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Home My WebLink About20260219_PJA26-0112_Insurance Renewal (1) State Farm Mutual Automobile Insurance Company PO Box 2368 Bloomington IL 61702-2368 • •ASta to Farm AT1 A-2883 A PUPUSERIA Y TIENDA LATINA 17202 51STAVE NE AUTO RENEWAL ARLINGTON WA 98223 PREMIUM PAID: $1,258.79 DO NOT PAY. Your premium is billed through the State Farm Payment Plan State Farm Payment Plan Number: 1705744969 Your State Farm Agent LUIS SANCHEZ Policy Number: 526 5864-D05-476 Office: 360-653-7560 Policy Period: October 5, 2025 to April 5, 2026 Address: 10525 STATE AVE STE 101 Vehicle: MARYSVILLE,WA 98271-7224 2015 FORD F59 SD Ifyouhaveanewordifferentcar,have added any drivers,,orhavemoved, please contact your agent. Thank you for choosing State Farm. Location used to determine rate charged-17202 51ST information from your check to make an electronic fund AVE NE,ARLINGTON WA 98223. transfer,funds may be withdrawn from your account as soon When you provide a check as payment, you authorize us as the same day we receive your payment, and you will not either to use information from your check to make a receive your check back from your financial institution. one-time electronic fund transfer from your account or to process the payment as a check transaction.When we use Policy Number:526 5864-D05-47B Page number 1 of 3 Prepared August 13,2025 1004583 143562 202 01-15-2018 y -By eb a clutter, hello green - Scan QR to sign up or visit — statefarm.com/paperless Enroll in paperless and you'll get emails _❑� { ❑� with links to do things like: •download or print your auto ID card, — • pay your bill, �� ■ •or view documents, like your renewal. I TP38 c - StateFarm VEHICLE INFORMATION Review your policy information carefully. If anything is incorrect,or if there are any changes to your vehicle information, please let us know right away. Vehicle Identification Vehicle Description Number(VIN) Who principally drives this vehicle? How is this vehicle normally used? 2015 FORD F59 SD 1 F65F5KY6F0A04781 For this commercial vehicle,contact your agent for a full review of drivers. Vehicle Body Type:Vending/Concession Truck, Vehicle Use:Delivery to non-business locations-Food,Business Description:Specialty-Fast Food Restaurants(Franchise),Radius of Operation:50 miles,Annual Distance Driven:12000 miles, Gross Vehicle Weight,Manufacturer's Suggested Retail Price, Year Business established:2021 Premium Adjustment annually to determine which makes and models have Each year,we review our medical payments and personal earned decreases or increases from State Farm's standard injury protection coverages claim experience to determine rates. If any changes result from our reviews, adjustments the vehicle safety discount that is applied to each make and are reflected in the rates shown on this renewal notice. model. In addition,we review the comprehensive, collision, bodily injury and property damage claim experience COVERAGE AND LIMITS See yourpolicy for an explanation of these coverages. A Liability Bodily Injury 1,000,000/1,000,000 Property Damage 1,000,000 $400.26 P1 Personal Injury Protection Includes Medical 10,000 Income Loss 200/wk/lyr $10.04 D Comprehensive $293.78 G 500 Deductible Collision $515.12 U Underinsured Motor Vehicle Bodily Injury 100,000/300,000 $37.79 U1 Underinsured Motor Vehicle Property Damage 1,000,0 $1.80 Total Premium $1,258.79 If any coverage you carry is changed to give broader you the broader protection without issuing a new policy, protection with no additional premium charge,we will give starting on the date we adopt the broader protection. SURCHARGES AND DISCOUNTS AUTOMOBILE RATING PLAN -Applies to private Accident-Free Discount —Once your policy has been in passenger cars only. force for at least three years with no chargeable accidents, you may qualify for our Accident-Free Discount. Once you (continued on next page) Policy Number:526 5864-D05-47B Page number 2 of 3 Prepared August 13,2025 - kateFarm qualify, this discount applies as long as there are no Surcharges —If there are chargeable accidents, you may chargeable accidents, and may even increase over time. lose your Good Driving Discount or Accident-Free Discount Good Driving Discount -Newer policyholders who do not and receive accident surcharges. But if the accident is the yet qualify for our Accident-Free Discount (available after first to become chargeable in nine years and this policy has three years with no chargeable accidents) may already be been in force for at least that long, the Accident-Free receiving a Good Driving Discount. This discount continues Discount will continue and no surcharge will apply.The to apply until your policy qualifies for the Accident-Free surcharge for each accident depends upon the number and Discount as long as there are no chargeable accidents and timing of the accidents, and each accident surcharge will no new drivers. If you add new drivers,they must also remain in effect up to three years. qualify in order for your Good Driving Discount to continue. Surcharges will be removed if the company is given Chargeable Accidents - For new business rating, an satisfactory evidence that the driver involved is no longer a accident is chargeable if it results in $750 or more of member of the household or will not be driving the car in the damage to any property. For renewal business, an accident future. If that driver is insured on another State Farm policy, is chargeable as of the date State Farm pays at least$750 his or her driving record will be considered in the rating of (for accidents occurring on or after April 1, 1999) under the other policy. property damage liability and collision coverages for an These discounts and surcharges do not apply to all at-fault accident. coverages. For complete details, see your State Farm agent. ADDITIONAL INFORMATION If any information on this renewal notice is incomplete or information regarding discounts or coverages, see your inaccurate, or if you want to confirm the information we have State Farm agent or visit statefarm.com®. in our records, please contact your agent. For additional Buying a new car? Remember to contact your agent! When you buy an additional car or one that replaces a car already on your policy,you need to report the change to your agent promptly. Even though the dealership you purchased the car from may offer to notify your agent or insurance company, you, as the named insured, are responsible for reporting all changes to your auto policy. By contacting your agent,you can help: • avoid any complications or lack of coverage in the event of an accident or loss, • avoid insurance verification problems with a Iienholder, the police, or the department of motor vehicles, and • ensure that you receive any new discounts you may be entitled to. Your current State Farm policy automatically provides certain coverages for a new or replacement car for up to a specified, limited number of days after you take possession of the car. Please refer to your policy for the number of days that applies in your state. If you have any questions about coverage for a newly acquired car, please contact your State Farm agent. Disclaimer: This message is provided for informational purposes only and does not grant any insurance coverage. The terms and conditions of coverage are set forth in your State Farm Car Policy booklet, the most recently issued Declarations Page, and any applicable endorsements. Policy Number:526 5864-D05-47B Page number 3 of 3 Prepared August 13,2025