Loading...
2019/05/16 Western A/V, Inc. Insurance Declarations (3)STATE FARM GENERAL INSURANCE COMPANY A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS DECLARATIONS COVERAGE SUMMARY DEC 31 201 StateFarn- A 8 R� haZZO 6 75085-3925 Addl Insured -Section II Only M-23-3535-FI38A F Z 001514 3123 CITY OF MENIFEE AND ITS OFFICERS, EMPLOYEES, AGENTS & AUTHORIZED VOLUNTEERS 29844 HAUN RD MENIFEE CA 92586-6539 �1��1�1�11�11�"I�I�'11��1�111�1111�1�111�11��11�11�11�1��'�I�"� Policy Number 92-EX-5166-6 Policy Period Effective Date Expiration Date 12 Months MAY 16 2019 MAY 16 2020 The poll y period begqins and ends at12:01 am standard time at a premises location. Named Insured WESTERN A/V INC 1592 N BATAVIA ST STE 2 ORANGE CA 92867-3554 Home Product Sales Policy 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 policv provisions or as reauired by law. Entity: Corporation Policy Premium Discounts Applied: Protective Devices $ 13,675.00 Prepared DEC 31 2019 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 014666 290 Al Continued on Reverse Side of Page N Page 1 of 7 530-666 0.2 05 31-2611 1o1132310 StateFarm A. DECLARATIONS (CONTINUED) Home Product Sales Policyy for CITY OF MENIFEE Policy Number 92-EX-5166-6 Employee Dishonesty $250 Equipment Breakdown L WME Other deductibles may apply - refer to policy. $2,500 0 SECTION I - EXTENSIONS OF COVERAGE - LIMIT OF INSURANCE - EACH DESCRIBED PREMISES �o 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 Fire Department Service Charge Fire Extinguisher Systems Recharge Expense Forgery Or Alteration Glass Expenses Increased Cost Of Construction And Demolition Costs (applies only when buildings are insured on a replacement cost basis) Money And Securities (Off Premises) Money And Securities (On Premises) Money Orders And Counterfeit Money Prepared DEC 31 2019 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 014667 290 Continued on Reverse Side of Page N Included $2, 500 $5,000 $10,000 Included 10% See Schedule See Schedule $1,000 Page 3 of 7 Li StateFarm 4_ DECLARATIONS (CONTINUED) Home Product Sales Policy for CITY OF MENIFEE Policy Number 92-EX-5166-6 Accounts Receivable (Off Premises) ra Back -Up Of Sewer Or Drain Money And Securities (Off Premises) Money And Securities (On Premises) Outdoor Property Property Of Others (applies only to those premises provided Coverage B - Business Personal Property) Signs in Valuable Papers and Records (On Premises) Valuable Papers and Records (Off Premises) SECTION.. I - EXTENSIONS OF COVERAGE --LIMIT QF INSURANCE - PER „POLICY $5,000 $15,000 $5,000 $10,000 $5,000 $2,500 $5,000 $10,000 $5,000 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 Loss Of Income And Extra Expense SECTION 11- DEDUCTIBLES LIMIT OF INSURANCE $5,000 $50,000 $5,000 $10,000 $1,000 12 months $35,000 $5,000 $10,000 Actual Loss Sustained - 12 Months Business Liability - Property Damage $1,000 Other deductibles- may apply - refer to policy. Prepared DEC 31 2019 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 014668 290 Continued on Reverse Side of Page Page 5 of 7 N StateFarm A� DECLARATIONS (CONTINUED) Home Product Sales Policy for CITY OF MENIFEE Policy Number 92-EX-5166-6 CMP-4839 CMP-4786.1 CMP-4787 CMP-4610 FD-6007 Loss Payable Addl Insd Owners Lessee Sched Waiver of Trans Rgt of Recov General Agg Limit Per Proj Inland Marine Attach Dec 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-� 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 Los Angeles, CA 90013 Phone # 1-800-927-HELP (4357) or visit www.insurance.ca.aov101-consumers Prepared DEC 31 2019 CMP-4000 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 014669 290 N Page 7 of 7 STATE FARM GENERAL INSURANCE COMPANY (: A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS INLAND MARINE ATTACHING DECLARATIONS Ric °x 8639?� �sos5 ss25 Policy Number 92-EX-5166-6 A" tardson, Named Insured Policy period Effective Dare Expiration Date M-23-3535-FI38A F Z 12 Months MAY 16 2_019 MAY 16 2020 The poll y period begins and ends at 12:01 am standard WESTERN A/V INC time at a premises locabon. 1592 N BATAVIA ST STE 2 ORANGE CA 92867-3554 RR 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 Declarabons- 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 subsequent to 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 DEC 31 2019 (V Copyright, State Farm Mutual Automobile Insurance Company, 2008 FD-6007 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 014670 530-888 a.2 05-31-2011 WH232c) StateFarm 92-EX-5166-6 014671 CMP-4786.1 ❑ 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 8 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 & AUTHORED VOLUNTEERS 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 dams personal and adverbs- p damage", or " that which you are required by the contract , ing injury' caused, in whole or in part, by: or agreement to provide for such addition- al insured; and a. Ongoing Operations 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 in the performance of your ongoing opera- additional insured is the lesser of that which: tions for that additional insured; or b. Products — Completed Operations (1) Is allowed for the satisfaction of a de- 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 StateFarm 92-EX-5166-6 014672 CMP-4787 � a 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 SCHEDULE q Policy Number: 92-EX-5166-6 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 AGENTS & AUTHOF ZED VOLFFIERS UNYEERS 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 worku 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 Q, Copyright, State Farm Mutual Automobile Insurance Company, 2008 Includes copyrighted material of Insurance Services Office, Inc., with its permission.