2022/09/23 CMS Mobile Glass Shop, LLC (4)StateFarm STATE FAFi' GENERAL INSUHAI{CE COMPANY
A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS DECLARATIONS AMENDED SEP 23 2022(-)@
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Addl lnsured-Sectlon ll Only
M-23-163A-FA41 F N
002846 3r23CITY OF i,IEIIIFEE & ITS OFFICERS
EI.IP L OYEES AGENTS & AUTHORIZED
VOLUNTEERS?98q{ HAUN RD
l{EN I FEE CA 92586-6539
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Auto Services Policy
Policyllumber 92-GR-O228-7
Policv Pe od Elfuctive Dale Exoiralion Date
12 Mbnths SEP 23 2022 SEP 23 2023
Ihe polipy period begins and ends at 12 0l am standardtme at lhe premrses locaton.
Named lnsured
CI'IS I.IOBILE GLASS SHOP LLC
II
Aulomrtic Ronewal - lf ttre pollcv period is shown as 12 months , this policy will be renewed automatically su biect to the premiums, rules and
forms in effect for each sucbeedin! policy period. lf dris policy is terminated, we will give you and the Mortgagee/Lienholder written notice in
compliance wih he policy provisions or as required by law
Entity: Limited Liability Company
Reason tor Declaratlons: Your policy is amended SEP 23 2022
LOSS PAYEE ADDED
FORM CMP.4875 ADDED
Endorsement Premium
Discounts Applied
Renewal Year
Claim Becord
None
Prepared
NOV 09 2022
cMP-4000
021729 290 At
N
O Copyright Stlte F.rm Mutu!l Automobile lnlurlnro Complny, 2m8
lnclud.s coEyriohtsd mrterirl ol lnlurrnca Sorvicss offico, lnc.,with rt! pormis!ion
Continued on Reverse Side of Page Page 1 ot 6
oEcLARAIONS (CONTTNUED)
Auto Sorvlc€s Pollcv ,or CITY OF MENIFEE & ITS OFFTCERSPollcy Number 92-GR4,228-7
sEcTtoN t - p OPERTY SCHEDULE
LocatlonNumbor Location ol
DescrlbedPremises
Llmit ol lnsurance'
Covsraoe A -
Bulldlngs
Llmit ol lnsurance*
Coveraoe B -Buslness FersonalProporty
Seasonallncrease-BusinessP€rsonalProperty
001 4351 BROOKSIDE DR
HETVET CA 92545-8988
No Coverage S 1,400 25%
As of the elreclive ate of this policy, t mit o nsurance as shown inc U es any ncrease
SECNON I.IN
n mit due to lnllation verage
FLATION COVEHAGE INDEXI ES)
Cov A - Inflation Coveraoe lndex.
Cov B - Consumer Price-lndex:
N/A
29?.3
sEcTtoN t -DEDUCTIBLES
BaEic Oeductlble
Speclsl Doductibl6s:
Money and Securities
Garagekeepers - Comprehensive
Equipment Breakdown
$1,000
s2s0
$2so
s1,000
Garagekeepers - Collision
Employee Dishonesty
$s00
$2so
Olher deductibles may apply - reter to policy
Pr egarcd
NOV 0S 2022
cMP-4000
021725
O Copyrigh! Stlte Fsrm Mutu il AutomobjlB ln!ur!noe Comp.nv, 2008
lncludEs coryilhiod mltsrislof lns!rrnc€ SB.vicss offics, lnc., with its permirsion
Continued on Next Page Page 2 of 6
StateFam(D@
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DECLAHATTONS (CONllNUED)
Auto Servlcss Policv for CITY OF MENIFEE & ITS OFFICERSPolicy Number 92-GH-O228-7
SECTION I. EXTENSIONS OF COVERAGE - LIMIT OF INSUBANCE - EACH OESCHIBED REMISES
COVEBAGE
Accounts Receivable
On Premises
Olf Premises
Arson Reward
Back-Up Ol Sowsr Or Drain
Collapse
Damage To Non-O,vned Buildings From Theft, Burglary Or Robbery
Debris Removal
Employee Tools (applies only to those premises provided Coverage B - Busin€ss
Personal Property)
Per Occurrence
Per Employee
Equipment Breakdown
Fire Department Service Charge
Fire Extinguisher Systems Rechargo Expense
Forgery Or Alteration
Garagekeeper's lnsurance - Comprehensive And Collision
Glass Expenses
lncroassd Cost Of Construction And Demolition Costs (applies only when buildings are
insured on a replacemenl cost basis)
Monoy And Socurities (Oll Premises)
Money And Securitiss (On Premis6s)
LIMIT OF
INSURANCE
$10,000
$s,000
$5,ooo
$15,000
tncluded
Coverage B Limit
25% of covered loss
$2,500
$soo
lncluded
$s,ooo
$5,000
$10,000
$25,000
lncluded
10%
$s,000
$10,000
Prepared
NOV 09 2022
cMP-4000
021730 290
N
O Cop/righ! Strts Flrm Mutu.l Automobilg lnt!rrncs Comp.ny, 2m
lncludls co[yrighlod mrtori.l ol lnsur0nca Ssruicor oftica, lnc., wid] it! permisiion
Continued on Beverse Side ol Page Page 3 ol 6
tl
r The coverages and corresponding limits shown below apply separalely to each desciibed premis€s.shown in these; Declaratlons, unless indicated by "See Sch6dule." lf a coverage does not have a co(esponding limlt shown below,
;E but has "lncluded" indlcated, please r€ter to that policy provlsion tor an explanation o, that coveragg.
DECLABATIONS (CONTINUED)
Auto Services Policv fo. CITY OF MENIFEE & tTS OFFTCEBSPolicy Number g2-cR-Q228-7
Money Orders And Count€rleit Money
Newly Acquired BusinEss Personal Property (applies only if this policy provides
Coverage B - Business Personal Property)
Newly Acquired Or.Con8tructed Buildings (applies onty if this poticy provides
Coverage A - Buildings)
Ordinance Or Law - Equipment Cwerage
Outdoor Property
Personal Etfects (applies only to those premises provided Coverage B . Business
Personal Property)
Personal Property Off Premises
Pollutant Clean Up And Rsmoval
Preservation Of Property
Property.Ol Others (applies only 1o those premises provided Coverage B - Business
Personal Property)
Signs
$1,000
$100,000
$250,000
lncluded
$s,000
$2,500
$15,000
$20,000
30 Days
$2,500
$5,000
$10,000
$5,000
Valuable Papers And Records
On Premises
Ofl Premises
SECTION I . E TENSIONS OF COVEBAGE -LIMIT OF INSUBANCE . PER POLICY
The coverages and corr$pondlng limils sho-rvn b€low are the most we will pay rogardless ot the number otdescrlbod pr€mises shown in th€s€ Declarations.
COVERAGE
Employee Oishonesty
Loss Of lncome And Extra Expense
@ Copyright, St0t€ tarm Nlutu al Automobils lnrurrnce Comp.ny, 20m
lncludss copyrightsd matorillof lnsursnts Sorvic0! offic€, lnc., with its osrrrussion
Conlinued on Next Page
LIMIT OF
INSURANCE
$10,000
Actual Loss Sustained - 12 Months
Prepared
NOV 09 2022
cMP-4000
o21730 Page 4 0l 6
StateFarm
DECLABATIONS (CONTINUED)
Auto Servic€s Policv tor CITY OF MENIFEE & ITS OFFICEBSPolicy Number 92-GR-O228-7
SECTION II - DEDUCTIBLES
8
E
33
Business Liability - Property Damage $250
Other deductibles may apply - refer to policy.
SECTION II - LIABILITY
COVERAGE
Coverage L - Business Liability
Coverage M - Medical Expenses (Any One Person)
Damage To Premises Bented To You
AGGREGATE LIMITS
Products/Completed Operations Aggregate
General Aggregate
Each paid claim for Liability Coverage reduces the amount of insurance we provide during the applicable
annual period. Please refer to Seclion ll - Liability in the Coverage Form and any attached endorsements
LIMIT OF
INSURANCE
$1,000,000
$5,000
$300,000
LIMIT OF
INSURANCE
$2,000,000
$2,000,000
Your poticy consists of 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 ENDORSEME
cMP-4101
cMP-4875
cMP-4412
cMP-4827.1
FE-6999.3
cMP-4260.1
Businessowners Coverage Form
'Loss Payable
Operalion ol Customers Auto
Employee Tool Coverage
Terrorism lnsurance Cov Notice
Amendatory Endorsement-CA
Prepared
NOV 09 2022
cMP-4000
021731 290
N
@ Copyrigh! Strte Ftrm Mutu!l Ailtomobil€ lnsurrnce Company,2008
lncludss copyrightod mst€ri!lo[ lnsu16ncs Sslvic0s offic€, lnc., with its psrmission
Continued on Reverse Side of Page Page 5 ol 6
&
ffii
DECLARATIONS (CONTINUED)
Auto Servlces Pollcy tor CITY OF MENIFEE & ITS OFFICEFSPollcy Number 92-GR-Q22&7
cMP-4261
cMP.4705.2
cMP-4710
cMP-4709
cMP-4470
cMP-4698
cMP-4786.1
cMP4787
FD-6007
Amendatory Endorsement
Loss of lncome & Extra Expense
Employee Dishonesty
Money and Securities
Garageksepers Direct Coverage
Back-Up ol Sewer or Drain
Addl lnsd Owners Lossee Sched
Waiver of Trans Bgt of Recov
lnland Marine Attach Dec- New Form Attached
This pollcy is issued by the State Farm Gen€ral lnsuranco Company.
Parlicipating Policy
You are onlitl€d to participate in a distribution of th€ earnings of th€ company as detsrmin€d by our Board of Diroctors in
aocordanco with the Company's Articles of lncorporation, as amended.
ln WtnE6s Whereof, tre State Farm General lnsurance Company has caused this policy to be slgned by it6 President andSecrelary al Eoomrngton, lllinois.
ff -tnY*"ttSscretary
-il,*t" C"/4
IMPORTANT NOTICE:
Clllomle hw recf,Jlres ua.to provlde you wth lnlormatlon ror llllng c{lnplolnts whh the State lnsurance Depanmetrt tegardlng thecov.ngo and eorvics provl&d under thie pof,cy.
YouJ agolll's flrme €nd cor rct larlomEtbn a]e prorided on the lrori ol lhis documem, AnottEr optbn l! to ,each out bymall or phono directly tol
Slato FrrrP Execuiye Curlomer Servicc
PO Box 2320
Bloomlngton lL 61702
Phon r 1€oo-STATEFAHX (t-80G782-8332)
I)sPrtnent of lrculance comPbln6 shoub t € llled only attei you lnd Stste Fam ol youl ogent or other companyr"p.eantative havs lrilod to roach E sotialactory eglgsment on s problofi,
Crlrornia DepEnment ol lnxrranca
ConeLher Serylces Dlvlalrn
300 South Sprlng Slre€t
L@ Angelss, CA 9O013
Phorlg | 1{O0-927.HELP (€54 or vbit iwwlnsuft nce,co.ooy/Ol.conlrrnsrs
President
@ Copyri!ht Stato fafnr Mutu!l Automobil6 ln!urrnoo Comp!ny, zoo8
lnclud€s copyrioht8d miterisl of lnsur!nce S6rvicBs offics, lnc., with its pormis3ion
Prepared
NOV 09 2022
cMP-4000
021731 zfi
N
Page 6 of 6
StateFarm STATE FAFM GENEBAL INSUFANCE COMPANY
A STOCK COMPANY WITH HOUE OFFICES IN ELOOMINGTON, ILLINOIS
Po Box 2915Bloominglon lL 6 1 702-291 5
Named lnsured
M-23-163A-FA41 F N
CIIS I4OBILE GLASS SHOP LLC
ft
INLAND MARINE ATTACHING DECLARATIONS-
Policyltlumber 92GR-O228-7
Policv Poriod Elhclive Dale Exoiralion Dale
12 Nilbnths sEP 23 2022 SEP 23 2023
Ihe polipy period begins and ends at 12:0'l am standardtme at me Plemrses loca0on.
ffi
3
ATTACHING INLAND MARINE
Aulomatic Ronewal ' ll dre policy podod is shown as 12 months , t'ris policy will be renewed automatically subject to the premiums, rules and
forms in effect for each succeedin g policy period. lf fiis policy is terminated, we will give you and tre Mortgagee/Lienholder written notice in
compliance wi$ $e policy provisions or as required by Iaw.
Annual Policy Prcmlum lncluded
The a bove Premium Amount is included in dre Policy Premium shown on $e Declarations
Your policy consists of hese Declarations, fie INLAND MARINE C 0NDlTl0NS shown below, and any odter [orms and endorsemenb drat
apply, including trose shown below as well as $ose issued subsequentto the issuance of ttis policy.
Foms. 0ptions, and Endorssmenb
FE-8739
FE-6271
FE-8745
lnland Marine Conditions
Amendatory Endorsement
lnland Marine Computer Prop
See Reverse for Schedule Page widr Limir
Prepared
NOV 09 2022
FD-6007
021732
O Copyri!h! St6t€ Flrm l\4utuilAutomobile lnrurrnc€ Comp.oy,2008
ln6lud0s copvrightqd n!t6rial of lnsurrnce SBrvicst olfice, lnc., wilfi its permiition
t30 516a.t 05 rl 20ll lollSzucl
(-OD
92-GR-O228-7
ATTACHING II{LANO MABIITE
ATTACHIilG INTAND MARINE SCHEDULE PAGI
ENDORSEMENT
NUM BEB
FE-87 45
COVEBAGE
lnland Marine Computer Prop
Loss of lncome and Extra Expense
Lil\4 rT 0F
INSUBANCE
DEDUCTIBLE
AMOUNT
s 500
ANNUAL
PREIVIUM
Included
Included
I
s
25,O00
25,000
Prepared
NOV 09 2022
FD-6007
021732
OTHEB LIMITS AND EXCLUSIONS MAY APPLY . REFER TO YOUR POLICY
O CopynghL Stot6 F6rm M(tu.l Automobile lnsur6nco Compsny, 2008
lncludes copyrighled m.terial ol lnsuronce Seryices office, lnc , with its oermission.
!30 60{ r 2 05 ll 20ll loll3z!3cl