER: iirexr c pxcrezszss $ 1 MrL NoRcocA e2g6o-1758 AGENT NAME: ToNvFBEEMAN 33S3 3EB.33[AGEIITPHONE: (soe)s42.6464 ENDOBSEMENT NO: 6O28BU POLICY EFFECTIVE OCT 18 2022 UNTIL TERMINATEDPOLICY MESSAGES: This policy shown above supersedes policy# 5017554-751. The policy includes a loss payable clause prolecting the additional insured's inleresl in the d€scrib€d car lo ihe extenl oi the rnsurance provided and subiect to all policy provisions. The additional insured will be givon 30 days notice ii lhe policy is terminaled. Until such notice is provided, il shall be presumed that lhe required renewal premiums have been paid. The addilional insured musl notify us within 10 days o, any change ol inlorost or ownorshipcoming lo lheir attention. Failure to do so will render this polacy null and void. ADDITIONAL INSUBED'S NOTICE OF COVERAGE Slato Farm Mulual Automobilo lnsurance Company 1045-FACEA NAMEo INSURED: POLICY NO: 647 8891-E2o-75C COVERAGE: ACT 1 CONSTRUCTION INC YR/MAKE/MODEL: 2019 FOBD PICKUP BIAND PD LIABILITY 444 6TH ST VIN/CAMPER: r FTEw1Ep9KKc61571 $ 1 MIL NoRCocA 92860-1758 AGENTNAME: ToNY FREEITAN $2000 DED' coMP' AGENT PHoNE: (909)s42-6464 s2000 DED' coLL' ENDORSEMENT NO: 6O28BU POLICY EFFECTIVE OCl 26 2022 UNTIL TERMINATED POLICY MESSAGES: This policy shown above supelsed€s policy* 6478891-758. The policy includ€s a loss payable clause prolecting the addiiional insured's inlerest in lhe describ€d car io tho exteni ot the rnsurance provided and subiecl to all policy provisions. The addilional insured will b€ giv€n 30 days noiice il the policy is terminated. Unlil such nolice is provided, it shall bo presumod lhal the required renewal premiums have been paid. The addilional insured must notily us wilhin 10 days o, any change ol inleresi or ownorship com ing to their atlention. Failure lo do so will render this policy null and void. ADDITIONAL INSURED'S NOTICE OF COVERAGE State Farm Mulual Aulomobil6 lnsurance Company 1045'FACEA NAMED INSURED: PoLIcY No: 462 9314.E27-75N covEBAGE:ACT 1 CONSTRUCTIoN INc YB/MAKE/MODEL: 2016 FoRD PIoKUP BI AND PD LIABILITY 444 6TH sr VIN/CAMPER: 1 FTExt C88GFA2 t 257 $ 1 MIL Nonco cA s2g60,1758 IGEHi HarrlE: ToNy FREEMAN s2000 DEB' colllP' AGENT PHONE: (909)s42-6464 s2000 DED' coLL' ENDORSEMENT NO: 6o28BU POLICY EFFECTIVE OCl 26 2022 UNTIL TER[/INATEDPOLICY MESSAGES: This policy shown above supersedes poticy# 4629314,75tr4. The policy includes a loss payabl€ clause prolecting the addilional insured's inl6rest in lhe described car lo lhe extenl o,lhe insurance provided and subjecl to all policy provisions. The additional insu.ed will be given 30 days nolice if lhe policy is terminated. Until such notice.. is provided. il shail be presumed lhal lhe required renewalpremiums have been paid. The addilional insured must notify us wilhin 1O days otf; any change ol inleresl or ownership coming lo their attention. Failure 1o do so will render this policy null and void. e; FFT ADDITIONAL INSURED'S NOTICE OF COVEHAGE State Faim Mulual Automobilo lnsurance Company 1045-FACEA NAMED INSURED: pOLtCy NO: 580 s7o1.Ao7-75c COVERAGE: ACT 1 CONSTBUCT ON INC YR/MAKE/MODEL: 2OO7 FORD PICKUP BI AND PD LIABILITY 444 6TH ST VIN/CAMPER: 1FTPX125O7KD42135 $ 1 MlL NORCOCA 92860.1758 AGENT NAME: TONY FREEMAN I?!99 PEP 99I1PAGENTPHONE: (909)942-6464 ENDORSEMENT NO: 6ozrjeu pOLtCy EFFECIyE OCT 18 2022 UNTIL TERMINATEDPOLICY MESSAGES: This policy shown above supersedes policy# 5805701-75F. The policy includes a loss payable clauss protecling the addillonal insured's interest in ihe described car to lhe exteni oi the rnsurance provided and subiecl lo all policy provisions. The addilional insured vrill b€ given 30 days notice it the policy is terminated. Unlil such nolice is provided, it shall be presumed that lhe required renewal premiums have b€en paid. The addilional insured must notify us within 10 days ol any change of inlerest or ownership coming to their altention. Failure lo do so will render lhis policy null and void. ADDITIONAL INSUBED'S NOTICE OF COVEBAGE Slate Farm Mulual Aulomobilo lngurance Company 1045-FACEA NAMED INSURED: PoLIcY No: 614 6670.E31.75D covERAGE: ACT 1 CONSTRUCTION INC YR/MAKE/MODEL: 2019 FORD PICKUP Bl AND Po LIABILTTY 444 6TH ST VIN/CAMPER: 1 FT8W3BT3KE E04541 $ 1 MIL NOBCOCA 92860-1758 AGEHi'I,IAME: TONYFBEEMAN $2OOO OED' COMP- AGENT PHoNE: igog)s42-6454 s2000 DED' coLL' ENOOBSEMENT NO: 6ozdgu PoLIcY EFFEoTIVE OCT 18 2022 UNTIL TERMINATED POLICY MESSAGES: This policy shown above supersedes policy* 6146670-75C The policy includes a loss payable clause protecting the additional nsured's inlerest in the described car to the exlent ol the insurance provided and subjecl to all policy provisions. The additional insured will be given 30 days notic€ il the policy is lerminaled. Until such notice is provided, il shall be pr€sum€d that lhe required renewal premiums have been paid. The addalional insured must nolity us wilhin 10 days ol any change ol interesl or ownership coming to their atlenlion. Failure to do so will render this policy null and void. ADDITIONAL INSUBED'S NOTICE OF COVERAGE State Farm Mulual Automobile lnsurance Company 1045-FACEA NAMED INSURED: POLICY NO: 636 1135.A02.75D COVEHAGE: ACT 1 CONSTRUCTION INC YR/MAKE/MODEL: 2019 FORD UTIL TRK BI AND PD LIABILIfi 444 6TH ST VIN/CAMPER: 1Fo8w3ETxKECs2393 $ 1 [.'!lL NoRCo cA e2e6o-1758 AGENTNAME: roNY FREEMAN l3l9l RER P:l4PAGENTPHONE: (sos)s42-64M ENDORSEMENT NO: 6o28BU PoLIcY EFFECTIVE OCT 26 2022 UNTIL TERMINATED POLICY MESSAGES: This policy shown above supersedes policy# 6361 135-75C. The policy includes a loss payable clause prolecting the additional insured's inlerest in lh€ describsd car to the extent of the insurance provided and subjecl !o all policy provisioos. The additional insured will be glven 30 days notice il lhe policy is ierminated. Until such notice ^ is provided, il shall be presumed thal the required renewal premiLrms have been paid. The additional insured must nolily us wlthin 10 days ol E any change o, interest or ownership coming lo lheir attenlion. Fa lure to do so will render this F,olicy null and void. g ADDITIONAL INSURED'S NOTICE OF COVERAGE Stato Farm Mutual Automobile lnsurance Company 1045-FACEA NAMEo INSUBED: pOLtCy NO: 277 9160,803-75K COVEBAGE: ACT 1 CONSTRUCTION INC YR/MAKE/MODEL: NONOWNED AUTO BIANO PD LIABILITY 444 6TH ST VIN/CAMPER: $ 1 MIL NORCO CA 92860.1758 AGENT NAME: TONY FREEMANAGEIITPHONE: (909)942-6464 ENDOHSEMENT NO: 6o28BU PoLICY EFFECTIVE6165CS OC1 26 2022 UNTTL IERMTNATED POLICY MESSAGES: This policy shown above supersedes policyt 2?79160-75J. The policy includes a loss payable clause proiecting the additional insured's inleresl in lhe described car 10 the extent of the insurance provided and subjecl to all policy provisions. The additional insured will be given 30 days noiice if lhe policy is ierminaled. Until such notice is provided, il shall be pr€sumed lhat the required renewal premiums hav6 been paid. The addilional insured musl noiily us wilhin 10 days of any chanoe ol interest or ownership coming to lheir attenlion- Fa lure lo do so will render lhis policy null and void. BCXl $atefr/rn STATE FARM@&.DATE OF NOTICE: NOV 1s 2022 CODE: NOTE: PLEASE NOTIFY STATE FARM AT THE ADDRESS LISTED AT THE TOP, LEFT CORNER OF THIS PAGE REGARDING ANY CHANGE OF ADDRESS INFORMATION. PO gox 2368 Bloomington lL 61 702-2368 ZJ @1140 0093CITY OF }IEN I F EE29844 HAUN RD IttENTFEE CA 92586-6539ffi e ADDITIONAL INSUFED'S NOTICE OF COVERAGE Slate Farm Mutual Automobile lnsurance Company 1045-FACEA NAMED INSURED: POLICY NO: 609 8506-807.75F covERAGE: ACT 1 CONSTFUCTION INC YR/MAKE/MODEL: 2oo4 FoRD PICKUP 8I AND PD LIABILIry 444 6rH Sr VIN/CAMPER: r iinpr +s++r'rczzozo $rb[ll.o. "orr.NORCO CA 92860-1758 AGENT NAME: TONY FREET\,4AN s2ooo DED. coLLAGENTPHONE: (909)942-6464 ENDOBSEMENT NO: 6o2IJBU POLICY EFFECTIVE ACT 18 2022 UNTIL TERIVINATED POLICY MESSAGES: This policy shown above supersed€s policy# 6098506-75E. The policy includes a loss payable clause proteclino lhe addiiional insured's int€resi in ihe described car to lh€ ext€nt ollhe rnsurance provided and subjsci to all policy provisions. Th€ addilional insured will be given 30 days notice il the policy is t€rminated. Unlil such notice is provided, il shall be pr€sumed that the required renewal premiums have been paid. The addilional insured musl notily us wilhin 10 days ot any change ol interesl or own€rship coming to their allenlion. Failure lo do so will render this policy null and void. ADDITIONAL INSUBED'S NOTICE OF COVERAGE Slale Farm Mulual Aulomobile lnsuranca Company 1045-FAoEA NAMED INSURED: POLICY NO: 711 4075.A23-75C COVERAGE: ACT 1 ooNSTRUCTIoN INc YR/MAKE/MODEL: 2015 IN-TL TANK TRK BI AND PD LIABILIW 444 6TH sT VIN/CAMPER: 3HAt/{MMMM6FL6oos3 i $ 1 [,!lL NoBcocA e2g6o-1758 AGENTNAME: ioruv rREeunu $39* REP 9Pl4P'AGENTPHONE: (909)942-6464 ENDORSEMENT NO: tio2dBu PoLIcY EFFEoTIVE OCT 18 2022 UNTIL TERIVINATED POLICY MESSAGES: This policy shown above supersedes polrcy* 7114075-75P. The policy includ€s a loss payable clause prolecting the additional insured s inlerest in the described car to the ertont ol the insurance provided and subject to all policy provisions. The additional insured will be given 30 days notice il the policy is lerminaled. Until such noiice is provided, it shall be presumed lhal lhe required r€newal premiums have been paid. The additional insured must noiiiy us within 10 days oi any change ol inlerest or ownership coming io lheir atlenlion. Failure to do so will render lhis policy null and void. E ADDITIONAL INSURED'S NOTICE OF COVERAGE Stale Farm Mutual Aulomobile lnsuranco Company 1045-FACEA NAMED INSURED: POLICY NO: 685 6946-C24.75E covEBAGE: ACT 1 CONSTRUCTTON tNC YR/MAKE/MODEL: 201 1 FORD ptCKUp BTAND pD LrABtLtTy 444 6TH sT VIN/CAMPEB: I FTFX1oT8BFC74225 s I MIL NoRCo cA e2860-r758 ecenr uaurE: roNY FREEMAN 33333 8E8 33[AGENTPHONET (909)942-6464 ENDORSEMENT NO: 6o28BU POLICY EFFECTIVE OCl 26 2022 UNTIL TERMINATED POLICY MESSAGES: This policy shown above supersedes policy# 6856946-75D. The policy includes a loss payable clause protecling lhe addilional insured's interest in lhe described car 10 lhe exlent o, lhe insurance provided and subjecl lo all policy provisions. The addilional insured will be giv€n 30 days notice il lhe policy ls terminaled. Unlil such notice = is provided, rl shall be presumed lhal the required renewal premiums have been paid. The addilional insured must nolify us wiihin 10 days ol(t any change ol rnl€resl or ovrnershrp coming to their atlention. Failure lo do so will render this policy null and void.