2022/10/31 Western A/V, Inc. (28)StateFarm STATE FABM GENEBAL INSUFA CE COI/IPANY
A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS OECLARATIONS AI\TENDED Nov 1 2022(-)oo
he
Po Box 2915Bloomi nglon I L 6 1 702-29 1 5
Addl lnsured-Section ll Only
M-23-61F8-FB8A F Z
001992 3123CITY OF IIEN I FEE
AND ITS OFFICERS, EI{PLOYEES,
AGENTS & AUTHORIZEI} VO LUIITEERS?9844 HAUN RDIENIFEE CA 9?556-6559
,rr llr 111r1' rlilll'il 1" 'lrlllrllt'ilhtllh, rlllh trtlr, il llrl
Home Product Sales Policy
Policyllumber 92-GY-D8124
Policv Period Elfuctive Dalc Exoiration Dale
12 M'onths OCT 31 2022 OCT 31 2023
Ihe policv period beqins and ends at l2:01 am standardtme at the premtses locabon.
Narned lnsured
tTESTERt{ A/V INC
IE
Aubmatic Renowal -lf the policypc od is shown as l2 rnonlhs , this policy will be renewed automatically subjecttothe premiums, rules and
forms in etfect for each suc beeding policy period. lf tris policy is terminated, we will give you and the Mortgagee/Lienholder written notice in
compliance witr the policy provisions or as required by law.
Entity: Corporation
Beason for Declarations:Your policy is amended NOV 1 2022
ADDITIONAL INSURED ADDED
PREMIUM ADJUSTMENT
FORM CMP.4786.1 ADDED
Endorsement Premium
lncrease
Discounts Applied:
Renewal Year
Years in Business
Enclosed Building
Protective Devices
Sprinkler
Claim Record
$ 44.00
Prepared
DEC 29 ?022
cMP-4000
O Copyright, Stato F!rm l\4utuil Automobilo lnsur.ncB Compiny,2008
lnclud.s copyrightod mrterial ol lnsurdncs Ssrvico3 offic., lnc., with its pormission
Continued on Reverse Side ol Page018493 290
N
Page 1 ol 7
Hom€ Product Sales Pollcv
Pollcy Number 92-G
DECLABATIONS (CONTINUED)
IOr CITY OF MENIFEE
Y-D812.0
SECTIONI-PFOPEBTYSCH EDULE
Location
Number Locatlon ol
Described
Premlses
Limit ot lnsuranc€'
Coveraoe A -
Buildi'ngs
Llmll oI lnsurance'
Covsraoe B -Busin6ss FersonalProporty
Seasonal
lncrease-BusinessPersonal
Property
001
o02
1592 N BATAVIA ST STE 2
oRANGE CA 92867-3554
1590 N BATAVIA ST STE 4
oRANGE CA 92867-3534
No Coverage
No Coverage
$ 141,100
$ 140,900
. As o, the ate of t s policy, t to lnsurance as s n rnc udes any increaso in lhe limit ue to n ation Coverage
SECTION I . INFLA ION COVERAGE INDEX'ES}
Cov A - lnllation Coverage lndex:
Cov B - Consumer Price lndex:
N/A
296.3
SECTION I. DEDU TIBLES
Basic D€ductiblo
Speclal Deductlbles:
Money and S€curities
$2,500
$250 Data Compromise
O Copyri!ht Stlte t6rm Mutu.l Automobil€ lnsur6nce Comp.ny.2OO8
lnclud0s copyrightod matori6l of lnsur!nce SoryicBs office, lnc., with its psrmisjion
Continued on Next Page
$1 ,000
Prepared
DEC 292022
cMP-4000
0r8.193 Page 2 ol 7
25%
25%
I
I
l
StateFarm D6)@
t.}-'lriEtr
Home Product Sales Policv
Pollcy Number 92-G
DECLARATIONS (CONTINUED)
for CITY OF MENIFEE
Y-O812{)
Employee Dishonesty $2s0 Equipment Breakdown $2,500
Other deductibles may apply - reler to policy
SECTION I. EXTENSIONS OF COVEBAGE . LIMIT OF INSUFANCE - EACH OESCBIBED REMISESQi
;g The coverages and corresponding limits shown bolow apply separately to each describ€d ptemises shown in these
Declarations, unless indicated by-"See Schedule." ll a cbverage does not have a corresponding limlt shown below,
but has "lncluded" lndlcated, pleaso refer to that policy provlsion lor an explanation ot that coverage.
COVEHAGE
Accounts Receivable
On Pr€mises
Off Premises
Arson Reward
Back-Up Ol Sewer Or Drain
Collapse
Damage To Non-Owned Buildings From Theft, Burglary Or Robbery
Debris Removal
Equipment Breakdown
Fire Department Service Charge
Fire Extinguisher Systems Becharge Expense
Forgery Or Alteration
Glass Expenses
lncreased Cost Of Construction And Demoltion Costs (applies only when buildings are
insured on a roplacement cosl basis)
Money And Securities (Orf Premises)
Money And Securities (On Premis6s)
Money Orders And Counterreit Monoy
LIMIT OF
INSUBANCE
See Schedule
See Schedule
$1,000
Prepared
DEC 29 2022
cMP-4000
018494 290
N
O Cogyriohl Stlt8 F.rm Mutusl Automobilt lnsurlnm Complny. 20m
lnclud0. cogyrightod m.t8ri.l ol lnsurrncr Sorvice! 0fficr, lhc., with iB pormissio0
Continued on Reverse Side ol Page Page 3 of 7
See Schedule
See Schedule
$s,000
See Schedule
lncluded
Coverage B Limit
2570 ot covered loss
lncluded
$2,500
$s,000
$10,000
lncluded
10.k
Home Product Sales PollcvPolicy Number 92-G
DECLARATIONS (CONTINUED)
'Or
CITY OF MENIFEE
Y-D812-O
Newly Acquired Businsss Personal Property (applies only il this policy provides
Coverage B - Business Personal Property)
Newly Acquired Or Constructed Buildings (applies only if this policy provides
Coverage A - Buildings)
Ordinance Or Law - Equipment Coverage
Ouldoor Property
Personal Effects (applies only to those premises provided Coverage B - Business
Personal Property)
Personal Property Otl Premises
Pollutant Clean Up And Removal
Preservation Of Proporty
Prop€rty Of Others (applies only to those premises provided Coverage B - Business
Personal Property)
Signs
$100,000
$2s0,000
lncluded
See Schedule
$2,500
$25,000
$10,000
30 Days
See Schedule
See Schedule
Se
Valuable Papers And Records
On Premises
Olf Premises
SECTION I. E
Se
Sc
Sc
e hedule
hedule
NSIONS OF COVERAGE - LIMIT OF INSURANCE - SCH DULE
The covorages and corr6ponding limits shown below apply only to the d€scribed premises as shown.
LOCATION
0001
Prepared
DEC 29 2022
cMP-4000
018494
COVERAGE
0002 Accounts Receivable (On Premises)
Signs
Back-Up Of Sewer Or Drain
Money And Securities (On Premises)
Money And Securities (Off Premises)
Property.Of Olhers (applies only to those premises provided Coverage B - Business
Personal Property)
Accounls Beceivable (On Premises)
Accounts Receivable (Of f Premises)
Outdoor Property
Valuablo Papers and Records (On Premises)
Valuable Papers and Records (Off Premises)
LIMIT OF
INSURANCE
$5,000
$15,000
$10,000
$s,ooo
$2,500
$10,000
$5,000
$s,000
s10,000
$5,000
$10,000
O Copyrigh! Ststo F.rm lvlutu rl Automobils lns!rEnc0 Complny, Z()(E
lncludss copyrighted m.t€rill ol lnsurrnce SBrvicss offics, lnc., wrth its pErmission
Continued on Next Page Page 4 ol 7
StateFarm(-@
E#
Home Product Sales Pollcv
Policy Number grl-G
DECLAHATIONS (CONTINUED)
'or
CITY OF MENIFEE
Y-D812-0
Accounts Recoivable (Off Premises)
Back-Up Of Sewer Or Drain
Money And Securities (Olt Premises)
Money And Sacuritias (On Premises)
Outdoor Property
Propefi Of Olhers (applies only to those premises provided Coverage B - Business
Personal Property)
Signs
Valuable Papers and Records (On Premises)
Valuable Papors and Records (Ofl Premises)
$5,000
$10,000
$5.000
$2,soo
$s,000
$15,000
$s,ooo
$10,000
$5,ooo
II
;3
SECTION I - EXTENSIONS OF COVEFAGE . LIMIT OF INSURANCE. PER POLICY
The coverages and coresponding limlts shown below are the most wo wlll pay regardless ol the number ol
describod premis6s shown ln th€so Declaralions.
COVEBAGE
Data Compromise
Legal And Forensic lnformation Technology Review
Per Occurrence
Depondent Property - Loss Ol lncome
Employee Dishonesty
ldentity Bestoration
Olher Expenses
Case Management Servicos
Per Occurrence
Losl Wages And Supervision Expenses
Utility lnterruption - Loss Ol lncome
Loss Ol lncome And Extra Expense
LIMIT OF
INSU RANCE
$5,000
$s0,000
$5,000
$10,000
$1,000
12 months
$3s,000
$s,000
Prepared
oEc ?9 2022
cMP-4000
018495 290
N
O CoWrigh! Stlto Frrm Mutu!l Automobil0 lnsurlncs Comp.ny, 20I)B
lnclud€s copyriohtsd m.terirl ol lnsurrncs S€n/ic€s officr, In.., with its p€rmilsion
Continued on Reverse Side ol Page
$10,000
Actual Loss Sustained - '12 Months
Page 5 of 7
Horno Product Sales PolicvPollcy ltumber 92-G
oEcLABATtONS (CONTTNUEO)
IOI CITY OF MENIFEE
Y-D812-0
SECTION II . LIABILITY
COVEFAGE
Coverage L - Business Liability
Coverage M - Medical Expenses (Any One Person)
Damage To Premises Rented To You
AGGREGATE LIMITS
Produclo/Completed Operations Aggregate
General Aggregate
LIMIT OF
INSURANCE
$2,000,000
$5.000
$500,000
LIMIT OF
INSUHANCE
$4,000,000
$4,000,000
Each paid claim for Liability Co_verage reduces the amount ol insurance we provide during the applicable
annual poriod. Please refer to Section ll - Liability in the Coverage Form and any attached endoidements.
Your poliry consists of these Declarations, the BUSINESSOWNERS COVERAGE FORM shown below, and any otherlorms and endorsements that apply, including those shown below as well as those issued subsequent to theissuance of this policy.
FORMS AND N DOBSEMENTS
cMP.4101
cMP-4786.1
cMP.4787
cMP-4260.1
cMP 4261
cMP -4705.2
cMP 4710
cMP4709
cMP-4698
cMP-4704.1
cMP-4703.1
cMP-46r0
cMP -4746.1
Businessowners Coverage Form.Addl lnsd Owners Lesses Sched-Waiver of Trans Rgt of Recov
Amendatory Endorsement-CA
Amendatory Endorsement
Loss of lncome & Extra Expense
Employeo Dishonesty
Money and Socurities
Back-Up of Sewer or Drain
Dependent Prop Loss of lncome
Utility lnterruption Loss lncm
General Agg Limit Per Proj
Hired Auto Liability
Pr eparcd
DEC 292022
cMP-4000
018,195
@ Copyrigh! St.t. t!rm M ut! El Automobile lnsur6ncB Comp!fly,2008
lncludRs copyri0ht0d m6terillof lnsu16ncB Services of{ic6, lnc., with its psrmi!sion
Conlinued on Next Page Page 6 of 7
StateFarm !
ffi
Home Product Sales Policv
Pollcy Number 92-G
DECLARATTONS (CONnNUEO)
for CITY OF MENIFEE
Y-D812.{)
cMP-4990.1
cMP-4994
cMP-4875
FE-6999.3
cMP-4793.1
cMP-4788.1
FD-6007a
E
This policy is issued by the State Farm General lnsurance Company.
Participating Policy
You are entitled to participate in a disfibution of the earnings ol the company as determined by our Board ot Dirsctors in
accordance with the Company's Articles of lncorporation, as amended,
ln Witness Whereof, he State Farm General lnsurance Company has caused this policy to be signed by lts President and
Secr€tary at Bloomington, lllinois
.{/,*tu e,hff7""*nlp.tt
Sscretary
IMPORTANT NOTICE:
Calfiomla hw ]eqlJres ur to Fovlde you uth lnlomatlon tor llllng colnphlms wlth the Strte ln$rEnce Oepanmet regrrdlm the
coveragc and rrvice prcvktd undar ttis pofcy.
Yout ago b nlme and cor ac! Homatbn llE provlded on the lror ol lhb documed. Anothel optbn ir to leach oul by
miilor phonc dhsc{ly lo:
strte Farll0 Executlys cuctmr.] Sarvlos
PO Box 2120
Bloomlngion lL 81702
Phone r 'l€OO-STATEFARX (t 3ocl1'2€glil)
O,eptfinsnt ot lnrursnce compLht rho.id be lllod only .lter you lnd Stste Flrm or your lgsm ol ollEr compiny
reprDsrtatko hrve hlod lo rt.€h a salidoclory agag.mo on o ptobLm.
C!liromi8 DepErunent ot lnerfrrE
Con3umor SarYlc€s Dlvlslon
300 Sourh EprlrU Slreet
Lo6 Ang.lo!, CA 90013
Phonr t l€o0427-HELP (4i154 or vbit rr .inlur8ncc.cs.osv/ol-clrEtmera
Prasident
O Copyright, StatB Farm lvlutunlAutomobile lnsuroncs Comptny,2008
lnclodes copyrigh$d mltori0l ol lnsurEnc6 S€rvicss oftice, lnc , with [s p€rmi!sion
Pre pared
DEC 29 2022
cMP-4000
018496 290
N
Page 7 ot 7
I
&
ldentity Restoration Coverage
Data Compromiso
Loss Payable
Terrorism lnsurance Cov Notice
Al State Political Perm Prem
Addl lnsd Mgrs Lessor ol Prem
lnland Marine Attach Dec
NOTICE: INFORMATION CONCERNING
CHANGES IN YOUR POLICY
LANGUAGE IS INCLUDED. PLEASE
CALL YOUR AGENT IF YOU HAVE
ANY QUESTIONS,
' New Form Attached
StateFarm STATE FARM GENEBAL INSURAiICE COMPANY
A STOCK COMPANY WTH HOME OFFICES IN BLOOMINGTON, ILLINOIS
E?API &?1i,, u, ro,-,', u
Named lnsured
M-23-61 F8-FB8A F Z
WESTERN A/V INC
ATTACHING INLAND MARINE
INLAND MAHINE ATTACHING DECLABATIONS
Policyl{urnber 92-GY-D812-O
Policv Period Etleclive Dale Exoiralion Dalo
12 Nlbnths OCT 31 2022 ocT 31 2023
Ihe policy period beqins and ends at l2 01 am standardtme atthe premlses I0calon
(-,@
E
i3
Aulomalic Renowrl . lf tire policy pcriod is shown as 12 monlhs , this policy will be renewed automatically subjectto the
forms in effect for each sucieeding policy period. l, fiis policy is terminated, we will give you and the Mortgagee/Lienhol
compliance witr tre policy provisions or as required by law.
premiums, rules and
der written notice in
AnnuolPolicy Premium lncluded
The above Premium Amountis included in tre Policy Premium shown on tre Declarations
Your policy c onsists of *rese Declarations. tre INLAND MARINE C 0NDlTlONS shown below, and any other forms and endorsemenb that
apply, including $ose shown below as well as $ose issued subsequent to $e issuance of this policy.
Forms, 0ptions, and Erldorsemonh
FE-8739
FE-627'l
FE-8745
lnland l\rarine Conditions
Amendatory Endorsement
lnland Marine Computer Prop
See Reverse for Schedule Page wi$ Limis
Prepared
DEC 29 2022
FD-6007
018497
O Cgpyright State Form Mutu6l Automobilo lnsur!nce Comp!ny, 2008
lncludrs oopyriqht0d mltoriEl of lnsur€nc0 SEr!ic€s office. lnc., with its permission
5$ 616 !.? 05 lr 20lt lollS?lzcl
ffi
02-GY-D812{)
ATTACHIIIG IIIIAND MARINE
ATTACHING INtAItID MABINE SCHEDUI-E PAGE
ENDORSEMENI
NUMBEB
FE-87 45
COVERAGE
lnland Marine Computer Prop
Loss of lncome and Exlra Expense
s
$
25,000
25,000
LIMIT OF
INSURANCE
DEDUCTIBLE
AI\4OUNT
ANNUAL
PREIUIUM
Prepared
oEC292022
FD-6m7
0t8,197
OTHER LIMITS AND EXCLUSIONS MAY APPLY, REFER T() YOUR POLICY
O Copyri0ht, St6te FErm IVI!t!!l AutomDbilo lnsursfloe Comp!ny,2008
lncludss copyliChled m6tori0l of lnsuranco SBrvicos oflice, lnc., with its pgrmis$ion.
$ 500 Included
Included
530 6[5a.2 05ll 20!l {ollu]3cl
I