2021/10/31 Western A/V, Inc.StateFa'I,,STATE FAAM GENEFAL INSURANCE COMPANY
A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS
Pr?"83 io€1i! R, u o t u. t t, u
Addl lnsured.Section ll Only
M.23-61F8.F88A F Z002523 3123CITY OF I{EN IFEEAND ITS OFFICERS, EI{PLOYEES,
AGENTS & AUTHORIZED VO L UNTEERS?9844 HAUN RD
lrEN I FEE CA 9?556-6539
l,ilr,tr,rIl,,lrltlll,ilIHilll,,t,iltr,trtlrlltlrltil,rlrlll
Home Product Sales Policy
DECLARATIONS At\,4ENDED JAN 31 2022
Named lnsured
WESTERN A/V INC
a
ffi
g
Policyllumbar 92-GY-D812-O
Aubmalic Renewal - lf the policy pedod is shown as t2 months , ttris policy will be renewed automatcally subject to the premiums, rules and
formsineffectforeachsucceedingpolicyperiod lf fiis policy is terminated, we will giveyou andthe lVlortgagee/Lienholder written notice in
compliance wi$ $e policy provisions or as required by law
Entity: Corporation
Beason lor Declarations:Your policy is amended JAN 31 2022
PREMIUM ADJUSTMENT
Endorsement Premium
lncrease $ 5.98
Dascounts Applied:
Benewal Year
Years in Business
Enclosed Building
Protective Devices
Sprinkler
Claim Record
Prepared
FEB 09 2022
cMP-4000
022022 290 At
N
O Copyri0ht, St6te Frrm fulutu rl Automobilo In!urrnco Complny, 2008
lncludes oopyrighted mrt8ri!l of lnsur.ncs S.rvices offic8, lnc.. witi its psrmi3rion
Continued on Reverse Side of Page Page 1of 7
Policv Period Ellective Date Exoiration Dab
'r 2 Mbnths ocT 31 2021 ocr 31 2022
The polipy period beoins and ends atl2:01 am standard[me at the premtses Iocaton.
Home Product Sales PollcvPolicy Numbor 92-G
DECLARATIONS (CONTINUED)
Ior CITY OF MENIFEE
Y-D812-0
SECTION I - PFOPERTY SCHEDULE
Location
Number Location ol
Oescribed
Premises
Limit ot lnsurance"
Coveraoe A -
Buildlngs
Limit ol lnsurance'
Covaraoe B -
Businoss Fersonal
Property
Seasonallncrease-
BusinessPersonal
Property
001
002
1592 N BATAVIA ST STE 2
oRANGE CA 92867-3554
1590 N BATAVIA ST STE 4
oRANGE cA 92867-3534
No Coverage
No Coverage
$ 129,300
$ 129,100
25%
'As of the effective date of this policy, the Limit o lnsurance as shown includes any increase in the limit due to lnlla on overage
SECTION I - INFLATION COVERAGE INDEX(ES}
Cov A - lnflation Coverage lndex:
Cov B - Consumer Price lndex:
N/A
271 .7
SECTION I - DEDUCTIBLES
Basic Deductible
Speclal Deductibles:
Money and Securities
$2,500
$2s0 Data Compromise
O Copyrioht Stlte Farm l\4utu.l Automobils lniurrncs Comp!ny, 2008
lncludes copyri0ht€d moteri0l of ln!ur.nc0 Ssruicss offic€, lnc , with its pErmission
Continued on Next Page
$1 ,000
Prepared
FEB 09 2022
cMP-4000
022022 Page zot 7
!6Doo
ffi
Home Producl Sales Policv
Policy Number 92-G
DECLARATIONS (CONTINUED)
Ior CITY OF MENIFEE
Y-D812-0
Employee Dishonesty $250 Equipment Breakdown $2,500
Other deduclibles may apply - refer to policy
SF.:TI.)N I. FYTFNqIr)Nq r)F
'r)VFEIAGF - I IT'IT 'IE INqI EANCF - FA(:H DFS(:RIRFD PREMISESIv
iR
The coverag€s and corresponding limits shown b€low apply s€paratoly lo each described premls€s shown in these
Declarations, unless indicated by "See Schedule." It a coverage does not have a correspondlng llmit shown below,
but has "lncluded" indicated, please refer to that pollcy provlsion for an explanation of that covorage.
COVERAGE
Accounts Receivable
On Premises
Oll Premises
Arson Reward
Back-Up Ol Sewer Or Drain
Collapse
Damage To Non-Owned Buildings From Theft, Burglary Or Hobbery
Debris Removal
Equipment Breakdown
Fire Department Service Charge
Fire Extinguisher Systems Rocharge Expense
Forgery Or Alteration
Glass Expenses
lncreased Cost Of Construction And Demolition Costs (applies only when buildings are
insured on a replacement cost basis)
Niloney And S6curities (Otf Premises)
Money And Securities (On Premises)
Money Orders And Counterleil Money
LIMIT OF
INSUHANCE
See Schedule
See Schedule
$5,000
See Schedule
lncluded
Coverage B Limit
25olo of covered loss
lncluded
$2,soo
$s,ooo
$10,000
lncluded
100/"
See Schedule
See Schedule
$1,000
Prepared
FEB 09 2022
cMP-4000
022023 290
N
Page 3 ol 7
StateFarm
O Copyriohl St.re Flrm lvlutu !l Automobils ln!urlnce gomprny, 2008
lncludEs copyrightsd m.tsrial of lnsur.nc0 Ssryic0s 0fficE, liE., with its p6rmi3!ior.
Continued on Reverse Side of Page
I
Home Product Sales Policv
Policy Number 92-G
DECLAFATIONS (CONTINUED)
Ior CITY OF MENIFEE
Y-D812-0
Newly Acquired 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)
Ordinance Or Law - Equipment Coverage
Outdoor Proporty
Personal Effects (applies only to those premises provided Coverage B - Business
Personal Property)
Personal Property Off Premises
Pollutant Cloan Up And Removal
Preservation Ol Property
Property Of Others (applies only to those premises provided Coverage B - Business
Personal Property)
Signs
$100,000
$250,000
lncluded
See Schedule
$2,500
s25,000
$10,000
30 Days
See Schedule
See Schedule
See Schedule
See Schedule
Valuable Papers And Becords
On Premises
Ofl Premises
SECTIONI-EXTENSIONSO ERAGE - LIMIT OF INSUBANCE . SCHEDULE
The covoragos and corrsspondlng limlts shown below apply only to the describod premises as shown.
LOCATION COVEBAG E
LIMIT OF
INSUBANCE
0001
0002
$5,000
$15.ooo
$10,000
$s,ooo
$2,500
Signs
Back-Up Of Sewer Or Drain
Money And Securities (On Premises)
Money And Securities (Off Premises)
Property Of Others (applies only to those premises provided Coverage B - Business
Personal Properly)
Accounts Receivable (On Premises)
Accounts Beceivable (Ofl Premises)
Outdoor Property
Valuable Papers and Records (On Premises)
Valuable Papers and Records (Off Premises)
Accounts Receivable (On Premises)
O Copyri0h! StstB Ffim Mutu0l Automobil6 lh!ur!nco Comprny, 2008
lncludss copyrighted moteri!l ol lnr!r![c€ SsrvicBs olfioB, lnc., wtth its p8rmission
Continued on Next Page
00
00
00
00
00
$10
$5
$s
$ro
Ss
0
0
0
0
0
$10,000
Prepared
FEB 09 2022
cMP-4000
022023 Page 4ol 7
StateFarm&
H#
Home Producl Sales Policv
Policy Number 92-G
oEcLAHATTONS (CONnNUED)
tor CITY OF MENIFEE
Y-D812-0
Accounts Receivable (Oll Premises)
Back-Up Of Sewer Or Drain
Money And Securilies (Off Premises)
Money And Securities (On Premises)
Outdoor Property
Property Of Others (applies only to those premises provided Coverage B - Business
Personal Property)
Signs
Valuable Papers and Records (On Premises)
Valuable Papers and Records (Oll Premises)
000$s
c
E63
$1s,000
$s,ooo
$10,000
$s.000
$2,soo
$5,ooo
$1o.ooo
$5,ooo
SECTION I . EXTENSIONS OF COVERAGE - LIMIT OF INSUBANCE - PER POLICY
The coverages and corresponding llmlts shown below are the most we will pay regardless o, lh6 number of
describod premises shown in these Declarations.
COVERAGE
Data Compromise
Legal And Forensic lnlormation Technology Review
Per Occurrence
Dependsnt Property - Loss Of lncome
Employee Dishonesty
ldentity Restoration
Other Expenses
Case Management Services
Per Occurrence
Lost Wages And Supervision Expenses
Utility lnterruption - Loss Of lncome
Loss Of lncome And Extra Expense
O CoEyright Sl!10 t!rm Muturl Automobilo ln!ur!ncr ComprnV.2008
lnclud.! cogyrighlod mliori.l of lnrurrnce Ssrvicds oftics. Inc., with its pormission
Continued on Reverse Side of Page
LIMIT OF
INSU RANCE
$5,000
$50,000
$s,000
$10,000
$1,000
12 months
$35,000
$s,000
$10,000
Actual Loss Sustained - 12 Months
Prepared
FEB 09 2022
cMP-4000
022024 290
N
Page 5 ol 7
Home Product Sales PolicvPolicy Number 92-G
DECLABATIONS (CONTINUED)
Ior CITY OF MENIFEE
Y-D812-0
AGGREGATE LIMITS
Products/Completed Operations Aggregate
General Aggregate
Each paid claim for 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
LIMIT OF
INSURANCE
$2,000,000
$s,000
$500.000
LIMIT OF
INSUFANCE
$4,000,000
$4,000,000
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
cMP-4260.1
cMP-426'l
cMP-4705.2
cMP-4710
CtvlP-4709
Cl\,'lP-4698
cMP-4704.1
cMP-4703.1
cMP-4786.1
cMP-4610
cMP-4746.1
Cl\ilP-4990.1
Prepared
FEB 09 2022
Cl\,lP-4000
022024
Businessowners Coverage Form
Amendatory Endorsement-CA
Amendatory Endorsement
Loss of Income & Extra Expense
Employee Dishonesty
Money and Securities
Back-Up of Sewer or Drain
Dependent Prop Loss of lncome
Utility lnterruption Loss lncm
Addl lnsd Owners Lessee Sched
General Agg Limit Per Prol
Hired Auto Liability
ldentity Restoration Coverage
O Copyri!h! St!t8 Flrm l\4utu6lAutomobrlo ln3ur.nc€ Comp6ny,zmg
lncludBs copyrilhtBd m!t6rislo, lnsurrnc6 Sorvicss office. lnc., with it! pBrmrs.ion
Continued on Next Page Page 6 of 7
SECTION II - LIABILITY
COVEHAGE
Coverage L - Business Liability
Coverage M - Medical Expenses (Any One Person)
Damage To Premises Rented To You
StateFarm
F)'.*tt'rFI
Home Product Sales Policv
Policy Number 92-G
cMP-4994
cMP-4787
cMP-4875
FE-6999.3
cMP-4793.1
cMP-4788.1
FD-6007
DECLARATIONS (CONTINUED)
for CITY OF MENIFEE
Y-D812-0
Data Compromise
Waiver ol Trans Bgt of Recov
Loss Payable
Terrorism lnsurance Cov Notice
Al State Poiitical Perm Prem
Addl lnsd Mgrs Lessor of Prem
lnland Marine Attach Dec
I
D
This policy is issued by the State Farm General lnsurance Company.
Participating Policy
You are €ntitled to participate in a disfibulion ol th€ €arnings ol the company as dstermined by our Board ol Dir€ctors in
accordanoe with the Company's Articles of lncorporation, as amended.
ln Witness Whereof, he State Farm General lnsurance Company has caused this policy to be signed by its President and
Secretary at Bloomington, lllinois
ffu"*rny*ltt
secr€tary
-{/,-e b,/r{
President
IMPOBTANT NOTICE:
Colltomla bw 1equl1E3 us to provlde you wlth lnlomotlon tor llllng comphllns wlth lhe Srole lnsuronce Deponment regordlno the
cover8g. and seryice prcvired undo, this policy.
Your aged's name and coriact inromrtlon rre provlded on the fror ol lhls documed. Another oplion le lo reach out by
mailor phom dkectly to:
Slrle Farm6 Executive Cuctomer Seryice
PO Box 2320
Bloomington lL 81702
Phone f 'l-80o-STATEFARU ('l -AtW02"8al2)
Department of lnsurance complaint! shouH be llled only alter you snd State Farm or your agsnt or olher compalry
rgpresent€livo have lrilod lo reach a sstlalactory agroomqnt on I probbm.
Calif omia Oepartrnent of lnsurance
Consumer S€rylce3 Olylslon
300 South gprlng Slre€t
Loa Angoles, CA 9Ool3
Phone I l€0O-927.HELP (4354 or ybit ruw.inrursnoe.ca.ooyiol-comtme6
Prepared
FEB 09 2022
cMP-4000
022025 290
N
Page 7 ol 7
(-@
O Copyright Stat€ t!rm l\4uturl Automobil€ lns!rrncr Comprny,2008
lnclod6s copyrightod mrterill ot lns!rancs Sorvic.s olficr, lnc.. wiih its psrmission
I
StateFarm STATE FARM GENEHAL INSUHANCE COMPANY
A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS INLAND MARINE ATTACHING DECLARATIONS
Policy umber 92-GY-D8124
Policv Period Ellectivs Date Exoiratior Drb
r 2 Mbnths OCT 31 2021 OCi 51 2422
The polipy period beqins qnd ends at l2 01 am standardlme atlhe Premlses I0caton
&
ffi
8I
'E
E?"F3/093f, :t ?* r' o, u. t n, u
Named lnsured
I{E STE RN A/V INC
ATTACHING INLAND MARINE
M.23-61F8-FB8A F Z
Aulomatic Renewal - lf the policy pedod is shown as 12 months , this policy will be renewed automatjcally subject to the premiums, rules and
forms in effect for each succeeding policy period. lf tris policy is terminated, we will give you and the Mortgagee/Lienholder written notice in
compliance witr the policy provisions or as required by law.
Annual Policy Premium lncluded
The above Premium Amount is included in the Policy Premium shown on $e Declarations
Your policy consists of these Declaratjons. $e INLAND MARINE C0NDITI0NS shown below, and any other forms and endorsements *tat
a pply, including trose shown below as well as $ose issued subsequent to the issua nce of this policy.
Foms, 0ptions, and Endorsomenb
FE-8739
FE-6271
FE-8745
lnland Marine Conditions
Amendatory Endorsement
lnland Marine Computer Prop
See Reverse for Schedule Page witr Limin
Prepared
FEB 09 2022
FD-6007
022026
@ CoEyriohl Strto F.rm Mutunl Automobilo lnlurlnco Comp.oy, 2008
lnclud0s copvriohtsd mlt3rill of lnsur!ncs S€rvic.! oflics, lnc.. wi$ its permission
530 636 i ? 05 ill ?01I 1oll323?cl
92-GY-D812-0
ATTACHING INLAND MARINE
ATTACHING INLAND MARINE SCHEDUTE PAGE
ENDORSEI\4ENT
NUMBEfl
FE-8745
C OVEflAG E
lnland l\4arine Computer Prop
Loss of lncome and Extra Expense
LllillT 0F
INSUBANCE
25,000
25,000
DEDUCTIBLE
AMOUNT
ANNUAL
PREN4IUI\4
OTHER LII\iIITS AND EXCLUSIONS MAY APPLY . BEFER TO YOUR POLICY
O Copyrilht Stato Farm Mutu.l Automobrls lnsur!nce Comp!ny.2008
lncludes copyliOht6d m6t0ri6l ol ln!ur.nc0 Ssryirss office, hc , with its psrmssion
$ 500 Included
Included
s
s
Prep ared
FEB 09 2022
FD-6007
022026
530 68 . Z 05 3l ?!ll loll3z33cl