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2022/11/20 Coplenas,Jacob DBA SAFEUSAStateFamt STATE FABM@&"PO Box 2368 Bloomington lL 61 702-2368 DATE OF NOTICE: OCf 18 2022 CODE: ATI 12 THE CITY OF I.IENIFEE, ISAOA29844 HAUN RD l'rEN I FEE CA 92556-6539 tltilllllilt,tilil,il,t,l,lil,r,,l,tl,qh,ltl,t[,,tl,tl,[,1 NOTE: PLEASE NOTIFY STATE FARM AT THE ADDFESS LISTED AT THE TOP, LEFT CORNEROF THIS PAGE REGARDING ANY CHANGE OFAODFESS INFORMATION. 2314 0@641 0093 P;i+itd* s ADDITIONAL INSUBED'S NOTICE OF COVERAGE Stale Farm Mutual Aulomobile lnsurance Company 61BF-FA96A NAMED INSURED: PoLIcY No: 442 2023.E20.55E cAR oo5 CoVERAGE: - COPLENAS, JACOB DBA SAFEUSA YR/MAKE/MODEL: 2oo2tSUzU BOxTRK Bl AND PD LlABlLlrY = 1O3O N NTOUNTAIN AVE VIN/CAMPER: 4KLB4B 1 R32J802383 $ 1 [,411/$ 1 MIL/S 1 MIL I oninnro cn stiai.2ift AGENTNAME: zAcH BAy rNS AND FrN svcs rNC 3]3338E8.33[I AGENIPI|OIET - \530)221.3224g ENDORSEMENT NO: 6O28BU PoLIcY EFFEoTIVEC NOV 20 2022 UNTIL TERMINATEDE POLICY MESSAGES: This policy shown above supersedes poticy# 4422a23-55D.t The policy includes a loss payable clause protecting the addilional insured's interest in the described car to the exl€nt ol the insurancaE provided and subjecl to all policy provisions. The addilional insured will be given 20 days notice il the policy is terminated. Unlil such notice(o is provided, itshallbe presumod lhat the required r6.ewal premiums have been paid. The additional insured must notily us within 1O days ot8 any change ol int€rest or on/nershrp coming to their altoolion. Failu.e to do so wlll render this poticy nu and void.6 F ADDITIONAL INSURED'S NOTICE OF COVEBAGE Stale Farm Mutual Automobile lnsuranc€ Company 618F-FA9GA NAMED INSURED: POLICY NO; 442 2023.E20.55E CAB OIO COVEFAGE: COPLENAS, JACOB DBA SAFEUSA YR/MAKE/MODEL: 1998 ISUZU NOC TRK BIANO PO LIABILIW 1O3O N MOUNTAIN AVE VIN/CAMPEF: JALB4B 1 K5W7OOO552 S 1 MIL i$ 1 I\,i|IL ,5 l MIL oNTARro cA 91162-2114 AGENT NAME: zAcH BAy rNs AND FrN svcs tNc s1000oED.coMP. AGENIPIoIE- \s3o)221-3224 $1000 oED CoLL' ENDORSEMENT NO: 6O2dBU POLICY EFFECTIVE NOV 2O 2022 UNTIL TEBMINATED POLICY MESSAGES: This policy shown above supersedes policy* 4422023-ss). The policy includes a loss payable claus€ protecting the additional insured's int€resl in the described car lo lhe exteni ol the insurance provided and subject to al policy provisions. The addiiional insured willbe given 20 days notice if the policy is terminated. Unlilsuch notice^ ls provided. il snall be presumed lhat the required renewal pr€miums have been paid. The additional insured must notify us wilhin 1O days ofN any change ol inleresl or ownership coming to their atlenlion. Failure lo do so will render this policy null and void.t.9 ADDITIONAL INSUBED'S NOTICE OF COVERAGE State Farm Mulual Automobils lnsurance Company 618F-FA96A NAMED INSURED: PoLIcY No: 442 2023-E20.55E CAB 013 CoVERAGE:COPLENAS. JACOB DBA SAFEUSA YR/MAKE/MODEL: 2OO7 APACHE TBL UTIL 61OOO DEO, COMP, 1O3O N MOUNTAIN AVE VIN/CAMPER: 5J8UE15277C011649 s1000DED CoLL' oNTARro cA 91762-21i4 AGENTNAME: ZACH BAy tNs AND FtN svcs tNcAGEr{lPIIONE: t53o)221.3224ENDORSEMENT NO: 60288U PoLIcY EFFECTIVE NOV 20 2022 UNTIL TERMINATEDPOLICY MESSAGES: This policy shown above supersedes policyt 4422O23-S'D. The policy includes a loss payable clause protecting the additional insured's interesi in the described car io lhe exteni ol lhe insurance provided and subiecl to all policy provisions. The addilional insured will be given 20 days notice it lhe policy is terminated. Unlil such noiice^ is provrded, rl shall be presumed that the required renewal premiums have been paid. The additional insured must nolily us within 1O days ofE any change ot in16rest or ownership coming to th€ir atlentidn. Failure 1o do so will render this policy null and void. e FBr ADDITIONAL INSURED'S NOTICE OF COVERAGE State Farm Mutual Automobile lnsurance Company olSF"FAssA NAMEDINSURED: pOLtCy NO: 442 2023-Ezo-55E cAR01s COVEFAGE: COPLENAS, JACOB DBA SAFEUSA YR/MAKE/MODEL: NONOWNED AUTO BI AND PO LIABILITY 1O3O N MOUNTAIN AVE VIN/CAMPEH: $ 1 MIL/$ t MIL /i I MrL ONTARIOCA 91762.2114 AGETIf XIUE: ZACH BAY INS AND FIN SVCS INC 35OO DED' COMP/COLL' AGENTPHONE: \530)221-3224ENOOBSEMENT NO: 6O2tiBU -_-_^^ pOLtCy EFFECTTVE6'164OP 6165CS ruov io zozz uvr[ TERI NATEDPOLICY MESSAGES: This policy shown abov€ supersedes policy* 4422023-55D. The policy includes a loss payable clause protecling the additional insured's int€resl in the described car lo ths exlenl of the insurancs provided and subjecl to all policy provisions, The addiiional insursd will b6 given 20 days nolice ii the policy is ierminated. Until such notice is provided, it shall be presumed lhal lhe required renewal premiums have been paid. The additional insured must notily us wilhin 10 days oi any change of inlorest or ownership coming lo their attention. Failure lo do so will rend€r this policy null and void. AODITIONAL INSUREO'S NOTICE OF COVEBAGE State Farm Mutual Automobils lnsurance Company 6l8F'FAgsA NAMED INSUFED: pOLtCy NO: 442 2023-E2o-55E cAR 01s COVERAGE: COPLENAS, JACOB DBA SAFEUSA YR/MAKE/MODEL: 2000 ISUZU BOX TRK Bl AND PD LIABILTTY 1o3o N MouNTAtN AVE vlNldAraiEn: JALB4B 143Y7000540 s 1 MIL /i 1 MIL /3 1 MIL oNrABrocA s1762-2114 AGEnT'iirrtiE, ZACH BAY rNS AND FrN svcs rNc 3]333 BE8.33lllAGENTPHONE: (530)221-3224 ENDORSEMENT NO: 6O28BU POLTCY EFFECTIVE NOV 20 2022 UNTIL TERMINATED POLICY MESSAGES: This policy shown above supersedes policy4 4422023-550. The policy includ€s a loss payable clause protecling the addilional insured's inlerest in the described car to the €xtent ol lhe rnsurance provided and subject to all policy provisions. The addilional insured will be given 20 days nolice il the policy is ierminaled. Unlil such notice ^ rs provrded, il shajl be presum€d that ihe required renewal premiums have b€en paid. The additional insured musl nolily us within 10 days ol E any change ol interesl or ownershlp corning lo lheir attention. Failure to do so will render thls policy null and void. 3I ADDITIONAL INSUBED'S NOTICE OF COVEBAGE Slale Farm Mulual Automobile lnsuranc€ Company 6i8F'FASEA NAMED INSURED: POLICY NO: 442 2023.820.55E CAR 025 COVERAGE: COPLENAS, JACOB OBA SAFEUSA YR/MAKE/MODEL: 2012 HINO BOX TRK BI ANO PD LIABILITY 1O3O N IV1OUNTAIN AVE VIN/CAMPEB: 5PVNJ8JT9C4S53583 $ 1 MIL/i 1 MIL /$ 1 MIL oNrARro cA s1762-2114 AGENT NAME: ZACIBAYINSAND FIN svcs rNC *]331RER :31'i'AGENTPHONE: \530t221-3224 ENDORSEMENT NO: 6o2riBu poLtcy EFFECTTVE NOV 20 2022 UNTIL TERMINATED POLICY MESSAGES: This policy shown above sup€rsedes policy* 4422023-55D. The policy includos a loss payabl€ clause prolecting the additional insur€d's inlerest in lhe described car to the erlent ol lhe nsurance providsd and subjocl lo all policy provisions. The additional insur6d will be given 20 days notice il th€ policy is terminaled. Uniil such notic€ is provided, it shall be presumed that lhe requir6d renewal premiums have been paid. The additional insured must notify us within 10 days oi any change ol interssl or ownership coming lo lheir attenlion. Fajlure to do so will render this @licy null and void. ADDITIONAL INSUBED'S NOTICE OF COVERAGE Slals Farm Mutual Aulomobile lnsurancs Company 6I8F'FA9&A NAMED INSURED: POLICY NO: 442 2023-E2o-55E CAR 027 COVERAGE: CoPLENAS, JAcoB DBA SAFEUSA YR/MAKE/MODEL: 2006 ]NTERNATNL BOx TBK BI ANO PD LIABILITY 1O3O N MOUNTAIN AVE vlN/cAMPER: 1 HTMMAAL56H 179685 $ t MIL /S I MIL /i I MIL oNrARrocA s1762-2114 AGENTNAME: zAcH BAY rNS AND FrN svcs rNc 3]333 BEB.33[AGENTPHONE: \s3o)?21-3224ENDORSEMENT NO: 6o2sBU PoLIcY EFFECTIVE NOV 20 2022 UNTIL TERMINATED POLICY MESSAGES: This policy shown above supersedes policy# 4422023-550. Th€ policy includes a loss payable clause prolecting the additional insured's interest in lhe described car lo the exlenl ol lhe nsurance provided and subject lo all policy provisions. The additional insured will be given 20 days nolice il tho policy is terminated. Unlilsuch nolice is provided, it shall be presumed thal lhe requir€d renewal premiums have been paid. Ths additional insured musl notify us within 10 days ol any change oi int€rest or ownership cominO lo lh€ir atleniion. Failure to do so rvill render lhis policy null and void. BCKl StalsErrn STAT E FAHM6) PO Box 2368Elwminglon lL 6 1 702-2368 2314 12 m0641 0093 THE CITY OF }lENIFEE, ISAOAE9844 HAUN RD l4EN I FEE CA 925A6-6539 &.DATE OF NOTICE: OCT 18 2022 CODE: NOTE: PLEASE NOTIFY STATE FARM AT THE ADDHESS LISTED AT THE TOP, LEFT CORNER OF THIS PAGE REGARDING ANY CHANGE OFADDRESS INFOBMATION.ffi ADOITIONAL IHSUHED'S NOTICE OF COVERAGE Slats Farm ilutuol Aulomobile lnsurance Company 618F"FA9GA NAiIEO INSUREO: POLICY NO: 442 2O23-E20.55E CAB 029 COVERAGE: COPLENAS, JACOB OBA SAFEUSA YB/MAKE/MODEL: 2011 CRAFT TRLFLTBD $1000 DED. coMP. 1o3o N MOUNTATN AvE VIN/CAMPEF: rcszerzzograrszss $1000DED coLL' ONTARIOCA 91?62"2114 AGENTNAME: ZACH BAY INS AND FIN SVCS INCAGENTPHONE: (530\221-3224 ENDORSEMENT NO: oozagu POLICY EFFECTIVE NOV 20 2022 UNTIL TERMINATEDPOLICY MESSAGES: This policy shown above supersedes policy# 4422O23-55D. The policy includss a loss payable clause prolecting the additional insured's interesl in the described car to the extent of the insuranceprovid€d and subiscl to all policy provisions. The additional insured will be giv€n 20 days notice il the policy is terminaled. Until such notice is providod, it shall b€ presumed thal the required renewal premiums have been paid. The additional insured must notily us within 1O days of any change of interost or ownership coming lo their attention. Failure to do so will render this policy null and void. ADDITIONAL INSUHED'S NOTICE OF COVERAGE Slats Farm Mutual Aulomobile lnsurance Company 618F-FAgeA NAMED INSUREO: POLICY NO: 442 2A23.E20.55E CAB 031 COVERAGE: COPLENAS, JACOB DBA SAFEUSA YB/MAKE/MODEL: 2OO3 INTERNATNL BOX TRK BI AND PD LIAB1LITY 1o3o N MOUNTAIN AvE VIN/CAMPER: I HTMNAAL6SH555755 $ 1 MIL/$ 1 MIL/$ 1 MIL oNrARro cA s1762-2114 AGENT NAME: ZACH BAy rNS AND FrN svcs rNC []9ll RER 9Pl4cAGENTPHONE: \530)221-3224ENDOBSEMENT NO: 6O2dBU POLICY EFFECTIVE NOV 2O 2022 UNTIL TEBMINATED POLICY MESSAGES: This policy shown above supersedes policy# 4422o23-55D. The policy includos a loss payable clause prolecting the additional lnsured's interest in the described car to the extent of the insurance provided and subiecl lo all policy provisions. The additional insured will be given 20 days nolice il the policy is terminaled. Until such notice s provided, it shall b€ prosumed thal the required renewal premiums have been paid. The addilional insured must nolily us wilhin 1O days of any change of intsreEt or ownership com ing to lheir attenlion. Failure lo do so will render this policy null and void. ADDITIONAL IN$URED'S NOTICE OF COVEBAGE slate Farm Mutuel Aulomobile lnsuranco company 618F-FA9GA NAMED INSURED: pOLtCy NO: 442 zaz}-E2o-ssE CAB os2 COVERAGE: COPLENAS, JACOB DBA SAFEUSA YR/MAKE/MODEL: 1986 TNTERNATNL BOx TRK BTAND pD L|AB Ltry 1030 N MoUNTATN AvE VIN/CAMPER: 1 HTLDTVB7GHA66864 1.1 MlL/$ 1 [,ll]s 1 MIL oNrARrocA s17oz-i114 AGENTNAME: zAcH BAy rNS AND FrN SVCS rNC ili;U tsEts. EBIIAGENTPHONE: (530)221"3224 ENDOHSEMENT NO: 6o28BU POLICY EFFECTIVE NOV 2O 2022 UNTIL TERMINATEDPOLICY MESSAGES: This policy shown above supersedes policy# 4422023-55D. The po icy includss a loss payable c ause proiectin0 the additiona insured's interest in the described car to the extent of the insurance provid€d and subiecl to all policy provisions. The additional insured will be given 20 days notice il the policy is terminaled. Until such notice^ is provrdecl, il shall be presumed thal the required renewal premiums have been paid. The addilional insured must noli,y us wilhin 1o days olfi any chang€ ol rntere6t or ownership com ing to their attention. Failure to do so will render this policy null and void. E rnr I E ADDITIONAL INSUFED'S NOTICE OF COVERAGE Stale Farm Mutual Automobile lnsuranco Company 618F-FASGA NAMED INSURED: pOLtCy NO: 442 2023-E2o-ssE cAB 9zz COVERAGE: COPLENAS, JACOB DBA SAFEUSA YR/MAKE/MODEL: 1O3O N MOUNTAIN AVE VIN/CAMPER: ONTARIO CA 91762.2114 AGENT NAME: ZACH BAY INS AND FIN SVCS ]NCAGENTPHONE: (5so)221-3224 ENDORSEMENT NO: 6o2tiBu poLtcy EFFECIyE poltcy MESSAGES: Nov 20 2022 UNTIL TERMINATED The policy includes a loss payabl€ clause prot€cting the addilional insured s interest in lhe described car to the extenl ol the insurance providsd and subject lo all policy provisions. The additional insured will be Oiven 20 days nolice il the policy s lerminated. Unlil such nolic€ is provided, it shall be presumed that the required renewal premiums have been paid. The addiliona insured musi notity us wilhin l0 days of any change ot inleresl or ownership coming to their allenlion. Failure lo do so will renderthispolcynull andvoid. SCKl