2021/10/31 Western A/V, Inc. (17)StateFarm STATE FABM GENEHAL INSUHANCE COMPANY
A STOCK CAMPANY WITH HOME OFFICES IN ELOOMINGiON, ILLINOIS
E?"F?ia€\i! ?* r' o ". r s %
Addl lnsured-Sectlon ll Only
M-23-61F8-FB8A F Z
002212 3123CITY OF I4EN I FEE
AND ITS OFFICERS, EHPLOYEES,
AGENTS & AUTHORIZED VO L UNTEERS29844 HAUN RD
r'rEr{ I FEE CA 92546-6539
Home Product Sales Policy
DECLAHATIONS AMENDED MAa 22 2a22
Policyilumbor 92-GY-D812{
Policv Period Etlective O.te ExDiration Dab
12 Mbnrhs OCT 31 202r OcI 31 2022
Ihe polipv period beoins and ends at l2:01 am standard!me at the premtses Iocaton.
Namod lnsured
WESTERN A/V INC
(-oo
tsi-.7,'
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II
Aulomatlc Ronewal ' lf tre pollcy period is shown as 12 months , t'ris policy will be renewed automatcally subjectto fie premiums, rules and
forms in effect for each succeeding policy period. lf $is policy is terminated, we will give you and ttre Mortgagee/Lienholder writen notice in
com pliance widr $e policy provisions or as required by law.
Entlly: Corporation
Rgason lor Declalalions:Your policy is amended MAR 22 2022
ADDITIONAL INSURED DELETED
PREMIUM ADJUSTMENT
FORM CIVIP.4786, 1 DELETED
Endorsement Premium
Discounts Applied:
Renewal Year
Years in Business
Enclosed Building
Protective Devices
Sprinkler
Claim Record
None
Prepared
MAY 04 2022
cMP-4000
O Copyright Stlto F!rm Mutual Automobil8 lnsurrnco Comp!ny,2008
lncludes copyriqhted mrt.n6l o[ lnsurance S0rvr6Br olfic6, lnc., with its permission
Continued on Reverse Side of Page Page 1ot 7
5!0 0Et..2 05ll l01l loltlzl!c)
019432 290
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AI
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Home Product Sales PollcvPolicy Number 92-G
DECLARATIONS (CONTINUED)
,or CITY OF MENTFEE
Y-D812-O
SECTIONI.PBOPEBTYSCH EDULE
Location
Number Location ol
Described
Pr€mises
Limit of lnsurance'
Coveraoe A -
Buildfngs
Limit ol lnsurance*
Coveraoo B -
Buslness FersonalProperty
Seasonallncrease-Business
Personal
Property
001
002
1592 N BATAVIA ST STE 2
oRANGE CA 92857-3554
No Coverage
No Coverage
$ 129,300
$ 129,100
250/0
' As of the effective teo policy, t e m o lnsurance as s own nc udes any increase in the limit due to lnflat on
sFcTroN r - r FLATION COVERAGE INDEX ES)
erage
Cov A - lnf lation Coverage lndex
Cov B - Consumer Price lndex:
NiA
271.7
SECTION I - DEOU BLES
Basic Deductibl6
Special Oeductibles:
Money and Securitaes
$2,s00
$2s0 Data Compromise
O Copyright, Strts F.rm Mltu sl Automobilo lnrurrnce Comp.ny, 2008
lncludes coEyrightod mitsri.l of lnsur.nc€ Services olfice, lnc., with its psrmission
Continued on Next Page
$1.000
Prep a red
MAY 04 2022
ci/P-4000
019432 Page zot 7
1590 N BATAVIA ST STE 4
oBANGE CA 92867-3534
StateFarm !
6Doo
HE
Home Product Sales Pollcv
Policy Number 92-G
DECLAFATIONS (CONNNUED)
tor CITY OF MENIFEE
Y-D812-0
Employee Dishonesty $250 Equipment Breakdown $2,s00
Other deductibles may apply - refer to policy
SECTION I . EXTENSIONS OF COVEFAGE - LIMIT OF INSURANCE . EACH DESCRIBED PBEMISESg
;E The coverages and corrssponding limits shown bolow apply separately to each described prsmlses shoryn in these
Declarations, unl€ss indlcated by "See Schedule." ll a coverage does not have a corresponding llmit shown below,
but has "lncluded" indicated, please reter to that policy provision lor an explanation ot that coverago.
COVERAGE
Accounts Receivable
On Premises
Ott PremiseE
Arson Raward
Back-Up Of Sewer Or Orain
Collapse
Damage To Non-Owned Buildings From Theft, Burglary Or Bobbery
Oebris Flemoval
Equipment Breakdown
Fire Deparlment Seivico Charge
Fire Extinguisher Systems Rocharge Expense
Forgery Or Alteration
Glass Expenses
lncreased Cost Of Construction And Demolition Costs (applies only when buildlngs are
insured on a replacement cost basis)
Money And Securities (Off Premises)
Money And Securities (On Prsmises)
Money Oders And Counterfeil Money
LIMIT OF
INSUHANCE
Se6 Schedule
See Schedule
$5,000
See Schedule
lncluded
Coverage B Limit
257o ol covered loss
lncluded
$2,s00
$s,000
$10,000
lnclud6d
10/"
See Schedule
See Schedule
$1,000
Prepared
MAY 04 2022
cMP-4000
@ Copyright Strtg F!rm Mutu6l Automobilo lnsur!noe Comp!ny, 2008
lncludes copyrightsd motsri.l of lnsurancs Sorvic€! oflic0, lnc., with its p€rmission
Continued on Reverse Side ol Page019433 290
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Page 3 of 7
Home Product Seles PolicvPolicy Number 92-G
DECLARATTONS (CONTtNrlEo)
Io] CITY OF MENIFEEY-0812-0
Newly Acquired Business Personal Property (applies only if this policy provides
Coverage B - Business Personal Property)
Newly Acquired Or Constructed Buildings (applies only il this policy provides
Coverage A - Buildings)
Ordinance Or Law - Equipment Coverage
Outdoor Property
Personal Effects (applies only to those premises provided Coverage B - Business
Personal Property)
Personal Property Off Premisos
Pollutant Clean Up And Removal
Preservation Of Property
Property Of Others (applies only to those premises provided Coverage B - Business
Personal Property)
Signs
Valuable Papers And Records
On Premises
Off Premises
$100,000
$250,000
lncluded
See Schedule
$2,soo
$25,000
$10,000
30 Days
See Schedule
See Schedule
See Schedule
See Schedule
SECTION I . EXTE SIONS OF COVEBAGE - LIMIT OF INSU RANCE - SCHEDULE
The covorages and corresponding limits shown bdow apply only to the describ€d premises as shown.
LOCATION
0001
0002
Prepared
MAY 04 2022
cMP-4000
019433
COVERAGE
O Copyfl0hl Strto Flrm lvlutusl Automobil. lnsur!noo Comp!nV, 2008
lncludes copyright8d mltsri6l of lnsu16nc0 ServirBs office, lnc., with its Dormirsion
Continued on Next Page
LIMIT OF
INSU RANCE
Signs
Back-Up Of Sewer Or Drain
Money And Securities (On Premises)
Money And Securilies (Off Premises)
Property.Of Others (applies only to those premises provided Coverage B - BusinessPersonal Property)
Accounts Receivable (On Premises)
Accounts Receivable (Of f Premises)
Outdoor Property
Valuable Papers and Records (On Premises)
Valuable Papers and Records (Off Premises)
Accounts Receivable (On Premlses)
$5,ooo
$15,000
$10,000
$5,000
$2,500
$10,000
$5,000
$5,000
$10,000
$5,000
$10.000
Page 4ol 7
StateFa'm !&
E#
Home Product Seles Policv
Policy Number 92-G
oEcLAAAIONS (CONTINUED)
tor CITY OF MENIFEE
Y-D812-0
E
6A
Accounts Receivable (Of f Premises)
Back-Up Of Sewer Or Drain
Money And Securilies (Olf Premises)
Money And Securities (On Premises)
Outdoor Property
Property Of Others (applies only to those premises provided Coverage B - Business
Personal Properly)
Signs
Valuable Papers and Records (On Premises)
Valuable Papers and Records (Olf Premises)
$s.ooo
$1s,ooo
$s,000
$10,000
$s,000
$2,500
$s,ooo
$10,000
$s,000
SECTION I - EXTENSIONS OF COVERAGE - LIMIT OF INSURANCE. PEB POLICY
The covorages and correspondlng llmits shown below are the most we wlll pay regardless ol tho number of
doscribed premises shown in these Doclarations.
COVERAGE
Data Compromise
Legal And Forensic lnformation T6chnology Review
Per Occurrence
Dependonl Proporty - Loss Of lncome
Employee Dishonesty
ldentity Restoration
Other Expenses
Case Manaqement Services
Per Occurrence
Lost Wages And Supervision Expenses
Utility lnterruption - Loss Of lncome
Loss Of lncome And Extra Expense
O Copyrilhl Strto F6rm irutual Automobile lnsur.nce Comp!ny, 2008
lncludo! copyrioht€d mitori.l of lnsur!flco Ssrvicss oftics, lnc., with it! p.rmission.
Conlinued on Reverse Side ol Page
LIMIT OF
INSUBANCE
$s,000
$s0,000
$s,000
$10,000
$1,000
1 2 months
$35,000
$5,000
$10,000
Actual Loss Sustained - 12 Months
Prepared
MAY 04 2022
cMP-4000
019{34 290
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Page 5 of 7
Home Product Sales PolicvPolicy Number 92-G
DECLABATIONS (CONTINUED)
'Or
CITY OF MENIFEE
Y-D812-0
sFcTtoNll-rtlFlll ITY
COVEBAGE
Coverage L - Business Liability
Coverage M - Medical Expenses (Any One Person)
Damage To Premises Rented To You
AGGREGATE LIMITS
Productsicompleted Operations Aggregate
General Aggregate
LIMIT OF
INSURANCE
$2,000,000
$5.000
$500.000
LIMIT OF
INSURANCE
$4,000.000
$4,000,000
Each paid claim for Liability Coverage reduces the amount of insurance we provide during the applicable
annual period. Please refer lo Section ll - Liability in the Coverage Form and any attached endoisements
Your policy consists of these Declarations, the BUSINESSOWNERS COVEBAGE FORM shown below, and any otherforms and endorsements that apply, including those shown below as well as those issued subsequent to theissuance o, this policy.
FOBMS AND NDOBSEMENTS
cMP-4'101
cMP-4260.1
ctvtP-4261
cMP-4705.2
Cl\ilP-4710
ctvtP-4709
crvrP-4698
cMP-4704.1
cMP-4703.1
ctltP-4786.1
ctvtP-461 0
cMP-4746.1
cL4P-4990.1
Prepared
MAY 04 2022
cMP-4000
019434
Businessowners Coverage Form
Amendatory Endorsement-CA
Amendatory Endorsement
Loss ol lncome & Extra Expense
Employee Dishonesty
Money and Securities
Back-Up of Sewer or Drain
Dependent Prop Loss o, lncome
Utility lnterruption Loss lncm
Addl lnsd Owners Lessee Sched
General Agg Limit Per Proj
Hired Auto Liability
ldentity Restoration Coverage
@ Copyri!h! Stlte Farm l\4utu6l Automobil. ln.urancs Comp6ny, ZOOS
lncludEr copyrightod m.tsri.l of lnsurance SorvicBs office, lnc., with tts psrmission
Continued on Next Page Page 6 of 7
Home Product Sales Poll
Policy Number 92
DECLARATIONS (CONTINUED)
tor CITY OF MENIFEE
Y-D812-0:T
ffii
cMP-4994
cMP-4787
Cl\ilP-4875
FE-6999.3
cMP-4793.1
cMP-4788.1
FD-6007
Data Compromise
Waiver ot Trans Rgt of Recov
Loss Payable
Terrorism lnsurance Cov Notice
Al State Political Perm Prem
Addl lnsd Mgrs Lessor ol Prem
lnland Marine Attach Dec
D
This policy is issued by the State Farm General lnsurance Company.
ParliciPating PolicY
You are entifled to participat€ in a distribution of th€ 6arnings of he company as determined by our Eloard ol Oir€ctors in
accordance with the Company's Articles ol lncorporation, as amended.
ln Witness Whereof, th6 State Farm General lnsurance Company has caused thls policy to be signed by its Prosidenl and
Secretary at Bloomington, lllinoisff*nyat
secreIary
-il-e b,h
P16sident
Prepared
MAY 04 202?
cMP-4000
O Cogyrich! St.rs F.rm MuturlAutomobil. lnsurlnco Complny,20(n
lncludBs copyriohtod m6tprial of lnsurrncr S.rvices oftic0,lnc.. with ib permission
019435 290
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Page 7 ot 7
StateFarm&
IMPORTANT NOTICE:
Callloml. bw requlBs us to provlde you wlth lnlom.rlon lor lllhg comphhts whh the S$te lnsuronoe tbp.rtment regatdlng tlf
coveragB and rrvice provkled undor this polcy.
Your age 's nrme and contact infomatbn 8re provided on tlE llo1|l ol thb documed. Another option i8 lo rerch out by
m8ilor phone diroc{V lo:
State Farm6 Executlva Cu8lomor g€rvlcc
PO Box 2320
Bloomlngion lL 6'1702
Phone f I {oo-STATEFARI (1'80+782'8332}
Depanment o, lnaurance comphint! should be liled only sttel you lnd Slste Farm or yoqr agent or olher comprny
rGprs$ntatlvo h€ve laiod lo reech 6 sstlrlrctory rglpomsrtr on a problem.
Cqlilomia DeprItI|ent ot lnerrEnce
Consumer Sorvlaes Dlvltlon
300 Sotnh gprlm Steft
Los Angpb8, CA 9ool3
PhorE S 1{00-927-HELP (/854 or vbit rsw.inlurance,cs.oov/o1-conu.mera
StateFarm STATE FARiT GENEFAL INSUHATICE COMPANY
A STOCK COMPANY WTH HOME OFFICES IN ELOOMINGTON, ILLINOIS
E?"F?ia€lff ?*, u o, u. r', u
Named lnsured
M-23.61F8-FB8A F Z
HESTERN A/V INC
I
INLAND MAHINE ATTACHING DECLARATIONS
Policy umber 92-GY-D812{
Policv Period Elleclive Dala Exoiralion Dab
12 Mbnths OCT 31 2021 ocr 31 2022
The polipy period begins and ends at 12:01 am standardume at the premtses locaton.
&
ffi*
I8
i3
ATTACHING INLAND MARINE
Automalic Rerewal . lf the policy period is shown as 12 months . this policy will be renewed automadcally subject to the
forms in effect for each succeeding policy period. lf tris policy is terminated, we will give you and t're Mortga gee/Lienhol
compliance wi$ tre policy provisions or as required by law.
premiums, rules and
der writen notice in
Annual Policy Premium lncluded
The above Premium Amount is included in the Policy Premium shown on $e Declaratons
Your policy consists of trese Declarations, $e INLAND IVIARINE C 0NDlTlONS shown below, and any otrer forms and endorsemenb trat
a pply, including trose shown below as well as trose issued subsequent to the issuance of dtis policy.
Forms, 0ptions, and Endorsomonts
FE-8739
FE-6271
FE-87 45
lnland Marine Conditions
Amendatory Endorsement
lnland Marine Computer Prop
See Reverse for Schedule Paqe wifi Limis
Prepared
MAY 04 2022
FD.6007
01s436
O Copyrioht S$tB t!rm Mutu!l Automobils ln!ur!ncr Comprny,2008
lncludos cogyri0htsd mltsri6l of Insuranre Srrvicr3 offico, lnc., witi its p0rmission
i30 6[602 0t X1 20ll lo1l3?3zc)
92-GY-D812-0
ATTACHIT{G INLAITD MARINE
ATTACHING INTAND MARINE SCHEDUTE PAGE
ENDORSEMENT
NUMBEB
FE-8745
C OVERAG E
lnland [Iarine Computer Prop
Loss ol lncome and Extra Expense
LIMIT OF
INSUBANCE
DEDUCIIBLE
AMOUNT
ANNUAL
PREM IU IV
OTHER LIMITS AND EXCLUSIONS MAY APPLY - REFER TO YOUR POLICY
O Copyri!h! St.tE Fsrm l\4 ut! rl Automobilo lnsur.ncs Comp.ny, 20(E
lncludes copyri0ht8d mlterinl o, lnrur!nce SErvicr5 office. lnc., wtth its permissron.
s 500 IncludedIncluded
$
$
25,O00
25,000
Prepared
MAY 04 2022
FD-6007
019436
530 686 a 2 05 31 20ll (ulh2l3cl