2021/10/31 Western A/V, Inc. (15)StateFarm STATE FARM GENEFAL INSURANCE COiIPANY
A STOCK COMPANY WITH HOME OFFICES IN ELOOMING|ON. ILLINOIS
E?"83h€3f,! ?* r s ou r - r s z s
Addl lnsured-Sectlon ll Only
M-23-61F8-FB8A F Z001965 3123CITY OF ilEN I FEEAND ITS OFFICERS, EI{PLOYEES,AGENTS & AUTHORIZED VO L UNTEERS29E44 HAUI{ RDt ENIFEE CA 9?546-6539
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Home Product Sales Policy
tlDECLARATIONS COVEHAGE SUMMARY i,4AR s 2022(-@
F.r*iffi$Namod lnsured
WESTERN A/V INC
a
F
Policyllumber 92-GY-D812-O
Policv Period Elfuctive Dats Exoiralion Dale'12 Mbnths OCT 31 2021 3cI 31 2022
The polipv period beqins and ends at 12.01 am standardtme atthe premtses loca0on.
Automatic Ronowal - lf $e policy period is shown as 12 monlhs , this policy will be renewed automatically su bject to $e premiums. rules and
torms in effect for each succeeding policy period. lf fris policy is terminated, we will give you and the Mortgagee/Lienholder written notice in
compliance wi$ the policy provisions or as required by law.
Entlty: Corporation
R€quested By:Policyholder
Policy Premium
Discounts Applied:
Renewal Year
Years in Business
Enclosed Building
Protective Devices
Sprinkler
Claim Record
$ 12,513.00
Prepared
MAH 09 2022
cMP-4000
O Copyriohl State trrm Mutu6l Automobils lniurunc6 Comprny, 2008
lncludos copyrightgd mrtori6l of lnsur!nc€ Soruico. olficr, lnr., with its pormission
Continued on Reverse Side of Page Page '1 ol 7017797 290
N
530 636 i 7 [5 3r 70]t r.1l32ilTr
l
i
:
Home Product Sales Policv
Policy Number 92-G
DECLARATIONS (CONTINUED)
'of
CITY OF MENIFEE
Y-D812-0
SECTION I - PROPEBTY SCHEDULE
Location
Number Location ofDescribedPremlses
Limit of lnsurance'
Coveraoe A -
Buildings
Limit ol lnsurance"
Cov€raoe B -Business PersonalProperty
Seasonal
lncrease-Business
PersonalProperly
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
$ 129,300
$ 129,100
25.k
. As ol the eflective date of this policy, the Limit of lnsurance as s own tnc udes any increase nt limit due to lnf lation Coverage
SECTION I - INFLATION COVERAGE INDEX(ESI
Cov A - lnflation Qovgrage lndex:
Cov B - Consumer Price lndex:
N/A
271 .7
Baslc Deductible
Speclal Deductibles:
lvloney and Securities
$2,500
$250 Data Compromise
O Copyright Stats F!rm Mut!!lAltomobilE lnsurlnc6 Comp!ny,2008
lnclrdes copyri0hted matsri.l of lnsurancs Sorvico! office. lnc.. with its pormrrston
Continued on Next Page
$1,000
Prepared
MAB 09 2022
cMP-4000
017797 Page zot 7
SECTION I . DEOUCTIBLES
StateFarm&
Home Product Sales PollcvPolicy Number 92-G
Employee Dishonesty
DECLARATIONS (CONTINUED)
tor CITY OF MENIFEEY-D812-0
$250 Equipment Breakdown $2,soo
Other deductibles may apply - refer to policy
SECTION I . EXTE SIONS OF COVERAGE - LIMIT OF INSU RANCE - EACH DESCFIBED PBEMIts
hB The covorages and corresponding limlts shown below apply separately to each doscribed premises shown in theseDeclarations, u.nless indicated by "See Schedule." ll a coverage does hot have a correspohding limlt shown below,but has "lncluded" lndicated, please r€ler lo that policy provision lor an explanatlon ol that coverage.
COVERAGE
Accounts Receivable
On Premises
Ofl Premises
Arson Reward
Back-Up Of Sewer Or Drain
Collaps6
Damage To Non-Owned Buildings From Thelt, Burglary Or Robbery
Debris Removal
Equipment Breakdown
Fire Departmsnt 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 Securilies (Otf 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
2570 ol covered loss
lncluded
$2'soo
$5,ooo
sI0.000
lncluded
10/"
See Schedule
See Schedule
$1 ,000
Prepared
MAR 09 2022
cMP-4000
O Copyri0h! Stats F!rm Mutual Automobile lnrur.nc. Compiny, 2008
lncludor copyri0htsd mnt8ri!l of lnsur.nce S€rvic€s offic!, lnc , with its p6rmi3sion
Continued on Roverse Sid6 of Page017798 290
N
Page 3 of 7
!
ffi
Home Product Sales Policv
Policy Number 92-G
DECLARATIONS (CONTINUEO)
'o.
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 Construoted Buildings (applies only if this policy provides
Coverage A - Buildings)
Ordinance Or Law - Equipmenl Coverage
Outdoor Property
Personal Effects (applies only to those premises provided Coverage B - Business
Personal Property)
Personal Property Olf Premises
Pollutant Clean Up And Removal
Preservation Of Property
Property Of Others (applie8 only lo those premises provided Coverage B - Business
Personal Property)
Signs
Valuable Papers And Records
On Premises
Oll Premises
SECTION I- EXTENSIONS OF COVEBAGE. LIMIT OF INSURANCE - SCHEOULE
$100,000
$250,000
lncluded
See Schedule
$2.500
$2s,000
$10,000
30 Days
See Schedule
See Schedule
See Schedule
See Schedule
The coverages and corresponding limits shown below apply only to the described premises as shown
LIMIT OF
INSURANCELOCATION
0001
Prepared
MAH 09 2022
cMP-4000
017798
COVEHAGE
Signs
Back-Up Of Sewer Or Drain
l\,loney And Securities (On Premises)
Money And Securities (Off Premises)
Property Of Others (applies only to those premises provided Coverage B - Business
Personal Property)
Accounls Receivable (On Premises)
Accounts Receivable (Off Premises)
Outdoor Property
Valuable Papers and Records (On Premises)
Valuable Papers and Becords (Off Premises)
0002 Accounts Receivable (On Premises)
$5,ooo
$1s,ooo
$10,000
$s,000
S2,50o
$10,000
$5,000
$s,000
$10,000
$s,000
$10,000
@ Copyright, St6ts Farm l\4 utu ! I Automobilo lnsur!ncs Compiny, 2008
lncludss copvrighted m.t€ri6l of lnsurrnc0 Sorvjcas olfics, lnc , with its psrmissron
Continued on Next Page Page 4 of 7
I
StateFarm(-)oo
Home Product Sales PollcvPolicy Numb€i 92-G
DECLARATIONS (CONTINUED)
lor CITY OF MENIFEE
Y-D812-0
fl:dtHfi
*E
Accounts Receivable (Oll Premises)
Back-Up Of Sewer Or Drain
Money And Securilies (Off Premises)
Money And Securitias (On Premises)
Ouldoor Property
Property Of Others (applies only to those premises providsd Coverage B - Business
Personal Properly)
Signs
Valuable Papers and Records (On Premises)
Valuable Papers and Records (Olf Premises)
$5,000
$1s,000
$5,000
$10,000
$5,000
$2,soo
$s,000
$10,000
$s,000
SFETIr)N I - FYTFNqIr)Nq r)F COVFFIAGF.I IMIT OF INSIIFIAN(:F - PFEI POI I(iY
The coverages and corresponding limlts shown below are tho most wo wlll pay regardless ot the number oldesc.lbed premis6s shown in lhese Declarations.
COVEHAGE
LIMIT OF
INSURANCE
$s,000
$s0,000
$s,000
$10,000
2
)
o
;:
Data Compromise
Legal And Forensic lnformation Technology Review
Per Occurrence
Dependent Property - Loss Of lncome
Employee Dishonesty
ldentity Restoration
Other Expenses
Case Management Services
Per Occurrence
Lost Wages And Supervision Expenses
Utility lnterruption - Loss Ol lncome
Loss Of lncome And Extra Expense
$1,000
1 2 months
$3s,000
$s,000
Prepared
tvtAB 09 2022
ct\4P-4000
017799 290
N
@ Copfighl Stlte F.rm Mutuil Automobilo ln!ur!no! Comp!ny, 2008
lncluds! copyriohtsd m.trrirl ol lflsu..nc. Sgrvic€s olfico, lnc., with it! prrmission
Conlinued on Rgverse Side ol Page
$10,000
Actual Loss Sustained - 12 Months
Page 5 of 7
!
Home Product Sales Policv
Policy Number 92-G
DECLABATIONS (CONTINUED)
Ior CITY OF MENIFEE
Y-D812-0
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
Each paid claim for Liability Coverage reduces the amount of insurance we provide during lhe applicable
annual period. Please refer to Section ll - Liability in the Coverage Form and any attached endorsements.
LIMIT OF
INSURANCE
$2,000,000
$s,000
$s00,000
LIMIT OF
INSURANCE
$4,000,000
$4,000,000
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.
FORMS AND ENDORSEMENTS
cMP-4101
FE-6999.3
cMP-4705.2
cMP-4990.1
cMP-4994
cMP-4250.1
cMP-4746.1
cMP-4261
cMP-4710
cMP-4698
cMP-4704.1
cMP-4709
cMP-4703.1
Businessowners Coverage Form
Terrorism lnsurance Cov Notice
Loss of Income & Exlra Expense
ldentity Restoration Coverage
Data Compromise
Amendatory Endorsement-CA
Hired Auto Liabilily
Amendatory Endorsement
Employee Dishonesty
Back-Up ol Sewer or Drain
Dependent Prop Loss of lncome
Money and Securities
Utility lnteruption Loss lncm
Prepared
MAR 09 2022
ct\rP-4000
017799
O Copyrigh! Stst€ Ffim Mltu!l Automobile lnrur!nc! Comp.ny,2008
lncludes copyriohtrd m6len.l of lnsur!rce SsrvicEs olfic6, lnc., with it! permission
Continued on Next Page Page 6 of 7
SECTION II - LIABILITY
StateFarm !&
Fri-dt
EGJG
Home Product Sales PolicvPolicy Numbsr 92-G
cMP-4786.1
cMP-4787
cMP-4610
cMP-4875
cMP-4793.1
cMP-4788.1
FD-6007
DECLABATIONS (CONTINUED)
'or
CITY OF MENIFEEY-D812-0
Addl lnsd Owners Lessee Sched
Waiver of Trans Rgl ol Becov
General Agg Limit Per Proj
Loss Payable
Al State Political Perm Prem
Addl lnsd Mgrs Lessor of Prem
lnland Marine Attach Decx
This policy is issued by the State Farm General lnsurance Company.
Participating Policy
You are entltled lo participats in a distribution of the earnings of the company as determinod by our Board of Directors inaccordance with the Company's Articles of lncorporation, as amended.
ln Witness Whereof, the State Farm
Secretary at Bloomington, lllinois.
ffu"^,:rn11*lt
Secreta"ry
IMPORTANT NOTICE:
Colf,omlt hw laqull?3 us.to provkh you whh lnlomorlon for llllng complalr s wlth rhe Store lneurance Depenment regordlng tlrecoverago and rrvico paovbd under thir pglicy.
Your Egpfi's nlme and cirtact lr ormatbn are provided on ttE lront o, lhls documern. Anothet option is to teach ont bymallor phono dlroclly to:
State Fsrllp Exocrnlye Cuetomor Ssryico
PO Bor 2320
Blooming on lL 61702
Phone * l -8oo-STATEFARTa (1-80c782-8fi]2)
[r,ep!ftment of lnsu]ance compl.lnt3 should be llled only after you and Slate Fam or youl agent or olher comparryroprosrftatfue havo lailed lo D6ch. tothlsctory agrogrnont on a problem.
CEI(omir Deputnent ol ln*rrsnce
Consumer Serylce3 DlYblon
300 South gprlng Srpot
Lo. Angelos, CA 90013
Phonc #, {OO-g27-HELP (41157) or ybh rrwjnsurEnc..ca.ooy/o1-coor{rners
General lnsurance Company has caused this policy to be signed by its President and
-il-t. erh
Prepared
rvrAR 09 2022
cMP-4000
017800 290
N
P resident
O CopyrighL St6te Form Mutusl Aulomobils lnsurrncc Company,2008
lnclud€s cofjyrighted mEterial of lnsu16nce SBrvices otfice, lnc., with its permis.ion
Page 7 ot 7
StateFarm STATE FARM GENERAL INSURANCE COMPANY
A STOCK COMPANY WITH HOME OFFICES IN ELOOMINGTON, ILLINOIS
E?"fr 3ia€3i! ?* r s oa s - s s r s
Named lnsured
IV.23-61F8-FB8A F Z
t{ESTERt{ A/V I NC
ATTACHING INLAND MARINE
INLANO MARINE ATTACHING O'"'O'O''O'J ]
t;diHtr
FrB
Policy umher 92-GY-D812-0
Pollcv Period E loctive Date Eroiralion Dale
12 Mbnths OCT 31 2021 OCI 31 2022
The polipv period beqtns 6nd ends at l2 0l am standardtme at me premrses I0caD0n.
Automatic Ronewal - lf the policy period is sh own as 12 monlhe , this policy will be renewed autom adcally su bject to $e premiums, rules and
forms in etfectfor each succeeding policy period. lf tris policy is terminated, we will glve you and the Mortgagee/Lienholder written notice in
compliance witr the policy provisions or as required by law.
Your policy consists ofthese Declarations, fre INLAND MABINE C0NDITI0NS shown below, and any ofter forms and endorsements that
apply, including $ose shown below as well as those issued subsequentto the issuance of this policy.
Foms, 0plions, and EndorsementE
FE.8
FE.6
FE-8
745
271
739
Inland Marine Computer Prop
Amendatory Endorsement
lnland Marine Conditions
See Reverse for Schedule Page witr Limits
Prepared
MAR 09 2022
FD-6007
017801
O Coryright Stoto t.rm Mutu6l Automobilo lnrurrncr Comp.ny.2008
lncludes cogyright€d m.torarl of lnsur!nc€ SsrviQs olfic6, lnc., with its psrmission.
530 6[6d 2 05 31 20ll (oll32J?(
(-@
Annual Policy Premium lncluded
The above Premium Amount is included in $e Poltcy Premium shown on fie Oeclaralions.
92-GY-D812-0
ATTACHING II{LAND MARINE
ATTACHING INtAND MARII'lE SCHEDU[E PAGE
ENDORSEMENT
NUMBER
FE-8745
C OVERAG E
lnland Marine Computer Prop
Loss of lncome and Extra Expense
Lll\4l] 0F
INS URANC E
DEDUCTIBLE
AMOUNT
I 500
ANNUAL
PREIUIUM
s
s
25,000
25,000
Included
Included
Prepared
MAR 09 2022
FD-6007
017801
oTH ER LtMtTS AND EXCLUSToNS MAy AppLy. REFER T0 y0UR p0ltcy
-
@ Copyright, State t6rm Mutu!l Automobrlo lnsur!nce Comp!nV,2008
lncludss copyrlghtEd m6tenal of lnsur!ncs Sorvices offirB, lnc., with iG pqrflsston
530 li80 u,2 05 ll ?0ll loll3233cl
StateFam u(Doo 92-GY-D812-0 017802
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
cMP-4786 '1
Page 1 of 2
CM
(sc
P.[786.1 ADDITIONAL INSURED - OwNERS, LESSEES, OR CONTRACTORS
heduled)
Filftb'#
This endorsement modrfies insurance provided under the following
BUSINESSOWNERS COVERAGE FORM
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 Operations
(1) Your acts or omissions, or
(2) The acts or omissions of those actrng
on your behalf;
in the performance of your ongoing opera-
tions for that additional insured, 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;
8
iF9co15
SCHEDULE
Policy Number: 92-cy-D812-o
Named lnsured:
WESTERN A/V INC
Name And Address Of Additional lnsured Person Or Organization:
CITY OF MENIFEE
AND ITS OFFICERS, EMPLOYEES.AGENTS & AUTHORIZED VOLUNTEERS29844 HAUN BD
MENIFEE CA 92586
1 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 byCalifornia Civil Code Section 2782 or
2782.05, the insurance provided to theadditional insured is the lesser of that
which:
(1) ls allowed for the satisfaction of a de-
fense or indemnity obligation by Cali-fornia Civil Code Section 2782 or
2782.05 for 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.
O, Copyright State Farm M utual Automobile lnEUrance Company, 2013
lncludes copyrighted material of lnsurance Services Ofiice, lnc., with its permEsron
CONTINUED
92-GY-D812-0 017802
2. Any insurance 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
additronal rnsured, 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 in the
Declarations.
With respect to the insurance afforded 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 COND]TIONS:
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
eltent 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
ci/P-4786 1
33J'X?l
(3) The nature and location of any injury
or damage arising out of the "occur-
rence" or oftense;
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 foI which we would
provide coverage under SEGTION ll -LIABILITY,
5. With respect to the insurance afforded the ad-
ditional insured, the following replaces SEC'
TION ll -LIABILITY of Paragraph 7. Othet
lnsurance of SECTION I AND SECTION ll -COMMON POLICY CONDITIONS:
a. This insurance rs pnmary to and will not
seek contribution from any other insurance
available to he additional insured, provided
that the additional insured is a named in-
sured under such other insurance.
b. Regardless of any agreement between
you and the additional insured, this insur-
ance is excess over any other insurance
whether pnmary, 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
4.
All other policy provisions apply
@, Copyright, State Farm Mutual Automobile lnsurance Company, 2013
lnoludes copyrighted material of lnsurance Services Omce, lnc. wth rts permiasion
I
StateFarm !6)@
THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY
CMP4787 WAIVER OF TRANSFER OF RIGHTS OF RECOVERYAGAINST
OTHERS TO US
cMP-4787
Page 1 of 1
ffi$
This endorsement modifies insurance provided under the following
BUSINESSOWNERS COVERAGE FORM
SCHEDULE
Policy Number: 92-GY-D812-{)
Named lnsured:
WESTEBN A/Ir' INC
Name And Address Of Person Or Organization:
CITY OF MENIFEE
AND ITS OFFICERS. EMPLOYEES.
AGENTS & AUTHOHIZED VOLUNTEEBS
29844 HAUN BD
MENIFEE CA 92586
The following is added to Paragraph '10.b. of SECTION I AND SECTION ll - COMMON POLICY
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 arising out of:
a. Your ongoing operations; or
b. "Your work'done under contract with that person or organization and included in the 'products-
com pleted operations hazatd".
This waiver applies only to the person or organ2ation shown in the Schedule.
All other policy provisions apply.
ct\4P-4787 o Copyrbht, Slate Farm l\4utual Automobile lnsurance Company, 2008
lncludes copyriglrted material of lnsurance Services Ofiice, lnc., wth its permission
Ea5
?j
o,
;,-
92-GY.D812{ 017803