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2020/09/25 Dent Knowledge Renewal DeclarationStateFarm A. STATE FARM GENERAL INSURANCE COMPANY A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS RENEWAL DECLARATIONS Richardson 9TX 75085-3925 Addl Insured -Section II Only AT2 002045 3125M-12-1112-FA59 F N CITY OF MENIFEE AND ITS OFFICERS, EMPLOYEES, AGENTS r: AND AUTHORIZED VOLUNTEERS 29714 HAUN RD MENIFEE CA 92586-6540 o'll�lll�l""II'�II�'IIIIIII�I.I"�..I"IIIII'I'I�II�II�III"��I� 0 S Auto Services Policy Policy Number 90-EN-B987-0 Policy Period Effective Date Ex 1 ation Data 12 Months SEP 25 2020 S�P 25 2021 The poll y period begins and ends at 12:01 am standard time atZ premises location. Named Insured ROUSE, TRAVIS DHA DENT KNOWLEDGE 8696 ORCHARD PARK DR RIVERSIDE CA 92508-2975 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/Lien holder written notice in compliance with the policy provisions or as required by law. Entity: Individual NOTICE: Information concerning changes in your policy language is included. Please call your agent if you have any questions. POLICY PREMIUM Discounts Applied: Years in Business $ 603.00 Prepared JUL 13 2020 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 012988 294 Al Continued on Reverse Side of Page N Page 1 of 7 536-666 a.2 05-31-2611 1o1r32310 I RENEWAL DECLARATIONS (CONTINUED) Auto Services Policy for CITY OF MENIFEE AND ITS Policy Number 90-EN-8987-0 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 8696 ORCHARD PARK DR No Coverage $ 5,100 25% RIVERSIDE CA 92508-2975 * 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: Cov B - Consumer Price Index: SECTION I - DEDUCTIBLES Basic Deductible $1,000 Special Deductibles: Money and Securities $250 Garagekeepers - Comprehensive $250 Equipment Breakdown $1,000 Other deductibles may apply - refer to policy. N/A 258.7 Garagekeepers - Collision $500 Employee Dishonesty $250 Prepared JUL 13 2020 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 012988 Continued on Next Page Page 2 of 7 StateFarm RENEWAL DECLARATIONS (CONTINUED) Auto Services Policy for CITY OF MENIFEE AND ITS Policy Number 90-EN-B987-0 ow. SECTION I - EXTENSIONS OF COVERAGE - LIMIT OF INSURANCE - EACH DESCRIBED PREMISES 0 6 4 The coverages and corresponding limits shown below apply separately to each described premises shown in these (0 Declarations, unless indicated by "See Schedule." If a coverage does not have a corresponding limit shown below, N but has "Included" indicated, please refer to that policy provision for an explanation of 0 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 Employee Tools (applies only to those premises provided Coverage B - Business Personal Property) Per Occurrence $2,500 Per Employee $500 Equipment Breakdown Included Fire Department Service Charge $5,000 Fire Extinguisher Systems Recharge Expense $5,000 Forgery Or Alteration $10,000 Garagekeeper's Insurance - Comprehensive And Collision $25,000 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 Prepared JUL 13 2020 © Copyright, State Farm Mutual Automobile Insurance Company, 2000 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc„ with its permission. 012989 294 Continued on Reverse Side of Page N Page 3 of 7 RENEWAL DECLARATIONS (CONTINUED) Auto Services Policy for CITY OF MENIFEE AND ITS Policy Number 90-EN-6987-0 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) 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 $15,000 Pollutant Clean Up And Removal $20,000 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 C VERA E - LIMIT QF IN URANC - 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 Employee Dishonesty Loss Of Income And Extra Expense LIMIT OF INSURANCE $10,000 Actual Loss Sustained - 12 Months Prepared JUL 13 2020 Q Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 012989 Continued on Next Page Page 4 of 7 StateFarm C° RENEWAL DECLARATIONS (CONTINUED) a Auto Services Policy for CITY OF MENIFEE AND ITS Policy Number 90-EN-B987-0 SECTION 11- DEDUCTIBLES Business Liability - Property Damage $250 Other deductibles may apply - refer to policy. SECTION Il - 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-4260.1 "Amendatory Endorsement -CA FE-6999.2 *Terrorism Insurance Cov Notice CMP-4412 Operation of Customers Auto CMP-4827.1 Employee Tool Coverage CMP-4261 Amendatory Endorsement Prepared JUL 13 2020 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 012990 294 Continued on Reverse Side of Page Page 5 of 7 N RENEWAL DECLARATIONS (CONTINUED) Auto Services Policy for CITY OF MENIFEE AND ITS Policy Number 90-EN-13987-0 CMP-4705.2 Loss of Income & Extra Expense CMP-4710 Employee Dishonesty CMP-4709 Money and Securities CMP-4470 Garagekeepers Direct Coverage CMP-4698 Back -Up of Sewer or Drain CMP-4857 Actual Cash Value Contents CMP-4742.1 Garage Liability CMP-4860.1 Al Design Person Org 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. �m C4 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 reach a satisfactory agreement on a problem, California Department of Insurance Consumer Services Division 300 South Spring Street Lou Art}r.ies, CA 90013 Rhode P i-iwo-921-HELP (4357) or visit vuwW.irtsrriMice .Ca.c of vMIn_rlirleus Prepared JUL 13 2020 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 012990 Continued on Next Page Page 6 of 7 RENEWAL DECLARATIONS (CONTINUED) Auto Services Policy for CITY OF MENIFEE AND ITS Policy Number 90-EN-13987-0 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 pclicy. 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 fo.r 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 JUL 13 2020 CMP-4000 012991 294 N Cc Copyright, State Farm Mutual Automobile Insurance Company, 2008 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7 of 7 90-E N-B987-0 012991 StateFarm A, STATE FARM GENERAL INSURANCE COMPANY A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS INLAND MARINE ATTACHING DECLARATION Policy Number 90-EN-B987-0 0 Ro !3a ason 9f 75085-3925 Named Insured M-12-1112-FA59 F N ROUSE, TRAVIS DBA DENT KNOWLEDGE 8696 ORCHARD PARK DR RIVERSIDE CA 92508-2975 ATTACHING INLAND MARINE Policy Period Effective Date Expiration Date 12 Months SEP 25 2020 SEP 25 2021 The policpy period be ins and ends at 12:01 am standard time atthe 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/Lien holder 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 JUL 13 2020 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 FD-6007 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 012992 530-09e a.2 05-31-2011 Io1f3232c1 90-E N-B987-0 ATTACHING INLAND MARINE SCHEDULE PAGE ATTACHING INLAND MARINE ENDORSEMENT NUMBER COVERAGE FE-8745 Inland Marine Computer Prop Loss of Income and Extra Expense Prepared JUL 13 2020 FD-6007 LIMIT OF INSURANCE 25,000 25,000 DEDUCTIBLE AMOUNT $ 500 OTHER LIMITS AND EXCLUSIONS MAYAPPLY - REFER TO YOUR POLICY © Copyright, State Farm Mutual Automobile Insurance Company, 20D8 Includes copyrighted material of Insurance Services Office, Inc., with its permission. ANNUAL PREMIUM Included Included 012992 530-666 u.2 05-31-2611 Io1F3233cI