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StateFarm STATE FARM FIRE AND CASUALTY COMPANY ❑ <br /> O A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS DECLARATIONS <br /> Po e'ox 853925_ Policy Number 98-C6-F927-8 <br /> ac ardson, 75085-3925 <br /> Named Insured Policy Period Effective Date Expiration Date <br /> M-15-2828-FB3C F Z 12 Months MAY 29 2020 MAY 29 2021 <br /> 001281 3123 The policy period begins and ends at 12:01 am standard <br /> STINN, DECARLA time atthe premisesTocation. <br /> 607 SE EVERETT MALL WAY STE 6A <br /> EVERETT WA 98208-3210 Agent and Mailing Address <br /> E) WARDS INS AND FIN SVS INC <br /> 1723 100TH PL SE STE D <br /> I1I) 11 �I I� I I� II 1� I�I� �IIII EVERETT WA 98208-3800 <br /> 111 I I. I. 11111 II 11� 11 111l111 I 1 I II <br /> s <br /> PHONE: (425) 337-4800 <br /> O <br /> �N <br /> (n 0 <br /> Hair Salon, Day Spa and Barber Policy <br /> Automatic Renewal- If the policy period is shown as 12 months,this policy will be renewed automatically subjectto the premiums,rules and <br /> forms in effectfor each succeeding policy period. If this policy is terminated,we will give you and the Mortgagee/Lienholder written notice in <br /> compliance with the policy provisions or as required by law. <br /> Entity: Individual <br /> POLICY PREMIUM $ 1,067.00 <br /> Discounts Applied: <br /> Years in Business <br /> Protective Devices <br /> Prepared <br /> JUN 24 2020 ©Copyright,State Farm Mutual Automobile Insurance Company,2D08 <br /> CMP-4000 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. <br /> 009109 290 I Continued on Reverse Side of Page Page 1 of 6 <br /> N 1R t <br /> 530•5860.2 05-31-2011 151t3231 <br />