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HomeMy WebLinkAboutSobel Communications - Insurance Certificate (2019)StateFarm AQ0 STATE FARM GENERAL INSURANCE COMPANY A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS DECLARATIONS AMENDED APR 17 2018 Pq gox 8539?_5 75085 -3925 Ric ardson, rX M- 02- 2094 -FB14 F U 000383 3123 Addl Insured - Section II Only CITY OF GILROY 7351 ROSANNA ST GILROY CA 95020 -6141 Office Policy Policy Number 97 -67 -3258-0 Policy Period Effective Date Expiration Date 12 Months JAN 15 2018 JAN 15 2019 The poll y period beggins and ends at 12:01 am standard time att�ie premisesTocatlon. 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 /Lienholder written notice in compliance with the policy provisions or as required by law. Entity: Individual Reason for Declarations: Your policy is amended APR 17 2018 ADDITIONAL INSURED ADDED ADDITIONAL INSURED DELETED PREMIUM ADJUSTMENT FORM CMP- 4788.1 ADDED FORM CMP - 4788.1 DELETED Endorsement Premium Discounts Applied: Renewal Year Years in Business Claim Record Prepared APR 272018 CMP -4000 None © Copyright State Farm Mutual Automobile Insurance Company, 2008 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 003053 290 Al Continued on Reverse Side of Page Page 1 of 6 N �_ 530 -666a2 05.31 -2611 fo1 Location . Location of .. Limit of Insurance* Limit of Seasonal .Number Described .Insurance'` ' _Increase - Premises ' Coverage A - Coverage B - Business Buildings Business . ersonal Personal . . Property Property 001 775 BAYWOOD DR 203 No Coverage $ . 32,400 .:25 %. PETALUMA CA 94954 -5500 %7teFarm AS 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 APR 27 2018 © Copyright, State Farm Mutual Automobile Insurance Company, 2005 CMP -4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 003054 290 Continued on Reverse Side of Page Page 3 of 6 N : DECLARATIONS (CONTINUED) . Office Policy for- CITY OF GILROY. Policy Number 97- 67- 3258 -0 Ordinance Or Law - Equipment 'Coverage Included ,Outdoor Property, $51000 Personal, Effects '( applies only,to' those premises provided Coverage B.,-'Business ; $5,000. Personal Property) . 'Pe rsonal.P rope rty Off Premises $15,000 Pollutant Clean.Up And Removal $1.0,000 Preservation Of Property 30 Days Property: Of Others (applies only to those premises provided Coverage B -. Business . $2,500 Personal. P rope rty) Signs: .$2;500 Unauthorized Business Card ;Use $5,000 Valuable Papers And Records- : On. Premises ; $50;000 Of Premises $1.5,000 Water Damage, Other Liquids, Powder Or Molten Material Damage Included SECTION 1- EXTENSIONS OF COVERAGE - .LIMIT -OF INSURANCE - PER POLICY. The coverages and correspbndi no. 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 'Interru'ption =' Loss Of Income . $10 ",000 Loss Of Income And, Extra Expense Actual Loss Sustained :- 12 Months Prepared . APR 27 2018 .. © Copyright, State Farm Mutual Automobile Insurance Company; 2008 CMP -4000 Includes copyrighted•material of Insurance Services .Office,.Ind.,,with its permission: 003054 Continued on Next.Page Page. 4 of 6 StateFarm • wee DECLARATIONS (CONTINUED) Office Policy for CITY OF GILROY Policy Number 97- 67- 3258 -0 SECTION 11- 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 FE- 6999.2 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 CMP - 4788.1 *Addl Insd Mgrs Lessor of Prem CMP- 4713.1 Excl Testing Consulting E &O FE- 6999.2 Terrorism Insurance Cov Notice 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 APR 27 2018 © Copyright State Farm Mutual Automobile Insurance Company, 2008 CMP -4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 003055 290 Continued on Reverse Side of Page Page 5 of 6 N StateFarm as STATE FARM GENERAL INSURANCE COMPANY A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS INLAND MARINE ATTACHING DECLARATIONS POox 8539? R,c ardson, 75085 -3925 M -02- 2094 -FB14 F U 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 15 2019 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 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 APR 27 2018 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 FD -6007 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 003056 530 -585 a.2 05 -31 -2011 WM2320