2021/10/31 Western A/V, Inc. (21)StateFarm !(-oo
fl.r-#it+xtudr
STATE FAFM GENERAL INSURANCE COMPANY
A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS
E?"fl?fa?1f,l ?* r s oe s. s s r s
Addl lnsured-Sectlon ll Only
M-23-61F8.FB8A F Z002309 3123CITY OF }IEN I FEEA D ITS OFFICERS, E]lPLOYEES,
AGENTS & AUTHORIZEII VO L UNTEE RS298({ HAUN RD
t{EN r FEE CA 92546-6539
Home Product Sales Policy
DECLARATIONS A[,4ENDED MAB 2 2022
Named lnsured
I{ESTERN A/V INC
a
x
Policyl{umber 92-GY-D812{)
Policv Perlod Elfuctive Oele Exoiralion Date
12 Mbnths OCT 31 2021 c,c\ 31 2022
The policv period beoins and ends at l2:01 am standardtme at the premtses Tocaton.
Automtlic Renowal - lt be policy pedod is shown as 12 monlhs , tris policy will be renewed automatically subiect to dre premiums, rules and
lorms in etfect for each suc ceeding policy period. lf dris policy is terminated, we will give you and tlre Mortgagee/Lienholder written notice in
compliance wifr fre policy provisions or as required by law
Entlty: Corporation
Reason for Doclarations:Your policy is amended MAR 2 2022
ADDITIONAL INSUBED ADDED
PBEMIUM ADJUSTMENT
FOHM CMP-4786.1 ADDED
?
1.
!
,-
?
Discounts Applied:
Renewal Year
Years in Business
Enclosed Building
Protective Devices
Sprinkler
Claim Record
$ 44.00
Prepared
MAR 24 2022
cMP-4000
O Copyriohl St6ts tlrm Mutual Aulomobile lnsurrnce Compr0y, 20m
lncludos copyriohtod mlterial ol ln!ur!nco Servicos officB. lnc., witfi its psrmission
Continued on Reverse Sido of Page Page 1ot 7
ll
018361 290
N
ltlt,,lil llll, t,,,, tl, rtil ll, rl,llItlrl,,l,,il h il,, tlltr, tlt,lr
Endorsemenl Premium
lncrease
Home Product Sales Policv
Policy Number 92-G
DECLABATIONS (CONTINUED)
tor CITY OF MENIFEE
Y-D812-0
SFCTION I. PROPERTY SCHEDULF
Location
Number Location otDescribed
Premises
Limit ol lnsurance'
Coveraoe h -
Bulldi'ngs
Limit ol lnsurance'
Coveraoe B -Business FersonalProperly
Seasonallncrease-Busineis
Personal
Property
001
002
1592 N BATAVIA ST STE 2
oBANGE CA 92867-3s54
1590 N BATAVIA ST STE 4
oBANGE CA 92867-3534
No Coverage
No Coverage
$ 129,300
$ 129,100
25./"
25%
'Asofthee ve date of this policy, t Limit of lnsurance as shown incl s any rncrease rn
SECTION I - INFLATION COVERAGE INDEX(ES)
m due to lnf lation Coverage
N/A
271 .7
SECTION I - DEDUCTIBLES
Baslc Deductible
Special Deductiblos:
Money and Securities
$2,s00
$250 Data Compromise
@ Copyriohl State F!rm Mutu!l Automobils ln!ur.nce Comp.ny,2008
lncludr3 copyri0hted msteridl of lnsurrncs SErvicB! office, lnc., with it! pornis!ion
Continued on Next Page
$1,000
Prepared
MAR 24 2022
cMP-4000
018361 Page 2ot 7
Cov A - Inf lation Coverage Index:
Cov B - Consumer Price lndex:
ffi
Home Product Sales PolicvPollcy Number 92-G
Employee Dishonesty
DECLARATIONS (CONTINUED)
,oT CITY OF MENIFEE
Y-D812-0
$2s0 Equipment Breakdown $2,s00
sFeTtr)N r FYTFNqI.}Nq rlF COVFRAGF - I II'IT r)F INSIIFIANllF. FA(lH NFqNtrIRFN PFIF[rlSFs8I
iR
The coverages and corresponding limits shown below apply separat€ly to each doscribod premises shown in theseDeclaratlons, unless indicated by "See Schedule." ll a coverage does not have a correspondlng llmit shown below,but has "lncluded" indicated, please reler to that policy provision for an explanatlon ol that covCrage.
COVERAGE
Accounls Receivable
On Premises
Otf Premises
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 Exp€nses
lncreased Cosl Ol Construction And Oemolition Costs (applies only whgn buildings ars
insured on a replacement cost basis)
Money And Securities (Otf Premises)
Money And Securities (On Premis€s)
Money Orders And Counterfeit Money
See Schedule
See Schedule
$s,000
See Schedule
lncluded
Coverage B Limit
25% ot covered loss
lncluded
$2,s00
$5,000
$10,000
lncluded
10%
See Schedule
See Schedule
$1,000
O Copyrioht, St.te t!rm Mutu !l Automobils lnsur!nc6 Complny.20m
lncludss copvriOht€d mrteri!l of lniunnce Soryrces oflico, lnc., with its psrmi.sion
Conlinued on Reverse Side of Page Page 3 of 7
StateFarm !(D@
Other deductibles may apply - refer to policy.
LIMIT OF
INSURANCE
Prepared
MAR 24 2022
cMP-4000
018362 290
N
Home Product Sales PolicvPolicy Numb€r 92-G
DECLABATIONS (CONTINUED)
tor 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 providss
Coverage A - Buildings)
Ordinance Or Law - Equipment Coverage
Outdoor Property
Personal Eltects (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
Off Premises
$100,000
$250,000
lncluded
See Schedule
$2,s00
$25,000
910,000
30 Days
See Schedule
See Schedule
See Schedule
See Schedule
SECTION I - EXTENSIONS OF COVEBAGE - LIMIT OF INSU FANCE - SCHEDULE
The coverages and corresponding limits shown below apply only to the described premises as shown.
LIMIT OF
INSURANCELOCATION
0001
Prepared
MAR 24 2022
cMP-4000
018362
COVERAGE
Signs
Back-Up Of Sewer Or Drain
Money And Securities (On Premises)
Money And Securities (Olf Premises)
Property Of Others (applies only to those premises provided Coverago B - Business
Personal Properly)
Accounls Receivable (On Premises)
Accounts Receivable (Of f Premises)
Outdoor Property
Valuable Papers and Records (On Premises)
Valuable Papers and Records (Off Premises)
0002 Accounts Receivable (On Premises)
$5,ooo
$15.000
$10,000
$5,000
$2,500
$10,000
$5,000
$s,ooo
$10,000
$5,ooo
$10,000
O Copyri0h! St!t0 t.rm Mutu6l Automobil6 lnsurance Comp!ny,2008
lncludos copyriohted mntorial ol lnsur!nco Sorvices oflice. lnc., with rts pormission
Continued on Next Page Page 4 ol 7
I
StateFarm D
Home Product Sales PolicvPolicy Number 92-G
DECLARATIONS (CONllNUED)
tor CITY OF MENIFEE
Y-D812-O
ffi
e
a
;g
Accounts Receivable (Olf Premises)
Back-Up Ot Sewer Or Drain
Money And Securities (Off Premises)
Monoy And Securitios (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 (Olt Premises)
SECTION I. EXTENSIONS OF COVEBAGE. LIMIT OF INSURANCE - PEH POLICY
$s,000
$15,000
$s,000
$10,000
$5,ooo
$2,soo
$5,000
$10,000
$5,000
The coverages and corresponding limits shown bolow a.e the most we wlll pay regardless ol the number ol
describ€d prgmis€s shown in th€se Declaratlons.
COVERAGE
@ Copyright St.to t6rm Mutu.l Automobilo lnsurrnc€ Conpnny, 2008
lncl!d€s copyrighted m.tori6l of lnsuranco S.rvicrs offire, lnc., wlth its permission
Continued on Reverse Side of Page
LIMIT OF
INSUFANCE
$s,000
$50,000
$5,000
$10,000
$1,000'l 2 months
$3s,000
$s,000
$10,000
Actual Loss Sustained - l2 Months
Data Compromise
Legal And Forensic lnformation Technology Roview
Per Occurrence
Dependent Property - Loss Ol lncome
Employee Dishonesty
ldentity Restoralion
Other Expenses
Case Managemenl Services
Per Occurrence
Lost Wages And Supsrvision Expenses
Utility lnterruption - Loss Ol lncome
Loss Of lncome And Extra Expense
Prepared
MAR 24 2022
cMP-4000
ll
018363 290
N
Page 5 of 7
&
Home Product Sales Policv
Policy Number 92-G
DECLARATIONS (CONTINUED)
lor CITY OF MENIFEE
Y-D812-0
sFcTtoN -IlaB rTY
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
LIMIT OF
INSUBANCE
$2,000,000
$5,000
$500,000
LIMIT OF
INSUBANCE
$4,000,000
$4,000,000
Each paid claim for Liability Coverage reduces the amount of insurance we provide durinq the applicable
annual period. Please refer to Section ll - Liability in the Coverage Form and any attached endoisements
Your policy consists of these.Declarations, the BUSINESSOWNERS COVERAGE FORM shown b€low, and any other
forms and endorsements that apply, including those shown below as well as those issued subsequent to the
issuance of this policy.
FOBMS AND ENDOBSEME
cMP-4101
cMP-4786.1
cM?-4787
cMP-4250.1
crvP-4261
cMP-4705.2
cMP-4710
cMP-4709
cMP-4698
cMP-4704.1
cMP-4703.1
cMP-4610
cMP-4746.1
Prepared
MAR 24 2022
Cl\ilP-4000
Businessowners Coverage Form
'Addl lnsd Owners Lessee Sched
'Waiver of Trans Rgt of Recov
Amendatory Endorsement-CA
Amendatory Endorsement
Loss of lncome & Extra Expense
Employee Dishonesty
Money and Securities
Back-Up of Sewer or Drain
Dependent Prop Loss ol lncome
Utility Interruption Loss lncm
General Agg Limit Per Proj
Hired Auto Llability
O Copyrighl Stats Farm fulutu6lAutomobilo lnsur!nos Complny,2008
lnclud6s copyrightBd mntefl6l gf lns!rEhcB Servic0s olfice, lnc., with its psrmissiofl
Continued on Next Page Page 6 of 7
I
I
(D@
Home Product 56los PolicvPolicy Number 92-G
oEcLAFAT|ONS (CONINUED)
Ior CITY OF MENIFEEY-D812-0
cMP-4990.1
cMP-4994
Ct\ilP-4875
FE-6999.3
cMP-4793.1
cMP-4788.1
FD-6007
ldentity Restoration Coverage
Data Compromise
Loss Payable
Terrorism lnsuranc€ Cov Notice
Al State Political Perm Prem
Addl lnsd Mgrs Lessor of Prem
lnland Marine Attach Dec
NOTICE: INFORMATION CONCEBNING
CHANGES IN YOUR POLICY
LANGUAGE IS INCLUDEO. PLEASE
CALL YOUR AGENT IF YOU HAVE
ANY QUESTIONS.t New Form Attachad
II
rrS
L]
This policy is issued by the State Farm General lnsurance Company.
Participating Policy
You are entit€d to participats in a distribution of the earnings ol the company as delermined by our Board of Directors in
accordance 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
&yYnW
secretary
.{/,*e Mq
IMPORTANT NOTICE:
Colroml. Lw rBqul]€s us to plovldc you whh lr orma on lor llllng cornphlr ! wlth the Stlte lnsur8nce Depi rnent tegardln0 tl?
covengc and rrvics proviled und€r tlis policy.
Your agenl'e name and cornact intomatlon src provided on tha ,rom ol lhis documer . Anothr optlon ls to reach out by
mallor phone dhoctt lo:
Sl8te FrrrP Executive Customsr Serylce
PO Box 2320
Bloominglon lL 61702
Phono t 1{q,-STATEFAR (1€0o-7E2"8332)
D,op!nment ol lnsul€rce complslnts lhould be tibd only slter you and Stste Fam or your agent or olher comprny
ropr?sortathe havo lsiled lo relch o t€tirlactory igrsoment on € problem.
Callomir Depsrtment ot lnsurance
consumcl Ssrvlce3 Dlvblon
300 South g}flng Slleet
Los Angpbs, CA go0l3
Phone f 1{oo-927-HELP (/*l54 or vbh xuw.insura noe,cs.ooy/o1-cs nr.me ra
President
O Copyri0h! State F.rm lvlutu !l Automobilo ln$urrncs Comp.ny, 2m
lncludos copyrightsd mrt8ri.l of lnsur!nco S€rvices oftice. lnc.. wrth its prrmission
Prepared
MAB 24 2022
cMP-4000
018364 290
N
StateFarm
Ei',iiLv.ttitEe.i
Page 7 ot 7
StateFama STATE FARM GENEFAL INSUBANCE COMPANY
A S|OCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS
E?"E?ia#i! ?* r s o e s. s s z s
Named lnsured
M.23-61F8-FB8A F Z
t{E ST ERt{ A/V INC
E
INLAND MAHINE ATTACHING DECLARATIONS
Policyl{umber 92-GY-D812{
Pollcv Period Elhclive ltale Exoiration Dab
12 Mbnrhs OCT 31 2021 C,cr 31 2022
Ihe policv oeriod beqins and ends at 12.01 am standardtme at the premtses Iocalon.
t{-.*i
HbE
Ea
rg
Aubmatic Roocwal - lf the policy padod is shown as 12 months . tris policy will be renewed automatjcally subiect o $e premiums, rules and
lorms in eflectfor each succeeding policy period. lf dris policy is terminated, we will give you and dre lMortgagee/Lienholder written notice in
compliance wifi *re policy provisions or as required by law.
Annual Policy Premium lncluded
The above Premium Amount is included in tre Policy Premium shown on he Declarations
Your policy consists of trese Declarations, tre INLAND MARINE C 0NDlTlONS shown below. and any other forms and endorsemenb trat
apply, including drose shown below as wellas trose issued subsequentto he issuance ofttis policy.
torms, 0ptions, and Endorsements
FE-8739
FE-6271
FE-8745
lnland lvlarine Conditions
Amendatory Endorsement
lnland lvlarine Computer Prop
See Reverse for Schedule Page wifr Limis
Prepared
MAR 24 2022
FD-6007
018365
iil0 6S a.2 05 3l 20ll (!lll2l2r
ATTACHING INLAND MARINE
2
)
!
'-
O Cowright StltB trrm Mutu.l Automobilo ln!urlnca Comp.ny.2008
lncludet copyright d mrtonll of lnsur!nc. Sorvic8t Olfics, lnc., with its permission
92-GY-D812-0
ATTACHIITG II{LAND MABII'IE
ATTACHING INLAND MABINE SCHEDUTE PAGE
ENDORSEMENT
NUMBER
FE-8745
C OVERAG E
lnland Marine Computer Prop
Loss of lncome and Extra Expense
sI
LIIVIT OF
INS UHANC E
DEDUCTIBLE
AMOUNT
$ 500
ANNUAL
PREIVIUM
Included
Included
Prepared
MAR 24 2022
FD-6007
018365
OTHER LII\iIIIS AND EXCLUSIONS MAY APPLY . REFER TO YOUR P(]LICY-
O Copyright Stats F,rm lvlutu6lAutomobrl6 lnsur!noo Comp!ny,2()Og
lnclude! copyriohtsd moteri!l ol lnsur.nce Srrvico! office. lnc., with its 00rmission.
25,000
25,000
tJo 686!.? 05 rl foll (olnzBcl
I