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COI - Ali, Kenyatta dba Special K Productions - Expires 2023-09-01StateFarm [7 STATE FARM GENERAL INSURANCE COMPANY ASTOCK COMPANY WITH HOME OFFICES /N8LODMINQTON, ILLINOIS 75085-3925 AddlInsured-Section |1Only 4T2 001605 3125 W1'02'8808'FBFF F N CITY OF GILR¢Y 7351 HOSANNA ST GILROY CA 95020-6141 UUU|| U || | |! UU|J| ||U UUU|} | | Businessowners Policy 11 RENEWAL DECLARATIONS Pm|huy Number 97-B8-B286-6 Pe'cy Period 12Months 8EP 1 2022 8EP 1 2023 The ooUoyondodbegins and ends at12�1om�andurd time atthapremises location. Named Insured AL3, KENYATTA DBA SPECIAL K PRODUCTIONS � � |UN �� 709Y � .~., � , �.^` . GIDR0YCITY CLERK'S OFFICE/ Automatic Renewal '|fthe policy period iushown ax12 months, this policy will be "v'redpremiums,rules and forms in effectfor each succeeding policy period. If this policy is terminated, we will give you and the Mortgagee/Lion holder written notice in compliance with the policy provisions nraurequired 6vlaw. Entity: Individual NOTICE: Information concerning changes in your policy language is included. Please call your agent 1fyou have any questions. POLICY PREMIUM $ 480.00 Discounts Applied: Renewal Year Years iOBusiness Claim Record Prepared JUN2O2O22 {}MP`4O0O | '' m�oamm;m/wf323w 06Copyright,State Farm Mutual Automobile Insurance CompnnK200u |oc|udo:copyrighted material ofInsurance Services Office, |nv,with its permission. RENEWAL DECLARATIONS (CONTINUED) Businessowners Policy for CITY OF GILROY Policy Number 97-B8-B286-6 SECTION I - PROPERTY SCHEDULE Location Number 001 Location of Described Premises 3687 ROCKY CREEK CT SAN JOSE CA 95148-1421 Limit of Insurance* Coverage A - Buildfngs No Coverage Limit of Insurance* Seasonal Increase Coverage B Business Business Personal Personal Property Property $ 2,000 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) Cov A - Inflation Coverage Index: Cov B - Consumer Price Index: SECTION 1- DEDUCTIBLES Basic Deductible Special Deductibles: Money and Securities $1,000 $250 Other deductibles may apply - refer to policy. Prepared JUN 20 2022 CMP-4000 009420 N/A 289.1 Equipment Breakdown ® Copyright, State Farm Mutual Automobile Insurance Company, 2008 Includes copyrighted material of Insurance Services Office, Inc., with its permission. $1,000 Continued on Next Page Page 2 of 7 StateFarm 0 RENEWAL DECLARATIONS (CONTINUED) Businessowners Policy for CITY OF GILROY Policy Number 97-B8-B286-6 SECTION 1- EXTENSIONS OF COVERAGE LIMIT OF INSURANCE - EACH ppacupED 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, us but has "Included" indicated, please refer to that policy provision for an explanation of that coverage. LIMIT OF COVERAGE INSURANCE Accounts Receivable On Premises $10,000 Off Premises $5,000 Arson Reward $5,000 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 $2,500 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) $2,000 Money And Securities (On Premises) $5,000 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 JUN 20 2022 CMP-4000 009421 294 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 3 of 7 RENEWAL DECLARATIONS (CONTINUED) Businessowners Policy for CITY OF GILROY Policy Number 97-B8-B286-6 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 $2,500 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 LIMIT OF INSURANCE Loss Of Income And Extra Expense Actual Loss Sustained - 12 Months SECTION II - LIABILITY COVERAGE Coverage L - Business Liability LIMIT OF INSURANCE $3,000,000 Prepared JUN 20 2022 co Copyright, State Farm Mutual Automobile Insurance Company, 2006 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 009421 Continued on Next Page Page 4 of 7 StateFarm 0 0`0 § ) 9 8 RENEWAL DECLARATIONS (CONTINUED) Businessowners Policy for CITY OF GILROY Policy Number 97-B8-B286-6 Coverage M - Medical Expenses (Any One Person) Damage To Premises Rented To You AGGREGATE LIMITS Products/Completed Operations Aggregate General Aggregate $5,000 $300,000 LIMIT OF INSURANCE $6,000,000 $6,000,000 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-4788.1 Addl Insd Mgrs Lessor of Prem CMP-4786.1 Addl Insd Owners Lessee Sched CMP-4787 Waiver of Trans Rgt of Recov CMP-4709 Money and Securities CMP-4705.2 Loss of Income & Extra Expense CMP-4860.1 Al Design Person Org CMP-4795.1 Addl Insd Designated Premises CMP-4260.1 Amendatory Endorsement -CA CMP-4261 Amendatory Endorsement FD-6007 Inland Marine Attach Dec * New Form Attached Prepared JUN 20 2022 CMP-4000 009422 294 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 5 of 7 RENEWAL DECLARATIONS (CONTINUED) Businessovvners Policy for CITY OF GILROY Policy Number 97-B8-B286-6 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. r4tt' Secretary IMPORTANT NOTICE: California law requires us to provide you with information for Thing 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: Slate Fan EXOCUHVG 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.aoW01-consumers dig001142- President Prepared JUN 20 2022 co Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 009422 Continued on Next Page Page 6 of 7 StateFarm C) RENEWAL DECLARATIONS NOTICE TO POLICYHOLDER: ~ m 0 (COBusinessowners Policy for CITY OF GILROY Policy Number 97-138-13286-6 NTINUED) For mcomprehensive description ofoo and forms, please refer to your policy. Policy changes requested b0fore the "Date Prepared", which appear on this notice, are effective on the Renewal Date of this policy unless otherwhge indicated by a separate endorsement, binder, or amended declarations, Any coverage forms attached to this notice are also effective an the Renewal Date of this policy. Policy changes requested after the "Date Prepared" w|Ubenontb7ynuemanernendgd declarations orauan endorsement to your policy. Billing for any additional premium for Such changes will be mailed at a later date. If, during the past �you've acquired any valuable property items, made any improvements toinsured property, or have any questions about your insurance coverage, contact your State Farm agent. Please keep this with Your policy. Prepared JUN2O2D22 CMP`4OOO (0 Copyright, State Form Mutual AmnmnN|nInsurance ComponK2008 Includes copyrighted material ofInsurance Services Office, |nv,with its permission. F1 97-B8-B286-6 009423 StateFarm C:) STATE FARM GENERAL INSURANCE COMPANY AS7DCK COMPANY NVT1fHOME OFFICES m/8LO[MINGTON, ILLIN0IS RRchaKds"N�'7x750m5-3825 Named Insured ALI, KENYATTA DQA SPECIAL K PRODUCTIONS ATTACHING INLAND MARINE 0 INLAND MARINE ATTACHING DECLARATIONS Policy Number 97-B8-B286-6 Pol'ry Period 12Months 5EP12O22 SEP12D23 The nnUoyperiodbn ' o@ndondoatl2:01 am standard Automatic Renewal '|fthe policy period |oshown eo1D1lomntha.th|n policywillbemnevvedoutomadoaUvmubjnottothepmmiu' s,m|nxand 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 oruurequired bvlaw. Annual Policy Premium Included The above Premium Amountis included in the Policy Premium shown on the Declarations. Your policy consists ofthese Declarations, the INLAND MARINE CONDITIONS shown below, and any otbnrfunnoand endorsements that apply, including -those shown below as well as those issued subsequeritto the issuance of this policy. Forms, Options, and Endorsements FE'6271 FE-9739 FE'8745 Amendatory Endorsement Inland Marine Conditions Inland Marine Computer Prop See Reverse for Schedule Page with Limits Prepared JUN2O2O22 FD-GOO7 009424 @Cnpyh8ht,State Farm Mutual Automobile Insurance Company, 2008 Includes nnmviUhmdmaterial OfInsurance Services Office, |no,with its permission. 97-B8-B286-6 ATTACHING INLAND MARINE SCHEDULE PAGE ATTACHING INLAND MARINE ENDORSEMENT LIMIT OF DEDUCTIBLE ANNUAL NUMBER COVERAGE INSURANCE AMOUNT PREMIUM FE-8745 Inland Marine Computer Prop 25,000 500 Included Loss of Income and Extra Expense 25,000 Included Prepared JUN 20 2022 FD-6007 009424 OTHER LIMITS AND EXCLUSIONS MAY APPLY - REFER TO YOUR POLICY 0 Copyright, State Farm Mutual Automobile Insurance Company, 2008 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 530-11115 0.2 U5-31-21111 10113233c:I