2022/10/31 Western A/V, Inc. (24)StateFarm STATE FAFI' GENEFAL IIISUFANCE COiIPANY
A STOCK COMPANY WI|H HOME OFFICES IN BLOOMINGTON. ILLINOIS&
E?oEPi fr?|i,, u,, o,. r', o
Addl lnsured-Sectlon ll Only
DECLABATIONS AMENDED t\4AR 1 2023
Policyllumber 92-GY-D812{
Pollcv Period Ellectivo Dale Exoiralion Dals
12 Mbnths OCr 31 2022 OCT 31 2023
The polipy period beoins and ends at 12:01 am standard
tme atl'le premlses l0caton
Nam€d lnsurod
HESTERil A./V INC
!
M-23.61F8.F88A F Z
H.,iGffi
002789 3123
CITY OF IIEN I FEE
AND ITS OFFICERS, EI{PLOYEES,
AGENTS & AUTHORIZED VOLUNTEERS
?9864 HAUII RD
I'tEr{ rFEE CA 9?546-6539
ilrlI
'
rlltr, ril tlil,Itrt,l,,ilil 1,ll,rilr,h [,ltrllrt,rltlr,il
Home Product Sales Policy
-E
Automalic Re nrwal , ll the policy pcrlod is shown as 12 months , this policy will be renewed automatcally subiect to $e premiums, rules and
forms in effectfor each sucLeedin! policy period. lf tris policy is terminated, we will give you and tre Mortgagee/Lienholder written notice in
compliance wifi fre policy pr ovisions or as required by law
Entity: Corporation
Heason tor Declaratlons: Your policy is amended MAR 1 2023
ADDITIONAL INSURED ADDED
PREMIUM ADJUSTMENT
FORM CMP.4786.1 ADDED
Endorsement Premium
lncrease
Discou nts Applied:
Renewal Year
Years in Business
Enclosed Building
Protective Devices
Sprinkler
Claim Becord
$ 44.00
Prepared
FEB 15 2023
cMP-4000
022518 290 Ar
N
O Copyri!h! St ts t.rm MutunlAutomobils lnsur.nc! Comp.ny,2008
lnclud€! cowrioht€d mrtsri.l of lnsursnco Servicss offiEo, lnc., with its pormission
Continued on Reverse Side of Page Page l ot 7
Home Product Sales Policv
Pollcy Number 92-G
DECLABATIONS (CONTINUED)
,or CITY OF MENIFEE
Y-D812.0
SECTION I - PROPEBTY SCHEDULE
Location
Numbo.Llmlt o, lnsuran@'
Coveraoe A -
Bulldfngs
Limll ol lnsurance'
Coveraoe B -
Buslness Personal
Proporty
Seasonal
lncrease-
Business
Personal
Property
001
002
1592 N BATAVIA ST STE 2
oRANGE CA 92867-3554
1590 N BATAVIA ST STE 4
oHANGE CA 92867-3534
No Coverage
No Coverage
$ 141,100
$ 140,900
'As the ate of t m o nsurance as own nc udes any ncrease in the limit eto tion overa9e.cy
SECTION I - INFLA TION COVERAGE INDEX(ES)
Cov A - lnflation Coverage lndex
Cov B - Consumer Price lndex:
N/A
296.3
SECTION I. DEOU LES
Baslc D6duc{ible
Spoclal Deductibles:
Money and $curities
$2,500
$2so Data Compromise
@ Copyriohl Sllte F!rm Muturl Automobilo lneuranco Compuy, 2m
lnclud!r copyri0htod mltorill ol lniur!ncB Sorvicsr Oflic0, lnc., with its porristion.
Continued on Next Page
s1,000
Prepared
FEB 15 2023
cMP-4000
022518 Page 2ol 7
Locatlon of
Descrlb6d
Prsmlses
25o/.
25v"
ll StateFatm(-dD
ll;lktift
Home Product Sales Policv
Policy Number 92-G
DECLARATIONS (CONTINUED)
for CITY OF MENIFEE
Y-O812-0
Employee Dishonesty $250 Equipment Breakdown $2,500
SECTION I - EXTENSIONS OF COVERAGE - LIMIT OF INSUBANCE. EACH DESCRIBED FEMISES
f;i8
COVERAGE
Accounts Receivable
On Premises
Ofl Pr6mises
Arson Reward
Back-Up Of Sewer Or Drain
Collapse
Damage To Non-Owned Buildings From Theft, Burglary Or Robbery
Debris Removal
Equipment Breakdown
Fire Department Service Charge
Fire Extinguisher Systems Recharge Expense
Forgery Or Alteration
Glass Expenses
lncreased Cost Ol 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)
lVloney Orders And Counterfeit lv'loney
LIMIT OF
INSURANCE
See Schedule
See SchEdule
$5,000
See Schedule
lncluded
Coverage B Limit
257" ol covered loss
lncluded
$2,500
$5,000
$10.000
lncluded
10y"
See Schedule
See Schedule
$1,000
Prepared
FEB 15 2023
cMP-4000
c copyright strto t6rm Mutu!lAutomobib lnsur.no€ Company,2008
lnclud0r copyrightsd mltoriEl of lnsurinre Sorvio.s offi06, lnc, with ils pormission
Continued on Reverse Side of Page022519 290
N
Page 3 ol 7
!
Other deductibles may apply - reter to policy.
The coverages and correspondlng limlts shown bolow apply soparately to each describ€d premises shown in these
Declarationa, unloss hdicatsd by-'See Schedule." lf a coverago does not have a corr€spondlng limit shown below,
but has "lncluded" indlcated, pl6as€ reler to that pollcy provision to, an oxplanatlon ol that coveiage.
?
l
3
;!
Home Product Sales Pollcv
Policy Number 92-G
OECLABATIONS (CONTINUED)
Ior CITY OF MENIFEE
Y-D812-O
Newly Acquired Busin€ss Personal Property (appliES only if this policy provides
Coverage B - Business Personal Property)
Newly Acquir€d Or Constructed Buildings (applies only il this policy provides
Coverage A - Buildings)
Ordinance Or Law - Equipment Coverage
Outdoor Property
Personal Etfects (applies only to those premises provided Coverage B - Business
Personal Property)
Personal Property Otf Promis€s
Pollulant Clean Up And Removal
Preserva$on Ol Prop€rty
Property.Of Others (applies only to those premises provided Coverage B - Business
PErsonal Property)
Signs
Valuable Papers Ard Records
On Premises
Off Premises
$100,000
$250,000
lncluded
See Schedule
$2,500
$2s,000
$10,000
30 Days
See Schedule
See Schedule
See Schedule
See Schedule
SECTION I -EXTENSIONS OF COV ERAGE . LIMIT OF INSU RANCE - SCHEDULE
Tho coverages and corrgsponding limits shown below apply only to the descrlb€d premis€s as shown.
LOCATION
0001
Prepared
FEB 15 2023
ct\4P-4000
022519
COVERAGE
LIMIT OF
INSURANCE
Signs
Back-Up Ot Sewer Or Drain
Money And Securities (On Premises)
l\/oney And Securities (Of, Premises)
Properly Of Others (applies only to th
Personal Property)
Accounts Receivable (On Premises)
Accounts Fleceivable (Off Premises)
Outdoor Properly
Valuablo Papers and Records (On Premises)
Valuable Papers and Becords (Off Pramises)
0002 Accounts Receivable (On Premises)
ose premises provided Coverage B - Business
$5,ooo
$15,000
$10,000
$s,000
$2,500
$10,000
000
000
000
000
000
$10
$s
$5
$10
$5
O Copyright SrotB trrm Muturl Automobile lnlurrncs Comp.ny. ZO(E
lncludgs copyrightod matsrirl of lnsurrncs SsrvicB! oflice, Inc., wtth its p6rmiision
Continued on Next Page Page 4 of 7
StateFann !&
Home Product Sales Pollcv
Policy Numb€r 92-G
DECLABATIONS (CONTINUED)
for CITY OF MENIFEE
Y-D812-0
ffi
I
Accounts Receivable (Off Premises)
Back-Up Of Sewer Or Drain
Money And Socurities (Orf Premises)
Money And Socuritias (On Premisss)
Outdoor Prop€rty
Property Ol Olhers (applies only to those premises provided Coverage B - Business
Personal Property)
Signs
Valuable Papers and Records (On Premises)
Valuable Papers and Records (Off Premises)
$5,ooo
$15,000
$s,000
$10,000
$5,ooo
$2,s00
$s,000
$10,000
$5,ooo
SECTION I . EXTENSIONS OF COVFRAGF - I IMIT OF INSURANCE . PER POLICY
The coverages and cotroSpondlng llmlts shown below are the mosl we wlll pay .ogardless of the number ol
described premises shown ln those Dsclaratlons.
COVEBAGE
Data Compromise
Legal And Forensic lnlormalion Technology Review
Per Occurrence
Dependent Property - Loss Of lncome
Employee Dishonesty
ldentity Restoration
Other Expenses
Case Management Services
Per Occurrence
Lost Wages And Supervision Expenses
Utility lnterruption - Loss Ol lncome
Loss Of Income And Extra Expense
O Copyriohl Stlts Flrm l\4utu.l Automobil. lnsur.n0e CompinY.2008
lnclud6s copyrilhtod material of lnsrranco Soruices office, lnc.. with its permission
Continued on Reverse Side of Page
$5,000
$50,000
$5,000
$10,000
$1,000
1 2 months
$35,000
$s,000
$10,000
Actual Loss Sustained - 12 Months
Prepared
FEB 15 2023
cMP-4000
022520 290
N
Page 5 ol 7
LIMIT OF
INSURANCE
Home Product Sales Pollcv
Pollcy Number 92-G
DECLARATTONS (CONTTNUED)
'or
CITY OF MENIFEE
Y-D812.0
SECTION II . LIABILITY
COVERAGE
Coverage L - Business Liability
Coverage M - Medical Expenses (Any One Person)
Damage To Premises Rented To You
AGGFEGATE LII'ITS
Productyoompleted Operations Aggrogate
General Aggregate
LIMIT OF
INSUFANCE
$2,000,000
$s,000
$500,000
LIMIT OF
INSURANCE
$4,000,000
$4.000.000
Each paid claim for Liability Co_verags roduces the amount of insurance we provide during tho applicable
annual period. Please refer to Section ll - Liability in the Coverage Form and any attached endoidements.
Your policy consists of theso Doclaralions, the BUSINESSOWNERS COVERAGE FORM shown below, and any otherforms and endorsements that apply, including those shown below as well as those issuod subsequent to the
issuance ol this policy.
FOFMS AND NDORSEMENTS
cMP-4101
cMP-4786.1
cMP-4787
cMP-4260.1
cMP-4261
cMP-4705.2
cMP-4710
cMP-4709
cMP-4698
cMP-4704.1
ctvtP-4703.1
cMP-4610
cMP-4746.1
Businessowners Coverage Form
'Addl Insd Owners Lessee Sched
'Waiver of Trans Rgt of Recov
Amendatory EndorsomenfCA
Amendatory Endorsement
Loss of lncome & Extra Expsnse
Employee Dishonesty
Money and S€curities
Back-Up of Sewer or Drain
Dependent Prop Loss of lncome
Utility lnterruption Loss lncm
General Agg Limit Per Proj
Hired Auto Liability
Prepared
FEB 15 2023
cMP-4000
022520
O Copyrilht Srlte torm Mutull Automobilo ln!ur!nco Complny, Zm
lncludir copyrlghtrd mlt€ri!l of ln!ur!nc€ Servicss Offico, lnE., tvith i$ psrmi!!ion
Continued on Next Page Page 6 of 7
Il StateFann&
ti,rf;H#
Home Product Sal6s Pollcv
Pollcy Number 92-G
OECLABATIONS (CONTINUED)
Ior CITY OF MENIFEE
Y-D812-0
cMP-4990.1
cMP-4994
cMP-4875
FE-6999.3
Cl\ilP-4793.1
cMP.4788.1
FD-6007I
E
+9
This policy is issued by the State Farm General lnsurance Company,
Participating Policy
You ara entitled to participat€ in a distribution of the €arnings o, ths company as determined by our Board of Directors in
accordance with the Company's Articles ol lncorporation, as amended,
ln Witness Whereot, he State Farm General lnsurance Company has caused this policy to be signed by its President and
Secretary at Bloomington, lllinois
trry^W
s9Cretary
-il*e Ldq
President
IMPOFTANT NOTICE:
Caltromla bw ieqlrlrc! us to plovlde you wlth lnlomatlon ,o1 llllng cfiplolms whh tl|e Stote lnsurance lleponmen legsrdlng tlE
coverrge and servics pmvk{od undor this Policy.
your age||t! name and comsd lnlormalion ate provlded on tlE lIoI o{ thie docume . Another optlon is to leach out by
mailor phono dlroctly to!
stste FarrP Execultvs customel gcrYice
PO Box 23m
Bloomin$on lL 61702
Phone f l{oo-STATEFAFL (1-80G762"8332)
Depadment of lnsurrncs complslnt! should be liled only altel you alrd Slste Fam or your agpm o] olhet comPalry
rsrreentatfuo h{ve lallod to r..ch a s€tislaclory lgrsernent on a p,oblom.
Califomia Depsnment ol lnsulance
Comumer Eorvlcca DlYl3lon
300 South gprlng $rc€t
Los Anqrlca. CA 90013
Phone i l€oo€z7-HELP (/li!54 or yhil uxlY.inruBnce.co 'oov/01'coJrrrme ra
Prepared
FEB 15 2023
Cl\ilP-4000
O Copyrigh! Stlte Form Mutual Autoflobil. lnsurancs Company.2008
lncludes copyrighted moteri6l gf lnsu16rce S€rvices offico, lnc , with its p€rmissioi
022521 290
N
Page 7 ol 7
ldentity Restoration Coverage
Data Compromise
Loss Payable
Tenorism lnsurance Cov Notice
Al State Political Perm Prem
Addl lnsd Mgrs Lessor of Prem
lnland Marine Attach Dec
NOTICE: INFORMATION CONCERNING
CHANGES IN YOUR POLICY
LANGUAGE IS INCLUDED. PLEASE
CALL YOUR AGENT IF YOU HAVE
ANY OUESTIONS,
* New Form Attached
StateFam STATE FAFM GENERAL INSUAA CE COMPANY
A STOCK COMPANY WI|H HOME OFFICES IN BLOAMNATON. ILLINOIS
E?oEPi &11i,, u, ror" r', o
Named lnsured
M-23-61F8-FB8A F Z
WESTERN A/V INC
ATTACHING INLAND MARINE
u
INLAND MARINE ATTACHING DECLARATIONS
Policyl{umber 92-GY-D812.0
Pollcv Pedod Ellective Date Exoiralion Dab
12 Mbnrhs OCT 31 2022 ocT 31 2023
Ihe policv oeriod begins and ends at 12 01 am standard
tme at thC premrses Tocaton.
&
ffi
8
8
pB
Aubmrtic R.lowal - lf $e policy prdod is shown as 12 monlhs , dris policy will be renewed automatically subjectto the premiums, rules and
forms in effect Ior each succeeding policy period. ll lhis policy is terminated, we will give you and fre Mortgagee/Lienholder wriften notice in
compliance wifi fie policy provisions or as required by law.
Annual Policy Premium lncluded
The above Premium Amount is included in fre Policy Premium shown on fie Declaratjons.
Your policy consisB of these Declarations. $e INLAND MARINE C 0NDlTl0NS shown below and any otrer forms and endorsements frat
apply. including $ose shown below as well as $ose issued subsequent to the issuance of fiis policy.
Foms, 0plions, and Endorsomenb
FE-8739
FE-6271
FE-8745
lnland Marine Conditions
Amendatory Endorsement
Inland Marine Computer Prop
See Reverse for Schedule Page wifr Limit
Prepared
FEB 15 2023
FD-6007
022522
o Cogyright St.to Frrm l\rutu.l Automobilo lnsurlnc. Comp!ny,2008
lncluds! copyrightsd mlteriil of lnsur.nce Sorvicq! offics, lnc., with its psrmlssion
5!0 606r7 05 31 20ll loll323?cl
92-GY-D812-0
ATTACHIl{G IIITAI{D MABI 1{E
ATTACHING INLANO MABINE SCHEDULE PAGE
ENDORS EMENT
NUMBER
FE-87 45
COVERA6E
ln land Marine Computer Prop
Loss of lncome and Extra Expense
LIMIT OF
INSURANCE
DEOUCTIBLE
AI\4OUNT
s 500
ANNUAL
PREIVI IUM
Included
Included
$
s
25,000
25,000
Prepared
FEB 15 2023
FD-6007
022522
OTHER LIMITS AND EXCLUSIONS MAY APPLY . REFER TO YOUR POLICY
O Copyri[h! Suts trrm Mutu!l Automobtlo lnsur.nc€ Comp!0y, 20fi
lnclud.r coEyrilhtad mltsrirl ol lnsurrncs S€rvioss offics, lnc., tvith i$ permisrion.
!10 00t. ? 05 3! l0lt lolllzllcl