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HomeMy WebLinkAboutCOI - Nichols Consulting - Expires: 2027-04-02State Farm Insurance PO Box 2915 Bloomington, IL 61702-2915 AT1 001031 1200 01 CITY OF GILROY ITS OFFICERS AN 7351 ROSANNA ST GILROY CA 95020 llrl1ltrrllnlllllll'lllllllrllnlirlllll'lllillllrlll1'lrllllllr Amended Declarations oo State Farm State Farm General Insurance Company Policy number: 90-AP-V789-3 Effective date:April 2, 2026 Policy period: 12 months The policy period begins and ends at 12:01 am standard time at the premises location Expiration date: April 2, 2027 OFFICE POLICY Automatic renewal - If the State Farm® 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. NAMED INSURED NICHOLS LOCAL GOVERNMENT CONSU ENTITY Limited Liability Company POLICY PREMIUM This is not a bit!. If an amount is due, then a separate statement will be sent prior to the due date, The premium(s) shown below are for the policy period and policy characteristics as described in this Declarations. increase in Premium: $1,949.00 Temp Supplemental Fee: $4.92 Total increase in Premium: $1,953.92 Discounts applied: Business Experience Rating Years in Business REASONS FOR DECLARATIONS Renewal Discount Business in Residence Premises Your policy is amended effective April 2, 2026 due to some recent policy changes you requested. Enclosed is a copy of your new endorsements, if any Policy number: 90-AP-V789-3 Page 1 of 5 t Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP Dec 3P CA CMP•4000 Prepared: January 26, 2026 1009462 2014 153089 214 05-17-2025 £StateFarm. SECTION I - PROPERTY SCHEDULE Location Location of described premises Limit of Insurance* Limit of Insurance* number Coverage A - Coverage B - Business Buildings Personal Property Seasonal Increase - Business Personal Property 001 1857 44TH ST SACRAMENTO CA 95819-4713 No Coverage $14,800 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: NIA Cov 8 - Consumer Price Index: 324.8 SECTION I — DEDUCTIBLES BASIC DEDUCTIBLE $1,000 SPECIAL DEDUCTIBLES: Data Compromise: $1,000 Employee Dishonesty: $250 Equipment Breakdown: $1,000 Money and Securities: $250 Other deductibles may apply - refer to policy. 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, 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 515,900 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 Policy number, 90-AP-V7B9-3 Page 2 of 5 Q Copyright, State Farm Mutual Automobile Insurance Company, 2008 cMP-4000 StateMart' Coverage Limit of Insurance Increased Cost of Construction and Demolition Costs (applies only when buildings are insured on a 10% replacement cost basis) Money Orders and Counterfeit Money $1,000 Money and Securities On Premises $10,000 Off Premises $5,000 Newly Acquired Business Personal Property (applies only if this policy provides Coverage B - Business $100,000 Personal Property) Newly Acquired or Constructed Buildings (applies only if this policy provides Coverage A - Buildings) $250,000 Ordinance or Law - Equipment Coverage Included Outdoor Property $5,000 Personal Effects (applies only to those premises provided Coverage B - Business Personal Property) $5,000 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 Personal $2,500 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 Coverage Limit of Insurance Data Compromise Legal and Forensic Information Technology Review $5,000 Per Policy Period $50,000 Dependent Property - Loss of Income $5,000 Employee Dishonesty $10,000 Identity Restoration Expense Reimbursement $35,000 Poky number: 90-AP-V789-3 Page 3 of 5 O Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 State fir3 tt Coverage Limit of Insurance Case Management Services 12 Months Other Costs $1,000 Lost Wages and Supervision Expenses $5,000 Loss of Income and Extra Expense 12 Months Actual Loss Sustained Utility Interruption - Loss of Income $10,000 SECTION II - LOCATION SCHEDULE Location number Location of described premises 001 1857 44TH ST SACRAMENTO CA 95819-4713 SECTION II - LIABILITY Coverage Limit of Insurance Coverage L - Business Liability Per Occurrence Coverage M - Medical Expenses Damage to Premises Rented to You $2,000,000 $5,000 Any One Person $300,000 Aggregate limits Limit of Insurance General Aggregate $4,000,000 Products/Completed Operations Aggregate $4,000,000 Each paid claim for Liability Coverage reduces the amount of insurance we provide during the applicable annual Liability in the Coverage Form and any attached endorsements. Your policy consists of these Declarations, the BUSINESSOWNERSCOVERAGE FORM shown below, and any apply, including those shown below as well as those issued subsequent to the issuance of this policy. FORMS AND ENDORSEMENTS CMP-4101 CM P-4260.2 CMP-4587 CMP-4b98 CMP-4703.1 CMP-4704.1 CMP-4705.2 CMP-4709 CMP-4710 CMP-4713.1 CMP-4786.2 CMP-4787 CMP-4819.1 • CMP-4990.1 • CMP-4994 FD-6007 Businessowners Coverage Form Amendatory Endorsement (California) Exclusion - Silica or Silica -Related Dust Back-up of Sewer or Drain Utility Interruption - Loss of Income Dependent Property - Loss of Income Loss of Income and Extra Expense Money and Securities Employee Dishonesty Exclusion - Testing or Consulting Errors and Omissions Additional Insured - Owners, Lessees or Contractors (Scheduled) Waiver of Transfer of Rights of Recovery Against Others To Us Unauthorized Business Card Use Identity Restoration Data Compromise Inland Marine Attaching Declarations period. Please refer to Section II — other forms and endorsements that Policy number: 90-AP-V789-3 Page 4 of 5 Q Copyright, State Farm Mutual Automobile Insurance Company, 2008 GMp 40E10 FE-6999.3 Policyholder Disclosure Notice of Terrorism Insurance Coverage *New Form Attached SCHEDULE OF ADDITIONAL INTERESTS) Interest type: Owners, Lessees, or Contractors (Schedul Endorsement number: CMP-4786.2 Loan number NIA CITY OF GILROY ITS OFFICERS AND EMPLOYEES 7351 ROSANNA ST GILROY CA 95020 FULL NAMED INSURED Named Insured; NICHOLS LOCAL GOVERNMENT CONSULTING LLC DBA NICHOLS CONSULTING 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. Wiet-th.a_. kfrlufrl,tua4 President Secretary OTHER MESSAGE(S) Companies admitted to write property and casualty insurance In California are required to participate in the California FAIR Plan Association, which makes basic property insurance available to California consumers who would otherwise be unable to obtain such insurance through the normal insurance market. in the event that catastrophic losses render the FAIR Plan unable to pay operating expenses and policyholder claims because it does not have sufficient retained earnings, reinsurance, a line of credit, if available, andlor proceeds from catastrophe bonds, if sold, the FAIR Plan may request the Insurance Commissioner's approval to assess each member insurance company its fair share if necessary to pay the Plans operating expenses and policyholder claims. To assure stability in the California property insurance market and to assure the continued availability of property insurance in California, the FAIR Plan's member insurance companies may collect a temporary supplemental fee to recover a portion of these assessments, If this happens, 'Temp Supplemental Fee' with an amount will be displayed on a notice, bill, or your policy declarations, Policy number, 90-AP-V789-3 Page 5 of 5 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-400D State Perm Insurance CIM Att Dec 3P CA FD-6007 PO Box 2915 Bloomington, IL 61702-2915 CITY OF GILROY ITS OFFICERS AN 7351 ROSANNA ST GILROY CA 95020 StateFarm. State Farm General Insurance Company Inland Marine Attaching Declarations Policy number: 90-AP-V789-3 Effective date: April 2, 2026 Policy period: 12 months The policy period begins and ends at 12:01 am standard time at the premises location. Expiration date: April 2, 2027 ATTACHING INLAND MARINE Automatic renewal - If the State Farm® 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. Annual policy premium: Included The above premium amount is included in the Policy Premium shown on the Declarations. FULL NAMED INSURED Named Insured: NICHOLS LOCAL GOVERNMENT CONSULTING LLC DBA NICHOLS CONSULTING 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 subsequent to the Issuance of this policy. FORMS, OPTIONS AND ENDORSEMENTS FE-6271 Amendatory Endorsement {California) FE-8739 Inland Marine Conditions FE-8745 Inland Marine Computer Property Form See below for schedule page with limits ATTACHING INLAND MARINE SCHEDULE PAGE Endorsement Coverage Limit of insurance Deductible amount Annual premium number FE-8745 Inland Marine Computer Property Form $25,000 $500 Included Loss of Income and Extra Expense $25,000 Included Other limits and exclusions may apply - refer to your policy. Policy number: 90-AP-V789-3 Page 1 of 1 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 10094e1 2002 153089 202 03-06-2021