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2022/12/13 Act 1 Construction, Inc. (6)fiitlahtm STATE FABM@&.PO Box 2368 Blaomington lL 61 702-2368 DATE OF NOTICE: JAN 03 2023 CODE: NOTE: PLEASE NOTIFY STATE FARM AT THE ADDRESS LISTEO AT THE TOP, LEFT COHNER OF THIS PAGE REGARDING ANY CHANGE OF ADDRESS INFORMATION, B5AATI 23 000999 0093CITY OF I{EN I FEE29844 HAUN RD irEN I FE E CA 92586-6559T,\I?EHf.1t ltr,lil,ilrl,,t,rll,[1ilr,l,,thlhll,hr,til,,,,Lttthllt,tl I ADDITIONAL INSUBED'S NOTICE OF COVEBAGE State Farm Mulual Aulomobilo lnsulanca Company 1045-FACEA NAMED INSURED: POLICY NO: 580 5701.A07-75H covERAGE: ACT 1 CONSTRUCTION INC YR/MAKE/MODEL: 2Oo7 FORD PICKUP EIAND PD LIABILITY 444 6rH Sr VIN/CAMPER: iiipx r zsozroaz r ss Srlllto.o. "or".NORCOCA 92860-1758 AGENTNAME: TONYFREEMAN s2ooo DED. coLL.AGENTPHONE: (909)942.6464 ENDORSEMENT NO; 6o2IiBU POLICY EFFECTIVE DEC 13 202? UNTIL TERMINATED POLICY MESSAGES: This policy shown above supersedes policy# 5805701-75G. The policy includes a loss payable clause protecting the additional insured s inlerest in lhe described car to lhe extenl ol the rnsurance provided and subjecl to all policy provisions. The additional insured will be giv€n 30 days nolice il the policy is terminated. Until such notice is provided. il shall be prosumsd lhat the required renewal premiums have been paid. The additional insured must notily us wilhin 10 days ol any change ol int€resl or ownership coming to their atlenlion. Failure to do so will render lhis policy null and void. ADDITIONAL INSURED'S NOTICE OF COVERAGE Stale Farm Mutual Automobils lnsurance Company 1045-FACEA NAMEo INSUREO: POLICY NO: 636 113s-Ao2-75E COVERAGE: AcT 1 coNSrRUCTtoN tNc YR/MAKE/MODEL: 2019 FoBD urL TRK Br AND pD LrABrLrw 444 6TH ST VIN/CAMPER: 1 FD8W3ETXKEC52393 $ 1 MIL Nonco cA s2s60,r758 AGENT NAME: roNY FREEMAN !39* PER 9914PAGENTPHONE: (909)942-6464 ENDORSEMENT NO: 6o2dBU PoLICY EFFECTIVE OEC 13 2022 L]NTIL TEBMINATED POLICY MESSAGES: This policy shown above supecedes policy* 6361135-75D. The policy includss a loss payable clause proteclino the addilional insursd's intsr€sl in the described car to the exlent ol the rnsurance provid€d and subject io all policy provisions. The addilional insured will be given 30 days notice ii lhs policy is lerminaled. Unlil such nolice is provided, il shall be presumod thal the required renewal premiums have b€en paid. The additional insured musl nolity us within 1O days o, any change of interest or ownership coming lo lhsir attention. Failure lo do so will render lhis policy null and void. ADDITIONAL INSUBED'S NOTICE OF COVERAGE State Farm Mulual Aulomobile lnsurance Company 1045-FAoEA NAMED INSURED: pOLtCy NO: 5oo 1614-C31,75p COVERAGE: ACT 1 CONSTBUCTION INC YF/MAKE/MOOEL: 2015 FORD UTIL TRK BIAND PD LIABILITY 444 6TH ST VIN/CAMPER: 1 FD8W3E63FE Bo85o7 $ 1 MIL NoRcocA s2860-1758 aGeHi rlaME: roNy FREEMAN 33333 8E8 33[AGENTPHONE: (909)942-6464 ENDOHSEMENT NO: 6O28BU POLICY EFFECTIVE DEC 13 2022 UNTIL TERMINATED POLICY MESSAGES: 'fhis policy shown above supersedes policy# 5001614-750. The policy includes a loss payable claus€ prolecting the additional insured s inlBrgsl in tho describ6d car lo lhe exlent o, lhe insuranc€ provided and subjecl lo allpolicy provisions. The additional insured willbe given 30 days nolice if the policy is terminated. Unlil such nolice ^ is provided. il shall be presumedlhallh€ required renewal premiums have been paid. Th€ addilional insured musi notily us within l 0 days olS any change of rnleresl or ownershrp Coming lO their atlenlion- Failure lo do so will render this policy null and void.I --- ADDITIONAL INSURED'S NOTICE OF COVEHAGE State Farm Mulual Aulomobilo lnsurance Company 1045-FAoEA NAMEDINSURED: pOLtCy NO: 569 1347.8r7-7sD COVERAGE: ACT 1 CONSTRUCT]ON INC YR/MAKE/MODEL: 2OO7 FORD PICKUP EIAND PD LIAEILITY 444 6TH ST VI},UCAMPER: 1FTPX12537KD42145 $1MlL NoRCo CA 92860.1758 AGEtIi IIIME: TONY FREEMAN S2OOO OED, COMP, aGEur pxotig: (909)94a,6464 s2000 DED' coLL' ENDORSEMENT NO: 6o28BU pOLtCy EFFECIVE PoLlcY MEssAGEs: This poticy shown above supersedes poticy# 5691847'75c. oEc 13 2o?2 UNTIL TERMINATED The policy includ6s a loss payable clause prolecting the additional insured's inleresl in the described car lo lhe extenl ol lhe insurance provided and subjecl to all policy provisions. The addilional insured will be given 30 days notic8 il lh€ policy is terminaled. Uniil such nolice is provided. il shall be presumed lhat lhe required renewal premiums have been paid. Tho addilional insured musl nolily us h,ithin 10 days ol any change ot interest or ownership comlng io their attenlion. Failure lo do so will render lhis policy null and void. ADDITIONAL INSURED'S NOTICE OF COVERAGE Slate Farm Mulual Aulomobile lnsurance Company 1045-FACEA NAMEO INSURED: pOLlCy NO: 568 9544"816.75F COVERAGE: ACT 1 CONSTRUoTIoN INc YR/MAKE/MODEL: 2OO5 FORD PICKUP EIAND PD LIABILITY 444 6TH ST VIN/CAMPEB: 1 FTRX 12W25NB28oO5 $ 1 MIL NORCOCA 92860-1758 AGENi'liauE: ToNyFBEEMAN $2000DED,coMP, acEiii i;rionE: (s-obtsaz,oao+ $2000 DED coLL' ENDORSEMENT NO: 60288U pOLtCy EFFECTTVE OEC 13 2022 UNTIL TEFiI/!INATED POLICY MESSAGES: This policy shown above supersedes policys 5689544-75E. The policy lncludes a loss payable clause protecling the additional insured's interesl ln the described car to the extent ol ihe ins!.ance provided and subJ€ct lo all policy provisions. The addilional insured will be given 30 days nolice il lhe policy is ierminated. Until such nolice is provided. it shall be presumed that the required renewal premiums have beon paid. Th€ additional insured must noliiy us wilhin 10 days ol any change ol inleresl or own6rship coming to their allention. Failure io do so will render ihis policy null and void. ADDITIONAL INSUBED'S NOTICE OF COVERAGE Stale Farm Mutual Automobile lnsurance Company 1045-FACEA NAMED INSUBED: POLtCy NO: 501 7ss4.E27-75N COVERAGE: ACT 1 CONSTRUCTION INC YR/MAKE/MODEL: 2016 FORD PICKUP BI AND PD LIABILITY 444 6TH ST VIN/CAMPER: 1 FTEX1 C PXGKE25255 $ 1 MIL NoBcocA s2860-17s8 AGENT NAME: roNy FREEMAN tilll RER 9Pl4PAGENTPHONE: (9os)s42.6464 ENDORSEMENT NO: bozdeu pOLtCy EFFECIvE DEC 13 2022 UNTIL TERMINATEO POLICY MESSAGES: "fhis policy shown above supersedes policy# 5017554-75M. The policy includes a loss payable clause prolecting lhe addiiional insured's interest in lh6 described car lo the exlenl of the rnsurance provided and subiscl lo all policy provisions. The additional insured will be given 30 days nolice il the policy is terminated. Unlil such notice is provided, il shall b€ prosumed lhal the required renewal premiums have been paid. The additional insured must nolily us within 10 days oi any change ol inleresl or ownership coming lo their atlention. Failure to do so will rend€r this policy null and void. ADDITIONAL INSURED'S NOTICE OF COVERAGE Slate Falm Mutual Aulomobils lnsurance Company 1045-FACEA NAMED INSUHEo: pOLtCy NO: 5e3 73s4-Br1-75H COVERAGE: AcT 1 CoNSTRUCTIoN INC YR/MAKE/MODEL: 2017 FoRD UTIL TRK BI AND PD LIABILITY 444 6TH ST VIN/CAMPER: 1FD8W3ET7HEEo7815 $ 1 MIL NoRCocA s286o-i758 AGENTNAME: roNv rnrevnn 833338E8.33[AGENT PHONE: (909)942 6464 ENDOHSEMENT NO: 6028Btl poltcy EFFECT|VE DEC 13 2022 UNTIL TERIVINATED POLICY MESSAGES: This policy shown above supersedes policy# 5937394-75c. The policy includes a loss payable clause prolecling the additional insured's interesl in lhe described car to the exlent or ihe insurance provided and subjecl to all policy provisions. The addillonal insured wil be givef 30 days notice il lhe policy is lerminaled. Unlil such nolice is provided, il shall b€ presumed that lhe required renewal premiums have been paid. The addilional insured musl noiity us within 10 days oi any change oi lnlerest or ownership coming to their atlenlion. Failure lo do so will render this policy null and void. BCKl