AG 7033 Auto Dec

8/4/2019 AG 7033 Auto Dec

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AG 7033 (5/07) Argo Group US

Includes copyrighted material of Insurance Services Office, Inc., with its permission.© ISO Properties, Inc., 2000

Page 1 of 8

Commercial Auto

BUSINESS AUTO DECLARATIONSPOLICY NO.: WNA800012201

Argonaut Insurance Company225 W. Washington Street, 6th Floor

Chicago, IL60606

S.N. Potter Insurance Agency, Inc.1901 W. Kettleman Lane, Suite 103

Lodi, CA 95242Agency License #0562307

ITEM ONE

NAMED INSURED: Fisher Vineyards

MAILING ADDRESS: 6200 Saint Helena Road Santa Rosa

CA 95404

POLICY PERIOD: From 05/04/2011 to 05/04/2012 at 12:01 A.M. Standard Time at your

mailing address shown above.

PREVIOUS POLICY NUMBER: NEW

FORM OF BUSINESS:

CORPORATION LIMITED LIABILITY COMPANY INDIVIDUAL

PARTNERSHIP OTHER

IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THISPOLICY, WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY.

PREMIUM FOR ENDORSEMENTS $ INCLUDED

*ESTIMATED TOTAL PREMIUM $ 2,085.00

*This policy may be subject to final audit.

Premium shown is payable: $ at inception.

AUDIT PERIOD (IF APPLICABLE) ANNUALLY SEMI-ANNUALLY QUARTERLY MONTHLY

ENDORSEMENTS ATTACHED TO THIS POLICY:

AG9500-0706, AG9524-0706, AG9544-0706, AG9565-0706, AG9587-0706, AG9700-0706, AG9724-0706, AG9757-0706AG9765-0706, AG9775-0706, AG9787-0706, AG9800-0706, AG9824-0706, AG9857-0706, AG9865-0706, AG9875-0706AG9887-0706, AG9900-0706, AG9924-0706, AG9957-0706, AG9965-0706, AG9975-0706, AG9987-0706, AG9501-0306AG9502-0306, AG9503-0306, AG9521-0306, AG9522-0306, AG9523-0306, AG9532-0306, AG9541-0306, AG9543-0306AG9552-0306, AG9563-0306, AG9576-0306, AG9583-0306, AG9701-0306, AG9702-0306, AG9703-0306, AG9721-0306AG9722-0306, AG9723-0306, AG9732-0306, AG9741-0306, AG9743-0306, AG9751-0306, AG9752-0306, AG9753-0306AG9756-0306, AG9763-0306, AG9776-0306, AG9783-0306, AG9801-0306, AG9802-0306, AG9803-0306, AG9821-0306AG9822-0306, AG9823-0306, AG9832-0306, AG9841-0306, AG9843-0306, AG9851-0306, AG9852-0306, AG9853-0306AG9856-0306, AG9863-0306, AG9876-0306, AG9883-0306, AG9901-0306, AG9902-0306, AG9903-0306, AG9921-0306AG9922-0306, AG9923-0306, AG9932-0306, AG9941-0306, AG9943-0306, AG9951-0306, AG9952-0306, AG9953-0306

AG9956-0306, AG9963-0306, AG9976-0306, AG9983-0306, AG9504-0702, AG9554-0702, AG9574-0702, AG9704-0702AG9744-0702, AG9754-0702, AG9774-0702, AG9804-0702, AG9844-0702, AG9854-0702, AG9874-0702, AG9904-0702AG9944-0702, AG9954-0702, AG9974-0702.

COUNTERSIGNEDBY

(Date) (Authorized Representative)

NOTEOFFICERS' FACSIMILE SIGNATURES MAY BE INSERTED HERE, ON THE POLICY COVER ORELSEWHERE AT THE COMPANY'S OPTION

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Page 2 of 8

Commercial Auto

POLICY NO.: WNA80001220ITEM TWO

SCHEDULE OF COVERAGES AND COVERED AUTOSThis policy provides only those coverages where a charge is shown in the premium column below. Each othese coverages will apply only to those "autos" shown as covered "autos". "Autos" are shown as covered "autosfor a particular coverage by the entry of one or more of the symbols from the Covered Autos Section of the BusinessAuto Coverage Form next to the name of the coverage.

COVERAGES

COVERED AU-TOS (Entry of one or more of the symbols

from the CoveredAutos Section of theBusiness Auto Cov-

erage Form showswhich autos arecovered autos.)

LIMIT

THE MOST WE WILL PAY FOR ANYONE ACCIDENT OR LOSS

PREMIUM

LIABILITY 04 $1,000,000 CSL $ 677.00

PERSONAL INJURYPROTECTION (or equivalent No-fault Coverage)

01 SEPARATELY STATED IN EACH P.I.P.ENDORSEMENT MINUS $ 250 DED.

$ 46.00

ADDED PERSONAL INJURY

PROTECTION (or equivalentadded No-fault Coverage)

01 SEPARATELY STATED IN EACH ADDED

P.I.P. ENDORSEMENT.

$ 4.00

PROPERTY PROTECTIONINSURANCE (Michigan only)

02 SEPARATELY STATED IN THE P.P.I.ENDORSEMENT MINUS $ 250 DED.FOR EACH ACCIDENT.

$ 4.00

AUTO MEDICAL PAYMENTS 01 $ 5,000 $ 1.00

UNINSURED MOTORISTS 01 $ 60000 $ 2,710.00

UNDERINSURED MOTOR-ISTS (When not included inUninsured Motorists Coverage)

01 $ 120000 $ 2,710.00

PHYSICAL DAMAGECOMPREHENSIVE COVERAGE

03 ACTUAL CASH VALUE OR COST OFREPAIR, WHICHEVER IS LESS, MINUS$ 100 DED. FOR EACH COVERED AU-TO, BUT NO DEDUCTIBLE APPLIES TO

LOSS CAUSED BY FIRE OR LIGHTNING.See ITEM FOUR For Hired Or Borrowed"Autos".

$ 231.00

PHYSICAL DAMAGESPECIFIED CAUSES OFLOSS COVERAGE

02 ACTUAL CASH VALUE OR COST OFREPAIR, WHICHEVER IS LESS, MINUS$ N/A DED. FOR EACH COVERED AUTOFOR LOSS CAUSED BY MISCHIEF ORVANDALISM. See ITEM FOUR For HiredOr Borrowed "Autos".

$ 217.00

PHYSICAL DAMAGECOLLISION COVERAGE

01 ACTUAL CASH VALUE OR COST OFREPAIR, WHICHEVER IS LESS, MINUS$ 2000 DED. FOR EACH COVERED AU-TO. See ITEM FOUR For Hired Or Bor-rowed "Autos".

$ 566.00

PHYSICAL DAMAGE TOW-

ING AND LABOR

01 $ 100 For Each Disablement Of A

Private Passenger "Auto".

$ 14.00

PREMIUM FOR ENDORSEMENTS $ 94.00

*ESTIMATED TOTAL PREMIUM $ 7,274.00

*This policy may be subject to final audit.

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Page 3 of 8

Commercial Auto

POLICY NO.: WNA80001220

ITEM THREE

SCHEDULE OF COVERED AUTOS YOU OWN

DESCRIPTION PURCHASED TERRITORY

CoveredAuto No.

Year, Model, Trade Name, Body TypeSerial Number (S) Vehicle Identification

Number (VIN)

OriginalCost New

ActualCost &

NEW (N)USED (U)

Town & StateWhere The

Covered AutoWill Be Principally

Garaged

1 2011 102 BMW MA0123 $ 2000 $ GaragingAddressAcampo CA

2 2010 BMW CM0988 $ 2000 $ GaragingAddressAcampo CA











13 2010 BMW CM0988 $ 2000 $ GaragingAddress

Acampo CA14 2010 BMW CM0988 $ 2000 $ GaragingAddressAcampo CA


CLASSIFICATION

CoveredAuto No.

RadiusOf

Operation

BusinessUse

s=service

Size GVW,GCW Or

Vehicle Seat-ing

AgeGroup

PrimaryRatingFactor

Secon-dary

RatingFactor

Code EXCEPT For Towing, All Phys-

ical Damage Loss Is

r=retailc=com’l

Capacity Liab. Phy.Dam.

Payable To YouAnd The Loss

Payee Named BelowAs Interests May

Appear At theTime

Of The Loss.

1 011 ABC Company

2 011 ABC Company

3 011 ABC Company

4 011 ABC Company

5 011 ABC Company

6 011 ABC Company

7 011 ABC Company

8 011 ABC Company

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Page 4 of 8

9 011 ABC Company

10 011 ABC Company

11 011 ABC Company

12 011 ABC Company

13 011 ABC Company

14 011 ABC Company

15 011 ABC Company

Covered

Auto No.

COVERAGES - PREMIUMS, LIMITS AND DEDUCTIBLES (Absence of a deductibleor limit entry in any column below means that the limit or deductible entry

in the corresponding ITEM TWO column applies instead.)LIABILITY PERSONAL INJURY

PROTECTIONADDED P.I.P. PROPERTY PROTEC-

TION(Michigan Only)

Limit Premium Limit StatedIn Each P.I.P.End. MinusDeductible

ShownBelow

Premium Limit StatedIn Each Add-ed P.I.P. End.

Premium

Limit StatedIn P.P.I.

End. MinusDeductibleShown Be-

low

Premium

1 $ 10000 $ 677.00 $ 250 $ 46.00 $ 4.00 $ 250 $ 4.00

2 $ 125000 $ 724.00 $ 250 $ 46.00 $ 4.00 $ 250 $ 4.00

3 $ 125000 $ 724.00 $ 250 $ 46.00 $ 4.00 $ 250 $ 4.00

4 $ 125000 $ 724.00 $ 250 $ 46.00 $ 4.00 $ 250 $ 4.00

5 $ 125000 $ 724.00 $ 250 $ 46.00 $ 4.00 $ 250 $ 4.006 $ 125000 $ 724.00 $ 250 $ 46.00 $ 4.00 $ 250 $ 4.00

7 $ 125000 $ 724.00 $ 250 $ 46.00 $ 4.00 $ 250 $ 4.00

8 $ 125000 $ 724.00 $ 250 $ 46.00 $ 4.00 $ 250 $ 4.00

9 $ 125000 $ 724.00 $ 250 $ 46.00 $ 4.00 $ 250 $ 4.00

10 $ 125000 $ 724.00 $ 250 $ 46.00 $ 4.00 $ 250 $ 4.00

11 $ 125000 $ 724.00 $ 250 $ 46.00 $ 4.00 $ 250 $ 4.00

12 $ 125000 $ 724.00 $ 250 $ 46.00 $ 4.00 $ 250 $ 4.00

13 $ 125000 $ 724.00 $ 250 $ 46.00 $ 4.00 $ 250 $ 4.00

14 $ 125000 $ 724.00 $ 250 $ 46.00 $ 4.00 $ 250 $ 4.00

15 $ 125000 $ 724.00 $ 250 $ 46.00 $ 4.00 $ 250 $ 4.00

Total

Pre-mium

$ 10,813.00 $690.00 $60.00 $60.00

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Commercial Auto

POLICY NO.: WNA80001220ITEM THREE

SCHEDULE OF COVERED AUTOS YOU OWN (Cont'd)

CoveredAutoNo.

COVERAGES – PREMIUMS, LIMITS AND DEDUCTIBLES (Absence of a deductibleor limit entry in any column below means that the limit or deductible entry

in the corresponding ITEM TWO column applies instead.)

AUTO MEDICAL PAYMENTS COMPREHENSIVE SPECIFIED CAUSES OFLOSS

Limit Premium Limit Stated InITEM TWO

MinusDeductible

Shown Below

Premium Limit StatedIn

ITEM TWODeductible

Shown Below

Premium

1 $ 4 $ 1.00 $ 100 $ 231.00 $ 250 $ 217.00

2 $ 4 $ 1.00 $ 100 $ 231.00 $ 250 $ 217.00

3 $ 4 $ 1.00 $ 100 $ 231.00 $ 250 $ 217.00

4 $ 4 $ 1.00 $ 100 $ 231.00 $ 250 $ 217.00

5 $ 4 $ 1.00 $ 100 $ 231.00 $ 250 $ 217.00

6 $ 4 $ 1.00 $ 100 $ 231.00 $ 250 $ 217.00

7 $ 4 $ 1.00 $ 100 $ 231.00 $ 250 $ 217.008 $ 4 $ 1.00 $ 100 $ 231.00 $ 250 $ 217.00

9 $ 4 $ 1.00 $ 100 $ 231.00 $ 250 $ 217.00

10 $ 4 $ 1.00 $ 100 $ 231.00 $ 250 $ 217.00

11 $ 4 $ 1.00 $ 100 $ 231.00 $ 250 $ 217.00

12 $ 4 $ 1.00 $ 100 $ 231.00 $ 250 $ 217.00

13 $ 4 $ 1.00 $ 100 $ 231.00 $ 250 $ 217.00

14 $ 4 $ 1.00 $ 100 $ 231.00 $ 250 $ 217.00

15 $ 4 $ 1.00 $ 100 $ 231.00 $ 250 $ 217.00

TotalPremium

$15.00 $3465.00 $3255.00

Covered

AutoNo.

COVERAGES – PREMIUMS, LIMITS AND DEDUCTIBLES (Absence of a deductibleor limit entry in any column below means that the limit or deductible entryin the corresponding ITEM TWO column applies instead.)

COLLISION TOWING & LABOR

Limit Stated InITEM TWO MinusDeductible Shown

Below

Premium Limit Per Disablement

Premium

1 $ 2000 $ 566.00 $ 20000 $ 14.00

2 $ 2000 $ 566.00 $ 20000 $ 14.00

3 $ 2000 $ 566.00 $ 20000 $ 14.00

4 $ 2000 $ 566.00 $ 20000 $ 14.00

5 $ 2000 $ 566.00 $ 20000 $ 14.00

6 $ 2000 $ 566.00 $ 20000 $ 14.007 $ 2000 $ 566.00 $ 20000 $ 14.00

8 $ 2000 $ 566.00 $ 20000 $ 14.00

9 $ 2000 $ 566.00 $ 20000 $ 14.00

10 $ 2000 $ 566.00 $ 20000 $ 14.00

11 $ 2000 $ 566.00 $ 20000 $ 14.00

12 $ 2000 $ 566.00 $ 20000 $ 14.00

13 $ 2000 $ 566.00 $ 20000 $ 14.00

14 $ 2000 $ 566.00 $ 20000 $ 14.00

15 $ 2000 $ 566.00 $ 20000 $ 14.00

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Page 6 of 8

TotalPremium

$8490.00 $ 210.00

ITEM FOUR

SCHEDULE OF HIRED OR BORROWED COVERED AUTO COVERAGE AND PREMIUMS

LIABILITY COVERAGE – RATING BASIS, COST OF HIRE

STATE ESTIMATEDCOST OF HIRE

HIRE FOR EACHSTATE

RATE PER EACH$100 COST OF HIRE

FACTOR (If Liability

Coverage Is Primary)

PREMIUM

CA $ 1000 $ 0.98 1 $ 7.00

TOTAL PREMIUM $ 7.00

Cost of hire means the total amount you incur for the hire of "autos" you don't own (not including "autos" you borrow or rent from your partners or "employees" or their family members). Cost of hire does not include charges foservices performed by motor carriers of property or passengers.

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Page 7 of 8

Commercial Auto

POLICY NO.: WNA80001220PHYSICAL DAMAGE COVERAGE

COVERAGES

LIMIT OF INSURANCETHE MOST WE WILL PAY

DEDUCTIBLE

ESTIMATEDANNUALCOST OF

HIRE

RATE PEREACH $100ANNUAL

COSTOF HIRE

PREMIUM

COMPREHEN-SIVE

ACTUAL CASH VALUE OR COST OF RE-PAIR, WHICHEVER IS LESS, MINUS$ 250 DED. FOR EACH COVERED AUTO,BUT NO DEDUCTIBLE APPLIES TO LOSSCAUSED BY FIRE OR LIGHTNING.

$ 24234.00 $ $ 91.00

SPECIFIEDCAUSES OF

LOSS

ACTUAL CASH VALUE OR COST OF RE-PAIR, WHICHEVER IS LESS, MINUS $ 250DED. FOR EACH COVERED AUTO FORLOSS CAUSED BY MISCHIEF OR VANDAL-ISM.

$ 24234.00 $ $ 47.00

COLLISIONACTUAL CASH VALUE OR COST OF RE-PAIR, WHICHEVER IS LESS, MINUS $ 250DED.FOR EACH COVERED AUTO.

$ 24234.00 $ $ 150.00

TOTAL PREMIUM $ 288.00

ITEM FIVE

SCHEDULE FOR NON-OWNERSHIP LIABILITY

NAMED INSURED'S BUSINESS RATING BASIS NUMBER PREMIUM

Other Than A Social Service Agency Number Of Employees

Number Of Partners $

Social Service Agency Number Of Employees 100 $ 2.00

Number Of Volunteers 50 $

TOTAL $ 2.00

8/4/2019 AG 7033 Auto Dec



Includes copyrighted material of Insurance Services Office, Inc., with its permission.© ISO Properties Inc 2000

Page 8 of 8

Commercial Auto

POLICY NO.: WNA80001220ITEM SIX

SCHEDULE FOR GROSS RECEIPTS OR MILEAGE BASIS – LIABILITY COVERAGE – PUBLIC AUTO ORLEASING RENTAL CONCERNS

RATES

ESTIMATE YEARLY

Per $100 Of Gross Receipts

Per Mile

PREMIUMS

Gross ReceiptsMileage

LIABILITYCOVERAGE

AUTO MEDICALPAYMENTS

LIABILITYCOVERAGE

AUTO MEDICALPAYMENTS

$ $ $ $

$ $ $ $

$ $ $ $

$ $ $ $

TOTAL PREMIUMS $ $

MINIMUM PREMIUMS $ $

When used as a premium basis:FOR PUBLIC AUTOS

Gross Receipts means the total amount to which you are entitled for transporting passengers, mail or merchandise during the policy period regardless of whether you or any other carrier originate the transportationGross Receipts does not include:

A. Amounts you pay to railroads, steamship lines, airlines and other motor carriers operating under theiown ICC or PUC permits.

B. Advertising revenue.

C. Taxes which you collect as a separate item and remit directly to a governmental division.

D. C.O.D. collections for cost of mail or merchandise including collection fees.

Mileage means the total live and dead mileage of all revenue producing units operated during the policy period

FOR RENTAL OR LEASING CONCERNSGross receipts means the total amount to which you are entitled for the leasing or rental of "autos" during thepolicy period and includes taxes except those taxes which you collect as a separate item and remit directly to agovernmental division.

Mileage means the total of all live and dead mileage developed by all the "autos" you leased or rented to othersduring the policy period

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AG 7033 Auto Dec