HomeMy WebLinkAboutInsurance Certificate: Dancing People Co (2) Policy Number DECLARATIONS PAGE COVERAGE SUMMARY
97-BB-W571-2 DEC 2 2011
STATE FARM FIRE AND CASUALTY COMPANY O
PO BOX 5000, DUPONT WA 98327-5000
A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS
Named Insured and Mailing Address
15-9A13-F473I
STIEHM, ROBIN
DBA DANCING PEOPLE CO
310 OAK ST STE 5
ASHLAND OR 97520-1877
Cov A - Inflation Coverage Index: N/A
3USINESS POLICY - SPECIAL FORM 3 Cov;B - Co_nsumer Price Index: 226.0 .
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 succeedinq policy period. If this policy is terminated, we will
live you and the Mortgagee/Lienholder written notice in compliance wl h the policy provisions or as required by law.
3olicy Period: 12 Months The policy period begins and ends at 12:01 am standard time at the
=ffective Date: SEP 25 2011 premises location.
xpiration Date: SEP 25 2012
famed Insured: NON-PROFIT Requested By: Policyholder
_ocation of Covered Premises:
310 OAK ST
ASHLAND OR 97520-1876
Coverages & Property Limits of Insurance
Section I.
4 Buildings Excluded
3 Business Personal Property $ 6 200
Loss of Income - 12 Months $ Actual foss
Section II Deductibles -Section
Business Liability $ 1,000,000
N Medical Payments $ 5,000 $ 500 Basic
Products-Completed Operations $ 2,000,000
(PCO)Aggregate
3eneral Aggregate (Other $ 2,000,000
Than PCO) In case of loss under this policy, the deductible will be
applied to each occurrence and will be deducted from the
amount of the loss. Other deductibles may apply - refer to
policy.
Policy Premium $ 375.00
:orms, Options, and Endorsements Minimum Premium
Special Form 3 FP-6103
Policy Endorsement-Business FE-6851 Discounts Applied:
Amendatory Collapse FE-6573.1 Renewal Year
Fungus (Including Mold)Excl FE-6566 Years in Business
Teachers Liability Endorsement FE-6359 Enclosed Building
Policy Endorsement- Business FE-8610 Protective Devices
Policy Endorsement FE-6656 Claim Record
''ontinued on Reverse Side of Page
OTHER LIMITS AND EXCLUSIONS MAY APPLY- ER TO YOUR POLICY
D repared
)EC 02 2011 Count s n I
P-8030.2C CGET By ` ent CA
6!1993 JONSNQWDEN
our policy consists of this page,any endorsements (541)4$2 A461
nd the oolicv form.PLEASE KEEP THESE TOGETHER-