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StafeFarm <br /> • State Farm Mutual Automobile Insurance Company 73631-4-A MATCH 00809 MUTL VOL <br /> PO Box 2368 <br /> Bloomington IL 61702-2368 DECLARATIONS PAGE <br /> NAMED INSURED 00809 <br /> 75-3EC5-4 A A POLICY NUMBER 561 0386-606-75C <br /> goastn onse <br /> HUNTER, SCOTT M POLICY PERIOD FEB 06 2026 to AUG 06 2026 DBA NILLSBOROUGH FENCE COMPANY 12:01 A.M.Standard Time <br /> 16241 MCGILL RD <br /> LA MIRADA CA 90638-6209 STATE FARM PAYMENT PLAN NUMBE9 <br /> 1191029423 <br /> AGENT _ <br /> PAULHERNANDEZ <br /> 12232 LA MIRADA BLVD <br /> LA MIRADA,CA 90638-1306 <br /> PHONE:(562)943-2700 <br /> ❑O NOT PAY PREMIUMS SHOWN ON THIS PAGE. <br /> IF AN AMOUNT IS DUE,THEN A SEPARATE STATEMENT IS ENCLOSED. <br /> YOUR CAR <br /> YEAR MAKE MODEL -BODY STYLE VEHICLE ID.NUMBER CLASS <br /> NONOWNED AUTO 6600ELOOGO <br /> SYMBOLS COVERAGE&LIMITS PREMIUMS <br /> Liability Coverage s_.._._ s` _ . ... ._ ,e :... .. $34,92 ... :_ <br /> Bodily Injury Limits <br /> Each Person; Each Accident <br /> $1,000,000 $1,000,000 <br /> Property Damage Lim�t <br /> Each Accident _ <br /> $1.000.000 <br /> Total premium for FEB 06 2026 to AUG 06 2026. $34.92 This is not a bill.. <br /> IMPORTANT MESSAGES <br /> IMPORTANT NOTICE <br /> For your protection California law requires the fallowing to appear with this policy: Any person who knowingly presents <br /> false or fraudulent information to obtain or amend insurance coverage or to make a claim for the payment of a loss is <br /> guilty of a crime and may be subject to fines and confinement in state prison. <br /> Replaced policy number 5610386-75B. <br /> Notice of insurance information collection practices-personal,family,or household insurance transactions: <br /> We may collect customer information from persons other than the individual or individuals applying for coverage. Such customer <br /> information as well as other personal or privileged information subsequently collected may,in certain circumstances,be disclosed <br /> to third parties without your authorization as permitted by law. <br /> You have the right to submit a written request to access,correct,amend,or delete your personal information and the right to <br /> receive a response within 30 days of submittirg your request. If we deny your request,you have the right to file a statement <br /> with us containing the information you feet is accurate and fair along with the reasons you disagree with our denial. Instructions <br /> on how to file such request and our full privacy notice can be found www.statefarm.com/customer-care/privacy-security/privacy <br /> or contact your State Farm Agent. <br /> EXCEPTIONS POLICY BOOKLET&ENDORSEMENTS(See policy Booklet&Individual erkdomements for coverage details:) <br /> YOUR POLICY CONSISTS OF THIS DECLARATIONS PAGE THE POLICY BOOKLET - <br /> FORM 9805Bl1BAND ANY <br /> ENDRENORSEMENTS <br /> NTICTHAT APPLY, INCLUDING THOSE ISSUED TO YOU <br /> WITHE. <br /> 6028BU ADDITIONNAL INSURED-CITY OF SANTA ANA ATTN PUBLIC WORKS AGENCY, 20 <br /> CIVIC CENTER <br /> INSURED701-4058. <br /> 6125A AMENDATORY ENDORSEMENT. <br /> 6126MD EXCESS COVERAGE FOR PERSONAL VEHICLE SHARING. <br /> 6129J AMENDATORY ENDORSEMENT. <br /> 61300 AMENDATORY ENDORSEMENT -EFF FEB 17 2026. <br /> 6165 S EMPLOYERS NON-OWNED CAR LIABILITY COVERAGE. <br /> 6196AA - WAIVER OF SUBROGATION UNDER THE LIABILITY COVERAGE THE CITY OF <br /> SANTA ANA ATTN PUBLIC WORKS AGENCY. <br /> Agent: PAULHERNANDEZ <br /> Telephone: (562)943-2700 <br /> 1 0 1 00/05990 See Reverse Side Prepared MAR 31 2025 3EC5-A62 <br /> 155.3866 CA.z US-zF)oz(ol aoz5lt} (�ta0254cj <br /> 14SXUN {.1a925te) <br />