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HomeMy WebLinkAboutSobel Communications - Insurance CertificateStateFarm • • • 0 0 STATE FARM GENERAL INSURANCE COMPANY A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS RENEWAL DECLARATIONS Rc hards'on9TX 75085 -3925 Addl Insured - Section II Only AT2 000524 3125 CITY OF GILROY 7351 ROSANNA ST GILROY CA 95020 -6141 M -02- 2094 -FB14 F U ' 1' 1' 11' III'I'I'I'Illlllllll'Illllll�ll '11111'1'1 "IIIIIII'Illlll Office Policy Policy Number 97 -67- 3258 -0 Policy Period Effective Date Expiration Date 12 Months JAN 15 2018 JAN 152019 The policy period begins and ends at 12:01 am standard time at the premises locabon. Named Insured SOBEL, BRIAN DBA SOBEL COMMUNICATIONS 775 BAYWOOD DR STE 203 PETALUMA CA 94954 -5500 Automatic Renewal - If the policy period is shown as 12 months , this policy will be renewed automatically subjectto the premiums, rules and forms in effectfor 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. Entity: Individual NOTICE: Information concerning changes in your policy language is included. Please call your agent if you have any questions. POLICY PREMIUM Minimum Premium Discounts Applied: Renewal Year Years in Business Claim Record $ 500.00 Prepared NOV 02 2017 U Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP -4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 002640 294 Al Continued on Reverse Side of Page Page 1 of 7 N RENEWAL DECLARATIONS (CONTINUED) Office Policy for CITY OF GILROY Policy Number 97 -67- 3258 -0 a 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 001 775 BAYWOOD DR 203 No Coverage $ 32,400 25% PETALUMA CA 94954 -5500 * 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 INDEWES) Cov A - Inflation Coverage Index: N/A Cov B - Consumer Price Index: 246.8 SECTION I - DEDUCTIBLES Basic Deductible $500 Special Deductibles: Money and Securities $250 Employee Dishonesty $250 Equipment Breakdown $500 Other deductibles may apply - refer to policy. Prepared NOV 02 2017 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP -4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission 002540 Continued on Next Page Page 2 of 7 StateFarm • •• RENEWAL DECLARATIONS (CONTINUED) Office Policy for CITY OF GILROY Policy Number 97 -67- 3258 -0 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. LIMIT OF COVERAGE 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 NOV 02 2017 C Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP -4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 002641 294 Continued on Reverse Side of Page Page 3 of 7 N RENEWAL DECLARATIONS (CONTINUED) Office Policy for CITY OF GILROY Policy Number 97- 67- 3258 -0 Ordinance Or Law - Equipment Coverage Outdoor Property Personal Effects (applies only to those premises provided Coverage B - Business Personal Property) Personal Property Off Premises Pollutant Clean Up And Removal Preservation Of Property Property Of Others (applies only to those premises provided Coverage B - Business Personal Property) Signs Unauthorized Business Card Use Valuable Papers And Records On Premises Off Premises Water Damage, Other Liquids, Powder Or Molten Material Damage Included $5,000 $5,000 $15,000 $10,000 30 Days $2,500 $2,500 $5,000 $50,000 $15,000 Included 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 NOV 02 2017 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP -4000 Includes copyrighted material of Insurance Services Office, Inc , with its permission 002641 Continued on Next Page Page 4 of 7 StateFarm • •• We- RENEWAL DECLARATIONS (CONTINUED) Office Policy for CITY OF GILROY Policy Number 97 -67- 3258 -0 SECTION II - LIABILITY ° LIMIT OF COVERAGE INSURANCE s ° Excl Testing Consulting E &O ° Coverage L - Business Liability $1,000,000 Coverage M - Medical Expenses (Any One Person) $5,000 Damage To Premises Rented To You $300,000 CMP -4704 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- 6999.2 `Terrorism Insurance Cov Notice CMP- 4713.1 Excl Testing Consulting E &O CMP- 4788.1 Addl Insd Mgrs Lessor of Prem CMP- 4819.1 Unauthorized Business Card Use CMP -4698 Back -Up of Sewer or Drain CMP -4704 Dependent Prop Loss of Income CMP -4710 Employee Dishonesty CMP -4709 Money and Securities CMP -4703 Utility Interruption Loss Incm CMP- 4705.1 Loss of Income & Extra Expnse CMP- 4786.1 Addl Insd Owners Lessee Sched FD -6007 Inland Marine Attach Dec Prepared NOV 02 2017 (D Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP -4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 002642 294 Continued on Reverse Side of Page Page 5 of 7 N RENEWAL DECLARATIONS (CONTINUED) Office Policy for CITY OF GILROY Policy Number 97 -67- 3258 -0 ` 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. ��, rn- - 4 . Secretary President IMPORTANT NOTICE: California law requires us to provide you with information for filing complaints with the Sta Insurance Department regarding the coverage and service provided under this policy. Complaints should be filed only after you and State Farm or your agent. or other compar representative have failed to reach a satisfactory agreement on a problem. Please forward such complaints to: California Department of Insurance Consumer Services Division 300 South Spring Street Los Angeles, CA 90013 You also may call toll free at 1- 800 - 927 -HELP or visit www.insurance.ca.gov /01- consumers Prepared NOV 02 2017 CMP -4000 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 Includes copyrighted material of Insurance Services Office, Inc , with its permission 002642 - Continued on Next Page Page 6 of 7 StateFarm • •• RENEWAL DECLARATIONS (CONTINUED) Office Policy for CITY OF GILROY Policy Number 97 -67- 3258 -0 - a-- - 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 NOV 02 2017 CM P -4000 002643 294 N Cc Copyright, State Farm Mutual Automobile Insurance Company, 2008 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7 of 7 97- 67- 3258 -0 002643 StateFarm • • • STATE FARM GENERAL INSURANCE COMPANY A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS INLAND MARINE ATTACHING DECLARATIONS Pq c Box ardson, 85394 75085 -3925 Rr M -02- 2094 -FB14 F U P-9., Named Insured SOBEL, BRIAN DBA SOBEL COMMUNICATIONS 775 BAYWOOD DR STE 203 PETALUMA CA 94954 -5500 ATTACHING INLAND MARINE Policy Number 97 -67- 3258 -0 Policy Period Effective Date Expiration Date 12 Months JAN 15 2018 JAN 152019 The poll y period begins and ends at 12:01 am standard time at e premises location. Automatic Renewal - If the policy period is shown as 12 months, this policy will be renewed automatically subjectto the premiums, rules and 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 Amendatory Endorsement FE -8739 Inland Marine Conditions FE -8745 Inland Marine Computer Prop See Reverse for Schedule Page with Limits Prepared NOV 02 2017 7 Copyright, State Farm Mutual Automobile Insurance Company, 2008 FD -6007 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 002644 530 666 a.2 05 31 2911 WN2320 97 -67- 3258 -0 ATTACHING INLAND MARINE SCHEDULE PAGE ATTACHING INLAND MARINE ENDORSEMENT LIMIT OF DEDUCTIBLE. ANNUAL NUMBER COVERAGE INSURANCE AMOUNT PREMIUM FE -8745 Inland Marine Computer Prop S 25,000 S 500 Included Loss of Income and Extra Expense S 25,000 Include d Prepared NOV 02 2017 FD -6007 002644 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, Inc., with its permission 530 -006 a 2 05 31 -2011 1011323