2021/10/31 Western A/V, Inc. (24)StateFarm !(-)oo STATE FABM GENEBAL INSURANCE COMPANY
A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON- ILLINOIS
E?"F 3/d3i ;e ?9, u o u'. s' r'
Addl lnsured-Section ll Only
[/-23-61 F8-FB8A F Z002727 3123CITY OF I.|EN I FEE
AND ITS OFFICERS, EHPLOYEES,
AGENTS & AUTHORIZED VO L UNTEERS29844 HAUN RD
t'tEN I FEE CA 9"586-6539
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Home Product Sales Policy
oECLARATIONS AMENDED NOV 17 2021
Policy umbar 92-GY-D812-0
Policv Pe od Elfeclive Date Exoiratior Date'12 Nlbnths OCT 31 2021 6Ai i ,oD
The polipv period beqins 4nd ends at l2:01 am standard[me at tie premtses Tocaton.
Named lnsured
WESTERN A/V INCHf*h.'dt
II
Automalic Rsnewal - lf the policy period rs
forms in effect for each succeeding pohcy p
compliance witlr the policy provisions or as
shown as 12 months , this policy will be renewed automatically subjectto the premiums, rules and
eriod. lf tris policy is terminated, we will give you and the Mortgagee/Lienholder written notice in
required by law.
Entity: Corporation
Reason lor Declarations:Your policy is amended NOV 17 2021
ADDITIONAL INSURED ADDED
PREMIUM ADJUSTIVIENT
FORIVI CIVIP-4786,1 ADDED
Endorsement Premium
lncrease
Discounts Applied:
Renewal Year
Years in Business
Enclosed Building
Protective Devices
Sprinkler
Claim Record
$ 44.00
Prepared
DEC 06 2021
cMP-4000
019631 290 At
N
O Copyrigh! Strta F.rm lvlutu6l Automobile lnsurrnce Company, 2008
lncludos copyrightsd m6teriol of lnsursnce Services office, Inc., wrth its permirsion
Continued on Beverse Side of Page Page 1of 7
Home Product Sales Poli
Policy Number 92
DECLARATIONS (CONTINUED)
for CITY OF MENIFEE
Y-D812-0
cI-u
SECTION I - PROPEBTY SCHEDULE
Location
Number Location ol
DescribedPremises
Limit ol lnsurance*
Coveraoe A -
Bulldings
Limit ol lnsurance*
Coveraoe B -
Business FersonalProperty
Seasonallncrease-Business
PersonalProperty
No Coverage
No Coverage
$ 129.300
$ 129,100
001
002
1592 N BATAVIA ST STE 2
oRANGE CA 92867-3554
1590 N BATAVIA ST STE 4
oRANGE cA 92867-3534
. As of the effective date of this po cy, t lmtto lnsurance as shown inclu s any increase in t e m ue to n ation overage
SECTION I - INFLATION COVEFAGE INDEX(ES)
Cov A - lnf lation Coverage lndex
Cov B - Consumer Price lndex:
SEOTIQNT - DEDUCTIBLES
N/A
27't .7
Basic Deductible
Special Deductibles:
lvloney and Securities
$2,500
$250 Data Compromise
@ Copyri0h! Stito Fdrm Mutu!l Automobilo lns!rancs Compony, 2008
lncludes copylight8d mitsrial of lnsurince Soryrces otfice, lnc., with its p€rmisslon
Continued on Noxt Page
$1,000
Prep ared
DEC 06 2021
Cl\ilP-4000
019631 Page 2ol 7
!
Ett{rffi
Home Product Sales Policv
Policy Number 92-G
DECLARATIONS (CONTINUED)
lor CITY OF MENIFEE
Y-D812-0
Employee Dishonesty $2s0 Equipment Breakdown
Other deductibles may apply - refer to policy
SECTION I. EXTENSIONS OF COVEBAGE. LIMIT OF INSUBANCE - EACH DESCBIBED PREMISESE
The coveragos and corresponding limits shown below apply soparately to each described premises shown in these
Declarations, unless indicated by "See Schedule." ll a covorage does not have a coresponding llmit shown below,
but has "lncluded" indicated, please reter to thal policy provision tor an explanation ol that coverage.
COVERAGE
Accounts Rec€ivable
On Premises
Off Premises
Arson Reward
Back-Up Ol Sewer Or Drain
Collapse
Damage To Non-Owned Buildings From Thelt, Burglary Or Robbery
Debris Removal
Equipment Breakdown
Fire Department Service Charge
Fire Extinguisher Systems Recharge Expense
Forgery Or Alteration
Glass Expenses
lncreased Cost Of Construction And Demolition Costs (applies only when buildings are
insured on a replacement cost basis)
Money And Securities (Off Premises)
Money And Securities (On Premises)
Money Orders And Counterfeit Money
LIMIT OF
INSUBANCE
See Schedule
See Schedule
$1,000
Prepared
DEC 06 2021
cMP-4000
019632 290
N
O Copyrigh! Strta Frrm Mutu!l Automobilo ln!ur.nc. Complny, 2m
lncludes copyriohtod mrtsrirl of lnsur0nc6 S0rvicos oftico, lnc.. witi ils pBrmission
Continued on Reverse Side of Page Page 3 of 7
StateFarm(D@
$2,s00
See Schedule
See Schedule
$5,000
See Schedule
lnciuded
Coverage B Limit
25% of covered loss
lncluded
$2,soo
$5,ooo
910,000
lncluded
100/o
Home Product Sales Policv
Policy Number 92-G
DECLABATIONS (CONTINUEO)
for CITY OF MENIFEE
Y-D812-0
Newly Acquired Eusiness 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
Porsonal Effects (applies only to thos6 premises provided Coverage B - Business
Personal Property)
Personal Property Oll Premises
Pollutant Clean Up And Bemoval
Preservation Of Property
Property Ol Others (applies only to those premises provided Coveragg B - Business
Personal Property)
Signs
Valuable Papers And Becords
On Premises
Off Premises
$100,000
$250.000
lncluded
See Schedule
$2,500
$25,000
$10,000
30 Days
See Schedule
See Schedule
See Schedule
See Schedule
SECTION I. EXTENSIONS OF COVERAGE - LIMIT OF INSURANCE - SCHEDULE
The coverages and corresponding limits shown below apply only to the described premises as shown
LOCATION
0001
Prepared
DEC 06 2021
cMP-4000
019632
COVEBAGE
@ Copyrighl St.te Frrm Mutu!l Automobilo lnsu16nce Conpuy, 2008
lnclude3 copvri0htod msterirl of lnsur.ncs S€rvics! olfice, lnc., with its oermisston
Continued on Next Page
LIMIT OF
INSUBANCE
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 Property)
Accounts Receivable (On Premises)
Accounts Receivable (Off Premises)
Ouldoor Property
Valuable Papers and Records (On Premises)
Valuable Papers and Records (Ofl Premises)
0002 Accounts Receivable (On Premises)
$s,000
$15,ooo
$10,000
$s,000
$2,soo
$10,000
$s.000
$5,000
$10.000
ss,000
$10,000
Page 4 ol 7
StateFarm !6@
ffi'-,Iiffi
Home Product Sales Policv
Policy Number 92-G
DECLARATIONS (CONTINUED)
Ior CITY OF MENIFEE
Y-D812-0
I
;3
Accounts Receivable (Off Premises)
Back-Up Of Sewer Or Drain
Money And Securities (Olt Premises)
Money And Securities (On Premises)
Outdoor Properly
Property Ol Others (applies oniy to those premises provided Coverage B - Business
Personal Property)
Signs
Valuable Papers and Records (On Prsmises)
Valuable Papers and Records (Off Premises)
$s,000
$1s,000
$s,000
$10,000
$5,000
$2,500
$5,ooo
$10,000
$5,000
SECTION I . EXTENSIONS OF COVERAGE - LIMIT OF INSUHANCE . PER POLICY
The covorages and corresponding limits shown below are the most we wlll pay regardless ol lhe number oldescribed premises shown in these Declarations.
COVEBAGE
Dala Compromise
Legal And Forensic lnformation Technology Beview
Per Occurrence
Dependent Property - Loss Ol lncome
Employee Dishonesty
ldentity Restoration
Other Expenses
Case Management Servrces
Per Occurrence
Lost Wages And Supervision Expenses
Utility lnterruption - Loss Of lncome
Loss Of lncome And Extra Expense
$s,000
$50,000
$5,000
$10,000
$1,000
1 2 months
$35,000
$5,000
Prepared
DEC 06 2021
cMP-4000
019633 290
N
s10,000
Actual Loss Sustained - '12 lvlonths
Page 5 of 7
LIMIT OF
INSU RANCE
O Copyright Stlts Farm Mutual AutomobilB lnsur!flcB Comp!ny, 2008
lncludos copyright6d mltsri!l ol lnsurancs Sorvicss offic.. lnc., with itr psrmission.
Continusd on Reverse Side of Pago
Home Product Sales PoliPolicy Number 92
OECLARATIONS (CONTINUED)
for CITY OF MENIFEE
Y-D812-0:d
COVERAGE
Coverage L - Business Liability
Coverage M - Medical Expenses (Any One Person)
Damage To Premises Rented To You
AGGHEGATE LIMITS
Products/Completed Operations Aggregate
General Aggregate
Each paid claim for Liability Coverage reduces the amount o[ jnsuranco we provide during the applicable
annual period. Please reler to Section ll - Liability in the Coverage Form and any attached endorsements.
LIMIT OF
INSUBANCE
$2,000,000
$5,000
s300,000
LIMIT OF
INSURANCE
$4.000.000
$4.000,000
Your policy consists ol these Declarations, the BUSINESSOWNERS COVERAGE FORM shown below, and any other
forms and endorsements that apply, including lhose shown below as well as those issued subsequent to the
issuance of this policy.
FORMS AND ENDORSEMENTS
cMP-4101
cMP-4786.1
cMP -4787
cMP-4260.1
cMP-4261
cMP-4705.2
cMP-4710
cMP-4709
cMP-4598
cMP-4704.1
cMP-4703.1
cMP-4610
cMP -47 46.1
Businessowners Coverage Form.Addl lnsd Owners Lessee Sched
'Waiver of Trans Rgt of Recov
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
General Agg Limit Per Proj
Hired Auto Liability
Prepared
DEC 06 2021
cMP-4000
019633
O Copyn!h! Stat. tarm fulut!.1 Automobil€ lnrur!ncs Comp.ny, 2008
lnDludes copyri0ht0d m.tori6l of lnsur!ncB Ssrvicss otfice, lnc., wth its p€rmissron
Continued on Noxt Page Page 6 of 7
SECTION II . LIABILITY
I
StateFarm(-)@
ffi
Home Product Sales PolicvPolicy Number 92-G
DECLARATIONS (CONTINUED)
lor CITY OF MENIFEE
Y-D812-0
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: INFOBMATION CONCERNING
CHANGES IN YOUB POLICY
LANGUAGE IS INCLUDED. PLEASE
CALL YOUR AGENT IF YOU HAVE
ANY OUESTIONS.
' New Form Attached
II
63
!
This policy is issued by the Slate Farm General lnsurance Company.
Parlicipating Policy
You are entitled to participate in a distribution of the €arnings ol th€ company as determined by our Board of Directors in
accordance with lhe Company's Articles of lncorporalion, as amended.
ln Witness Whereof, the State Farm General lnsuranc€ Company has caused this policy to b€ signed by its President and
Secretary at Bloomington, lllinois
{*ntP""n
s6Cr€tary
-{t*t'" C"/q
President
IMPORTANT NOTICE:
Callloml6 hw requlrc3 ue to provlde you whh lnrorm.tlon ror llllng complalms wlth the State lneursnce Oepanmer regordlng tlE
coveruge and Eryice provided undsr this poncy.
Your age 's name and contact inlomatbn ar€ provided on tlE lront ol thir documenl. Another option is to reach out by
msilor phonc directly to:
Stalc Farmo Executive Cuglomer Servica
PO Box 2320
Bloominglon lL 61702
Phone # 1€oo-STATEFARM (1-6uF78 2-8332)
Depanmert of lnsur8nce complsint! ghould be llbd only alter you lnd State Fam or your Egant or olh€r comprrry
reprerertative have lailed lo rs.c+r a satiglactory .grsoment on r paoblem.
calilomia Department ot ln8urance
Congumer Servlces DlYlslon
300 goulh gprlng Slrset
LoE Angebs, CA 90013
Phone * l{oO-927-HELP (4354 or vbit rww.insur8nce.c€.qov/o1-con$me]!
Prepared
DEC 06 2021
cMP-4000
019634 290
N
O Copyrighl State F6rm Mutual Automobile lnsur!nce Comp0ny, 2008
lncludes copyrioht8d mitorial ol lnsur0nc€ SEryicss otficB, lnc., with its pgrmission
Page 7 ol 7
StateFarm STATE FARM GENEBAL INSURANCE COMPANY
A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON. ILLINOIS
E?"8 3/o€3i,t ?* r t ou'. " r'
Named lnsured
M.23-61F8.FB8A F Z
IIESTERN A/V INC
u
INLAND MARINE ATTACHING DECLARATIONS
Policyilumber 92-GY-D812-0
Policv Pedod Elloctive Dale Exoiralion Date
12 l\ilbnths OCT 31 2021 OCI 31 2022
Ihe poliOy period beqrns and ends at I2:01 am standardIme at the premlses Iocaton.
Hrr'-fiH&
I
;3
ATTACHING INLAND MARINE
Aubmatic Ronowal - lf ttre policy period i
forms in effectlor each succeeding policy
compliance witr the policy provisions or a
s shown as 12 monlhs, *tis policy will be renewed automatically subjectto $e premiums, rules and
period. lf fris policy js terminated, we will give you and t're Mortgagee/Lienholder written notjce in
s required by law.
Annual Policy Premium lncluded
The above Premium Amountis included in the Policy Premium shown on fie Declarations
Your policy consists of these Oeclarations, dre INLAND l\4ARlNE C 0NDlTlONS shown below, and any other form s and endorsements that
a pply, including trose shown below as well as those issued subsequent to the issuance of this policy.
Forms, 0ptions. and Endorsemonls
FE-8739
FE-8271
FE-87 45
lnland Marine Conditions
Amendatory Endorsement
lnland Marine Computer Prop
See Reverse for Schedule Page wirh Limis
Prepared
DEC 06 2021
FD-6007
019635
@ Copyright Stcto Frrm lvlutual Automobils lnBur!nco Company, 2008
lncludes copyrightod matErial of lnsur.ncs Seryices office, lnc., [rith it. permission
530 63602 05 31 2Dl1 loll3232c)
(Doo
92-GY-D812-0
ATTACHITTG INLAND MARIITE
ATTACHING INTANO MABINE SCHEDULE PAGE
ENDORS EI\4 ENT
NUMBER
FE-8745
LIMIT OI
INSURANC E
DEDUCTIBLE
AI\4OUNT
ANNUAT
PREI\4IUM
IncludedIncluded
C OVEBAGE
lnland Marlne Computer Prop
Loss of Income and Extra Expense
II 25,000
25,000
s 500
Prepared
DEC 06 2021
FD-6007
019635
OTHER LIMITS AND EXCLUSIONS MAY APPLY , REFER TO YOUR
O Copyri0h! St!t6 F6rm Mrtu0l Automobile lnsurEnce Company, 2tO8
lncludsr copyri!ht€d m.tefl6l of lnsu16nc€ Ssruicei otfice, lnc , with its permission
I
I
5:10 6[6s2 05 ill 2[rl lolrS?r3Ll