2021/10/31 Western A/V, Inc. (23)StateFarm !(-OD
STATE FAFM GENEBAL INSURANCE COMPANY
A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTAN, ILLINOIS
E?"Flia€li! ?* r s * s. r s r s
Addl lnsured-Sectlon ll Only
M-23-3535-FB8A F Z002507 3123CITY OF I.IENIFEEAt{D ITS OFFICERS, EtlPLOYEES,
AGENTS & AUTHORIZED VO L UNTEERS29844 HAUr{ RD
r.rEN I FEE CA 9?546-6539
lrllrt,,Itltl,ltl,l,rtltlt,trliltrhttl,,lth,lttltil,llttt,tl
Home Product Sales Policy
DECLARATIONS AMENDED NOV 12 202.I
Policyl{umber 92-GY-D812-0
Policv Period Eflective Dale Exoilrtion Deb
12 Mbnths OCT 31 2021 ]cr 31 2022
Ihe polipy period begins and ends at 12:01 am standardtme at me Premlses locaton
Named lnsured
t.,ESTERN A/V INCffi
II
Aubmatic Re nowal - lf he policy period is shown as 12 months . $is policy will be renewed automatically subject to tre premiums, rules and
lorms in et{ect for each succeeding policy period. lf tris policy is terminated, we will give you and t}re Mortgagee/Lienholder written notjce in
compliance wi$ $e policy provisions or as required by law.
Entity: Corporation
Reason for Declarations:Your policy is amended NOV 12 2021
ADDITIONAL INSURED ADDED
PHEI\,IIUM ADJUSTMENT
FORM CMP.4786.1 ADDED
Endorsement Premium
lncrease
Discounts Applied:
Benewal Year
Years in Business
Enclosed Building
Protective Devices
Sprinkler
Claim Flecord
$ 44.00
Prepared
NOV 17 2021
cMP-4000
019320 290 At
N
O Cowri0ht, St6ts Frrm l\rlutu al AutomobilB lnsurrnc0 Comprny, 2008
lncludos copyriohtsd matsrial of lnsu16nco S€rvic€s oflicB, lrc., with its p0rmission
Continued on Reverse Side o, Page Page 1 of 7
Home Product Sales Pollcv
Policy Number 92-G
DECLARATIONS (CONTINUED)
for CITY OF MENIFEE
Y-D812-0
Location
Number Location o,
Described
Premises
Limit ol lnsurance'
Coveraoe A -
Buildi-ngs
Limit ol lnsurance'
Coveraoe B -
Business FersonalProperty
S€asonallncrease-BusinessPersonalProperly
001
002
1592 N BATAVIA ST STE 2
oRANGE CA 92867-3554
1590 N BATAVIA ST STE 4
oRANGE CA 92867-3s34
No Coverage
No Coverage
$ 1 29,300
$ 1 29,1 00
25%
25./"
' As of the ct ate of thrs po cy, the Limit of lnsurance as shown inc s any lncrease rn e m e to lnflation Coverage
SECTION I . INFLATION COVERAGE INDEX(ESI
Cov A - lnf lation Coverage lndex
Cov B - Consumer Price lndex:
SECTION I . DEDUCTIBLES
N/A
271 .7
Basic Deductible
Special Deductibles:
Money and Securities
$2,500
$2s0 Data Compromise
@ Copynghl St6t6 F!rm Mutuil Automobile lnsur.nce Company.2008
lncludss copyrighted msterial of lnsuroncs ServiEBs offioe, lnc , with its permis5ior
Continued on Next Page
$1 ,000
Prepared
NOV 17 2021
cMP-4000
019320 Page 2 ol 7
SECTION I - PROPEBTY SCHEDULF
StateFarm
15@
T.nIIIt4#
Home Product Sales PolicvPolicy Number 92-G
oEcLARATTONS (CONnNUED)
tor CITY OF MENIFEE
Y-D812-0
Employee Dishonesty $250 $2,500
Other deductibles may apply - refer to policy.
SECTION I - EXTENSIONS OF COVERAGE - LIMIT OF INSUHANCE. EACH DESCRIBED PREMISESe
a
The coverages and corespondlng limlts shown below apply separately to each descrlbed premises shown in these
Declarations, unless indicated by "See Schedulo." ll a coverage does not have a corresponding llmlt shown below,
but has "lncluded" indicated, please reler lo that policy p.ovision for an explanation of that coverage.
COVERAGE
Accounts Rec€ivable
On Premisos
Off Promises
Arson Reward
Back-Up Ol Sewer Or Drain
Collapse
Damage To Non-Owned Buildings From Theft, Burglary Or Robbery
Debris Removal
Equipment Breakdown
Fire Department SeNice Charge
Fire Extinguisher Systems Recharge Expense
Forgery Or Alteration
Glass Exp€nses
lncreased Cost Of Construclion And Demolition Costs (applies only when buildings are
insured on a replacement cost basis)
Money And Securities (Otf Premises)
Money And Securities (On Premises)
Money Orders And Counterfeit Money
LIMIT OF
INSUBANCE
See Schedule
See Schedule
$s,000
See Schedule
lncluded
Coverage B Limit
257o of covered loss
lncluded
$2,s00
$s'ooo
$10,000
lncluded
100/o
See Schedule
See Schedule
$1,000
Prepared
NOV 17 2021
cMP-4000
@ Cogyri0h! Stlt€ Frrm l\4utusl Automobil€ hsurincE Comp!nv.2008
lncludo! copyrilhtod mltsri!l of Insur!nce Soruics! offi06, lnc., witt ilr prrmission
Continued on Reverse Side of Page019321 290
N
Page 3 of 7
Equipment Breakdown
Home Product Sales PoliPolicy Number 92:d
oEcLARATTONS (CONTTNUEO)
'Or
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 Ellects (applies only to thoso premises provided Coverage B - Business
Personal Property)
Personal Properly Off Premises
Pollutant Clean Up And Removal
Preservation Ol Property
Property.Of Others (applies only to those premises provided Covorage B . Business
Personal Property)
Signs
Valuable Papers And Records
On Premises
Off Premises
SECTION I . E
$100,000
$250,000
lncluded
See Schedule
$2,soo
$2s,000
$10,000
30 Days
See Schedule
See Schedule
S Schedule
Schedule
ee
eeS
TENSIONS OF COVERAGE - LIMIT OF INSUBANCE - SCH ULE
The coverages and corresponding limits shown below apply only to the described premises as shown.
LOCATION
0001
0002
Prepared
NOV 17 2021
CN/'lP-4000
019321
COVERAGE
Signs
Back-Up Of Sewer Or Drain
Money And Securities (On Premises)
lvloney And Securities (Off Premises)
Property Of Others (applies only to those premises provided Coverage B - Business
Personal Property)
Accounts Beceivable (On Premises)
Accounts Beceivable (Off Premises)
Outdoor Property
Valuable Papers and Records (On Premises)
Valuable Papers and Records (Off Premises)
Accounts Receivable (On Premises)
O Copyri0ht, 5t.ts f !rm lvlutuil Automobile lngur!nc€ Comp6ny, 2OO8
lnclude! copyrohted mlt8riil of lnsur!ncs Soruic0s officE, l0c, with its p6rmission
Continued on Next Page
$5,ooo
$1s,000
$10,000
$5,000
$2,500
LIMIT OF
INSURANCE
$10,000
$5,000
$s,000
$10,000
$s,000
$10,000
Page 4ol 7
StateFann E
[#
Home Product Sales Policv
Policy Number 92-G
DECLARATIONS (CONTINUEO)
'or
CITY OF MENIFEE
Y-D812-0
Ea3
Accounts Receivable (Off Premises)
Back-Up Of Sewer Or Drain
Money And Securities (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 Becords (Off Premises)
$5,000
$1s,000
$5,000
$10,000
$5,000
$2,soo
$5,ooo
$10,000
$s,ooo
The coverages and corresponding limits shown below are the most we will pay regardless ol the number ol
described premises shown in these Oeclarations.
COVERAGE
Data Compromise
Legal And Forensic lnlormation Technology Review
Per Occurrence
Dependent Properly - Loss Of lncome
Employee Dishonesty
ldentity Restoration
Olher Expenses
Case Management Services
Per Occurrence
Lost Wages And Supervision Expenses
Utility lnterruption - Loss Of lncome
Loss Of lncome And Extra Expense
LIMIT OF
INSUBANCE
$s,000
$s0,000
$5,000
$10,000
$1,000
1 2 months
$35,000
$5,000
Prepared
NOV 17 2021
cMP-4000
019322 290
N
O Copyrighl Stot. F..m Nkitu il Automobils lnsur6nc0 CompEny,2008
lncludos copyri0ht6d m.torial of lnsur.ncs Sorvicos oflic., lnc., with its pormis.ion
Continued on Reverse Side ol Page
$r 0,000
Actual Loss Sustained - '12 lvlonths
I
Page 5 of 7
(D@
SECTION I - EXTENSIONS OF COVERAGE . LIMIT OF INSURANCE. PER POLICY
Home Product Seles Policv
Policy Number 92-G
DECLAHATIONS (CONTINUED)
'or
CITY OF MENIFEE
Y-D812-0
SECTION II . LIABILITY
COVERAGE
Coverage L - Business Llability
Coverage M - Medical Expenses (Any One Person)
Damago To Premises Rented To You
AGGHEGATE LIMITS
Products/Completed Operations Aggregate
General Aggregate
LIMIT OF
INSURANCE
$2,000,000
$5,ooo
$300.000
LIMIT OF
INSURANCE
$4,000,000
$4,000,000
Each paid claim for Liability Coverage reduces the amount ol insurance we provide during the applicable
annual period. Please reler to Section ll - Liability in the Coverage Form and any attached endoisements
Your policy consists of these Declarations, the BUSINESSOWNERS COVERAGE FOBIVI shown below, and any other
forms and endorsements that apply, including those shown below as well as those issued subsequent to the
issuance ol this policy.
FORMS AND ENDORSEMENTS
c t\4 P -41 01
ct\4P-4786.1
cMP-4787
Cl\,lP-4260.1
ctvtP-4261
cMP-4705.2
cMP-4710
cMP-4709
cMP-4698
cMP-4704.1
cMP-4703.1
cMP-4610
cMP-4746.1
Prepared
NOV 17 2021
cMP.4000
019322
Businessowners Coverage Form.Addl lnsd Owners Lessee Sched.Waiver ol Trans Rgt of Becov
Amendatory Endorsement-CA
Amendalory Endorsement
Loss of lncome & Extra Expense
Employee Dishonesty
I\roney and Securities
Back-Up ol Sewer or Drain
Dependent Prop Loss ol lncome
Utility Interruption Loss lncm
General Agg Limit Per Proj
Hired Auto Liability
O Copyrighl Stat8 F.rm Muturl Automobile lnsurinoo Comp.ny, 2008
l0cludss copyrigh1ed mrt€ri6l of ln3u16ncs Ssrurc€s 0ffice, lnc., w h rts permisflon
Continued on Next Page Page 6 of 7
StateFarm(-oo
ffi
Home Product Sales Policv
Policy Numb€r 92-G
DECLARATTONS (CONINUEO)
Ior CITY OF MENIFEE
Y-0812-0
cMP-4990,1
cMP-4994
cMP-4875
FE-6999.3
cMP-4793.1
cMP-4788.1
FD-6007
ldentity Restoration Coverage
Data Compromise
Loss Payable
Terrorism lnsurance Cov Notice
Al State Political Perm Prem
Addl lnsd Mgrs Lessor of Prem
lnland Marine Attach Dec
NOTICE: INFORMATION CONCERNING
CHANGES IN YOUR POLICY
LANGUAGE IS INCLUDED. PLEASE
CALL YOUB AGENT IF YOU HAVE
ANY OUESTIONS.. New Form Attached
E
3;3
This policy is issued by the State Farm General lnsurance Company.
Parlicipating Policy
You are entitled to participate in a distribution of the €arnings o, th€ company as determined by our Board of Directors in
accordance with the Company's Articles of lncorporation, as amended.
ln Witness Whereof, the State Farm General lnsurance Company has caused this policy to be signed by its President and
Secretary at Bloomington. lllinois
{r-nl"",t
secr€Iary
-il,*r," Mq
President
IMPOBTANT NOTICE:
Callloml€ hw r€qultes us to provlde you whh lnlormatlon for llllno complslrts lylth lhe State ln3urEnce Deponmen rcgardlng the
covcrage and rrvice provUed unde. tliE policy,
Yout sgem's name and cor act inlormatbn are provided on the lronl ol lhle docume , Another oplbn is to rerch oul by
mrllor phono diroctly lo:
Statg FarnlD Executive cuglomgr S€rvlce
PO Box 2320
Bloomlngton lL 61702
Phone # 1€oo-STATEFARL (l -80G782-8332)
Departnent o, lnsurance complaints should b€ liled only alter you and Stste Flrm or your ager or olh€r comp€ny
reprDsor*allvE hsvo lalled lo rs6ch I 3€tisl€ctory sglggment on a problem.
CalilomiE oepsrtnent of Insurance
Consumer Sorvlces DVlslon
300 Souh Sprlng SlrEet
Loo Ang.bs, CA g0ol3
Phone * I €o0-927-HELP (4357) or ybil !!E[,i[!gI!IEn!.Ogl9!:ggIgJEgIl
Prepared
NOV 17 2021
CNiIP-4000
019323 290
N
@ Cop\/right St6te F6rm Mutuol Automobils lnsurnn0e Compsny, 2008
lncludes copyrightsd m.tsrial of lnsuronc0 Sorvices oflice, lnc., with iB pormission
Page 7 ot 7
92-GY-D812-0
0r 9323
StateFam STATE FARM GENEFAL INSURANCE COUPANY
A STOCK COMPANY WITH HOME OFFICES IN BLOOMING|ON, ILLINOIS
E?"F 3ia€3f,1 ?* r' o". " r s
Named lnsured
M-23-3535-FB8A F Z
UESTERN A/V INC
INLANO MARINE ATTACHING DECLABATIONS
Policyltlumber 92.GY-D812-0
Policv Pedod Ethclive Dats Exniralion Daie
12 Mbnlhs OCT 31 2021 }cr 31 2022
Ihe policv period beqins and ends at '12.01 am standardtme at tie premtses Tocaton.
(DCD
Er*kd-r
a
H
ATTACHING INLAND MARINE
Aubmalic Renswal - lf $e policy period is shown as 12 monlhs , fiis policy will be renewed automatically subiect to fie premiums. rules and
forms in effect for each succeeding policy period. lt fiis policy is terminated, we will give you and the Mortgagee/Lienholder written notice in
compliance wi$ fie policy provisions or as required by law.
Annual Policy Premium lncluded
The above Premium Amountis included in the Policy Premium shown on fie Declarations
Your policy consists of $ese Declarations. tre INLAND MARINE C0N0lTl0NS shown below. and any other forms and endorsements that
apply. including trose shown below as well as $ose issued subsequentto the issuance of this policy.
Foms, 0plioIs, and Endorssmsnls
FE-8739
FE-6271
FE-8745
lnland Marine Conditions
Amendatory Endorsement
lnland Marine Computer Prop
See Reverse for Schedule Page wi$ Limits
Prepared
NOV 17 2021
FD-6007
0 t9324
O Cowright, Strto Farm Muturl Automobils ln!ur!nco Comprny, 2008
lncludss copyrightod mltrri6l of Ins!16nco Seruices offic€, lnc., with it3 psrmission.
530 6E63? 05 31?0ll lollU3?cl
92-GY-D812-0
ATTAC HING II{LAND MARIT{E
ATTAGHING INLAND MABINE SCHEDULE PAGE
ENDORSEIVIENT
NUM BER
FE-8745
COVERAGE
lnland Marine Compuler Prop
Loss of lncome and Extra Expense
TIMIT OF
INSURANCE
DEDUCTIBLE
AMOUNT
ANNUAL
PREI\4IUI\4
s
$
25,000
25,000
Included
Incl.uded
Prepared
NOV 17 2021
FD-6007
o19324
OTH ER LIM ITS AND EXC LUSIONS MAY APP LY , REFER TO YOUR POLICY
-
O Copyri0ht Stlt€ t!rm lvlutu !l Automobile lnsurlnca Comprny, 2008
lncludss copyriChtod mrt6rirl of lnsur.nce S0rvic6! ofticB, lnc., wrth its p0rmi$sion.
510 6d6i.2 0i 3l ?0ll loll323!cl
$ 500