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2021/05/27 Roger K. Kobata Associates, Inc.5tateFarm 0 S L6 0 0 STATE FARM GENERAL INSURANCE COMPANY A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS RENEWAL DECLARATIONS R%haidn9TX 75085 3925 Policy Number 92-84-1995-6 Addl Insured -Section II Only Policy Period Effective Data Expiration Date AT2 M-23-7993-FA2D F U 12 Months MAY 27 2021 MAY 27 2022 004181 3125 The poll y period begins and ends at 12:01 am standard CITY OF MENIFEE time at a premisesTacalion. 29714 HAUN RD MENIFEE CA 92586-6540 - - Named Insured ROGER K KOBATA & ASSOCIATES INC 15417 CORNET ST SANTA FE SPGS CA 90670-5533 Office Policy U Automatic Renewal - If the policy period is shown 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 Mortgagee/Lienholder written notice in compliance with the policy provisions or as required by law. Entity: Corporation NOTICE: Information concerning changes in your policy language is included. Please call your agent if you have any questions. POLICY PREMIUM Discounts Applied: Renewal Year Years in Business Claim Record $ 537.00 Prepared MAR 15 2021 O Copyright, State Farm Mutual Automobile Insurance Company, 2000 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 025577 294 Al Continued on Reverse Side of Page N Page 1 of 7 avn.ens n 7 06.,Ai-m1 L.1mgi,1 RENEWAL DECLARATIONS (CONTINUED) Office Policy for CITY OF MENIFEE Policy Number 92-84-1995-6 �,E T ON 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 002 15417 CORNET ST No Coverage $ 10,400 25% SANTA FE SPRINGS CA 90670-553 * As of the effective date of this policy, the Limit of Insurance as shown includes any increase in the limit due to Intlation Uoverage. SECTION I - INFLATION COVERAGE INDEXES) Cov A - Inflation Coverage Index: Cov B - Consumer Price Index: SECTION I - DEDUCTIBLES N/A 261.6 Basic Deductible $1,000 Special Deductibles: Money and Securities $250 Employee Dishonesty $250 Equipment Breakdown $1,000 Other deductibles may apply - refer to policy. Prepared MAR 15 2021 © Copyright, State Farm Mutual Automobile Insurance Company, 2000 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 025577 Continued on Next Page Page 2 of 7 RENEWAL DECLARATIONS (CONTINUED) Office Policy for CITY OF MENIFEE Policy Number 92-84-1995-6 R, SE TI N - EXTENSIONS OF COVERAGE - LIMIT OF INSURANCE - EACH DESCRIBED PREMISES 0 0 q 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, N 0 but has "Included" indicated, please refer to that policy provision for an explanation of that coverage. LIMIT OF COVERAGE INSURANCE Accounts Receivable On Premises $50,000 Off Premises $15,000 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 $5,000 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 MAR 15 2021 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 025578 294 Continued on Reverse Side of Page Page 3 of 7 N RENEWAL DECLARATIONS (CONTINUED) Office Policy for CITY OF MENIFEE Policy Number 92-84-1995-6 Ordinance Or Law - Equipment Coverage Included Outdoor Property $5,000 Personal Effects (applies only to those premises provided Coverage B - Business $5,000 Personal Property) Personal Property Off Premises $15,000 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 $2,500 Unauthorized Business Card Use $5,000 Valuable Papers And Records On Premises $50,000 Off Premises $15,000 ,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 Dependent Property - Loss Of Income Employee Dishonesty Utility Interruption - Loss Of ''Income Loss Of Income And Extra Expense LIMIT OF INSURANCE $5,000 $10,000 $10,000 Actual Loss Sustained - 12 Months Prepared MAR 15 2021 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 025578 Continued on Next Page Page 4 of 7 xarerarm A RENEWAL DECLARATIONS (CONTINUED) Office Policy for CITY OF MENIFEE Policy Number 92-84-1995-6 Lai SECTION 11- LIAPILITY - 0 0 $ LIMIT OF 0 COVERAGE INSURANCE Coverage L - Business Liability $1,000,000 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 Excluded General Aggregate $2,000,000 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 ENQQRSEMENTS CMP-4101 Businessowners Coverage Form FE-6999.3 *Terrorism Insurance Cov Notice CMP-4786.1 Addl Insd Owners Lessee Sched CMP-4845 Excl Product Comp Operatn Liab CMP-4819.1 Unauthorized Business Card Use CMP-4698 Back -Up of Sewer or Drain CMP-4704.1 Dependent Prop Loss of Income CMP-4710 Employee Dishonesty CMP-4709 Money and Securities CMP-4703.1 Utility Interruption Loss Incm CMP-4705.2 Loss of Income & Extra Expense CMP-4787 Waiver of Trans Rgt of Recov CMP-4260.1 Amendatory Endorsement -CA Prepared MAR 15 2021 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission, 025579 294 Continued on Reverse Side of Page N Page 5 of 7 RENEWAL DECLARATIONS (CONTINUED) Office Policy for CITY OF MENIFEE Policy Number 92-84-1995-6 CMP-4261 Amendatory Endorsement FD-6007 Inland Marine Attach Dec * 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. *nl-g- M , 4OW004" 6044 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: Stale 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 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 wwJn ur nce.ca ovf0 -rQmumers Prepared MAR 15 2021 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 025579 Continued on Next Page Page 6 of 7 Jtd1Vrann RENEWAL DECLARATIONS (CONTINUED) Office Policy for CITY OF MENIFEE Policy Number 92-84-1995-6 NOTICE TO POLICYHOLDER: For a comprehensive description of coverages and forms, please refer to your policy. Policy changes requested before the "Date Prepared", which appear on this notice, are effective on the Renewal Date of this policy unless otherwise indicated by a separate endorsement, binder, or amended declarations. Any coverage $ forms attached to this notice are also effective on the Renewal Date of this policy. Policy changes requested after the "Date Prepared" will be sent to you as an amended declarations or as an endorsement to your policy. Billing for any additional premium for such changes will be mailed at a later date. If, during the past year, you've acquired any valuable property items, made any improvements to insured property, or have any questions about your insurance coverage, contact your State Farm agent. Please keep this with your policy. Prepared MAR 15 2021 CMP-4000 025580 294 N (D Copyright, State Farm Mutual Automobile Insurance Company, 2008 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7 of 7 92-84-1995-6 025580 srarerarm STATE FARM GENERAL INSURANCE COMPANY ❑ Al A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS INLAND MARINE ATTACHING DECLARATIONS Policy Number 92-84-1995-6 RC 9rarolson 'TX 750&5-3925 Named Insured M-23-7993-FA2D F U ROGER K KOBATA & ASSOCIATES INC Y. 15417 CORNET ST SANTA FE SPGS CA 90670-5533 5 ATTACHING INLAND MARINE Policy Period Effective Date Expiration Date 12 Months MAY 27 2021 MAY 27 2022 The poll y period begins and ends at 12:01 am standard time atge 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 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-8739 Inland Marine Conditions FE-6271 Amendatory Endorsement FE-8745 Inland Marine Computer Prop See Reverse for Schedule Page with Limits Prepared MAR 15 2021 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 FD-6007 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 025581 530-506 a.2 05-31-2611 1o113232cI 92-84-1995-6 ATTACHING INLAND MARINE SCHEDULE PAGE ATTACHING INLAND MARINE ENDORSEMENT LIMIT OF DEDUCTIBLE NUMBER COVERAGE INSURANCE AMOUNT FE-8745 Inland Marine Computer Prop $ 25,000 $ 500 Loss of Income and Extra Expense $ 25,000 Prepared MAR 15 2021 FD-6007 025581 OTHER L►MITS AND EXCLUSIONS MAY APPLY - REFER TO YOUR POLICY © Copyright, State Farm Mutual Automobile Insurance Company, 2008 Includes copyrighted material of Insurance Services Office, Inc., with its permission. ANNUAL PREMIUM Included Included 630-6060.2 05-31-2011 laif3233c1