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COI - Lynx Technologies Inc - Expires 2022-05-16State Farm O CYO S 0 0 th (A0 STATE FARM GENERAL INSURANCE COMPANY A STOCKBgCOMPANY22WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS Rchard8on 9TX 75085-3925 Addl Insured -Section II Only M-02-3269-FC05 F U 000675 3123 CITY OF GILROY, ITS OFFICERS, REPRESENTATIVES, AGENTS & EMPLOYEES 7351 ROSANNA ST GILROY CA 95020-6141 Illllutlllllllll 1,I,I1"111'l'Ill'lllllllll'l1.111111.111l11.11.I Office Policy DECLARATIONS COVERAGE SUMMARY MAR 29 2021— Policy Number 97-QE-4200-7 Policy Period Effective Date Expiration Date 12 Months MAY 16 2021 MAY 16 2022 The poly period begins and ends at 12:01 am standard time atthe premises location. Named Insured LYNX TECHNOLOGIES INC 1350 41ST AVE STE 202 CAPITOLA CA 95010-3935 Automatic Renewal - If the policy period is shown as 12 months , this policy will be renewed automatically subject to the premiums, rules and forms in effect for each succeeding policy period. If this policy is terminated, we will give you and the Mortgagee/Lienholder written notice in compliance with the policy provisions or as required by law. Entity: Corporation Requested By: Policyholder Policy Premium Discounts Applied: Renewal Year Years in Business Sprinkler Claim Record $ 1,906.00 Prepared MAR 29 2021 C M P-4000 006415 290 Al N © Copyright, State Farm Mutual Automobile Insurance Company, 2008 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Continued on Reverse Side of Page Page 1 of 6 DECLARATIONS (CONTINUED) Office Policy for CITY OF GILROY, ITS OFFICERS, Policy Number 97-QE-4200-7 SECTION I - PROPERTY SCHEDULE Location Number Location of Described Premises Limit of Insurance* Coverage A - Buildings Limit of Insurance* Coverage B - Business Personal Property Seasonal Increase - Business Personal Property 001 1350 41ST AVE STE 201 & 202 CAPITOLA CA 95010-3935 No Coverage $ 163,400 25% * As of the effective date of this policy, the Limit of Insurance as shown includes any increase in the limit due to Inflation Coverage. SECTION I - INFLATION COVERAGE INDEX(ES) Coy A - Inflation Coverage Index: N/A Coy B - Consumer Price Index: 261.6 SECTION I - DEDUCTIBLES Basic Deductible $5,000 Special Deductibles: Money and Securities $250 Employee Dishonesty $250 Equipment Breakdown $2,500 Other deductibles may apply - refer to policy. Prepared MAR 29 2021 U Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 006415 Continued on Next Page Page 2 of 6 StateFarm ®O DECLARATIONS (CONTINUED) Office Policy for CITY OF GILROY, ITS OFFICERS, Policy Number 97-0E-4200-7 SECTION I - EXTENSIONS OF COVERAGE - LIMIT OF INSURANCE - EACH DESCRIBED PREMISES The coverages and corresponding limits shown below apply separately to each described premises shown in these Declarations, unless indicated by "See Schedule." If a coverage does not have a corresponding limit shown below, but has "Included" indicated, please refer to that policy provision for an explanation of that coverage. COVERAGE LIMIT OF INSURANCE Accounts Receivable On Premises $50,000 Off Premises $15,000 Arson Reward $5,000 Back -Up Of Sewer Or Drain $15,000 Collapse Included Damage To Non -Owned Buildings From Theft, Burglary Or Robbery Coverage B Limit Debris Removal 25% of covered loss Equipment Breakdown Included Fire Department Service Charge $5,000 Fire Extinguisher Systems Recharge Expense $5,000 Forgery Or Alteration $10,000 Glass Expenses Included Increased Cost Of Construction And Demolition Costs (applies only when buildings are 10% insured on a replacement cost basis) Money And Securities (Off Premises) $5,000 Money And Securities (On Premises) $10,000 Money Orders And Counterfeit Money $1,000 Newly Acquired Business Personal Property (applies only if this policy provides $100,000 Coverage B - Business Personal Property) Newly Acquired Or Constructed Buildings (applies only if this policy provides $250,000 Coverage A - Buildings) Prepared MAR 29 2021 CMP-4000 006416 290 t Copyright, State Farm Mutual Automobile Insurance Company, 2008 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Continued on Reverse Side of Page Page 3 of 6 DECLARATIONS (CONTINUED) Office Policy for CITY OF GILROY, ITS OFFICERS, Policy Number 97-QE-4200-7 Ordinance Or Law - Equipment Coverage Included Outdoor Property $5,000 Personal Effects (applies only to those premises provided Coverage B - Business $5,000 Personal Property) Personal Property Off Premises $15,000 Pollutant Clean Up And Removal $10,000 Preservation Of Property 30 Days Property Of Others (applies only to those premises provided Coverage B - Business $50,000 Personal Property) Signs $2,500 Unauthorized Business Card Use $5,000 Valuable Papers And Records On Premises $50,000 Off Premises $15,000 SECTION I - EXTENSIONS OF COVERAGE - LIMIT OF INSURANCE - PER POLICY The coverages and corresponding limits shown below are the most we will pay regardless of the number of described premises shown in these Declarations. LIMIT OF COVERAGE INSURANCE Dependent Property - Loss Of Income $5,000 Employee Dishonesty $10,000 Utility Interruption - Loss Of Income $10,000 Loss Of Income And Extra Expense Actual Loss Sustained - 12 Months Prepared MAR 29 2021 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 006416 Continued on Next Page Page 4 of 6 StateFarm ❑ DECLARATIONS (CONTINUED) Office Policy for CITY OF GILROY, ITS OFFICERS, Policy Number 97-QE-4200-7 8 SECTION II - LIABILITY LIMIT OF COVERAGE INSURANCE Coverage L - Business Liability $2,000,000 Coverage M - Medical Expenses (Any One Person) $5,000 Damage To Premises Rented To You $300,000 LIMIT OF AGGREGATE LIMITS INSURANCE Products/Completed Operations Aggregate Excluded General Aggregate $4,000,000 Each paid claim for Liability Coverage reduces the amount of insurance we provide during the applicable annual period. Please refer to Section II - Liability in the Coverage Form and any attached endorsements. 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 ENDORSEMENTS CMP-4101 Businessowners Coverage Form CMP-4714 Excl Data Processing and Prog CMP-4705.2 Loss of Income & Extra Expense CMP-4710 Employee Dishonesty CMP-4260.1 Amendatory Endorsement -CA CMP-4698 Back -Up of Sewer or Drain CMP-4704.1 Dependent Prop Loss of Income CMP-4709 Money and Securities CMP-4703.1 Utility Interruption Loss Incm FE-6999.3 Terrorism Insurance Coy Notice CMP-4261 Amendatory Endorsement CMP-4819.1 Unauthorized Business Card Use CMP-4845 Excl Product Comp Operatn Liab Prepared MAR 29 2021 o Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 006417 290 Continued on Reverse Side of Page Page 5 of 6 N DECLARATIONS (CONTINUED) Office Policy for CITY OF GILROY, ITS OFFICERS, Policy Number 97-QE-4200-7 CMP-4786.1 Addl lnsd Owners Lessee Sched CMP-4787 Waiver of Trans Rgt of Recov FD-6007 Inland Marine Attach Dec This policy is issued by the State Farm General Insurance Company. Participating Policy You are entitled to participate in a distribution of the earnings of the company as determined by our Board of Directors in accordance with the Company's Articles of Incorporation, as amended. In Witness Whereof, the State Farm General Insurance Company has caused this policy to be signed by its President and Secretary at Bloomington, Illinois. M. 4#01012. Secretary President IMPORTANT NOTICE: California law requires us to provide you with information for filing complaints with the State Insurance Department regarding the coverage and service provided under this policy. Your agent's name and contact information are provided on the front of this document. Another option is to reach out by mail or phone directly to: State Farm® Executive Customer Service PO Box 2320 Bloomington IL 61702 Phone # 1-800-STATEFARM (1-800-782-8332) Department of Insurance complaints should be filed only after you and State Farm or your agent or other company representative have failed to reach a satisfactory agreement on a problem. California Department of Insurance Consumer Services Division 300 South Spring Street Los Angeles, CA 90013 Phone # 1-800-927-HELP (4357) or visit www.insurance.ca.Aov/01-consumers Prepared MAR 29 2021 CMP-4000 006417 290 N © Copyright, State Farm Mutual Automobile Insurance Company, 2008 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 6 of 6