Laserfiche WebLink
5tateFarm <br /> State Farm Mutual Automobile Insurance Company 92918-4-A MATCH 01013 MUTL VOL <br /> PO Box 2368 <br /> Bloomington It 61702-2368 DECLARATIONS PAGE <br /> 01013 PAGE 2 OF 2 <br /> NAMED INSURED 75-2ED8-4 A A POLICY NUMBER 776 3587-F22-75E <br /> �01013 I POLICY PERIOD OCT 01 2025 to DEC 22 2025 <br /> 875 IRON HORSE DR 5TE A271 SL5 PROPERTY SOLUTIONS, 12:01 A.M.Standard Time <br /> PARK CITY UT 84060-5158 <br /> STATE FARM PAYMENT PLAN NUMBER <br /> 1256610923 <br /> ExGEPT10NS,POLICY BOOKL T&ENDCMEMEWS(Sm pol boa-Met_&r kOQual.en►dorsetrterrts for covcra9e detwAivi) . <br /> YOUR POLICY CONSISTS OF THIS DECLARATIONS PAGE THE POLICY BOOKLET FORM <br /> 9805S�1BAND NT ENDORSEMENREN AL TS APPLY, INCLUDING THOSE ISSUED TO YOU <br /> CREDITOR- FORD MOTOR CREDIT - LIEN INSURANCE SERVICE CENTER, PO BOX 390858, <br /> MINNEAPOLIS MN 55439-0858. <br /> 01 ffI /EpOEgSgIGGUNADENGITNIEERINGNSEOEQICYCENTERARNPA ANSANTALANAWCCAK8UO1I4658. <br /> G2 6028BU ADDITIONAL I�JSURED CITY OF ONITAH6, 303 E B ST, N <br /> 91764-4196. <br /> 03 6028BU ADDITIONAL INSURED-CITY OF SANTA ANA ATTENTION: PLANNING & <br /> 603OGFNG20 BUSINE55NNAMEDLINSORE�NTA ANA CA 92�01-9999. <br /> 6I25 AMENDATORY ENDORSEMENTT <br /> 6126 D EXCESS COVERY RAGE FOR &SONAL VEHICLE SHARING. <br /> 6289DW SINGLE LIMIT LIABILITY COVERAGE. <br /> 6196AA - WAIVER OF SUBROGATION UNDER THE LIABILITY COVERAGE FOR <br /> CITY OF SANTA ANA PUBLIC WORKS AGENCY, CIP/DESIGN ENGINEERING; CITY OF <br /> SANTA ANA PLANNING AND BUILDING. <br /> Agent: JOSE GASTELUM <br /> Telephone: C714)557-3344 <br /> 21734/16185 Prepared OCT 03 2025 2EDB-138A <br /> 15518456 G4.2 05,Q 2(01a925rc) (a1a0z4c) <br /> 139X0 (OU025M <br />