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DocuSign Envelope ID:9D2184B7-05D2-4DD9-9684-OAE766AE09DC katp Farm <br /> VEHICLE INFORMATION <br /> Review your policy information carefully. If anything is incorrect,or if there are any changes to your vehicle information, please <br /> let us know right away. <br /> Vehicle Identification <br /> Vehicle Vehicle Description Number(VIN) Who principally drives this vehicle? How is this vehicle normally used? <br /> 1 2005 DODGE CARAVAN 1 D4GP25E45B307373 For this commercial vehicle,contact your <br /> agent for a full review of drivers. <br /> Vehicle Body Type:Mini Van, Vehicle Use:Delivery to other businesses-Food-On Demand,Business Description: <br /> Caterers,Radius of Operation:50 miles,Annual Distance Driven:10000 miles,Manufacturer's Suggested Retail Price, <br /> Year Business established:2001 <br /> 3 2005 DODGE CARAVAN 1 D4GP25E45B307499 For this commercial vehicle,contact your <br /> agent for a full review of drivers. <br /> Vehicle Body Type:Mini Van, Vehicle Use:Delivery to other businesses-Food-On Demand,Business Description: <br /> Caterers,Radius of Operation:50 miles,Annual Distance Driven:10000 miles,Manufacturer's Suggested Retail Price, <br /> Year Business established:2001 <br /> 4 2005 DODGE CARAVAN 1D4GP25E15B307377 For this commercial vehicle,contact your <br /> agent for a full review of drivers. <br /> Vehicle Body Type:Mini Van, Vehicle Use:Delivery to other businesses-Food-On Demand,Business Description: <br /> Caterers,Radius of Operation:50 miles,Annual Distance Driven:10000 miles,Manufacturer's Suggested Retail Price, <br /> Year Business established:2001 <br /> Premium Adjustment comprehensive and collision rates. If you carry <br /> Comprehensive and collision rates are based upon State comprehensive and/or collision coverages, these <br /> Farm's loss experience. This loss experience is reviewed adjustments are reflected in the rates shown on this renewal <br /> periodically to determine which makes and models have notice. <br /> earned decreases or increases from State Farm's standard <br /> COVERAGE AND LIMITS See your policy for an explanation of these coverages. <br /> Vehicle 1 Vehicle 3 Vehicle 4 <br /> AB Liability Bodily Injury 1,000,000/1,000,000 $284.13 $284.13 $284.13 <br /> Property Damage 100,000 Included Included Included <br /> C Medical Payments 5,000 $11.83 $11.83 $11.83 <br /> U1 Combined Uninsured/Underinsured Motor Vehicle <br /> Bodily Injury 1,000,000/1,000,000 $39.30 $39.30 $39.30 <br /> Property Damage 100,000 Included Included Included <br /> Premium by Vehicle $335.26 $335.26 $335.26 <br /> Total Premium $1,005.78 <br /> Coverages AB and U1 are on a per policy basis. you the broader protection without issuing a new policy, <br /> If any coverage you carry is changed to give broader starting on the date we adopt the broader protection. <br /> protection with no additional premium charge,we will give NOTICE OF RIGHT TO PURCHASE HIGHER LIMITS OF <br /> UM/UIM NOTICE:YOU ARE REQUIRED TO PURCHASE <br /> UNINSURED MOTORIST BODILY INJURY COVERAGE, <br /> (continued on next page) <br /> Policy Number:385 4515-C24-33A Page number 2 of 3 <br /> Prepared August 3,2020 <br />