Loading...
2020/10/31 Western A/V, Inc. Declaration Amended Jan 28, 2021i STATE FARM GENERAL INSURANCE COMPANY A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS DECLARATIONS AMENDED JAN 28 2021 POkK, 8sor.rfl"' RAC ,5k 75085-3925 Addl Insured -Section II Only M-23-3535-FB8A F Z 003092 3123 CITY OF MENIFEE AND ITS OFFICERS, EMPLOYEES, AGENTS & AUTHORIZED VOLUNTEERS 29844 HAUN RD MENIFEE CA 92586-6539 Home Product Sales Policy Policy Number 92-GY-D812-0 Policy Period Effective Date Expiration Date 12 Months OCT 31 2020 OCT 31 2021 The poll y period begins and ends at 12:01 am standard time at a premises location. Named Insured WESTERN A/V INC 1592 N BATAVIA ST STE 2 ORANGE CA 92867-3554 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. Entity: Corporation Reason for Declarations: Your policy is amended JAN 28 2021 ADDITIONAL INSURED ADDED PREMIUM ADJUSTMENT FORM CMP-4786.1 ADDED Other items shown are effective with the policy's 2020 renewal Endorsement Premium Increase $ 88.00 Discounts Applied: Renewal Year Years in Business Protective Devices Claim Record Prepared FEB 23 2021 (D Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 027466 290 Al Continued on Reverse Side of Pago N Page 1 of 7 Fan-nse o 9 ne-%i--)mi i. puni,% DECLARATIONS (CONTINUED) Home Product Sales Policyy for CITY OF MENIFEE Policy Number 92-GY-D812-0 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 001 1592 N BATAVIA ST STE 2 No Coverage $ 248,400 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. E T N I- INFLATION COVERAGE INDEX ES Cov A - Inflation Coverage Index: Cov B - Consumer Price Index: N/A 260.3 SECTION I --DEDUCTIBLES Basic Deductible $2,500 Special Deductibles: Money and Securities $250 Data Compromise $1,000 Employee Dishonesty $250 Equipment Breakdown $2,500 Other deductibles may apply - refer to policy. Prepared FEB 23 2021 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 027466 Continued on Next Page Page 2 of 7 �StateFart DECLARATIONS (CONTINUED) Home Product Sales Policy for CITY OF MENIFEE Policy Number 92-GY-D812-0 E 1 SECTION 1 - EXTENSIONS OF COVERAGE - LIMIT OLINSURANCE - EACH DESCRIBED PREMISES s 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, �o but has "Included" indicated, please refer to that policy provision for an explanation of that coverage. LIMIT OF COVERAGE INSURANCE Accounts Receivable On Premises $10,000 Off Premises $5,000 Arson Reward $5,000 Back -Up Of Sewer Or Drain $15,000 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) $5,000 Money And Securities (On Premises) $10,000 Money Orders And Counterfeit Money $1,000 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) Prepared FEB 23 2021 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 027467 290 Continued on Reverse Side of Page Page 3 of 7 N DECLARATIONS (CONTINUED) Home Product Sales Policy for CITY OF MENIFEE Policy Number 92-GY-D812-0 Ordinance Or Law - Equipment Coverage Included Outdoor Property $5,000 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 $2,500 Personal Property) Signs $5,000 Valuable Papers And Records On Premises $10,000 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. COVERAGE Data Compromise Legal And Forensic Information Technology Review Per Occurrence Dependent Property - Loss Of Income Employee Dishonesty Identity Restoration Other Expenses Case Management Services Per Occurrence Lost Wages And Supervision Expenses Utility Interruption - Loss Of Income Prepared FEB 23 2021 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 027467 Continued on Next Page LIMIT OF INSURANCE $5,000 $50,000 $5,000 $10,000 $1,000 12 months $35,000 $5,000 $10,000 Page 4 of 7 DECLARATIONS (CONTINUED) Home Product Sales Policy for CITY OF MENIFEE Policy Number 92-GY-D812-0 Loss Of Income And Extra Expense Actual Loss Sustained - 12 Months M g SECTION II - DEDUCTIBLES w _ - 0 �o Business Liability - Property Damage $1,000 Other deductibles may apply - refer to policy. SECTION 11 - 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 reduces 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-4786.1 *Addl Insd Owners Lessee Sched CMP-4787 *Waiver of Trans Rgt of Recov FE-6999.2 Terrorism Insurance Cov Notice Prepared FEB 23 2021 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 027468 290 Continued on Reverse Side of Pago N Page 5 of 7 DECLARATIONS (CONTINUED) Home Product Sales Poll cyy for CITY OF MENIFEE Policy Number 92?6Y-D812-0 CMP-4260.1 Amendatory Endorsement -CA CMP-4261 Amendatory Endorsement CMP-4705.2 Loss of Income & Extra Expense CMP-4710 Employee Dishonesty 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 CMP-4610 General Agg Limit Per Proi CMP-4746.1 Hired Auto Liability CMP-4990.1 Identity Restoration Coverage CMP-4994 Data Compromise CMP-4875 Loss Payable FD-6007 Inland Marine Attach Dec NOTICE: INFORMATION CONCERNING CHANGES IN YOUR POLICY LANGUAGE IS INCLUDED. PLEASE CALL YOUR AGENT IF YOU HAVE ANY QUESTIONS. " New Form Attached 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. *n111t_ 1 Secretary President Prepared © FEB 23 2021 Copyright, State Farm Mutual Automobile Insurance Company, 2000 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc„ with its permission. 027468 Continued on Next Page Page 6 of 7 StateFarm Aw DECLARATIONS (CONTINUED) Home Product Sales Policy for CITY OF MENIFEE Policy Number 92-GY-13812-0 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: g State Farm Executive Customer Service 0 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 reach 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) or visit www.inaurance.ca.stovf0l-consumers Prepared FEB 23 2021 CMP-4000 027469 290 N © Copyright, State Farm Mutual Automobile Insurance Company, 2008 Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 7 of 7 92-GY-DB12-0 027469 StateFarm STATE FARM GENERAL INSURANCE COMPANY J A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS INLAND MARINE ATTACHING DECLARATIONS Policy Number 92-GY-D812-0 RJ Pard8o9394 75085-3925 Named Insured M-23-3535-1`68A F Z WESTERN A/V INC 1592 N BATAVIA ST STE 2 ORANGE CA 92867-3554 S 0 0 �o ATTACHING INLAND MARINE Policy Period Effective Date Expiration Date 12 Months OCT 31 2020 OCT 31 2021 The poll y period begins and ends at 12:01 am standard time at a premises location. 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 Amountis 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-8739 Inland Marine Conditions FE-6271 Amendatory Endorsement FE-8745 Inland Marine Computer Prop See Reverse for Schedule Page with Limits Prepared FEB 23 2021 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 FD-6007 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 027470 530-666 o.2 05-31-2011 (W32320 92-GY-D812-0 ATTACHING INLAND MARINE SCHEDULE PAGE ATTACHING INLAND MARINE ENDORSEMENT LIMIT OF DEDUCTIBLE ANNUAL NUMBER COVERAGE INSURANCE AMOUNT PREMIUM PE-8745 Inland Marine Computer Prop S 25,000 S 500 Included Loss of Income and Extra Expense S 25,000 Included Prepared FEB 23 2021 FD-6007 027470 OTHER LIMITS AND EXCLUSIONS MAY APPLY -REFER TO YOUR POLICY O Copyright, State Farm Mutual Automobile Insurance Company, 2008 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 530-686 e 2 05-31-2011 (o1F3233c)i