2022/10/31 Western A/V, Inc. (27)StateFam STATE FARM GENERAL INSURANCE COUPANY
A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS
Po Bo\ mlsBloominglon lL 61 702-29 I 5
Addl lnsured.Section ll Only
M-23-61F8-FB8A F Z002343 3123CITY OF !.,IEN I FEEAND ITS OFFICERS, EI{PLOYEES,
AGENTS & AUTHORIZED VO LUNTEERS29844 HAUN RD
l{EN I FEE CA 92546-6539
l, r, r,, tl,llh rtlh rlltlt,,, r,l,lh lt,lI tr,I, r,1,, tl,l,lr, tl,,,
Home Product Sales Policy
DECLARATIONS AMENDED OCr 31 2022
Policyilumbor 92-GY-O812-0
Policv Period Ellecllvr Dale Exoiralion Date
12 Mbnths OCT 31 2022 ocT 31 2023
The poltpy pertoy' begtns qnd ends at 12:0'l am standardtme at me premrses locat0n
Named lnsured
I{ESTERN A,/V INC
u(-)oo
ffi
I
Aubmrtic Renowal - lf fie pollcy pe riod is shown as 12 montha , fiis poltcy
forms in effect for each succeeding policy period. lf fris policy is terminated
compliance wifi tlre policy provisions or as required by law.
will be renewed automatcally sublectto $re premiums, rules and
we will give you and the Mortgagee/Lienholder written notice in
Enlity: Corporation
Reason lor Declarations:Your policy is amended OCT 31 2022
ADDITIONAL INSURED ADDED
PREMIUM ADJUSTMENT
FORM CI\,{P-4786.1 ADDED
Endorsement Premium
lncrease
Discounts Applied:
Renewal Year
Years in Business
Enclosed Building
Proteclive Devices
Sprinkler
Claim Record
$ 44.00
Prepared
sEP 14 2022
cMP-4000
o copyri0h! St tB trrm Mutu!lAutomobih Inlur.nco Complny,2[,(B
lnclud6s copyri0ht8d m.tsri.l of Insurrncs S0rvic6! 0fficB. lnc., wih its pgrmirlion
Continued on Reverse Side ol Page Page I of 7
5 tl6r ? 0! !l Z0ll loltlzuc)
018410 290
N
AI
Home Product Sales PollcvPolicy Number 92.G
DECLARATIONS (CONTINUED)
tor CITY OF MENIFEE
Y-D812-0
SECTIONI-PROPFRTYSCH EOULE
LocstionNumbor Location of
Doscribed
Premises
Limit ot lnsuranc€'
Coveraoe A -Buildlngs
Limit ol lnsurance*
Covsrade B -
Business PersonalProporty
S€asonallncrease-
Business
Personal
Property
001
002
1592 N BATAVIA ST STE 2
OBANGE CA 92867-359
1590 N BATAVIA ST STE 4
oRANGE CA 92867-3534
No Coverage
No Coverage
$ 141 ,100
$ 140,900
250/.
25%
'Aso e ct e date of lhis po cy, t Limit of nsu rance as s own nc s any rncrgaseu n the limit due to lnf la on overage
SECTION I - INFLATION COV RAGE INDEX(ES)
Cov A - lnf lation Coverage lndex
Cov B - Consumer Price lndex:
N/A
296.3
SECTION I - DEDUCTIBLES
Baslc Deductible
Speclal Oeductlbles:
Monoy and Securities
$2,500
$250 Data Compromise
@ Copyri!h! Stlto Fi.m l\4 ut! !l Automobilo ln!urrnoB Comprny,20(ts
lnclirdes copyri!htsd m.tori!l ol lnsur!nce Sorvicsr ollicE, lnc., with ib pormission
Continued on Next Page
$1,000
Prepared
sEP 14 2022
cMP-4000
018410 Page zot 7
StateFann E&
W
Home Product Sales Policv
Policy Number 92-G
oEcLARATTONS (CONTTNUEO)
lor CITY OF MENIFEE
Y-D812-0
Employee Dishonesty $250 Equipmsnt Breakdown $2,s00
Other deductibles may apply - reler to policy
SECTION I - EXTENSIONS OF COVEBAGE . LIMIT OF INSU RANCE - EACH DESCRIBED PBEMISES
E63 The coverages and corro3ponding limits shown below apply separalely to each dosc.ibed premises shown in these
Declaratlona, unless indlcated by "Soe Schedulo." ll a coverago doos not have a correspondlng llmlt shown below,
but has "lncluded" lndlcated, please refer to that policy provlslon tor an gxplanalion ol that coverago.
LIMIT OF
INSURANCE
See Schedule
See Schedule
$5,000
See Schedule
tncluded
Covorage B Limit
25% of covered loss
lncludod
$2,soo
ss,000
$10,000
lncluded
10%
See Schedule
See Schedule
$1,000
Pre p ared
sEP 14 2022
cMP-4000
O Copyrioht Stlts Flrm Mulu!l Automobil. lnrurtnc! Comprny, 2m
lncludes copyrightod mltsri!l of lnsur!nce S.avicar ollici, lnc., wi6 its p0rmission
Continued on Revorso Sid6 ol Page018411 290
N
Page 3 of 7
COVERAGE
Accounts Receivable
On Premises
Otl Premises
Arson Reward
Back-Up Of Sewer Or Drain
Collapse
Damage To Non-Orvned 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 Ol Construction And Demolition Costs (applies only wh€n buildings are
insured on a roplacsment cost basis)
Money And SscuriliEs (Off Premises)
Money And Securities (On Premises)
Money Orders And Counterl€it Money
Homo Producl Sales PolicvPolicy Number 92-G
Valuable Papers And Records
On Premisos
Off Premises
DECLARATIONS (CONTINqED)
'or
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 (appli6s only if this policy provides
Coverage A - Buildings)
Ordinance Or Law - Equipment Coverage
Outdoor Property
Personal Etfects (applies only to those premises provided Coverage B - Business
Personal Property)
Personal Property Of, Premises
Pollutant Clean Up And Removal
Preservation Of Prop€rty
Properly Of Others (applies only to those premises provided Coverage B - Business
Personal Property)
Signs
$100,000
$250,000
lncluded
See Schedulo
$2,soo
$2s,000
$10,000
30 Days
See Schedule
See Schedule
See Schedule
See Schedule
SECTION I - EXTENSIONS OF COVERAGE - LIMIT OF INSURANCE. SCHEDULE
The coverages and corresponding limits shown below apply only to the described premises as shown.
LOCATION
0001
0002
Prepared
sEP 14 2022
cMP-4000
0't8411
COVERAGE
LIMIT OF
INSUHANCE
Signs
Back-Up Ol Sewer Or Drain
Money And Securlties (On Premises)
Money And Securities (Off Premises)
Property Of Olhers (applies only to those premises provided Coverage B - Business
Personal Property)
Accounts Receivable (On Premises)
Accounts R6ceivable (Olf Premises)
Outdoor Property
Valuable Pap€rs and Flecords (On Prsmises)
Valuable Papers and Records (Off Premises)
Accounts Receivable (On Premises)
@ Copyri0h! Stlto Flrm lllutu sl Automobil0 lns!rance Comp.ny, 200€
lncluds! copyri0hted m.lgri.lol lnsur.nce Sorvicss otlic€, lnr., with it5 pBrmi$sion
Continued on Next Page
$s,000
$15,000
$10,000
$5,000
s2,500
00
00
00
00
00
$
$
10o<
$5
10
$5
0
0
0
0
0
$10,000
Page 4 ot 7
StateFarm !&
ffit
Home Product Sales PolicvPolicy Number 92-G
DECLARATIONS (CONTINUED)
Ior CITY OF MENIFEE
Y-D812-0
Accounts Receivable (Of f Premises)
Back-Up Of Sewer Or Drain
Money And Securities (Olf Premises)
Money And Securities (On Premises)
Outdoor Property
Property Of Others (applies only to those premises provided Coverage B - Business
Personal Property)
Signs
Valuable Papers and Records (On Premises)
Valuabls Papers and Records (Off Premises)
$s,ooo
$10,000
$s,000
$2,soo
$s,ooo
$15,000
$s,ooo
$10,000
$5,ooo
g
AB
SECTION I . EXTENSIONS OF COVEBAGE - LIMIT OF INSURANCE - PEB POLICY
The coverages and corrospondlng lhits shown below are the most we will pay regardless ol ths number ol
descrlbed premises shown ln these Declarations.
Data Compromise
Legal And Forensic lntormation Technology Review
Per Occurrence
Dependent Property - Loss Of lncome
Employee Dishonesty
COVERAGE
ldentity Flestoration
Olher Expenses
Case Management Services
Per Occurrence
Lost Wages And Supervision Expenses
Utility lnterruption - Loss Of lncome
Loss Of lncome And Extra Expense
O Copyrioht, StltB Firm Mutu6l Automobilo l0surlncs Complny. 2m
lnclud€s copyrighted m0t6ri!l ol lnsur!0c. ssrvicss officB, lnc., with its prrmission
Conlinued on Fleverse Side ol Page
LIMIT OF
INSU RANCE
$s,000
$50,000
$5,000
$10,000
$1 ,ooo
'1 2 months
$35,000
$5,000
$10,000
Actual Loss Sustained - 12 Months
Prepared
sEP 14 2022
Cl\ilP-4000
018412 290
N
Page 5 of 7
Home Producl Sales Pollcv
Pollcy Number 92-G
DECLARATIONS (CONTINUED)
tor CITY OF MENIFEE
Y-D812-0
SECTION II - LIABILITY
COVERAGE
Coverage L - Business Liability
Coverage M - Medical Expensos (Any One Person)
Damage To Premises Rented To You
AGGHEGATE LIMITS
Producls/Completed Operatlons Aggregate
General Aggregate
Each paid claim for Liability Co-verage reduces the amount ol 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,000
$500,000
LIMIT OF
INSUHANCE
$4,000,000
$4,000,000
Your policy consists of these Dsclarations, the BUSINESSOWNERS COVERAGE FORM shown below, and any otherforms and endorsements that apply, including those shown below as well as those issued subsoquent to the
issuance of this policy.
FOFMS ANN FNNONSEMENTS
ctvtP-4101
ct\4P4786.1
c[/P-4787
cN,rP4260.1
CMP4261
cMP-4705.2
cMP-4710
Cl\,tP-4709
CN,tP-4698
ctltP-4704.1
ct!!P-4703.1
Cl\,lP-4610
Cl\,lP-4746.1
Prepared
sEP 14 2022
cMP-4000
0t84r2
Businessowners Coverage Form.Addl lnsd Owners Lessee Sched.Waiver ot Trans Rgt of Becov
Amendatory Endorsement-CA
Amendatory Endorsemenl
Loss of lncomo & 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
O Copyri!ht Stlto F.rm ir!turl Automobils lnsursnc0 Comp.ny,20(tr
lnoludes copyrighted matBri6l of ln!ur!nco S6rvic0s offico, lnc., with it! p€rmigsion
Continued on Next Page Page 6 ol 7
I
SlateFarm3
ffi
Home Product Sales Pollcv
Policy Number 92-G
DECLARATIONS (CONTINUED)
lor CITY OF MENIFEE
Y-D812-0
cMP-4990.1
cMP-4994
cMP-4875
FE-6999.3
Cl\,lP-4793.1
ctvtP-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: INFORMATION CONCERNING
CHANGES IN YOUR POLICY
LANGUAGE IS INCLUDED. PLEASE
CALL YOUR AGENT IF YOU HAVE
ANY OUESTIONS.
' New Form Attached
a
GA
This policy is issued by the State Farm General lnsurance Company.
Parthipating Policy
You are entitled to participato in a distribution of th€ earnings of lhe company as determined by our Board of Directors in
accordance with the Company's Articles of lncorporation, as amended.
ln Witness Whereof, he State Farm General lnsurance Company has cau6ed this policy to be signed by its President and
Secretary at Bloomington, lllinois.
fi*rnltr*,t
Secretary
-{l*e b,h
President
IMPOBTANT NOTICE:
Calfoml. hw rcqulles us ro provld€ you wlth lr ormatlon for llllno comphlIrt! wlth the glfle lnsurance Depanmem r€gardlng tlE
coveragc and eervico provkled undor this policy.
Your agem'! name and contrct intomrlbn are provided on tlE tlont ol lhb docume . Another optlon i3 to rerch out by
mqilor phono dhectly lo:
srde FrrrP Erscutiye cultomer servioe
PO Bor 2320
Eloomlnglon lL 61702
Phone * I€O0STATEFAH (1-80G782-831!2)
Ospanment ot lnsuranco complrlms should be llbd only atter you lnd Strle Frm or your agent or olher comparry
roprs*ntstlvo JEve lrilod lo rBach a satisloqtoay rgtBomeril ol| I probhm.
Cslilomh Oep8rtment o, lnsursnce
consumel 6eff lcoe OlYlslon
300 Sourh gprlng St]eotLc Angohs, CA soo13
Phone, l€OO-927-HELP (1854 or viEit rwwjnrurance.ci,ooY/o1-colEtmer!
Prepared
sEP 14 2022
cMP-4000
018413 290
N
@ CopyriohL State Flrm Muturl Automobilo lnrurrncr Comp!ny,2008
lnclud6i copyright8d matorial ol lntu16nc. So.vicr! oflicr, lnc., with its pormis3ion.
Page 7 ot 7
!
I
StateFann STATE FAHM GEI.IEBAL INSURANCE COMPANY
A STOCK COMPANY WITH HOME OFFICES IN SLOOMINGTON, ILLINOIS
E?A4i,fi||i, t u,,0,.,,,,
Named lnsured
M-23-61 F8-FB8A F Z
tNLANo MARTNE ATTACHtNG oeclanarroH$
Policyl{umber 92-GY-O812{
Policv Pcriod Etlscllvr Dals Exoiration Dab
12 Mbnrhs OCT 31 2022 ocT 31 2023
Ihe polipv period begins qnd ends at l2:01 am standardtme atme premlses locaton.
(Dco
ls;'-'iiu#
I{E STERN A/V INC
a
E
*3
ATTACHING INLAND MARINE
Aubmrtic Ronewal - lf tre policy pedod is shown as 12 months , tris policy will be renewed automatically subject to the premiums, rules and
forms in effectfor each succeeding policy period. lf his policy is terminated, we will give you and dre Mortgagee/Lienholder written notice in
compliance widr $e policy provisions or as required by law.
Annurl Policy Promium lncluded
The above Premium Amount is included in dre Policy Premium shown on tre Declarations
Your policy consists of t'rese Declarations, tre INLAND MARINE C 0NDlll0NS shown below, and any otter forms and endorsemenb that
apply, including $ose shown below as well as fiose issued subsequent to *re issuance of fltis policy.
Forms, options, and Endorssmanb
FE-8739
FE-6271
FE-87 45
lnland lvlarine Conditions
Amendatory Endorsement
Inland Marine Computer Prop
See Reverse for Schedule Page wi$ Limis
Prepared
sEP 14 2022
FD-6007
018414
O Copyri0hL Stlte trrm Mutu.l Automobils lnrur!nce Componv.2008
Ificludss cogyrightod materirl of lnsur!nc. Sorvioo. office, lnc., with its pormission
530 686 r.2 05 ll ?01I lollJll2cl
92-GY-D812-0
ATTACHII{G IIILAI{D MARII{ E
ATTACHING IttItAND MABINE SCHEDULE PAGE
ENOORSEMENT
NUMBER
FE-8745
LIIMIT OF
INS URANC E
DEDU CTIBLE
AMOUNT
ANNUAL
PREMIUMC OVERA6E
lnland Marine Computer Prop
Loss of lncomo and Extra Expense
$
$
25,000
25,000
$ 500 Included
Included
Prepared
sEP 14 2022
FD-6007
0 t 8414
0THERL||\4lTsANDExCLUSl0NSMAYAPPLY'REFERT0Y0URP0L|CY-
O Cogyri!h! Stlto F6rm Mutu.l Automobilg ln!urlncr Comp.ny, 2008
lncludrr copyriChtsd mrtrri.l of lnsur!ncs Ssrvicas olfic6, lnc.. with itt pgrmirliofl
5!U tdt r.2 05 3l 20ll iollil2Jlcl
I