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2020/05/16 Western A/V, Inc. Certificate of Liability Insurance (4)
�« STATE FARM GENERAL INSURANCE COMPANY A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS DECLARATIONS COVERAGE SUMMARY OCT 1 2020 Po Lrn .';�s2g 75085-3925 y Polic Number 92-EX-5166-6 Rtcl;�.3ld5r,ir, TX Addl Insured-Section II Only Policy Period Effective Date Expiration Date M-23-3535-FB8A F Z 12 Months MAY 16 2020 MAY 16 2021 002052 3123 The poli y period beggins and ends at 12:01 am standard CITY OF MENIFEE time attie premises on. AND ITS OFFICERS, EMPLOYEES, AGENTS & AUTHORIZED VOLUNTEERS 29844 HAUN RD Named Insured MENIFEE CA 92586-6539 WESTERN A/V INC 1592 N BATAVIA ST STE 2 ORANGE CA 92867-3554 8 d 0 0 of o Home Product Sales Policy Automatic Renewal - If the policy period is shnwn as 12 months,this policy will be renewed automatically subjectto the premiums,rules and forms in effect for each succeeding policy period. If this policy is terminated,we will give you and the Mortga gee/Lien holder written notice in compliance with the policy provisions or as required by law. Entity: Corporation Policy Premium $ 10,614.00 Discounts Applied: Protective Devices Claim Record Prepared OCT 01 2020 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP-4000 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 017772 290 Al Continued on Reverse Side of Page Page 1 of 7 N 530-686 u.2 05-31-2011 IoIt32310 DECLARATIONS(CONTINUED) Home Product Sales Policyy for CITY OF MENIFEE Policy Number 92-EX-5166-6 SECTION I - PROPERTY SCHEDULE Location Location of Limit of Insurance* Limit of Insurance* Seasonal Number Described Increase- Premises Coverage A- Coverage B - Business Buildings Business Personal Personal Property Property 003 6353 CORTE DEL ABETO STE 106 No Coverage $ 23,800 25% CARLSBAD CA 92011-1437 004 1592 N BATAVIA ST STE 2 No Coverage $ 224,600 25% ORANGE CA 92867-3554 " As of the effective date of this policy, the Limit of Insurance as shown includes any increase in the limit due to Inflation Coverage. SECTION I- INFLATION COVERAGE INDEX ES Cov A- Inflation Coverage Index: N/A Cov B - Consumer Price Index: 257.3 SECTION I - DEDUCTIBLES Basic Deductible $2,500 Special Deductibles: Money and Securities $250 Data Compromise $1,000 Prepared OCT 01 2020 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP-4000 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 017772 Continued on Next Page Page 2 of 7 StateFarm 0 DECLARATIONS(CONTINUED) Home Product Sales Policy for CITY OF MENIFEE Policy Number 92-EX-5166-6 Employee Dishonesty $250 Equipment Breakdown $2,500 Other deductibles may apply- refer to policy, $ SECTION I- EXTENSIONS OF COVERAGE - LIMIT OUNSURANCE- EA0 DESCRIBED PREMI E C. 55� The coverages and corresponding limits shown below apply separately to each described premises shown in these Declarations, unless indicated by"See Schedule." If a coverage does not have a corresponding limit shown below, but has "Included" indicated, please refer to that policy provision for an explanation of that coverage. LIMIT OF COVERAGE INSURANCE Accounts Receivable On Premises See Schedule Off Premises See Schedule Arson Reward $5,000 Back-Up Of Sewer Or Drain See Schedule Collapse Included Damage To Non-Owned Buildings From Theft, Burglary Or Robbery Coverage B Limit Debris Removal 25% of covered loss Equipment Breakdown Included Fire Department Service Charge $2,500 Fire Extinguisher Systems Recharge Expense $5,000 Forgery Or Alteration $10,000 Glass Expenses Included Increased Cost Of Construction And Demolition Costs (applies only when buildings are 10% insured on a replacement cost basis) Money And Securities (Off Premises) See Schedule Money And Securities (On Premises) See Schedule Money Orders And Counterfeit Money $1,000 Prepared OCT 01 2020 ©Copyright,State Farm Mutual Automobile Insurance Company,2000 CMP-4000 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 017773 290 Continued on Reverse Side of Page Page 3 of 7 N i DECLARATIONS(CONTINUED) Home Product Sales Policy for CITY OF MENIFEE Policy Number 92-EX-5166-6 Newly Acquired Business Personal Property (applies only if this policy provides $100,000 Coverage B- Business Personal Property) Newly Acquired Or Constructed Buildings (applies only if this policy provides $250,000 Coverage A- Buildings) Ordinance Or Law- Equipment Coverage Included Outdoor Property See Schedule Personal Effects (applies only to those premises provided Coverage B- Business $2,500 Personal Property) Personal Property Off Premises $25,000 Pollutant Clean Up And Removal $10,000 Preservation Of Property 30 Days Property Of Others (applies only to those premises provided Coverage B - Business See Schedule Personal Property) Signs See Schedule Valuable Papers And Records On Premises See Schedule Off Premises See Schedule SECTION I- EXTENSIONS OF COVERAGE - LIMIT OF INSURANCE -SCHEDULE The coverages and corresponding limits shown below apply only to the described premises as shown. LIMIT OF LOCATION COVERAGE INSURANCE 0003 Accounts Receivable (On Premises) $10,000 Accounts Receivable (Off Premises) $5,000 Back-Up Of Sewer Or Drain $15,000 Money And Securities (Off Premises) $5,000 Money And Securities (On Premises) $10,000 Outdoor Property $5,000 Property Of Others (applies only to those premises provided Coverage B - Business $2,500 Personal Property) Signs $5,000 Valuable Papers and Records (On Premises) $10,000 Valuable Papers and Records (Off Premises) $5,000 0004 Accounts Receivable (On Premises) $10,000 Prepared OCT 01 2020 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP-4000 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 017773 Continued on Next Page Page 4 of 7 StateFarm nr W W DECLARATIONS(CONTINUED) Home Product Sales Policy for CITY OF MENIFEE Policy Number 92-EX-5166-6 Accounts Receivable (Off Premises) $5,000 Back-Up Of Sewer Or Drain $15,000 Money And Securities (Off Premises) $5,000 Money And Securities (On Premises) $10,000 Outdoor Property $5,000 $ Property Of Others (applies only to those premises provided Coverage B - Business $2,500 g Personal Property) No Signs $5,000 Valuable Papers and Records (On Premises) $10,000 Valuable Papers and Records (Off Premises) $5,000 SECTION I - EXTENSIONS OF COVERAGE- LIMIT OF INSURANCE- PER POLICY The coverages and corresponding limits shown below are the most we will pay regardless of the number of described premises shown in these Declarations. LIMIT OF COVERAGE INSURANCE Data Compromise Legal And Forensic Information Technology Review $5,000 Per Occurrence $50,000 Dependent Property - Loss Of Income $5,000 Employee Dishonesty $10,000 Identity Restoration Other Expenses $1,000 Case Management Services 12 months Per Occurrence $35,000 Lost Wages And Supervision Expenses $5,000 Utility Interruption - Loss Of Income $10,000 Loss Of Income And Extra Expense Actual Loss Sustained- 12 Months SECTION li - DEDUCTIBLES Business Liability - Property Damage $1,000 Other deductibles may apply- refer to policy. Prepared OCT 01 2020 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP-4000 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 017774 290 Continued on Reverse Side of Page Page 5 of 7 N DECLARATIONS(CONTINUED) Home Product Sales Poll' for CITY OF MENIFEE Policy Number 92-Ex-5166-6 SECTION I]-- LIABILITY LIMIT OF COVERAGE INSURANCE Coverage L- Business Liability $2,000,000 Coverage M - Medical Expenses (Any One Person) $5,000 Damage To Premises Rented To You $300,000 LIMIT OF AGGREGATE LIMITS INSURANCE Products/Completed Operations Aggregate $4,000,000 General Aggregate $4,000,000 Each paid claim for Liability Coverage reduccs the amount of insurance we provide during the applicable annual period. Please refer to Section II - Liability in the Coverage Form and any attached endorsements. Your policy consists of these Declarations, the BUSINESSOWNERS COVERAGE FORM shown below, and any other forms and endorsements that apply, including those shown below as well as those issued subsequent to the issuance of this policy. FORMS AND ENDORSEMENTS CMP-4101 Businessowners Coverage Form CMP-4705.2 Loss of Income & Extra Expense CMP-4990.1 Identity Restoration Coverage FE-6999.2 Terrorism Insurance Cov Notice CMP-4994 Data Compromise CMP-4710 Employee Dishonesty CMP-4746.1 Hired Auto Liability CMP-4261 Amendatory Endorsement CMP-4260.1 Amendatory Endorsement-CA CMP-4709 Money and Securities CMP-4698 Back-Up of Sewer or Drain CMP-4704.1 Dependent Prop Loss of Income CMP-4703.1 Utility Interruption Loss Incm Prepared OCT 01 2020 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP-4000 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 017774 Continued on Next Page Page 6 of 7 Stat�eFaarm `~= DECLARATIONS(CONTINUED) Home Product Sales Policy for CITY OF MENIFEE Policy Number 92-EX-5166-6 CMP-4786.1 Addl Insd Owners Lessee Sched EQCMP-4787 Waiver of Trans Rgt of Recov CMP-4788.1 Addl Insd Mgrs Lessor of Prem CMP-4610 General Agg Limit Per Proj FD-6007 Inland Marine Attach Dec 0 0 S 0 This policy is issued by the State Farm General Insurance Company. Participating Policy You are entitled to participate in a distribution of the earnings of the company as determined by our Board of Directors in accordance with the Company's Articles of Incorporation,as amended. In Witness Whereof, the State Farm General Insurance Company has caused this policy to be signed by its President and Secretary at Bloomington, Illinois. �.rn-�- Secretary President IMPORTANT NOTICE: California law requires us to provide you with Information for filing complaints with the State Insurance Department regarding the coverage and service provided under this policy. Your agent's name and contact information are provided on the front of this document.Another option is to reach out by mail or phone directly to: State Farm®Executive Customer Service PO Box 2320 Bloomington IL 61702 Phone#1-800-STATEFARM(1-800-782-8332) Department of Insurance complaints should be filed only after you and State Farm or your agent or other company representative have failed to leach a satisfactory agreement on a problem. California Department of Insurance Consumer Services Division 300 South Spring Street Los Angeles,CA 90013 Phone#1-800-927-HELP(4357)orvish v_uwva.irisncairci c,�i.t oy_ir)#-cotl§iiiraeis Prepared OCT 01 2020 Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP-4000 Includes copyrighted material of Insurance Services Office,Inc.,with its permission 017775 290 Page 7 of 7 N 92-EX-5166-6 017775 StateFarm STATE FARM GENERAL INSURANCE COMPANY A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS INLAND MARINE ATTACHING DECLARATIONS 2255 R0 hBB a°rd98o a 94 75085-3925 Policy Number 92-EX-5166-6 Named Insured Policy Period Effective Date Expiration Date M-23-3535-FI38A F Z 12 Months MAY 16 2020 MAY 16 2021 The poll�py period begins and ends at 12:01 am standard WESTERN A/V INC time atihe premises location. 1592 N BATAVIA ST STE 2 ORANGE CA 92867-3554 - 8 0 0 ATTACHING INLAND MARINE Automatic Renewal- If the policy period is shown as 12 months,this policy will be renewed automatically subjectto the premiums,rules and forms in effectfor each succeeding policy period. If this policy is terminated,we will give you and the Mortgagee/Lienholder written notice in compliance with the policy provisions or as required by law. Annual Policy Premium Included The above Premium Amount is included in the Policy Premium shown on the Declarations. Your policy consists of these Declarations,the INLAND MARINE CONDITIONS shown below,and any other forms and endorsements,that apply,including those shown below as well as those issued subsequentto the issuance of this policy. Forms,Options,and Endorsements FE-8745 Inland Marine Computer Prop FE-6271 Amendatory Endorsement FE-8739 Inland Marine Conditions See Reverse for Schedule Page with Limits Prepared OCT 01 2020 c7 Copyright,State Farm Mutual Automobile Insurance Company,2008 FD-6007 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 017776 530-666 a.2 05-31-2011 I0132320 92-EX-5166-6 ATTACHING INLAND MARINE SCHEDULE PAGE ATTACHING INLAND MARINE ENDORSEMENT LIMIT OF DEDUCTIBLE ANNUAL NUMBER COVERAGE INSURANCE AMOUNT PREMIUM FE-8745 Inland Marine Computer Prop S 25,000 $ 500 Included Loss of Income and Extra Expense S 25,000 Included OTHER LIMITS AND EXCLUSIONS MAY APPLY-REFER TO YOUR POLICY Prepared OCT 01 2020 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 FD-6007 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 017776 530-666 e.2 05-31-2011 10132330 92-EX-5166-6 017777 CM P-4786.1 =.;7 Page 1 of 2 THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY. CMP-4786.1 ADDITIONAL INSURED — OWNERS, LESSEES, OR CONTRACTORS (Scheduled) This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM $ SCHEDULE Policy Number: 92-EX-5166-6 �o Named Insured: WESTERN A/V INC 1592 N BATAVIA ST STE 2 ORANGE CA 92867-3554 Name And Address Of Additional Insured Person Or Organization: CITY OF MENIFEE AND ITS OFFICERS EMPLOYEES AGENTS & AUTHOF IZED VOLUNYEERS 29844 HAUN RD MENIFEE CA 92586 1. SECTION II — WHO IS AN INSURED of b. If coverage provided to the additional in- SECTION II — LIABILITY is amended to in- sured is required by a contract or agree- clude, as an additional insured, any person or ment, the insurance provided to the organization shown in the Schedule but only with respect to liability for "bodily injury", additional insured will not be broader than "property damage", or "personal and advertis- that which you are required by the contract ing injury" caused, in whole or in part, by: or agreement to provide for such addition- a. Ongoing Operations al insured; and c. If the contract or agreement between you (1) Your acts or omissions; or and the additional insured is governed by (2) The acts or omissions of those acting California Civil Code Section 2782 or on your behalf; 2782.05, the insurance provided to the additional insured is the lesser of that in the performance of your ongoing opera- which: tions for that additional insured; or (1) Is allowed for the satisfaction of a de- b. Products—Completed Operations fense or indemnity obligation by Cali- "Your work" performed for that additional fornia Civil Code Section 2782 or insured and included in the "products- 2782.05 for your sole liability; or completed operations hazard". (2) You are required by contract or However, Paragraph 1. above is subject to the agreement to provide for such addi- following: tional insured. a. The insurance afforded to the additional We have no duty to defend or indemnify the insured only applies to the extent permit- additional insured under this endorsement un- ted by law; til a claim or "suit" is tendered to us. ©, Copyright, State Farm Mutual Automobile Insurance Company, 2013 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. CONTINUED 92-EX-5166-6 017777 CMP-4786.1 Page 2 of 2 2. Any insurance provided to the additional in- (3) The nature and location of any injury sured shall only apply with respect to a claim or damage arising out of the "occur- made or a "suit" brought for damages for rence" or offense; which you are provided coverage. b. Tender the defense and indemnity of any 3. With respect to the insurance afforded to the claim or "suit" to us and to all other insur- additional insured, the following is added to ers who may have insurance potentially SECTION II — LIMITS OF INSURANCE: available to the additional insured, and If coverage provided to the additional insured c. Agree to make available any other insur- is required by contract or agreement, the most ante the additional insured has for de- we will {ray on behalf of the additional insured fense or damages for which we would will be the lesser of the amount of insurance: provide coverage under SECTION II — a. Required by the contract or agreement; or LIABILITY. b. Available under the applicable Limits Of 5. With respect to the insurance afforded the ad- Insurance shown in the Declarations. ditional insured, the following replaces SEC- TION II —LIABILITY of Paragraph 7. Other This endorsement shall not increase the ap- Insurance of SECTION I AND SECTION II — plicable Limits Of Insurance shown in the COMMON POLICY CONDITIONS: Declarations. a. This insurance is primary to and will not 4. With respect to the insurance afforded to the seek contribution from any other insurance additional insured, the following is added to available to the additional insured, provided Paragraph 3. Duties In The Event Of Occur- that the additional insured is a named in- rence, Offense, Claim Or Suit of SECTION sured under such other insurance. II — GENERAL CONDITIONS: b. Regardless of any agreement between The additional insured must: you and the additional insured, this insur- ance is excess over any other insurance a. See to it that we are notified as soon as whether primary, excess, contingent or on practicable of an "occurrence" or an of- any other basis for which the additional in- fense which may result in a claim. To the sured has been added as an additional in- extent possible, notice should include: sured on other policies. (1) How, when and where the "occur- There will be no refund of premium in the event rence" or offense took place; this endorsement is cancelled. (2) The narnes and addresses of any in- jured parsons and witnesses; and All other policy provisions apply. CMP-4786 1 m, Copyright, State Farm Mutual Automobile Insurance Company,2013 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Stater` 92-EX-5166-6 017778 CMP-4757 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY CMP-4787 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM f SCHEDULE s Policy Number: 92-EX-5166-6 cno Named Insured: WESTERN A/V INC 1592 N BATAVIA ST STE 2 ORANGE CA 92867-3554 Name And Address Of Person Or Organization: CITY OF MENIFEE AND ITS OFFICERS EMPLOYEES AGENTS& AUTH&IZED VOLUNTEERS 29844 HAUN RD MENIFEE CA 92586 The following is added to Paragraph 10.b. of SECTION I AND SECTION II — COMMON POLICY CONDITIONS: We waive any right of recovery we may have against the person or organization shown in the Schedule because of payments we make for injury or damage arising out of: a. Your ongoing operations; or b. "Your work" done under contract with that person or organization and included in the "products- completed operations hazard". This waiver applies only to the person or organization shown in the Schedule. All other policy provisions apply. CMP-4787 ©,Copyright,State Farm Mutual Automobile Insurance Company,2008 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. 92-EX-5166-6 017778