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U <br /> AStateFarmt <br /> VEHICLE INFORMATION continued <br /> annually to determine which makes and models have rates. If any changes result from our reviews, adjustments <br /> earned decreases or increases from State Farm's standard are reflected in the rates shown on this renewal notice. <br /> M` , <br /> DRIVER INFORMATION <br /> Assigned Driver(s) <br /> co<o The following driver(s)are assigned to the vehicle(s)on this policy. <br /> �N <br /> o Driving Experience as of Marital <br /> Name June 10. 2025 Status <br /> ANTHONY MEDINA 10 years Single <br /> Other Household Driver(s) <br /> In addition to the Principal Driver(s) and Assigned <br /> Driver(s),your premium may be influenced by the <br /> drivers shown below and other individuals permitted to <br /> drive your vehicle. This list does not extend or expand <br /> coverage beyond that contained in this automobile <br /> policy. The drivers listed below are the drivers reported <br /> to us that most frequently drive other vehicles in your <br /> household. <br /> SANDRA MEDINA <br /> ANTONIO R MEDINA <br /> ALEXIS MEDINA <br /> Principal Driver&Assigned Drivers premium may be influenced by the information shown for <br /> For each automobile, the Principal Driver is the individual these drivers. <br /> who most frequently drives it. <br /> Each driver is designated as an Assigned Driver on the <br /> household automobile that they most frequently drive. Your <br /> C 0 V E R A G E A N D L I M I T S See your policy for an explanation of these coverages. <br /> A Liability <br /> Bodily Injury 30,000/60,000 <br /> Property Damage 25,000 $608.86 <br /> H Emergency Road Service $4.74 <br /> U Uninsured Motor Vehicle <br /> Bodily Injury 30,000/60,000 $63.94 <br /> U1 Uninsured Motor Vehicle <br /> Property Damage $18.91 <br /> Total Premium $696.45 <br /> Policy Number:737 4537-F10-75B Page number 3 of 5 <br /> Prepared April 18,2025 <br /> 107145 <br />