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COI - Del Sol Bakery - Expires 2023-04-13StateFarm 0 ©Q STATE FARM GENERAL INSURANCE COMPANY A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS RENEWAL DECLARATIONS a1 S s 0 0 POc Sardsn, ox o5n5k 9' Ri75085-3925 Addl Insured -Section II Only AT2 000745 3125 M-02-28OB-FBFF F Z CITY OF GILROY 7351 ROSANNA ST GILROY CA 95020-6141 �IIIII�'I'Ill'I.��III"��'�I�I�������IIII�IIII�I��II�II�III'Il"I Food Shop Policy Policy Number 97-CW-BO44-0 Policy Period Effective Date Expiration Date 12 Months APR 13 2022 APR 13 2023 The poll y period begins and ends at 12:01 am standard time atle premises 0cation. Named Insured BATISTA & CARRAZCO INC DBA DEL SOL BAKERY Automatic Renewal - If the policy period is shown as 12 months, this policy will be renewed automatically subjectto 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 NOTICE: Information concerning changes in your policy language is included. Please call your agent if you have any questions. POLICY PREMIUM Discounts Applied: Renewal Year Years in Business Protective Devices Sprinkler Claim Record $ 1,374.00 Prepared JAN 31 2022 Cc Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 004081 294 Al Continued on Reverse Side of Page Page 1 of 7 N RENEWAL DECLARATIONS (CONTINUED) Food Shop Policy for CITY OF GILROY Policy Number 97-CW-BO44-0 SECTION I - PROPERTY SCHEDULE Location Location of Limit of Insurance* Limit of Insurance* Seasonal Number Described Increase - Premises Coverage A - Coverage B - Business Buildings Business Personal Personal Property Property 001 7901 WESTWOOD DR STE K No Coverage $ 165,400 25% GILROY CA 95020-4745 * 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 INDEMES) Cov A - Inflation Coverage Index: Cov B - Consumer Price Index: SECTION I - DEDUCTIBLES NIA 278.8 Basic Deductible $1,000 Special Deductibles: Money and Securities $250 Employee Dishonesty $250 Equipment Breakdown $1,000 Other deductibles may apply - refer to policy. Prepared JAN 31 2022 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 004081 Continued on Next Page Page 2 of 7 StateFarm 0 (90 RENEWAL DECLARATIONS (CONTINUED) Food Shop Policy for CITY OF GILROY Policy Number 97-CW-BO44-0 SECTION I - EXTENSIONS OF COVERAGE - LIMIT OF INSURANCE - EACH DESCRIBED PREMISES 0 The coverages and correspondinglimits 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, N but has "Included" indicated, please refer to that policy provision for an explanation of that coverage. 0 LIMIT OF COVERAGE INSURANCE Accounts Receivable On Premises $10,000 Off Premises $5,000 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 Food Contamination Additional Advertising Expenses $3,000 Per Occurrence $10,000 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 Prepared JAN 31 2022 C Copyright, State Farm Mutual Automobile Insurance Company, 2000 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 004082 294 Continued on Reverse Side of Page Page 3 of 7 N RENEWAL DECLARATIONS (CONTINUED) Food Shop Policy for CITY OF GILROY Policy Number 97-CW-BO44-0 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) Ordinance Or Law - Equipment Coverage Included Outdoor Property $5,000 Personal Effects (applies only to those premises provided Coverage B - Business $2,500 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 $2,500 Personal Property) Signs $10,000 Spoilage (applies only to those premises provided Coverage B - Business Personal Property) Expediting Expenses $1,000 On Premises $15,000 Off Premises $5,000 Valuable Papers And Records On Premises $10,000 Off Premises $5,000 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. COVERAGE Dependent Property - Loss Of Income Employee Dishonesty Prepared JAN 31 2022 U Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 004082 Continued on Next Page LIMIT OF INSURANCE $5,000 $10,000 Page 4 of 7 State Farm 0 0 0 RENEWAL DECLARATIONS (CONTINUED) S S Food Shop Policy for CITY OF GILROY Policy Number 97-CW-BO44-0 Utility Interruption - Loss Of Income $10,000 Loss Of Income And Extra Expense Actual Loss Sustained - 12 Months us 0 SECTION II - LIABILITY LIMIT OF COVERAGE INSURANCE Coverage L - Business Liability $1,000,000 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 $2,000,000 General Aggregate $2,000,000 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 FE-6999.3 `Terrorism Insurance Cov Notice CMP-4697 Food Contamination CMP-4705.2 Loss of Income & Extra Expense CMP-4710 Employee Dishonesty CMP-4709 Money and Securities CMP-4471 Spoilage Coverage CMP-4698 Back -Up of Sewer or Drain CMP-4704.1 Dependent Prop Loss of Income Prepared JAN 31 2022 (0 Copyright, State Farm Mutual Automobile Insurance Company, 200E CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 004083 294 Continued on Reverse Side of Page N Page 5 of 7 RENEWAL DECLARATIONS (CONTINUED) Food Shop Policy for CITY OF GILROY Policy Number 97-CW-BO44-0 CMP-4703.1 Utility Interruption Loss Incm CMP-4857 Actual Cash Value Contents CMP-4795.1 Addl Insd Designated Premises CMP-4260.1 Amendatory Endorsement -CA CMP-4788.1 Addl Insd Mgrs Lessor of Prem CMP-4261 Amendatory Endorsement FD-6007 Inland Marine Attach Dec * New Form Attached 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. *WMX- rn. 40WO04- 6041# 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.insurence.ce.92v/01-consumers Prepared JAN 31 2022 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 004083 Continued on Next Page Page 6 of 7 StateFarm 00 RENEWAL DECLARATIONS (CONTINUED) Li Food Shop Policy for CITY OF GILROY Policy Number 97-CW-BO44-0 NOTICE TO POLICYHOLDER: For a comprehensive description of coverages and forms, please refer to your policy. Policy changes requested before the "Date Prepared", which appear on this notice, are effective on the Renewal Date of this policy unless otherwise indicated by a separate endorsement, binder, or amended declarations. Any coverage forms attached to this notice are also effective on the Renewal Date of this policy. Policy changes requested after the "Date Prepared" will be sent to you as an amended declarations or as an endorsement to your policy. Billing for any additional premium for such changes will be mailed at a later date. If, during the past year, you've acquired any valuable property items, made any improvements to insured property, or have any questions about your insurance coverage, contact your State Farm agent. Please keep this with your policy. Prepared JAN 31 2022 CMP-4000 Cc` Copyright, State Farm Mutual Automobile Insurance Company, 200E Includes copyrighted material of Insurance Services Office, Inc., with its permission. 004084 294 N Page 7 of 7 StateFarm 0 o9 STATE FARM GENERAL INSURANCE COMPANY A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS INLAND MARINE ATTACHING DECLARATIONS Pp �ox 8539? Ric ardson, 75085-3925 Named Insured M-02-280E-FBFF F Z 0 BATISTA & CARRAZCO INC DBA DEL SOL BAKERY ATTACHING INLAND MARINE Policy Number 97-CW-B044-0 Policy Period Effective Date Expiration Date 12 Months APR 13 2022 APR 13 2023 The poll y period begins and ends at 12:01 am standard time atle premises T0cation. 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/Lien holder written notice in compliance with the policy provisions or as required by law. Annual Policy Premium Included The above Premium Amount is included in the Policy Premium shown on the Declarations. Your policy consists of these Declarations, the INLAND MARINE CONDITIONS shown below, and any other forms and endorsements that apply, including those shown below as well as those issued subsequentto the issuance of this policy. Forms, Options, and Endorsements FE-8739 Inland Marine Conditions FE-6271 Amendatory Endorsement FE-8745 Inland Marine Computer Prop See Reverse for Schedule Page with Limits Prepared JAN 31 2022 Copyright, State Farm Mutual Automobile Insurance Company, 2008 FD-6007 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 004085 530 686 a.2 05 31 2011 (0132320 y i-L;w-tsU44-U ATTACHING INLAND MARINE SCHEDULE PAGE ATTACHING INLAND MARINE ENDORSEMENT LIMIT OF NUMBER COVERAGE INSURANCE FE-8745 Inland Marine Computer Prop S 2 5, 0 0 0 Loss of Income and Extra Expense 5 25 , 0 0 0 Prepared JAN 31 2022 FD-6007 004085 DEDUCTIBLE AMOUNT $ 500 OTHER LIMITS AND EXCLUSIONS MAY APPLY - REFER TO YOUR POLICY © Copyright, State Farm Mutual Automobile Insurance Company, 2008 Includes copyrighted material of Insurance Services Office, Inc., with its permission. ANNUAL PREMIUM Included Included 530-666 a.2 05-31 2011 lolf3233c) State Farm Lloyds PO Box 653925 Richardson, TX 75085-3925 08 3864 AT1 002005 1005 01 CITY OF GILROY ITS OFFICERS & EMPLOYEES 7351 ROSANNA ST GILROY CA 95020-6141 s 0 I.III'��II'I"I�I�IIII'�'I�I�I�I�Irlrllllll�rrlllllll�i11�1"I'� �= �o Notice of Reinstatement Office Reinstatement date: February 8, 2022, 12:01 a.m. Standard Time Date processed: February 1, 2022 Amount paid: No Amount Due AslCi(ei l tid 6 Policy number: 93-TV-3354-6 SFPP number: 1238498908 Your State Farm Agent Mike Baker 2100 Valley View Lane Suite 425 Dallas, TX 75234-8953 Bus: 214-780-0900 Email: mike.baker.b4h4@statefarm.com State Farm Lloyds Please keep for your records We are pleased to acknowledge receipt of the premium due on this policy. This policy will be continued in force subject to its printed terms and conditions upon the payment check clearing through your bank. Insured: PETDATAINC Policy Number: 93-TV-335CB Prepared. February 01. 2022 a-v Location: 8585 N STEMMONS FWY STE 1100N DALLAS TX 75247-3822 Page 1 of 1 W2005 1009364 2000152632 200 09-08-2017