2021/10/31 Western A/V, Inc. (14)StateFarm STATE FARM OENERAL INSURANCE COMPANY
A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS
E?,E?id€lf, ! ?* r s o a s. s s z s
Addl lnsured-Section ll Only
M-23-3535-FB8A F Z001693 3123CITY OF ]'IEN I FEEAND ITS OFFICERS, El.IPLOYEES,
AGENTS & AUTHORIZED VO L UNTE ERS?9E44 HAU}I RD
t{EN I FEE CA 9?586-6539
t,t,|lil,r,,r,rItrI,rth,lhllt,l,illttlilqqltt,t,tlilhI
Home Product Sales Policy
Policyilumber 92-GY-O812{)
Policv Period Elleclive Date Exoiration Date12 l\ilbnths OCT 31 2021 OCI 31 2022
Ihe polipv perrod begins 4nd ends at 12 01 am standardtme at thC DremrsesTocaton
DECLAHATIONS CoVEHAGE SUt\,4t\rABY NoV 5 2021
Named lnsured
I{ESTERN A/V INC
(-@
lln'Sffi
I
a
Aubmatic Ronowll - lf tre policy period rs
forms in etfect for each succeeding policy p
compliance witr tfre policy provisions or as
shown as 12 months, t'ris policy
eriod. lf tris policy is terminated
required by law.
will be renewed automatjcally subjectto the premiums, rules and
we will give you and fre Mortgagee/Lienholder written notice in
Entity: Corporation
Policy Premium
Discounts Applied:
Enclosed Building
Protective Devices
Sprinkler
Claim Record
$ 12,283.00
Prepared
NOV 05 2021
cMP-4000
014945 2S0 At
N
O Cowri0ht, Stito F0rm Mutual Automobils ln5urrncs Comp6ny, 2008
liclud0! copyri0hted matsrirl ol lnsurnnce Services offics, lnc., with its permr!sion
Continued on Reverse Side of Pags Page 1 of 7
Home Product Sales Policv
Policy Number 92-G
DECLARATIONS (CONTINUED)
foT CITY OF MENIFEE
Y-D812-0
SECTIONI-PROPERTYSCH EDU LE
Seasonallncrease-Business
PersonalProperty
Limit of lnsurance'
Coveraoe A -
Buildi-ngs
Limit ot lnsurance'
Coveraoe B -
Business FersonalProperty
LocalionNumber Location of
Oescribed
Premises
No Coverage
No Coverage
$ 129,300
$ 129,100
001
002
1592 N BATAVIA ST STE 2
oBANGE CA 92867-3554
1590 N BATAVIA ST STE 4
oRANGE CA 92867-3534
. As of the effeclive date of th s policy, the Limit of nsurance as shown includes any increase in the limit due to lnllation verage
SECTIONI.INFLATIONCO BAGE INDEX(ES)
Cov A - lnflation Coverage lndex:
Cov B - Consumer Price lndex:
SECTION I . DEDUCTIBLES
N/A
271.7
Baslc Deductlble
Special Deductibles:
lvloney and Securities
$2,500
$250 Data Compromise
O Copyri0ht, Stats Fsrm lvlutual Altomobilo lnsurance Company,2008
lncludss copyri0ht0d m6t8ri6l of lnsuranoe S6rvicBs 0ffice. lnc., with its psrmission
Continued on Noxt Page
$1 .000
Prepared
NOV 05 2021
cMP-4000
014945 Page 2ot 7
StateFarm !&
ffi
Home Product Sales Policv
Policy Numbor 92-G
oEcLABATTONS (CONTTNUED)
Ior 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 INSU RANCE - EACH DESCRIBED PBEMISESg
ag Tho coverages and corresponding limits shown b€low apply separatoly to each described premis€s shown in these
Declaratlons, unless indicated by "See Schedule." It a cov€rage does not have a corresponding limlt shown below,
but has "lncluded" indicated, please rerer to that pollcy provlsion tor an explanation of that coverage.
COVEHAGE
Accounts Receivable
On Premises
Otf Premises
Arson Reward
Back-Up Ol Sewer Or Drain
Collapss
Damage To Non-Owned Buildings From Thefl, Burglary Or Bobbery
Debris Removal
Equipment Breakdown
Fire Deparlmanl Service Charge
Fire Extinguisher Systems Recharge Expense
Forgery Or Alleration
Glass Exp6nses
lncreased Cost Of Construction And Demolition Cosls (applies only when buildings are
insured on a replacement cost basis)
Mon€y And Securilies (Otl Premises)
Money And Securities (On Premises)
Money Orders And Counterfeit Money
LIMIT OF
INSU RANCE
See Schedule
See Schedule
$s,ooo
See Schedule
lncluded
Coverage B Limil
25% of covered loss
Included
$2,s00
$s,ooo
$10,000
lnctuded
10%
See Schedule
See Schedule
$1,000
Prepared
NOV 05 2021
cMP-4000
014946 290
N
@ Cogyright Stlto trlm Mutu!l Automobils ln!ur!nc. Complny,2008
lncludss copyrioht0d mrt0rirl ol lnturlncs Ssrvices 0lfic6, lnc., rvi6 hs psrmrssion
Continued on Reverse Side ol Page Page 3 of 7
Home Product Selos PollcvPolicy Number 92-G
DECLARATIONS (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 providos
Coverage A - Buildings)
Ordinance Or Law - Equipment Coverage
Outdoor Property
Personal Etfects (applies only to those premises provided Coverage B - Business
Personal Property)
Personal Proporty Off Premises
Pollutant Clean Up And Removal
Preservation Of Property
Property Ol Olhers (applies only to those premises provided Coverage B - Business
Personal Property)
Signs
Valuable Papers And Records
On Premises
Olf Premises
$100,000
$2s0,000
lncluded
Sse Schedule
$2,500
$25,000
$10,000
30 Days
See Schedule
See Schedule
See Schedule
See Schedule
SECTION I . EXTENSIONS OF COVERAGE - LIMIT OF INSU RANCE. SCHEDULE
The coveragos and corresponding limits shown below spply only to the desctibod premisos as shown.
LOCATION
0001
Prepared
NOV 05 2021
cMP-4000
014946
COVERAGE
Sig ns
Back-Up Of Sewer Or Drain
Money And Securities (On Premises)
Money And Securilies (Ofl Premises)
Property Of Others (applies only to those premises provided Coverage B - Business
Personal Property)
Accounts Beceivable (On Premises)
Accounts Receivable (Olf Premises)
Outdoor Property
Valuable Papers and Records (On Premises)
Valuable Papers and Records (Off Premises)
0002 Accounts Receivable (On Premises)
LIMIT OF
INSURANCE
$5,ooo
$15,000
$10,000
$5,000
$2,s00
$10,000
$s,000
$5,000
$10.000
$5,000
$10,000
O Copynohl State F.rm Mutu!l Altomobil6 lniur!nco Complny,2008
lncludes cogyri0hted mst8ri!l ot lnsur!flcs ServicBr officB, lnc., with its psrmission
Continued on Next Page Page 4 ot 7
StateFarm6,@
Home Product Sal€s PolicvPollcy Number 92-G
DECLARATIONS (CONTINUED)
for CITY OF MENIFEE
Y-D812-0
lfillr]ffi
8
N
6A
Accounls Receivable (Oll Premises)
Back-Up Of Sewer Or Drain
Money And Securities (Ofl Premises)
Money And Securities (On Premises)
Outdoor Property
Property Ol Others (applies only to those premises provided Coverage B - Business
Personal Property)
Signs
Valuable Papers and Records (On Premises)
Valuable Papers and R6cords (Ott Premises)
$s,000
$1s,000
$5,000
$10,000
$5,000
$2,500
$s,ooo
$10,000
$5,ooo
SECTION I . EXTE ONS OF COVEBAGE - LIMIT OF INSURANCE. PER POLICY
The covorages and corresponding llmlts shown below are the most we wlll pay .ogardless ol ths number oldescrlbod premises shown in these Declaratlons.
COVEFAGE
@ Copyrigh! Stlto Flrm Mutu.l Automobils lnrurrncB Complny,2m8
lncludo! copyrighi.d mrtsrill of lnsurrnce Servic0s offics, lnc.. wifi it! p6rmission
Continued on Reverse Side of Page
LIMIT OF
INSU RANCE
$s,000
$50,000
$5,000
$10,000
$1,000'l 2 months
$35,000
$5,000
$10,000
Actual Loss Sustained - 12 Months
Data Compromise
Legal And Forensic lnformalion Technology Review
Per Occurrence
Dependent Property - Loss Of lncome
Employee Dishonesty
ldentity Restoration
Other Expenses
Case lVlanagement Services
Per Occurrence
Losl Wages And Supervision Expenses
Utility lnterruption - Loss Of lncome
Loss Of lncome And Extra Expense
Prepared
NOV 05 2021
cMP-4000
014947 290
N
Page 5 ol 7
Home Product Sales Policv
Policy Number 92-G
OECLARATIONS (CONTINUED)
tor CITY OF MENIFEE
Y-D812-0
SECTION II - LIABILITY
COVERAGE
Coverage L " Business Liability
Coverage M - Medicai Expenses (Any One Person)
Damage To Premises Rented To You
AGGREGATE LIMITS
Products/Completed Operations Aggregate
General Aggregate
Each paid claim for Liability Coverage reduces the amount ot insurance we provide during the applicable
annual period. Please refer to Section ll - Liability in the Coverage Form and any attached endorsements
LIMIT OF
INSUFANCE
$2,000,000
$5,ooo
$300,000
LIMIT OF
INSURANCE
$4,000,000
s4,000,000
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.
FOHMS AND ENDOBSEMENTS
cMP-4101
FE-6999.3
cMP-4705.2
cMP-4990.1
cMP-4994
cMP-4260.1
cMP-4746.1
Cl\ilP-4261
c[/4P-4710
Cl\,tP-4698
Cl\ilP-4704.1
ct\/tP-4709
ctltP-4703.1
Businessowners Coverage Form
Terrorism lnsurance Cov Notice
Loss of Income & Extra Expense
ldentity Restoration Coverage
Data Compromise
Amendatory Endorsement-CA
Hired Auto Liability
Amendatory Endorsement
Employee Dishonesty
Back-Up of Sewer or Drain
Dependent Prop Loss of lncome
lvloney and Securities
Utility Interruption Loss lncm
Prepared
NOV 05 2021
cMP-4000
014947
O Copyrigh! St.ts Flrm Nlut!!l Automobilo lflsur.ncs Comp!ny.2008
lncludEs copyrightod mltori.lof lnsursnce ServicEs offic0, lnc., with its pormi.sion
Continued on Next Page Page 6 of 7
ttndu
Egfr
DECLAHATIONS (CONTI NUED)
Io] CITY OF MENIFEE
Y-0812-0
Home Product Sales PollcvPollcy Number 92-G
clMP-4786.1
cMP-4787
Cf\,lP-4610
ctvtP-4875
ctvlP-4793.1
Cl\ilP-4788.1
FD-6007
Addl lnsd Owners Lessee Sched
Waiver of Trans Rgt of Becov
General Agg Limit Per Proj
Loss Payable
Al State Political Perm Prem
Addl lnsd Mgrs Lessor of Prem
lnland Marine Attach DecEa
!
This policy is issued by the Stat€ Farm General lnsuranoe Company.
Participating Policy
You are entitled to participate in a distribution of th€ oarnings o, th6 company as d€lormined by our Board ot Dir€ctors in
accordanoe with the Company's Articles of lncorporalion, as amended.
In Witness Whereof, the State Farm General lnsurance Company has caused this policy to be signed by its Presldent and
Secrotary at Bloomington, lllinois
ffu*-ny*,*
Socretary
-il-h b/ry
IMPORTANT NOTICE:
Callfomlo bw re+rlre3 r.r3 to provlde you whh lnlomarbn tor llllno comphlflr wih rhe Srato lnauEnce Departrnent reg.rdlm the
cove[ogo srd servic€ provk ed under thiE polcy,
Your sgenll nrme snd cgntlct intomstlon sre provlded on ttr llo ol lhb docume . AnotlEr oplbn is lo rerch oul bym.ll or phons directly to:
Stcts F8rnt" Erecutivo Customer Service
PO Box 2320
Bloominglon lL 81702
Phone f I {oo-STATEFARI (l -8m"782"83}2)
Depsnmcnt or lneuronce comphlntr ahouH be llled only alter you rnd Strle Frrm oryour agent or olher compalry
rgprcgoriathe hovo hlled lo roich o !€tlslactoty tgrromoti on s plobhm.
Calilomir Depstunent o, lnanrrnce
Consumgr S€rylc€ Dlvlslon
300 Sourh Sprlru Slreet
Lo€ Angelss, CA S0013
Phorle * l€{Xr427-HELP (4354 or vbit ruwjnlulanc..ca.ooy/o1-corEunorr
President
O Copvri0hl, Strts Firm lvlutual Automobils lnrur.nre Comp.ny, 2008
lnclLrdos copyrightod mitrrial of lnsuroncs S€rvico! oflic8, lnc., with its pormission
Prepared
NOV 05 2021
cMP-4000
014948 290
N
Page 7 ol 7
StateFatm&
StateFarm STATE FARM GENERAL INSURANCE COMPANY
A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS INLAND MARINE ATTACHING DECLAHATIONS
Policyllumber 92-GY-O812{
Policv Period E bctive Drto Exoiration Dab12Months OCT31 2021 OCI 31 ZO22
Ihe polipy period begins qnd ends at 12 01 am standardtme attie Premtses Tocaton.
E?,F3if"lf,:l*75085-3925
Named lnsured
I{E STERN A/V INC
M-23-3535-FB8A F Z
8
E
F8
ATTACHING INLAND MARINE
Automalic Renewal - lf fre policy pedod i
forms in effect for each succeeding pohcy
compltance wi$ the policy provisions or a
s shown. as 12 months . this policy will be renewed automatically su bject to the premiums, rules and
period. lf tris policy is terminated, we will give you and the Mortgagee/Lienholder written noice in
s required by law.
Annual Pollcy Pnmium lncluded
The above Premium Amount is included in fre Policy Premium shown on 6e Declaratjons
Your policy consists of these Declarations. tre INLAND MARINE C 0NDlTl0NS shown below, and any other lorms and endorsemenb that
a pply, including trose shown below as well as $ose issued subsequent to $e issuance ol $is policy.
Forms, 0ptions, and Endorsements
FE-87 45
FE-6271
FE-8739
lnland Marine Computer Prop
Amendatory Endorsement
I nland l\,larine Conditions
See Reverse for Schedule Pa ge widr Limrts
Prepared
NOV 05 2021
FD-6007
014949
O Cogyright Strto f!rm Mutu!l Automobile lnsur.nce Comp.ny.2008
lncludos copyrightsd m!t6ri!l of lnsur0nco S6rvices office, lnc, with its psrmis.ion
tlu 0000 2 0! 31 20ll loll3232cl
(-@
e*
92-GY-t)812.0
ATTACHII'IG INIAND MABINE
ATTACHING INtAItIO MABINE SGHEDUTE PAGE
ENDOBSEMENT
NUM BER
FE-8745
C OVERAG E
lnland Marine Computer Prop
Loss of lncome and Extra Expense
LIMIT OF
INSURANC E
DEDUCTIBLE
AMOUNT
s 500
ANNUAL
PBEMIUM
$
$
25,000
25,000
Included
Included
Prepared
NOV 05 2021
FD-6007
014949
OTHER LIMITS AND EXCLUSIONS MAY APPLY . REFER TO YOUR POLICY
O Copyri0ht Stlt€ Fsrm l\4ltu0l Automobile lnsur!nco Comp!ny, 2008
lncl!dBs copyri0hted mlt€ri6l of lnsur!ncs Srrvices offics, lnc., with its pgrmission.
530 68602 05 ill 2011 lolt3233c
StateFarm 92-GY-D812-O 014950
THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY
CMP-.0786,1 ADDITIONAL INSURED - OWNERS, LESSEES, OR CONTRACTORS(Scheduled)
!6,@
cMP.4786.1
Page 1 ot 2
l'n'tIf.rIFf:tst&i
This endorsement modifies insurance provided under the following
BUSINESSOWNERS COVERAGE FORI\4
in the performance of your ong
tions for that additional insured;
orng opera-
or
b. Products - Completed Operations
"Your work" performed for that additional
insured and included in the "products-
completed operations hazard".
However, Paragraph 1. above is subject to the
following
a. The insurance afiorded to the additional
insured only applies to the extent permit-
ted by law;
SCHEDULE
Policy Number: 92-cy-D812{
Named lnsured:
WESTERN A/V INC
Name And Address Of Additional lnsured Person Or Organizataon:
CITY OF MENIFEE
AND ITS OFFICERS. EMPLOYEES.
AGENTS & AUTHOHIZEO VOLUNTEERS
29844 HAUN HD
MENIFEE CA 92586
SECTION II _ WHO IS AN INSURED of
SECTION ll - LIABILITY is amended to in-
clude, as an additional insured, any person or
organization shown in the Schedule, but onlywith respect to liability for "bodily injury",
"property damage', or "personal and advertis-
ing injury" caused, in whole or in part, by:
a. Ongoing Oparations
(1) Your acts or omissions; or
(2) The acts or omissions of those acting
on your behalf;
b. lf coverage provided to the additional in-
sured is required by a contract or agree-
ment, the insurance provided to the
additional insured will not be broader than
that which you are required by the contract
or agreement to provide for such addition-
al insured; and
c. lf the contract or agreement between you
and the additional insured is governed by
California Civil Code Section 2782 or
2782.05, the insurance provided to the
addrtional insured is the lesser of that
which:
(1) ls allowed for the satisfactron of a de-
fense or indemnity obligation by Cali-fornia Civil Code Section 2782 or
2782 05 tor your sole liability; or
(2) You are required by contract or
agreement to provide for such addi-
tional insured.
We have no duty to defend or indemnify the
additional insured under this endorsement un-
til a claim or "suit" is tendered to us.
F
dg
1
O, Copyright, State Farm MutualAutomobile ln6urance Company. 2013
lnclude6 copyrighted material of lnsurance S6rvices Office, lnc., with its permission
CONTINUED
2. Any rnsurance provided to the additional in-
sured shall only apply with respect to a claim
made or a "suit" brought for damages for
which you are provided coverage.
3. With respect to the insurance afiorded to the
additional insured, the following is added to
SECTION II - LIMITS OF INSURANCE:
lf coverage provided to the additional insured
is required by contract or agreement, the most
we will pay on behalf of the additional insured
will be the lesser of the amount of insurance:
a. Required by the contract or agreement; or
b, Available under the applicable Limits Of
lnsurance shown in the Declarations.
This endorsement shall not increase the ap-plicable Limits Of lnsurance shown rn the
Declarations.
4, Wth respect to the insurance afiorded to the
additional insured, the following is added to
Paragraph 3. Duties ln The Event Of Occur-
rence, Offense. Claim Or Suit of SECTION
II _ GENERAL CONDITIONS:
The additional insured must:
a. See to it that we are notified as soon as
practicable of an 'occurrence" or an of-
fense which may result in a claim. To the
extent possible, notice should include:
(1) How, when and where the ''occur-
rence" or offense took place;
(2) The names and addresses of any in-jured persons and witnesses; and
cMP-4786 1
92-GY-D812-0 014950 ?:JiT]
(3) The nature and location of any rnjury
or damage arising out of the "occur-
rence" or offense;
b. Tender the defense and indemnity of any
claim or "suit" to us and to all other insur-
ers who may have insurance potentially
available to the additional insured; and
c. Agree to make available any other insur-
ance the additional insured has for de-
fense or damages for which we wouldprovide coverage under SECTION ll -LIABILITY.
5. With respect to the insurance afforded the ad-
ditional insured, the following replaces SEG-
TION ll -LIABILITY of Paragraph 7. Other
lnsurance of SECTION I AND SECTION ll -COMMON POLICY CONDITIONS:
a. This insurance is primary to and will not
seek contribution from any other insurance
avarlable to the additional insured, provided
that the additional insured is a named rn-
sured under such other insurance.
b. Regardless of any agreement betweenyou and the additional insured, this insur-
ance b excess over any other insurance
whether primary, excess, contingent or on
any other basis for which the additional in-
sured has been added as an additional in-
sured on other policies.
There will be no refund of premium in the event
this endorsement is cancelled
All other policy provisions apply.
O, Copyright, State Farm M utual Ar.ltomobrle lnsurance Company, 2013
lncludG copyrighted material of lnsurance SeMces Ofiice, lrE wth its permission
92-GY-D812{ 014951
THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY
CMP.I787 WAIVER oF TRANSFER oF RIGHTS oF RECOVERYAGAINST
OTHERS TO US
&cl\4P-4787
Page 1 ol 1
ErihUJ.Iti
E
This endorsement modifies rnsurance provided under the following
BUSINESSOWNERS COVERAGE FORM
SCHEDULE
Policy Number: 92-GY-D812{)
Named lnsured:
WESTEBN A/V INC
Name And Address Of Person Or Organization:
CITY OF MENIFEE
AND ITS OFFICEBS. EMPLOYEES.
AGENTS & AUTHORIZED VOLUNTEERS
29844 HAUN RD
MENIFEE CA 92586
llle following is added to Paragraph 10.b. of SECTION I AND SECTION tt - COMMON pOLtCy
CONDITIONS:
We waive any right of recovery we may have against the person or organization shown in the Schedule
because of payments we make for injury or damage arisin! out of:
a. Your ongoing operations; or
b. "Your work" done under conlract with that person or organization and included in the "products-
completed operations hazard" .
This waiver applies only to the person or organization shown in the Schedule.
All other policy provisions apply.
cMP-4787
O, Copyrighl, State Farm MutualAutomobile tnsurance Company. 2008
lnclude6 copyrighted material ot lnsurance Services Oilice, lno., with iG permission.
StateFam