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COI - Ali, Kenyatta dba Special K Productions - Expires 2024-09-01StateFarm 0 CDC) 0 0 0 u) 0 STATE FARM GENERAL INSURANCE COMPANY A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS BoX 2915 PRoommgton IL 61702-2915 Addl Insured -Section II Only M-02-6868-FBFF F N 000276 3123 CITY OF GILROY ITS OFFICERS EMPLOYEES & VOLUNTEERS 7351 ROSANNA ST GILROY CA 95020-6141 I"II'l11111'1'1l11(11iI1111111111I11'ii'III'1'Ilili11111li(us((1 Businessowners Policy DECLARATIONS AMENDED JUN 14 2023 Policy Number Policy Period 12 Months 97-B8-B286-6 Effective Date Expiration Date SEP 1 2023 SEP 1 2024 The poli y period begins and ends at 12:01 am standard time atthe premises location. Named Insured ALI, KENYATTA DBA SPECIAL K PRODUCTIONS Automatic Renewal - If the policy period is shown as 12 months , this policy will be renewed automatically subjectto the premiums, rules anc forms in effectfor 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: Individual Reason for Declarations: Your policy is amended JUN 14 2023 ADDITIONAL INSURED ADDED PREMIUM ADJUSTMENT FORM CMP-4860.1 ADDED Other items shown are effective with the policy's 2023 renewal Endorsement Premium None Discounts Applied: Renewal Year Years in Business Claim Record Prepared AUG 09 2023 CMP-4000 001971 290 Al N CO 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 53(1.606x.7 05-31,2011 lull: DECLARATIONS (CONTINUED) Buslnessowners Policy for CITY OF GILROY Policy Number 97-B8-B286-6 SECTION - PROPERTY SCI-IEDULE Location Number Location of Described Premises 001 3687 ROOKY CREEK CT SAN JOSE CA 95148-1421 Limit of insurance* Coverage A - Buildings No Coverage * As of the effective date of this policy, the Limit of Insurance as shown includes any increa SECTION - INFLATION COVERAGE jIsIDE)c(ES) Cov A - Inflation Coverage Index: N/A Cov B - Consumer Price Index: 303.4 SECTION I - DEDUCTIBLES Basic Deductible Special Deductibles: Money and Securities $1,000 $250 Other deductibles may apply - refer to policy. Prepared AUG 09 2023 CMP-4000 001971 Equipment Breakdown Limit of insurance* Coverage B Business Personal Property $ 2,100 Seasonal Increase - Business Personal Property 25% in the limit due to Inflation Coverag $1,000 O Copyright, State Form Mutual Automobile Insurance Company, aggg Includes copyrighted material of Insurance Services Office, Inc., with its permission. Continued on Next Page Page 2 of 6 State Farm 00 DECLARATIONS (CONTINUED) Businessowners Policy for CITY OF GILROY Policy Number 97-B8-B286-6 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, ,.o 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 AUG 09 2023 C M P-4000 001972 290 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 6 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 these 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 1. EXTENSIONS 0F COVERAGE - LIMIT OF INSURANCE 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 8 -LIABILITY COVERAGE LIMIT OF INSURANCE Coverage L - Business Liability $3,000,000 Prepared AUG 09 2023 0 Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 includes copyrighted material of Insurance Services Office, In c„ with its permission, 001972 Continued on Next Page Page 4 of 6 StateFarm 0 oo 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 CMP-4860.1 CMP-4787 FE-6999.3 CMP-4788.1 CMP-4786.1 CMP-4709 CMP-4705.2 CMP-4795.1 CMP-4260.1 CMP-4261 FD-6007 Prepared AUG 09 2023 CMP-4000 001973 290 N Businessowners Coverage Form *Al Design Person Org *Waiver of Trans Rgt of Recov Terrorism Insurance Coy Notice Addl Insd Mgrs Lessor of Prem Addl Insd Owners Lessee Sched Money and Securities Loss of Income & Extra Expense Addl Insd Designated Premises Amendatory Endorsement -CA Amendatory Endorsement Inland 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 CO 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 6 DECLARATIONS (CONTINUED) Businessowners 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 Farrn General Insurance Company has caused this policy to be signed by its President and Secretary at Bloomington, Illinois. t.t.)11 0/104.4d., 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 roach out by mail or phone directly io: State Fare Executive Customer Seivice PO Box 2320 Bloomington IL 61702 Phone #1 -800-STATEFARM (1-600-782-8332) 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 Immense Consumer Services Division 300 South Spring Street Los Angeles, CA 90013 Phone # 1-800-927-HELP (4357) or visit www.inernance.ca.aovi01-consumers Prepared AUG 09 2023 CMP-4000 001973 290 N CO Copyright, State Farm Mutual Automobile Insurance Company, MOB Includes copyrighted material of Insurance Services Office, Inc,, with its permission. Page 6 of 6 StateFarm 0 STATE FARM GENERAL INSURANCE COMPANY A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS PoBo2 B�oom�ngton915 IL 61702-2915 Named Insured M-02-6868-FBFF F N ALI, KENYATTA DBA SPECIAL K PRODUCTIONS ATTACHING INLAND MARINE INLAND MARINE ATTACHING DECLARATIONS Policy Number 97-B8-B286-6 Policy Period Effective Date Expiration Date 12 Months SEP 1 2023 SEP 1 2024 The policy period begins and ends at 12:01 am standard time atthe premises location. Automatic Renewal - If the policy period is shown as 12 months , this policy will be renewed automatically subjectto the premiums, rules anc forms in effectfor 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. 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-6271 FE-8739 FE-8745 Amendatory Endorsement Inland Marine Conditions Inland Marine Computer Prop See Reverse for Schedule Page with Limits Prepared AUG 09 2023 FD-6007 001974 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 530-666 a.2 65-31-2011 1o113 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 ?5 ,000 $ 500 -Included Loss of Income and Extra Expense 25000 Included Prepared AUG 09 2023 FD-6007 001974 OTHER LIMITS AND EXCLUSIONS MAY APPLY REFER TO YOUR POLICY Copyright, State Form Mutual Automobile Insurance Company, 2008 Includes copyrighted material of Insurance Services Office, isa., with its permission, 1130-68U u2 116-21-2011 (o1f32330