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HomeMy WebLinkAboutCOI - Netfile Inc - Expires 2024-03-01STATE FARM GENERAL INSURANCE COMPANY A STOCK COMPANY WITH HOME OMCES IN BLOOMINGTON, ILLINOIS RENEWAL DECLARATIONS n StateFarm • • fl F Sour 2115 PB ooming on IL 61702-2915 Addl Insured -Section II Only AT2 007059 3125M-23-3003-FA2F F Z CITY OF GILROY, ITS OFFICERS AND EMPLOYEES 7351 ROSANNA ST GILROY CA 95020-6141 :IIIIIIlluIIIII III11"'11111111111 11111111111111611111111111111 Office Policy Policy Number 92-XV-7702-4 Policy Period Effective Date Expiration Date 12 Months MAR 1 2023 MAR 1 2024 The pollCy period beg9ins and ends at 12:01 am standard time atthe premiseslocation. Named Insured NETFILE INC JAN 2 5 2023 GILROY CITY CLERICS OFFICE Automatic Renewal -If the 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 reauired by law. Entity: Corporation NOTICE: Information concerning changes in your policy language is included. Please call your agent if you have any questions. POLICY PREMIUM Discounts Applied: Renewal Year Years in Business Protective Devices Claim Record $ 5,069.00 Prepared DEC 19 2022 © Copyright, State Farm Mutual Automobile Insurance Company, 200a CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 049282 294 At Continued on Reverse Side of Page Page 1 of 7 N RENEWAL DECLARATIONS (CONTINUED) Office Policy for CIO& GILROY, ITS OFFICERS Policy Number 92-XV-7702-4 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 2707 AURORA CT $ 357,400 $ 103,100 25% MAR I POSA CA 95338-9755 * 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: Cov B - Consumer Price Index: SECTION I - DEDUCTIBLES 234.8 298.0 Basic Deductible $1,000 Special Deductibles: Money and Securities $250 Employee Dishonesty $250 Equipment Breakdown $1,000 Other deductibles may apply - refer to policy. Prepared DEC 19 2022 (D Copyright, State Farm Mutual Automobile Insurance Company, 2000 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 049282 Continued on Next Page Page 2 of 7 StateFarm ncD ®®, RENEWAL DECLARATIONS (CONTINUED) Office Policy for CITY OF GILROY, ITS OFFICERS Policy Number 92-XV-7702-4 F1 SECTION I - EXTENSIONS OF QOVERAGE - LIMIT OF INSURANCE - EACH DESCRIBED PREMISES S $ 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, N but has "Included" indicated, please refer to that policy provision for an explanation of that coverage. 0 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 DEC 19 2022 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 049283 294 Continued on Reverse Side of Page Page 3 of 7 N RENEWAL DECLARATIONS (CONTINUED) Office Policy for CITY OF GILROY, ITS OFFICERS Policy Number 92-XV-7702-4 Ordinance Or Law - Equipment Coverage Included Outdoor Property $5,000 Personal Effects (applies only to those premises provided Coverage B - Business $5,000 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 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 Dependent Property - Loss Of Income Employee Dishonesty Utility Interruption - Loss Of Income Loss Of Income And Extra Expense LIMIT OF INSURANCE $5,000 $10,000 $10,000 Actual Loss Sustained - 12 Months Prepared DEC 19 2022 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 049283 Continued on Next Page Page 4 of 7 sraref-arm RENEWAL DECLARATIONS (CONTINUED) u Office Policy for CITY OF GILROY, ITS OFFICERS Policy Number 92-XV-7702-4 SECTION 11- LIABILITY LIMIT OF COVERAGE 0 INSURANCE M Coverage L - Business Liability $2,000,000 Coverage M - Medical Expenses (Any One Person) $5,000 Damage To Premises Rented To You $300,000 LIMIT OF AGGREGATE LIMITS INSURANCE Products/Completed Operations Aggregate $4,000,000 General Aggregate $4,000,000 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 am CMP-4101 Businessowners Coverage Form FE-6999.3 *Terrorism Insurance Cov Notice CMP-4713.1 Excl Testing Consulting E&O CMP-4714 Excl Data Processing and Prog CMP-4795.1 Addl Insd Designated Premises CMP-4786.1 Addl Insd Owners Lessee Sched CMP-4787 Waiver of Trans Rgt of Recov 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-4704.1 Dependent Prop Loss of Income CMP-4710 Employee Dishonesty CMP-4709 Money and Securities Prepared DEC 19 2022 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 049284 294 Continued on Reverse Side of Page Page 5 of 7 N RENEWAL DECLARATIONS (CONTINUED) Office Policy for CITY OF GILROY, ITS OFFICERS Policy Number 92-XV-7702-4 CMP-4703.1 Utility Interruption Loss Incm CMP-4705.2 Loss of Income & Extra Expense CMP-4860.1 Al Design Person Org CMP-4260.1 Amendatory Endorsement -CA CMP-4261 Amendatory Endorsement FD-6007 Inland Marine Attach Dec * 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. *nit,r, M. 40wo*. C444 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 reach out by mail or phone directly to: State Farm Executive 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.aov/01-consumers Prepared DEC 19 2022 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 049284 Continued on Next Page Page 6 of 7 StateFarm (09), RENEWAL DECLARATIONS (CONTINUED) R Office Policy for CITY OF GILROY, ITS OFFICERS Policy Number 92-XV-7702-4 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 DEC 19 2022 CMP-4000 C Copyright, State Farm Mutual Automobile Insurance Company, 2008 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 049285 294 N Page 7 of 7 STATE FARM GENERAL INSURANCE COMPANY f A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS INLAND MARINE ATTACHING DECLARATIONS StateFarm n5 ®®. O C> 8 us S 0 g?BoX 2915 omrngton IL 6 i 702-2915 Named Insured M-23-3003- FA2 F F Z NETFILE INC ATTACHING INLAND MARINE Policy Number 92-XV-7702-4 Policy Period Effective Date Expiration Date 12 Months MAR 1 2023 MAR 1 2024 The poll y period begins and ends at 12:01 am standard time att�ie premises location. Automatic Renewal - If the policy period is shown as 12 months, this policy will be renewed automatically subject to 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-8739 Inland Marine Conditions FE-6271 Amendatory Endorsement FE-8745 Inland Marine Computer Prop See Reverse for Schedule Page with Limits Prepared DEC 19 2022 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 FD-6007 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 049286 530 585 a.2 05 31 2011 10132320 a4nv-I r tic Y ATTACHING INLAND MARINE SCHEDULE PAGE ATTACHING INLAND MARINE ENDORSEMENT LIMIT OF NUMBER COVERAGE INSURANCE FE-8745 Inland Marine Computer Prop 5 25 , 0 0 0 Loss of Income and Extra Expense 5 25 , 0 0 0 Prepared DEC 19 2022 FD-6007 049286 DEDUCTIBLE AMOUNT $ 500 OTHER LIMITS AND EXCLUSIONS MAY APPLY - REFER TO YOUR POLICY O Copyright, State Farm Mutual Automobile Insurance Company, 2008 Includes copyrighted material of Insurance Services Office, Inc., with its permission. ANNUAL PREMIUM Included Included 530-686 a.2 05-31 2011 1032330