2022/02/19 Arguin, Angela & Watson, CalebStateFarm STATE FAFtil GENERAL INSURANCE COMPANY
A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS
E?,F8 io€}f,! ?*, u o r'. s', u
Addl lnsured-Sectlon ll Only
arz 002001 31251\r-23- 163A-FA41 F Z
CITY OF IIE}IIFEE, ITS OFFICER,
OFFICIALS, E'lPLOYEES,
DESIGNATED VOLUNTEERS, AND
AGENTS29844 HAUN RD
i{ENTFEE CA 92546-6539
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Animal Care Services Policy
RENEWAL DECLABATIONS
Policyl{umber 92-GJ-T657-5
Policv Period Eflective Dale Exoiralion Dale
12 Nlbnrhs FEB 19 2022 FEB 19 2023
Ihe polipy period beqtns and ends at 12 01 am standardime atthe premrses locaton
Named lnsured
ARGUIN, ANGELA &
I{ATSOt,I, CALEB
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Aubmatic Renewal - lf dre policy period is shown as 12 months , fris policy will be renewed automatcally sublect to tre
forms in effect for each sucbeeding policy period. lf this policy is terminated, we will give you and the Mortgagee/Lienhol
compliance witr ttre policy provisions or as required by law.
premiums. rules and
der written notice in
Entity: lndividual
NOTICE: lnformation concerning changes in your policy language is included. Please call your agent
il you have any questions.
POLICY PRE|\illUM $ 643.00
Discounts Applied:
Renewal Year
Protective Devices
Claim Record
Prepared
DEC 07 2021
cMP-4000
012777 294 At
N
Page 1 of 7
O Coprri0h! Stlto Flrm Mutu.l Automobilq lnsurlnc0 Complny, 2m
lncl!dos copyriohtod mlisri!l ol lnrurnnc0 Servicss 0fficr, lnc., wi$ itr permission.
Conlinued on Reverse Side ol Page
RENEWAL DECLARATIONS (CONTINUEO)
Animal.Care Services Poll9y.lgr CITY OF MENtFEE, tTS OFFICER,Policy Number 92-cJ-T657.5
SECTION I . PBOP HTY SCHEDULE
Location
Number Location ol
Described
Premises
Limit ol lnsurance'
Coveraoe A -
Buildi-ngs
Limit ol lnsurance*
Coveraoe B -
Business Fersonal
Property
Seasonal
lncrease-
Business
PersonalProperly
001 28989 MORNINGSIDE LN
MENTFEE CA 92584-7469
No Coverage $ 11,100
' As of the effective teo this po tcy,e Limit of lnsurance as shown includes any increase in t mit due to lnf latton verage
SECTION I - INFLATION COVERAGE INDEX(ES)
Cov A
Cov B
- lnllation Coverage lndex:
- Consumer Price lndex:
N/A
276.6
SECTION I - D DUCTIBLES
Basic Deductible
Special Deductibles:
Money and Securities
Employee Dishonesty
$1,000
$2so
$250
Accidental lnjury to Animals
Equipment Breakdown
$1oo
$1,000
Other deductibles may apply - refer to policy
Prepared
DEC 07 2021
cMP-4000
012777
O Copyri0h! StrtE Form Vlutu a I Altomobil€ lnsurrncs Comp6ny, 2008
lnclud6s copyrighted matrrirl of lnsurancr SBrvicrs offlcs, lnc., wtth [a pormrssron
Continued on Next Page Page 2 ol 7
StateFann(D@ RENEwAL DEcLARATToNs (coNTTNUED)
Animal Care Services Policy lor CITY OF MENIFEE, ITS OFFICER,Pollcy Number 92-GJ-T557-5
[ir*iffi
SECTION I . EXTENSIONS OF COVEFAGE . LIMIT OF INSUBANCE - EACH DESCBIBED PREMISES
Ei Tho coverag€s and corresponding limits shown below apply separatsly to oach described premises ahown in these
Declarations, unless indicated by "See Schedule." lf a coverage does not have a corresponding limit shown below,
but has "lncluded" indicated, please reler to that policy provision lor an explanation of that coverage.
LIMIT OFCOVEBAGE INSUBANCE
Accidental lnjury To Animals
Per Occurrence
Per Animal
Accounls Receivable
On Premises
Orf Promises
Arson Reward
Collapse
Damage To Non-Owned Buildings From Th€ft, Burglary Or Robbery
Debris Removal
Equipment Breakdown
Fire Department Service Charge
Fire Extinguisher Systems Recharge Expense
Forgery Or Alteration
Glass Expenses
lncreased Cost Ol Construction And Demolition Costs (applies only when buildings are
insursd on a replacement cost basis)
Money And Securities (Ofi Premises)
Money And Securities (On Premises)
Money Orders And Counterfeit Money
Newly Acquired Business Personal Property (applies only il this policy provides
Coverage B - Business Personal Property)
$10,000
$s,000
$5,000
lncluded
Coverage B Limit
25% of covered loss
lncluded
$2,s00
$5,000
$10,000
lncluded
lOlo
$10,000
$1,000
$s,000
$10,000
$1,000
$100,000
Prepared
DEC 07 2021
cMP-4000
012?78 294
N
O Copyri0h! Stltr t!rm Mutu6l Automobils lnrurrnc0 Comp!ny,2008
lncludo! cogvrightod mltori6l ol lnsur!nco Sorvico! olfic€, lnc., with its pormi!sion
Continued on Reverse Side of Page Page 3 ol 7
!
RENEWAL DECLARATIONS (CONTINUED)
Anlmal.Care Services Policy tor CITY OF MENIFEE, ITS OFFtCER,Policy Numb€r 92-GJ-T657-5
Newly Acquired Or Constructed Buildings (applies only if this policy provides
Coverage A - Buildings)
Ordinance Or Law - Equipment Coverage
Outdoor Property
Personal Eflects (applies only to those premises provided Coverage B - Businoss
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
Spoilage (applies only to those premises provided Coverage B - Business Personal
Property)
Expediting Expenses
On Premises
Off Premises
$250,000
lncluded
$5,000
$2,500
$15,000
$10,000
30 Days
$2,500
$2,s00
$1,000
$5,000
$5,000
$10,000
s5,000
Valuable Papers And Records
On Premises
Oft Premises
SECTION I. EXTENSIONS OF COVEBAGE - LIMIT OF INSURANCE . PER POLICY
The coverages and corresponding limits shown below are lhe most w€ will pay regardless ol the number ofdescribed premises shown in these Declarations.
COVEHAGE
Employee Dishonesty
Loss Of lncome And Extra Expense
O Copyn0hl Stste Fsrm Mutu6l Automobilo lnsur!nc0 Comprny, 2008
lncludes cogyrioht'd msteriil of ln!ur!nce Servic65 offrcB, lnc., with ds prrmission
Continued on Next Page
LIMIT OF
INSURANCE
' $10,000
Actual Loss Sustained - 12 Months
Prepared
DEC 07 20?1
Cl\ilP-4000
o12774 Page 4 ot 7
StateFarm
11!.1.i1;
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RENEWAL OECLABATIONS (CONTINUED)
Animal Care Services Policy lor CITY OF MENIFEE, ITS OFFICEB,
Policy Number 92-GJ-T657.5
SECTION II - LIABILITY
I
COVERAGE
Coverage L - Business Liability
Coverage M - lvladical Expenses (Any One Person)
Damage To Premises Rented To You
AGGREGATE LIMITS
ProductyCompleted Operalions Aggregate
General Aggregate
Each paid claim for Liability Coverage reduces the amount of insurance we provide during the applicable
annual period. Please reler to Section ll - Liability in the Coverage Form and any attached endorsements
LIMIT OF
INSURANCE
$2,000,000
$s,ooo
$300,000
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 ENDOBSEMENTS
cMP-4101
FE-6999.3
cMP-4824.1
cMP-4260.1
cMP-4705.2
Cl\ilP-4710
Cl\ilP-4709
cMP-4471
cMP-4261
cMP-4785.1
FD-6007
Businessowners Coverage Form.Terrorism lnsurance Cov Notice
Accidental lnjury to Animals
Amendalory Endorsement-CA
Loss of lncome & Exlra Expense
Employee Dishonesty
Money and Securities
Spoilage Coverage
Amendatory Endorsement
Addl lnsd Owners Lessee Sched
lnland Marine Attach Dec
' New Form Attached
Prepared
DEC 07 2021
cMP-4000
012n9 294
N
O Cofyri!ht StEts F6rm MuEsl Aulomobil€ ln!urlncs Comprnv,2u)B
lncludss copyrightsd mlterirl of lnsur.nca Sorvico! offlco, lnc., witi its pormisiion
Continued on Reverse Side of Page Page 5 of 7
(-@
RENEWAL DECLARATIONS (CONTINUED)
Animal-Care Services Pqliey. EI CITY OF MENtFEE, tTS OFFtCEF,Policy Number 92-GJ-T557-5
This policy is issued by the State Farm General lnsurance Company.
Participating Policy
You ar€ entitled to particiPate in a distribution of the sarnings of the company as determined by our Board of Directors inaccordance 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
Sscretary at Bloomington, lllinois.
ff7,,^.n14,,,tt
secrelary
-ilr-t" Mr{
President
IMPORTANT NOTICE:
Collromlo lsw lequlrce us.to provlde you whh lnlormatlon lor tlllng complalnts wlth ttle gtate lnsumnce Depanment reg€rdlng thecoverEge and aervics provklod undsr this policy,
Youl ag€fi|'s name and c'orirct lntomation are provided on the lrori ol lhts documenl. Anothet option b to reach out bymailor phono direc,tV to:
Stale Farms Executive Curlomer Servico
PO Box 2320
Bloomingron lL 61702phone f 1{oo-STATEFABI ( l -8oG782-8332)
D,epattment ol lnsurance complaints should be liled only alter you and State Fam or your agent or oth€r companyroprc$ntatfue havo lrilgd lo rEach 0 s€tlalaetory agreomert on a problsm,
CalifemiE Depsrbnent ol lnaurEnce
Consumer Serylces DlYlsbn
300 Sornh Sprlng Street
Los Angeles, CA 9ool3phorle * l€00-927-HELP (/l;,54 or virit vyww,insurance.cq.oov/0't-consmera
Prepared
oEc 07 2021
cMP-4000
012779
@ Copyright, St6te F!rm lllutu0l Automobtls lnsur!nc6 Comp!ny,2OO8
lncludes copyrightsd mlteri!l ol lnsur0nce SoNicas officB, lnc, with its permission
Continued on Next Page Page 6 of 7
StateFarm !&
L'tr,rtri
Hi$&
Animal Care Services Policy lor CITY OF MENIFEE, ITS OFFICEB,
Policy Number 92-GJ-T657-5
NOTICE TO POLICY}IOLDER:
For a comprehensive description of coverages and lorms, please reler lo your policy.
Policy changes requesled before the "Dale Prepared", which appear on this notice, are effective on the Renewal Date
of lhis policy unless otherwise indicated by a separate endorsement, binder, or amended declarations. Any coverage
lorms attached to lhis notice are also elfective on he Renewal Date of this policy.
Policy changes requested afler lhe "Date Prepared" will be senl to you as an amended declarations oras an
endors€ment to your policy. Billing lor any additional premium lor such changes will be mailed al a laler date.
ll, during the past year, you've acquired any valuable property items, made any improvements to insured property,
or have any questions aboul your insuranc€ coverage, contact your State Farm agent.
Please keep this with your policy.
RENEWAL OECLARATIONS (CONTINUED)
@ Copyright Strls F6rm Mutu al Automobilo lnsur.ncB Comp!ny, 2008
lncludes copynght0d material ot lnsuranc€ Srrvices 0ffico, lnc., with its permissron
B
E
Prepared
DEC 07 2021
cMP-4000
012780 294
N
Page 7 ol 7
StateFann(-)oo STATE FAFM GENEHAL INSUHANCE COMPANY
A STOCK COMPANY WITH HAME OFFICES IN BLOOMINGTON, ILLINOIS
E?"83 io€li! fr , u o u u - " r'
Named lnsured
ARGUIN, ANGELA &
UATSON, CALEE
INLANO MAHINE ATTACHING DECLARATIONS
Policyl{umbor 92-GJ-T657-5
Policv Period Elloctivo Dtlo Exoiralion Dals
12 Mbnrhs FEB 19 2022 FEB 19 2023
The polipy periofl begins qnd ends at 12:01 am standardume atthe premtses locaton
l1r.r.i{iE#
q
3
ATTACHING INLAND MARINE
Aulomatic Renewal - lf the policy period is shown as 12 monlhs , this policy will be renewed automatcally su bject to the premiums. rules and
forms in effectfor each succeeding policy period. lf tris policy is terminated. we will give you and the Mortgagee/Lienholder written notice in
compliance wi$ the policy provisions or as required by law.
Your policy c onsists of these Declarations, tre INLAND MARINE C 0NDlTl0NS shown below, and any otter forms and endorsements that
apply, including trose shown below as well as th ose issued subsequent to the issuance of this policy.
Foms, 0ptions, and Endorsemonts
FE-8739
FE-6271
FE-8745
lnland Marine Conditions
Amendatory Endorsement
lnland Marine Computer Prop
See Reverse for Schedule Page widr Limir
Prepared
DEC 07 2021
FD-6007
012781
O Copyright Stlts Farm Mutual Automobil€ lnrur.nco Compdny.2008
lncludes copyrightsd mntarirl of lnsuranc€ SErvicas office, lnc., with its p.rmission
5J0 El6a ? 0i 31 20ll lolt3?32c1
l\il-23- 163A-FA41 F Z
Annual Policy Premium lncluded
The above Premium Amountis included in the Policy Premium shown on fie Declarations.
92-GJ-T657-5
ATTACHII{G II{LAND MABINE
ATTACHING INTAND MARINE SCHEDUTE PAGE
ENDORSEMENI
NUI\4BER
FE-8745
COVERAGE
lnland Marine Computer Prop
Loss of lncome and Extra Expense
LII\iIIT OF
INS URANC E
DEDUCTIBLE
AMOUNT
$ 500
ANNUAL
PRE IVI IUM
Included
Included
$
s
25,000
25,000
Prepared
DEC 07 2021
FD-6007
012781
OTHER LIMITS AND EXCLUSIONS I/AY APPLY . REFER TO YOUR POLICY
O Copyri0ht, St.ts Fnrm l\4utu!lAutomobil6 lnsur!nc€ Comp.ny,zmB
lncludrs copyrightod mntErial of lnsurnnc€ S.rvicBs office, lnc., with its permls3ion.
i30 686 a 2 0l31 20ll rollrxlc