2021/10/01 Armstrong & Brooks Consulting Engineers Inc (9)t,StateFarm !
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Office Policy
STATE FABM GENEFAL INSUFA CE COMPANY
A STOCK COMPANY WITH HOME OFFICES IN ELOOMINGTON, ILLINOIS
B?"F3ia93i! ?*, u o, u. t n, u
Addl lnsured-Sectlon ll Only
M-23-0555-FACE F U001964 3123CITY OF I{ENI FEE29844 HAUN RD
t{EI I FEE CA 925A6-6539
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DECLAFATIONS A[/ENDED MAR 7 2022
Named lnsured
ARI4STRONG & BROOKS COI{SULT I NG
ENGII{EER5 INC
Policy umber 92-CV-K20&3
Policv Period Ellsctiyo Deo ExDirstion Date12 Mbnths OCr 12021 OCr 12022
Ihe polipy period beqtns qnd ends at l2 0'l am standardtme atthe premrses locaton.
Automalic Rottrwal - lf $e policy period is shown as 12 months , this policy will be renewed automatcally subiect to $e premiums, rules and
lorms in effectfor each succeeding policy period. lftris policy is terminated, we will give you and the Mortgagee/Lienholder written notice in
com plian ce witr the policy provisions or as required by Iaw
Entity: Corporation
Reason lor Declarations:Your policy is amended MAR 7 2022
ADDITIONAL INSURED ADDED
PHEMIUM ADJUSTMENT
FORM CMP-4859 ADDED
Discounts Applied:
Renewal Year
Years in Business
Protective Dovices
Claim Record
None
Prepared
MAR 22 2022
cMP-4000
O Cogyright, Stlt€ Flrm Muturl Altomobil8 ln.ur!ncs Complny,2008
lncludss copyrightod mrlBrirl of ln!urrnc6 soruicss offics, lnc., with rt! pormission
Continued on Revorse Side of Page016078 290
N
Page 1 of 6
(-@
l
)
;:l Endorsement Premium
T'
DECLABATIONS (CONTINUED)
Oflice Policv lor CITY OF MENIFEEPolicy Num6er 92-CV-K20G3
SECTION I - PROPERTY SCHEDULE
Location
Number Location o,Described
Premls€s
Limit o, lnsurance'
Coveraoe A -
Bulldi-ngs
Limit ol lnsurance'
Coveraoe B -
Business Personal
Property
Seasonal
lncrease-
Busine$s
PersonalProperly
001 1350 E CHASE DR
coBoNA cA 9288 r -4001
No Coverage $ 77 ,4oo D E,O/.
- As ol the effective date o is po icy, the Limit of lnsurance as s own ncludes any increase in the limit due to I on overage
SFCTION I - INFLATION COV AGE INDEXTESI
Cov A - Inf lation Coverage lndex
Cov B - Consumer Price lndex:
SECTION I - DEDUCTIBLES
N/A
269.2
Basic Deductible
Speclal Deductibles:
Money and Securities
Equipment Breakdown
$1,000
$250
$1,000
Employee Dishonesty $250
Other deductibles may apply - ref er to policy
Prepared
MAR 22 2022
cMP-4000
016078
O Copyrigh! State F0rm Muturl Automobile lnsur!nc0 Comprny, zmg
lnclude! copyrighted msteri!l of ln!!16ncs S€rvic0s oflic€, lnc., wi$ its pBrmi!sion
Continued on Next Page Page 2 of 6
StateFarm&
fl.-48
DECLARATIONS (CONTINUED)
Otfice Policv for CITY OF MENIFEEPolicy Num6er 92-CV-K206-3
SECTION I - EXTE SIONS OF COVERAGE - LIMIT OF INSU BANCE . EACH DESCRIBED PREMI
!
I The covotages and coresponding limits shown below apply separately to each describod premises shown in theseDeclarations, unless indicated by "See Schedule." ll a coverage do6s hot have a corresponding llmlt shown below,but has "lncluded" indicatod, please reler to that policy provision for an explanation of that coverage,
COVERAGE
Accounts Fleceivable
On Premises
Off Premises
Arson Reward
Back-Up Of Sewer Or Drain
Collapse
Oamage To Non-Owned Buildings From Theft, Burglary Or Bobbery
Debris Removal
Equipment Breakdown
Fire Department Service Charge
Fire Extinguisher Systems Recharge Expense
Forgery Or Alteration
Glass Expenses
lncreased Cost Of Construction And Demolition Costs (applies only when buildings are
insured on a replacement cost basis)
Monoy And Securities (Off Premises)
Money And Securities (On Premises)
Money Orders And Counterfeit Money
Newly Acquirod Business Personal Property (applies only if this policy provides
Coverage B - Business Personal Property)
Newly Acquired Or Constructed Buildings (applies only if this policy provides
Coverage A - Buildings)
LIMIT OF
INSUBANCE
$50,000
$15,000
$s,000
$15,000
lncluded
Coverage B Limit
25% of covered loss
Included
$5,000
$5,000
$10,000
lncluded
1o%
Prepared
MAR 22 2022
C l\,'l P -4000
016079 290
N
O Copyrighl St6t6 F6rm Mutual Automobilo lnsurrnce Compnny, 2008
lnclud€s copyrightod material of lnsur0nce S€rvices offica, lnc , with its pErmission
Continued on Beverse Side ol Page
$s,000
$10,000
$1,ooo
$100,000
$2s0,000
Page 3 of 6
DECLABATIONS (CONTINUED)
Ottice Policv lor CITY OF MENIFEE
Policy Num6er 92-CV-K20&3
Ordinance Or Law - Equipment Coverage
Outdoor Property
Personal Effects (applies only to those premises provided Coverage B - Business
Personal Property)
Personal Property Ofl Premises
Pollutant Clean Up And Removal
Preservation Of Property
Property Of Others (applies only to those premises provided Coverage B - Business
Personal Property)
Signs
Unauthorized Business Card Use
Valuable Papers And Becords
On Premises
Off Premises
SECTION I- EXTENSIONS OE EOVERAGE. LIMIT OF INSUBANCE - PER POLICY
lncluded
$s,000
$s,000
$15,000
$10,000
30 Days
$2,soo
$2,500
$s,000
$5
$
0
0
0 00
00
The coverages and cor.esponding limits shown below are the most we will pay regardless of the number of
described premises shown in thoss Declarations.
COVEBAGE
Dependent Property - Loss Of lncome
Employee Dishonesty
Utility lnterruption - Loss Of lncome
Loss Of Income And Extra Expense
@ Copyright, Stote Farm Nlutu0l Automobile lnsurance Compsny,2008
lncludes copyri0hted materiol of lnsuroncs S6rvices office, lnc., with its permission
Continued on Next Page
LIMIT OF
INSUHANCE
$5'000
910,000
910,000
Actual Loss Sustained - 12 Months
Prepared
MAR 22 2022
Cl\ilP-4000
016079 Page 4 of 6
ll StateFarm
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DECLAFATIONS (CONTI NUED)
Oflice Policv for CITY OF MENIFEE
Policy Number 92-CV-K206-3
SECTION II . LIABILITY
u
$
c
COVERAGE
Coverage L - Business Liability
Coverage M - Medical Expenses (Any One Person)
Damage To Premises Rented To You
AGGBEGATE LIMITS
Products/Completed Operations Aggregate
General Aggregate
Each paid claim for Liability Coverage reduces the amount ol insurance we provide during the applicable
annual period. Please refer to Section ll - Liability in the Coverage Form and any attached endorsements
LIMIT OF
INSURANCE
$2,000,000
$s,000
$300,000
LIMIT OF
INSUEANCE
Excluded
$4,000,000
Your policy consists of these Declarations, the BUSINESSoWNEHS 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 ENDOBSEMENTS
cMP-4101
cMP-4859
cMP-4787
FE-6999.3
cMP-4845
cMP-4819.1
cMP-4698
cMP-4704.1
cMP-4710
cMP-4709
cMP-4703.'l
cMP-4705.2
cMP-4260.1
Businessowners Coverage Form.Al Engineer Architect Survey*Waiver of Trans Rgt of Recov
Terrorism lnsurance Cov Notice
Excl Product Comp Operatn Liab
Unauthorized Business Card Use
Back-Up of Sewer or Drain
Dependent Prop Loss of lncome
Employee Dishonesty
Money and Securities
Utility lnterruption Loss lncm
Loss of lncome & Extra Expense
Amendatory Endorsement-CA
Prepared
MAR 22 2022
cMP-4000
016080 290
N
O Copyri!h! Stlto Flrm MutuElAutomobll0 lnrurlnc0 Complny,20{E
lnclud0s copyrightod m.t.ri.l ol ln!ur.nco Ssrvice! oltic0. lnc. vrnh ilr psrmission
Continued on Reverse Sid€ ol Page Page 5 ol 6
&
DECLABATIONS (CONTINUED)
Oftice Policv ,or CITY OF MENIFEE
Policy Number 92-CV-K20&3
cMP-4261
cMP-4786.1
FD-6007
Amendatory Endorsement
Addl lnsd Owners Lessee Sched
lnland lvlarine Attach Dec
NOTICE: INFOHMATION 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 Stat6 Farm General lnsurance Company.
Participating Policy
You are entitlsd to participate in a distribution of the earnings ot the company as determined by our Board of Directors in
acrordance with the Company's Articles of lncorporation, as amended.
ln Witness Whereof , he State Fa
Secretary at Bloomington, lllinois.
rm General lnsurance Company has caused this policy to be signed by its President and
ff -n\""'ttsecretary
-il-r," C"/4
IMPORTANT NOTICE:
Coltromla hw rrqulres ue.to provlde you wlth lnlomatlon tor llllng comphlme wlrh rho gtate lnsuranee Oepanmet tegdtdlng the
covsrsgs snd soryice provided urder thiE policy.
Your sgsrt'3 name a-nd clnt8ct lnlormatbn qre provlded on tlE lrorll ol this docum€m. Another optbn is to resch oul by
msll or phone dircctly to:
Slale Falrlil Exsculivo Cuslomer Sorvico
PO Box 2320
Bloominglon lL 6'1702
Phone r i €oo-STATEFARH (1-80G782-8332)
D€pannent of ln8urance complaints should be liled only alter you and State Fam ol your r0em or other compatry
ioplosentstfuo h{ve hlgd lo resch a s€tlalactory ogreoment on a probbm,
CalilomiE Deparurlent of lnsurance
Consumel Ssrvlces DlYlgbn
300 Sorxh gprlrlo SrBet
LoE Angohs, CA 9o013
Phone I l€O0-927.HELP (i854 or vbit rrw.insuasnce.cE.qoy/o1-coEs.mers
Prssident
O Copyrighl. Stats farm l\4utu!l Automobilo ln!ur!nca Cornplny,2008
lncludos copvrightod mltsri!l of lnsuranco S€rvicas office. lnc., wfh its permissiofl
Prepared
MAR ?2 2022
cMP-4000
016090 290
N
Page 6 ol 6
StateFarm&STATE FAHM GENEFAL INSUBANCE COMPANY
A STOCK COMPANY WITH HOME OFFICES IN ELOOMINGTON, ILLINOIS INLAND MARINE ATTACHING DECLAHATIONS
E?"F 3/d3ie l*, u o" - r', u Policyl{umber 92-CV-K206.3
Policv Period Elhclive Date Exoiration Dals
12 Mbnths OCT 12021 O1i1r6a2
Ihe polipy period begins qnd ends at l2:01 am standardflme atlie Premrses l0Caton.
Named lnsured
ATTACHING INLAND MARINE
M-23-0555-FACE F U
ARIISTRONG & !ROOKS COt{SUITING
Et,IGI NEERS I t'IC
tnlltFffi
E
Aubmalic.X.ne wtl - lf the policy pcriod is shown as 12 months , tris policy will be renewed automatically subject to tre premiums, rules and
forms.in effect for.each.succeeding policy period. lf tris policy is terminated, we will give you and ttre Mortgagee/Lienholder writen notice in
complrance wit) the policy provisions or as required by law.
Annual Pollcy Premium $ 373.00
The above Premium Amountis included in tre Policy Premium shown on fie Declaratjons
Your policy consists ofthese Declarations, $e INLAND MARINE C0NDITI0NS shown below, and any other forms and endorsemenb that
a pply, tncluding trose shown below as well as fiose issued subsequent to the issuance of tris policy.
Foms, 0ptions, and Endorsomenb
FE-8739
FE-6271
FE-8745
FE-8760
lnland Marine Conditions
Amendatory Endorsement
lnland Marine Compuler Prop
Mobile Equipment Form
See Reverse for Schedule Page wifi Limis
Prepared
MAR 22 2022
FD-6007
016081
@ Copyrighl St6t0 trrm Mutuol Automobil0 ln!uranco Comp!ny,2008
lncludes copyrighted moreri!l of lnsu16nce Ssrvicsr offiE6, lnc., with its psrmission
510 086r.2 05 ill 20ll lollUJ2c)
92-CV-K206-s
ATTACHII{G I LAND MARINE
ATTACHIT{G INTAND MARINE SGHEDUTE PAGE
ENDOBSEMENT
NUMBER
FE-87 45
FE-8760
COVERA6E
LIMII OF
INS URANC E
DEDUCTIBLE
AMOUNT
ANNUAL
PREN4IUM
lnland Marine Computer Prop
Loss of lncome and Extra Exoense
Mobile Equipment Form
25,000
25,00057,000
Included
IncludedI 573,00
s
$I
$ 500
I 1,000
Prepared
MAR 22 2022
FD-6007
016081
OTHER LIMITS AND EXCLUSIONS MAY APPLY , REFER TO YOUR POLICY
O Copy(0ht, St.te Fdrm lvlutuslAutomobiJe lnsu16nce Compony,2008
lncludos copyrightod mltBriIlof lnsurrncs Services olfice, lnc., with its permission
5:t0 0!00 2 0l ll ?0ll lollSz3ilcl