2021/10/31 Western A/V, Inc. (18)StateFarm&
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STATE FARU GENERAL INSURANCE COMPANY
A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON. ILLINOIS
B?"F?ldlfr ,e ?* r s o e s. s s r s
Addl lnsured.Section ll Only
M-23-61F8-FB8A F Z001934 3123CITY OF ilEN I FEE
AND ITS OFFICERS, EI{PLOYEES,
AGENTS & AUTHORIZED VOL UITEERS298{4 HAUt'r RD
MENIFEE CA 92546-6539
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Home Product Sales Policy
DECLARATIONS A|\,4ENDED NOV 1s 2021
PolicyNumber 92-GY-D8124
Policv Poriod Elleclivo Dats Exoiration Dale
12 Mbnrhs OCT 31 2021 ]cT a1 2022
The poltpy period begins 3nd ends at 12.01 am standardtme at tie premtses I0calon.
Named lnsured
t{E STE RN A,/V INC
E
Aubmalic Fenewal " lf the policy period is shown as 12 nronlhs , this policy will be renewed automatically subjectto the premiums. rules and
forms in effect Ior each succeeding policy period. lf fris policy is terminated, we will give you and tre Mortgagee/Lienholder wriften notice in
compliance witr tre policy provisions or as required by law.
Entlty: Corporation
Beason lor Declaratlons:Your policy is amended NOV 19 2021
ADDITIONAL INSURED ADDED
PBEMIUM ADJUSTI\iIENT
FORIV CMP.4786.1 ADDED
Endorsement Premium
lncreas6
Discounts Applied:
Renewal Year
Years in Business
Enclosed Building
Protective Devices
Sprinkler
Claim Record
$ 214.00
O Copyright Stlto t!rm Mutual Automobils ln3urlnc0 Comp6ny,2008
lncludqr cogyri!ht.d mlteriol of lnsurance Servico3 oflico, lnc., with its psrmission
Conlinued on Reverse Side ol Page Page 1of 7
Prepared
DEC 07 2021
cMP-4000
016134 290 At
N
Home Product Sales Policv
Policy Number 92-G
DECLABATIONS (CONTINUED)
for CITY OF MENIFEE
Y-D812-0
SECTION I - PBOPEBTY SCHEDULE
Localion
Number Location of
Described
Premises
Limit ol lnsurance'
Coveraoe A -
Buildfngs
Llmit ol lnsurance'
Coveraoe B -
Business Fersonal
Property
Seasonallncrease-
BusinessPersonalProperty
001
002
1592 N BATAVIA ST STE 2
oBANGE CA 92867-35s4
1590 N BATAVIA ST STE 4
oBANGE CA 92867-3534
No Coverage
No Coverage
$ 129,300
$ 129,100
25%
25./"
. As of the effectite date of thrs po icy, the Limit of nsurance as shown includes any increase in the limit due to lnflation overage
SECTION I . INFLATION COV HAGE INDEX(ES)
Cov A - lnf lation Coverage lndex
Cov B - Consumer Price lndex:
N/A
271 ,7
SECTION . DEDUCTIBLES
Basic Deductlble
Special Deduclibles:
Money and Securities
$2,500
$2s0 Data Compromise
O Copyri!ht Strto tsrm Mutu6l Automobil6 lnsur!nca Comp.ny, 2008
lncludes Gopyrioht€d m6ts(01 of lnsur0nce SBrvicss officB, lhc , wth [s permission
Continued on Nsxt Page
$1 ,000
Pre p a red
DEC 07 2021
cMP-4000
016134 Page 2 ol 7
StateFarm !(D@
ffitE-lir
Home Product Sales PolicvPolicy Number 92-G
oEcLARATTONS (CONnNUED)
lor CITY OF MENIFEE
Y-D812-0
Employee Dishonesty $2s0 Equipment Breakdown $2,s00
Other deductibles may apply - refer to policy
SECTION I. EXTENSIONS OF COVERAGE. LIMIT OF INSUBANCE - EACH DESCEIBED PEEMISESE
a3 The coverages and corresponding limits shown below apply s€parately to each described premises shown in these
Declarations, unless indicated by "See Schedule." ll a coverage does nol have a corresponding limit shown below,
but has "lncluded" indicated, please reter to that policy provision lor an explanation ol that coverage.
COVERAGE
Accounts Receivable
On Premises
Ofl Premises
Arson Reward
Back-Up Of Sewer Or Drain
Collapse
Damage To Non-Owned Buildings From Thett, Burglary Or Robbory
Debris Removal
Equipment Breakdown
Fire Departmenl Sewice Charge
Fire Extinguisher Systems B6charge 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 (Oft PrEmises)
Money And Securities (On Premises)
Money Orders And Counterfeit Money
LIMIT OF
INSURANCE
See Schedule
See Schedule
$5,000
See Schedule
lncluded
Coverage B Limit
25% of covered loss
lncluded
$2,500
$5'ooo
$10,000
lncluded
1Oo/.
See Schedule
See Schedule
$1,000
Prepared
DEC 07 2021
CNiIP-4000
O Copyright, StrtB Farm Mutual Automobilo lniurrnce Comp!ny, 2008
lnclud€s copyriohted mltori!l of lns!r0nc€ SBrvicrs offic6, lnc., with its p€rmission
Continued on Beverse Side of Page016135 290
N
Page 3 of 7
Home Producl Sales PolicvPolicy Number 92-G
DECLABATTONS (CONTTNUEO)
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 Property
Personal Etfects (applies only to those premises provided Coverage B - Business
Personal Property)
Personal Property Off Premises
Pollutant Clean Up And Removal
Preservation Of Property
Property Of Others (applies only to those premises provided Coverage B - Business
Personal Property)
Signs
Valuable Papers And Records
On Premises
Otf Premises
$100,000
$2s0,000
lncluded
See Schedule
$2,500
$25,000
$10,000
30 Days
See Schedule
See Schedule
See Schedule
See Schedule
SECTION I - EXTE SIONS OF COVERAGE . LIMIT OF INSU RANCE . SCHEDULE
The covsrages and corresponding limits shown below apply only to the descrlbed premises as shown.
LOCATION
0001
0002
Prepared
oEc 07 2021
cMP-4000
016135
COVEFAGE
LIMIT OF
INSURANCE
Signs
Back-Up Of Sewer Or Drain
Money And Securities (On Premises)
Money And Securitres (Off Premises)
Property Of Others (applies only to those premises provided Coverage B - Business
Personal Property)
Accounts Receivable (On Premises)
Accounts Receivable (Off Premises)
Outdoor Property
Valuable Papers and Flecords (On Premises)
Valuable Papers and Records (Off Premises)
Accounts Receivable (On Premises)
O Copyngh( Stato Farm Muturl Automoblio ln!urrncE Company, ZOOS
lncludgs copyrightsd msterirl ol lnsursnce SErvicBs otfic€, lnc., with its Dermission
Continued on Nexl Page
$10,000
$5,ooo
$2,s00
$s,000
$15,000
$10,000
$5,ooo
$5,000
$10.000
$5,ooo
$10,000
Page 4 ol 7
StateFarm !6-@
pg
Home Product Sales Policv
Policy Number 92-G
DECLARATIONS (CONTINUEO)
,or CITY OF MENIFEE
Y-D812-0
Accounts Receivable (Of f Premises)
Back-Up Of Sewer Or Drain
Money And Securities (Oll Premises)
Monoy 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 Flecords (Olf Premises)
$s,ooo
$10,000
$s,000
$2,500
$5,000
$1s.000
$s,ooo
$10,000
$5,ooo
8I
6g
SFCTION I. FXTFNSIONS OF COVFRAGF .I IMIT OF INSII RANCE - PEB POLICY
The coverages and corresponding limits shown below are lhe most we will pay regardless of the number ol
describod premises shown in theso D€clarations.
COVERAGE
Data Compromise
Legal And Forensic lnformation Technology Review
Per Occurrence
Dependent Properly - Loss Of lncome
Employee Dishonesty
ldentity Bestoration
Other Expenses
Case Management Services
Per Occurrence
Lost Wages And Supervision Expenses
Utility lnterruption - Loss Ol lncome
Loss Of lncome And Extra Expense
LIMIT OF
INSUBANCE
$s,000
$s0,000
$s,000
$10,000
$1,000
1 2 months
$3s,ooo
$s,ooo
Prepared
DEC 07 2021
cMP-4000
0r6136 290
N
O Copyrioht Stat. t.rm Mutu0l Automobilo lnsur.rc. Comprny.2008
lflcludrs cogyriCht.d m.t6ri!l of lnsur!nce Sorvices 0ffice. lnc., with hr psrmission
Continued on Reverse Side of Page
$10.000
Actual Loss Sustained - '12 Months
Page 5 of 7
Home Product Sales PolicvPolicy Number 92-G
DECLARATIONS (CONTINUED)
Ior CITY OF MENIFEE
Y-D812-0
SECTION II . LIABILITY
COVERAGE
Coverage L - Business Liability
Coverage M - [iledical Expenses (Any One Person)
Damage To Premises Rented To You
AGGREGATE LIMITS
Products/Completed Operations Aggregate
General Aggregate
LIMIT OF
INSUBANCE
$2,000.000
$5,000
$300.000
LIMIT OF
INSURANCE
$4,000,000
$4,000,000
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
Your policy consists of these Declarations, the BUSINESSOWNEBS COVERAGE FORM shown below, and any other
forms and endorsements that apply, including those shown below as well as those issued subsequent to theissuance of this policy.
FOFMS AND ENDORSEMEN S
ctv'tP-4101
Cl\,lP-4786.1
cMP-4260.1
cMP-4261
cMP-4705.2
cMP-4710
cMP-4709
cMP-4698
cMP -4704.1
cMP-4703.1
cMP-4610
cMP-4746.1
C[ilP-4990.1
Pre p ared
DEC 07 2021
cMP-4000
016136
Businessowners Coverage Form.Addl lnsd Owners Lessee Sched
Amendatory Endorsement-CA
Amendatory Endorsement
Loss o[ lncome & Extra Expense
Employee Dishonesty
Money and Securities
Back-Up of Sewer or Drain
Dependent Prop Loss of lncome
Utility lnterruption Loss lncm
General Agg Limit Per Proj
Hired Auto Liability
ldentity Restoration Coverage
O Copyrighl Strts Forrn l\4utu.l Automobils lnsu16ncE Comp6ny, 2008
lncludes copyrightsd mltsri!l of lnsur{nce Services otfic€, lnc., wth [s parmissron
Continued on Next Page Page 6 of 7
StateFarm !3
ffi
Home Product Sales PollcvPolicy Numb€r 92-G
DECLARATIONS (CONTINUED)
Ior CITY OF MENIFEE
Y-D812-0
cMP-4994
cMP-4787
cMP-4875
FE-6999.3
cMP-4793.1
cMP-4788.1
FD-6007
Data Compromise
Waiver of Trans Rgt of Recov
Loss Payable
Terorism lnsurance Cov Notice
Al State Political Perm Prem
Addl lnsd Mgrs Lessor of Prem
lnland Marine Attach Dec* New Form Attached
a
5
This policy is issued by the State Farm General lnsurance Company.
Parlicipating Policy
You are entitlsd to participate in a distribution of the €arnings of the company as determined by our Board of Directors in
accordance with the Company's Artioles of lncorporation, as amended.
ln Witness Whereof, lhe State Farm General lnsurance Company has caused lhis policy to be signed by its President and
Secretary at Bloomington, lllinois
fi"^-tnlp*tt
:'ecreiary
-{/,-e C*/ry
President
IMFORTANT NOTICE:
CEllrornlo law requlres u9 to provlde you whh lnlormatlon for llllng complolrts whh the Stote lngursnce Oepanment regordln0 the
coverags and service provklsd under this poficy.
Your agent's name snd contact ir orm.tlon are provlded on the lror o{ lhis documeri. Another option i3 to rcach ont by
mail or phorE diroclt lo:
Slalg Falm@ Executive cuglomer ssrvice
PO Bor 2320
Bloomlngton lL 6'1702
Phone # l€q)-STATEFAH (1-60G782-6332)
Department ot lnsursnoe complaltrtc ahould be llled only atter you snd Stste Fam or your agent or olher company
reprE$ntativs hsvo lsled to rsach a salislaqlory .grcomon on a ploblom.
CalilomiE Department ol ln8rrr8nce
Congumer Servlceg Dlvlgbo
300 South Sprlm Sl]aet
Lo6 Angebs, CA 90013
Phorp * l€o0427-HELP (/xt54 or vbil ruw.insurEnce,cr.ooy/o1-coErtmera
Prepared
DEC 07 2021
ct\4P-4000
O Copyrigh! Si.ts F!rm MuturlAutomobil0 lns!r6ncs Comp.ny,2u)8
lncludes copyrighted m.t'ri!l of lnsurrncs S€ruic€s oflics, lnc., r'/ilh its permission
016137 290
N
Page 7 ol 7
StateFarm 9TATE FARM GENERAL INSURANCE COMPANY
A STOCK CAMPANY WITH HOME OFFICES IN BLOOMINGTON. ILLINOIS(-@
P_o 9o^ 853925.Htcnarclson_ lx 75085-3925
Named lnsured
t{E STE R N A/V INC
INLAND MARINE ATTACHING DECLAHATIONS
Policy umber 92-GY-D812{)
Policv Padod Ellective Date Exoiralion Dab
12 Mbnlhs OCT 31 2021 0ct ss z6ZZ
The poltpv period begins and ends at 12 0l am standardume at tie premtses Ioca00n.
ffi
II
;E
ATTACHING INLAND MARINE
Aubmalic Bonow.l ' lf the policy pedod is shown as 12 monlhs , 6is policy will be renewed automatically subiect to lhe premiums, rules and
forms an effect for each succeeding policy period. lf fiis policy is terminated. we will give you and t'te Mortgagee/Lienholder written notice in
compliance wi$ the policy provisions or as required by law.
Annral Policy Prcmium lncluded
The above Premium Amount is included in the Policy Premium shown on tre Declarations
Your policy consists of these Declarations, fie INLAND MARINE C0NDITI0NS shown below, and any ofrer forms and endorsements frat
apply, including drose shown below as well as trose issued subsequentto the issuance of*ris policy.
Forms, 0ptions, and Endorssmsnts
FE-8
FE-6
FE-8
739
271
745
lnland Marine Conditions
Amendatory Endorsement
lnland N4arine Computer Prop
See Reverse for Schedule Page wifr Limis
Prepared
DEC 07 2021
FD-6007
016138
@ Copyri0h! Strte Frrm Mltusl Automobile ln!urlnce Comp!ny, 2008
lncludos copyri!htrd m6tora6l of lnsurance S€rvrc€s oflicB. lnc., with its p€rmission
5m 6$i7 Dl lr 70ll loll32l2cl
M-23-61F8.F88A F Z
92-GY-D812-0
ATTACHIT{G II'ILAND MARIT{E
ATTACHING INLAND MARINE SCHEDUTE PAGE
ENDORSEMENT
NUI\4BER
FE-87 45
COVEBAG E
lnland lv'larine Computer Prop
Loss of lncome and Extra Expense
t MtT 0F
INSURANCE
DEDUCTIBLE
AMOIJNT
$ 500
ANNUAL
PBEM IUIVI
$
$
25,000
25 , OOO
Included
Included
Prep a red
DEC 07 2021
FD-6007
016138
OTHEB LIMITS AND EXCLUSIONS MAY APPLY - HEFER T(] YOUR POLICY
O Copyrigh! Strt€ tErm Mutu!l Automobilo lnrursncs Comp6ny, 2000
lnclude! copyrightBd mltorirl of lnsur!noe S6rvicss offico, lnc., w$ its p.rmission.
53, 016 o 2 05 31 20ll lolr3133c!