2021/09/23 CMS Mobile Glass Shop, LLCStateFarm !(-)@
STATE FARM GENEFAL INSUBANCE COMPANY
A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS
E?"F 3id,38,t ?*, u ot u. t n, u
Addl lnsured-Section U Only
M-23-163A-FA41 F N002305 3123CITY OF TIENIFEE & ITS OFFICERS
EIIPLOYEES AGENTS & AUTHORIZED
VOLUNTEERS
29844 HAUI{ RDitE[rFEE CA 92546-6539
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Auto Services Policy
Policyl{umber 92-GR-O228-7
Policv Period Etleclivo Dale Exoiralion Dale
12 Mbnrhs SEP 23 202r Sti ?32022
Ihe polipy period begtns 4nd ends at 12 0'l am standardbme at lhe premtses locaton.
DECLARATIONS AMENDE D FEB 12022
Named lnsuredCIIS I{OBILE GLASS SHOP LLCffi
88
Atttomalic Ronowal - lf ttre policy period is shown as 12 months , thls policy will be renewed automatically su bject t0 the premiums, rules and
forms in effect for each succeeding policy period. lf tris policy is termin ated, we will give you and tfre Mortgagee/Lienholder written notice in
compliance witr the policy provisions or as required by law
Entlty: Limited Liability Company
Reason for Oeclaratlons: Your policy is amended FEB 1 2022
ADDITIONAL INSUBED ADDED
PREMIUM ADJUSTMENT
FORM CMP-4786.1 ADDED
Endorsement Premium
lncrease $ 55.00
Prepared
FEB '17 2022
cMP-4000
019927 290 Ar
N
Page 1of 6
O Copyrigh! St.tB F!rm Muturl Automobilo ln!ur!nco Complny,20(E
lncludes copyri0hlsd mit'rill of ln3!rrncs Ssrvices 0ffico. lnc., with its permission
Continued on Reverse Side ol Page
DECLARATIONS (CONTINUED)
Auto Servicss Policv for CITY OF MENIFEE & ITS OFFICEFSPolicy Number 92-GR-Q228-7
SECTION I - PROPERTY SCHEDULE
Location
Number Location ofDescribedPremises
Llmlt of lnsurance*
Coveraoe A -
Buildfngs
Limit of lnsurance.
Coverade B -Business FersonalProperty
Seasonal
lncrease-Business
Personal
Property
001 4351 BROOKSIDE DR
HEMET CA 92545-8988
No Coverage $ 1,200 25%
.As ee ve date of this po icy, t t of lnsurance as shown incl s any increase in the limit due to lnf lation overage.
SECTION I - INFI ATION CO BAGE INDEXIESI
Cov
Cov
A - lnf lation Coverage lndex
B - Consumer Price lndex:
N/A
269.2
SECTION I - DEDUCTIBLES
Basic Deductible $1,000
$250
$2so
$1,000
Special Deductlbles:
Money and Securities
Garagekeepers - Comprehensive
Equipment Breakdown
Garagekeepers - Collision
Employee Dishonesty
$500
$2so
Other deductibles may apply - refer to policy
Prepared
FEB 17 2022
cMP-4000
019927
O Copyright, Stlto Flrm l\4utu !l Aulomobih lnsur!ncB Compiny,2CO8
lncludes copyrighted mrtsrirl of lnsur.ncB Srrvicas offire, lnc., with it! p€rmission
Continued on Next Paga Page 2 of 6
StateFarm(-@
lli,t$t#*
Auto Services Policv lor CITY OF MENIFEE & ITS OFFICEHS
Pollcy Numb€r 92-GR-Q228-7
SECTION I . EXTENSIONS OF COVEFAGE - LIMIT OF INS HANCE - EACH DESCRIBED PFEMISES
!
8el
The coverages and corr6sponding limlts shown below apply soparaloly to each descrlbed premises shown in these
Oeclaralions, unless indlcaled by "See Schedulo." l, a coverage does not havs a cor.esponding limit shown below,
but has "lncluded" indicated, please refer to that pollcy provision tor an oxplanatlon of that coverags.
LIMIT OF
INSURANCE
$10,000
$5,000
$5'000
$1s,000
lncluded
Coverage B Limit
257o of covered loss
$2,500
$soo
lncluded
$s,000
$5,000
$10,000
$25,000
lncluded
100/o
$s,000
$10,000
Prepared
FEB 17 2022
cMP-4000
O Copyrich! St.t6 frrm Muturl Automobil0 lnsur.nc. Comprny, 20@
lncludss copyrightrd mrtsrill of lnsursnco Ssryicqi oflicr, lnc., wi$ its pBrmilsion
Continued on Reverse Side of Page019928 290
N
Page 3 of 6
DECLARATIONS (CONTINUED)
COVERAGE
Accounts Receivable
On Premises
o(l Premises
Arson Reward
Back-Up Of Sewer Or Drain
Collapse
Damage To Non-Owned Buildings From Thelt, Burglary Or Hobbery
Debris Removal
Employee Tools (applies only to those premises provided Coverage B - Business
Personal Property)
Per Occurrence
Per Employee
Equipment Breakdown
Fire Department Service Charge
Fire Extinguisher Systems Recharge Expense
Forgery Or Alteration
Garagokeoper's lnsurance - Comprehensive And Collision
Glass Expenses
lncreased Cost Of Construction And Demolition Costs (applies only when buildings are
insured on a replacement cost basis)
Money And Securities (Olf Premises)
Money And Securities (On Premises)
I
DECLARATIONS (CONTINUED)
Auto Sorvlces Pollcv tor CITY OF MENIFEE & ITS OFFICERS
Pollcy Number 92-GR-O228-7
Money Orders And Counterfeit Money
Newly Acquirod Business Personal Property (applies only if this policy provides
Coverage B - Business Personal Property)
Newly Acquirad Or Constructed Buildings (applies only it this policy provides
Coverage A - Buildings)
Ordinance Or Law - Equipment Coverage
Outdoor Proporty
Personal Effecls (applies only to those premises provided Coverage B - Business
Personai Property)
Personal Property off Premises
Pollutant Clean Up And Flemoval
Preservation Of Property
Property Of Others (applies only to those premises provided Coverage B . Business
Personal Property)
Signs
Valuable Papers And Records
On Premises
Off Premises
$1,ooo
$100,000
$250,000
lncluded
$5,000
$2,500
$1s,000
$20,000
30 Days
$2,500
$5,000
$10,000
$5,000
SECTION I . EXTENSIONS OF COVERAGE - LIMIT OF INSU HANCE . PER POLICY
The coverages and corresponding limits shown b€low are the most we will pay .ogardless o, the number ofdescribed premises shown in those Declarations.
COVEBAGE
Employee Dishonesty
Loss Of lncome And Extra Expense
O Copyright, Stats Frrm Mutu6l AutomobilB lnsur!ncs Comp!ny, 2008
lncludss copyrightod mat8rirl ol lnlur!ncs Ssrvic6! oftico, lnc., with ils p6rmtsrion
Continued on Next Page
LIMIT OF
INSUBANCE
$10,000
Actual Loss Sustained . 12 Months
Pre pa red
FEB 17 2022
cMP-4000
019928 Page 4 of 6
6-oo
kt
DECLARATIONS (CONTINU EO)
Auto Services Policv tor CITY OF MENIFEE & ITS OFFICERSPolicy Number 92-GR-O228-7
SECTION II . DEDUCTIBLES
!
I
,s Business Liabiiity - Property Damage $250
Other deductibles may apply - reler to policy.
SECTION II - LIABILITY
COVERAGE
Coverage L - Business Liability
Coverage M - Medical Expenses (Any One Person)
Damage To Premises Rented To You
AGGREGATE LIMITS
Products/Completed Operations Aggregate
Genoral Aggregate
LIMIT OF
INSURANCE
$1,000,000
$5,000
$300,000
LIMIT OF
INSURANCE
$2,000,000
$2,000,000
Each paid claim lor Liability Coverage reduces the amount of insurance we provide during the applicable
annual period. Please refer to Section ll - Liability in the Coverage Form and any attached endorsements
Your policy consists of these Declarations, the BUSINESSOWNERS COVEBAGE FOBM shown b€low, and any other
forms and endorsements that apply, including lhose shown below as well as those issued subsequent lo the
issuance of lhis policy.
FORMS AND ENDOBSEMENTS
cMP-4101
cMP-4786.1
cMP-4787
cMP-4412
cMP-4827.1
FE-6999.3
Prepared
FEB 17 2022
cMP-4000
019929 290
N
Businessowners Coverage Form
'Addl lnsd Owners Lessee Sched
'Waiver of Trans Bgt of Flecov
Operation of Customers Auto
Employee Tool Coverage
Terrorism lnsurance Cov Notice
Page 5 ol 6
StateFarm
O Copyrigh! Stlto F.rm Mut!rl Automobilo lnlurrnce Comp.ny.2008
lnclud0s copyri0htBd mltori!l ol ln!u16nce S€rvicr! office. lnc., with it psrmission.
Continuod on Reverse Sid€ of Page
DECLARATIONS (CONTINUED)
Auto Servlc€s Policv lor CITY OF MENIFEE & ITS OFFICEBSPolicy Number 92-GR-O228-7
crvlP-4260.1
cMP-4261
cMP-4705.2
cMP-4710
cMP-4709
cMP-4470
cMP-4698
FD-6007
Amendatory Endorsement-CA
Amendatory Endorsement
Loss of lncome & Extra Expense
Employee Dishonesty
Money and Securities
Garagekeepers Direct Coverage
Back-Up of Sewer or Drain
lnland lvlarine Attach Dec
NOTICE: INFORMATION CONCEBNING
CHANGES IN YOUR POLICY
LANGUAGE IS INCLUDED, PLEASE
CALL YOUB AGENT IF YOU HAVE
ANY OUESTIONS.- New Form Attached
This policy is issued by the State Farm General lnsurance Company.
Participating Policy
You are entitled to participat€ in a distribution of lhe earnings of the company as determined by our Board of Directors in
accordance with the Company's Articles of lncorporation, as amended.
In Witness Whereof, he State Farm
Sacretary at Bloomington, lllinois.
General lnsurance Company has caused this policy to be signed by its President and
fi*ny"*
Secretary
-{/,-tu C-/q
President
IMPOFTANT NOTICE:
Cslfomla hw rcqulreg us-to provlde you whh lnlomatlon toi llllng complalms wlth the Stote lnsurance Deponment regardlng tlle
covemgo snd srvics provkled under tlis pof,cy,
Your aoem's name and contact iniormstion are provided on the lrori ol lhls document. Another optbn ls to reach oul by
mailor phono dhoctly lo:
Stat€ Formo Execuliye Custome, Service
PO Box 2320
Bloomington lL 61702
Phono t 1€{X)-STATEFAH (t-60G782-8382)
Depsrlment ot lnsurance complsintr shouH be llled onty aftEr you End Slate F8m or your sgent or olher comparry
reprc$mattue hrvo lalled to rorch 6 s€tislactory .g]gsmoitt on o probLm.
CElitomis oeparlment of lnEursnce
Consumer EerYlce3 Dlvlglon
300 South 8pllng Strset
LoE Angoler, CA 90013
Phone # l-8oO.927.HELP (4357) or vbit rww.insurance.ca,qoy/o l-consrmeta
Prepared
FEB 17 2022
cMP-4000
019929 290
N
@ Copyri!h! Strto Flrm l\4 utu rl Automobi16 lnsurrncs Comp6ny, 2008
lnclud€s copyrightsd mrt8rial ol lnsur.nc€ Ssrvicos officB, lnc.. with its pormission
Page 6 ot 6
StateFarm STATE FAFM GENEFAL INSURANCE COMPANY
A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS
E?"83 ia933! 1* r s oe s. s s z s
Nemed lnsured
M-23-163A-FA41 F N
C]IS T,IOBILE GLASS SHOP I-LC
ATTACHING INLAND MARINE
!
INLAND MARINE ATTACHING DECLARATIONS6)@
E;?S[#
Ea,a;5
Policyl{umbor 92-GR-O228-7
Policv Period'12 Mbnths
The polipy period btme at the premlse
Elhctivs Date
sEP 23 2021
Exoiration DatestP 23 2022
eoins and ends at 12.01 am standard
s Tocaton
Aubmslic Ronewal - lf he policy period is shown as 12 months , $is policy
torms in effect for each succeeding policy period. lf tris policy is termrnated
compliance wi$ 6e policy provisions or as required by law.
will be renewed automatically subjectto the premiums, rules and
we will give you and the Mortgagee/Lienholder written notce in
Annual Policy Premium Included
The above Premium Amount is included in $e Policy Premium shown on fie Declarations
Your policy consists of these Declarations, tre INLAND MARINE C 0NDlTl0NS shown below, and any other forms and endorsemenB dtat
apply, including frose shown below as well as $ose issued subsequentto he issuance ol tfris policy.
Forms, 0ptions, and EndorsomentE
FE-8739
FE-6271
FE-8745
lnland Marine Conditions
Amendatory Endorsement
lnland Marine Computer Prop
See Reverse for Schedule Page witr Limits
Prepared
FEB 17 2022
FD-6007
019930
O Copyrigh! St.ta Flrm Mutual Automobil0 lnsur.nc. Comp!ny, 2008
lncludes copyri0ht0d m.t€ri6l of lnsurancs Sorvicss oftico, lnc., with its permission
130 !&i7 0t 3l toll lolflzl?c
92-GB-O228-7
ATTACHIT{G INTAI'IO MABII{E
ATTACHING INIANO MABINE SCHEDUTE PAGE
ENDORSEMENT
NUI\4 BER
FE-8745
Llr\4tT 0F
INSURANCE
DEDUCTIBLE
AMOUNT
ANNUAL
PREMIUMCOVERAGE
lnland Marine Computer Prop
Loss of lncome and Extra Expense
s
$
25,000
25,000
Prepared
FEB 17 2022
FD-6007
019930
OTHER LIMITS AND EXCLUSIONS MAY APPLY . REFER TO YOUR POLICY
O Copyr0hL Stat. Ffim Mutu6l Automobile lnsurrnco Comp6ny, 2008
lncludes copyri0hled moterial of lnsurcnce Services offlce. lnc., ralth its 0srmission.
s 500 Included
Included
530 t0tr ? 0b 3l l0ll {oll3l33c,
StateFam(-@
92-GR-O228-7 019931
THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY
CMP4786,1 ADDITIONAL INSURED - OWNERS, LESSEES, OR CONTRACTORS
(Scheduled)
Ct\4P-4786.1
Paqe 1 ol2
tli:rftbrdu
I
This endolsement modifies insurance provided under the following:
BUSINESSOWNERS COVERAGE FORM
1. SECTION ll - WHO lS AN INSURED of
SECTION ll - LIABILITY is amended to in-
clude, as an additronal insured, any person or
organization shown in the Schedule, but onlywith respect to liability for "bodily injury",
"property damage", or "personal and advertis-
ing injury" caused, in whole or in part, by:
a. Ongoing Operations
(1) Your acts or omissions, or
(2) The acts or omissions of those actng
on your behalf;
in the performance of your ongoing opera-
tions for that additional insured, or
b. Products - Completed Oprations
"Your work" performed for that additional
insured and included in the "products-
com pleted operations hazard".
However, Paragraph '1. above is subject to the
following:
a. The insurance afforded to the additional
insured only applies to the extent permit-
ted by law;
SCHEDULE
Policy Number: .92-cR-e228-7
Named lnsured:
CMS MOBILE GLASS SHOP LLC
Name And Address Of Additional lnsured Person Or Organization:
CITY OF MENIFEE & ITS OFFICERS
EMPLOYEES AGENTS & AUTHOBIZED
VOLUNTEERS
29844 HAUN RD
MENTFEE CA 92s86-6539
b. lf coverage provided to the additional in-
sured is required by a contract or agree-
ment, the insurance provided to the
additional insured will not be broader than
that which you are required by the contract
or agreement to provide for such addition-
al insured; and
c. lf the contract or agreement between you
and the additional rnsured is governed by
California Civil Code Section 2782 or
2782.05, the insurance provided to the
additional insured is the lesser of that
which.
(1) ls allowed for the satisfaction of a de-
fense or indemnity obligation by Cali-fornia Civil Code Section 2782 or
2782.O5 for your sole liability; or
(2) You are required by contract or
agreement to provide for such addi-
tional insured.
We have no duty to defend or indemnity the
additional insured under this endorsement un-
til a claim or "suit" is tendered to us.
O, Copyright, State Farm M utual Automobile lnsurance Company, 2013
lncludes copyrighted material of lnsurance Services Offce, lnc., with its permrssion
CONTINUEO
E
2. Any insurance provided to the additional in-
sured shall only apply with respect to a claim
made or a "suit" brought for damages for
which you are provrded coverage.
3. With respect to the insurance afforded to the
additronal insured, the following is added to
SECTION ll - LIMITS OF INSURANCET
lf coverage provided to the additional insured
is required by contract or agreement, the most
we will pay on behalf of the additional insured
will be the lesser of the amount of insurance:
a. Required bythe contract or agreement; or
b. Available under the applicable Limits Of
lnsurance shown in the Declarations.
This endorsement shall not increase the ap-
plicable Limrts Of lnsurance shown in the
Declarations.
4. With respect to the insurance afforded to the
additional insured, the following is added to
Paragraph 3. Duties ln The Event Of Occur-
rence, Offense, Claim Or Suit of SECTION
II - GENERAL CONDITIONS:
The additional insured must:
a. See to it that we are notified as soon aspracticable of an "occurrence" or an of-
fense which may result in a claim. To the
extent possible, notice should include.
('1) How, when and where the "occur-
rence" or offense took place;
(2) The names and addresses of any in-
jured persons and witnesses; and
cMP-4786 1
92-GB-O228-7 019931 H"'iT;
(3) The nature and location of any injury
or damage arising out of the "occur-
rence" or offense;
b. Tender the defense and indemnrty of any
claim or "suit" to us and to all other insur-
ers who may have insurance potentially
available to the additional insured; and
c. Agree to make available any other insur
ance the additional insured has for de-
fense or damages for which we wouldprovide coverage under SECTION ll -LIABILITY,
5. With respect to the insurance afforded the ad-
ditional insured, the following replaces SEG-
TION ll -LIABILITY of Paragraph 7. Other
lnsurance of SECTION IAND SECTION ll -COMMON POLIGY CONDITIONS:
a. This insurance is primary to and will not
seek contribution from any other insurance
available to the additional insured, provided
that the additional insured is a named in-
sured under such other rnsurance.
b. Regardless of any agreement betweenyou and the additional insured, this insur-
ance is excess over any other insurance
whether primary, excess, contingent or on
any other basis for which the additional in-
sured has been added as an additional in-
sured on other policies.
There will be no refund of premium in the event
this endorsement is cancelled.
All other policy provisions apply.
O, Copynght, State Farm tyl utual Automobile lnsurance Company, 2013
lncludes copyrighted material of lnsurance Services Office lnc , with its permission
StateFam(-co 92-GR-O228-7 019932
THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY
CMP4787 WAIVER OF TRANSFER OF RIGHTS OF RECOVERYAGAINST
OTHERS TO US
clvtP-4787
Page 1 of 1
ffi This endorsement modifies insurance provided under the following
BUSINESSOWNERS COVERAGE FORM
SCHEDULE
Policy Number: 92-cH-O228-7
Named lnsured:
CMS MOBILE GLASS SHOP LLC
Name And Add ress Of Person Or Organization:
The following is added to Paragraph 10.b. of SECTION I AND SECTION ll - 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 work" done under contract with that person or organtzation and included in the 'products-
completed operations hazard".
This waiver applies only to the person or organization shown in the Schedule.
All other policy proviBions apply.
cMP-47 87
@, Copyright, State Farm MutualAutomobile lnsurance Company, 2008
lncludes copyrighted material ol lnsurance Services Oflice, lnc , with its permission.
EU
;$
!
CITY OF MENIFEE & ITS OFFICERS
EMPLOYEES AGENTS & AUTHOBIZED
VOLUNTEEHS
29844 HAUN RD
MENTFEE CA 92586-6539
I