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Home My WebLink AboutInsurance Certificate: Cascade Research (2) STATE FARM EIRE AND CASUALTY COMPANY A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS DECLARATIONS AMENDED AUG 16 2016 P.O. Bo 7.991C.Q Policy Number 97-B2-R064-9 Dallas. X 753 '79-9100 Policy Period Effective Date Expiration Date M-15-2155-FAE6 F N 1 Year MAR 1 2016 MAR 1 2017 001864 3123 The policy period begins and ends at 12:01 am standard Addl Insured-Section II Only time atthe premises location. CITY OF ASHLAND Named Insured 20 E MAIN ST CASCADE RESEARCH LLC ASHLAND OR 97520-1814 27 W HERSEY ST ASHLAND OR 97520-1158 Office Policy Automatic Renewal - If the policy period is shown as 12 months, this policy will be renewed automatically sublectto 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 required by law. Entity: Limited Liability Company Reason for Declarations: Your policy is amended AUG 16 2016 ADDITIONAL INSURED DELETED FORM CMP-4860 DELETED FORM CMP-4684 DELETED Endorsement Premium None Audit Period: Annual Discounts Applied: Renewal Year Years in Business Claim Record Prepared AUG 29 2016 CcO Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 OR Includes copyrighted material of Insurance Services Office, Inc., with its permission. 014467 290 Al Continued on Reverse Side of Page Page 1 of 6 N h30 fie0 a7 05 31-7071 1o1t3731r1 DECLARATIONS (CONTINUED) Office Policy for CITY OF ASHLAND Policy Number 97-132-13064-9 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 27 W HERSEY ST No Coverage $ 4,100 25% ASHLAND OR 97520-1158 1 L- I I L I * 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 INDEX(ES) Cov A - Inflation Coverage Index: N/A Cov B - Consumer Price Index: 238.7 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 AUG 29 2016 Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 OR Includes copyrighted material of Insurance Services Office, Inc., with its permission. 014467 Continued on Next Page Page 2 of 6 DECLARATIONS (CONTINUED) Office Policy for CITY OF ASHLAND Policy Number 97-132-R064-9 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 AUG 29 2016 O Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 OR Includes copyrighted material of insurance Services Office, Inc., with its permission. 014468 290 Continued on Reverse Side of Page Page 3 of 6 N DECLARATIONS (CONTINUED) Office Policy for CITY OF ASHLAND Policy Number 97-132-13064-9 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 Water Damage, Other Liquids, Powder Or Molten Material Damage 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 AUG 29 2016 O Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 OR Includes copyrighted material Of hisurance Services Office, Inc., with its permission. 014468 Continued on Next Page Page 4 of 6 DECLARATIONS (CONTINUED) Office Policy for CITY OF ASHLAND Policy Number 97-132-13064-9 SECTION II - 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 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-4100 Businessowners Coverage Form CMP-4819.1 Unauthorized Business Card Use FE-6999.2 Terrorism Insurance Cov Notice CMP-4237 Amendatory Endorsement CMP-4705 Loss of Income & Extra Expnse CMP-4710 Employee Dishonesty CMP-4709 Money and Securities CMP-4706 Back-Up of Sewer or Drain CMP-4704 Dependent Prop Loss of Income CMP-4703 Utility Interruption Loss Incm CMP-4713 Excl Testing Consulting E&O CMP-4683 Addl Ins Owners Lessee Blkt CMP-4684 Addl Insd Owners Lessee Sched Prepared AUG 29 2016 Cc, Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 OR Includes copyrighted material of Insurance Services Office, Inc., with its permission, 014469 290 Continued on Reverse Side of Page Page 5 of 6 N DECLARATIONS (CONTINUED) Office Policy for CITY OF ASHLAND Policy Number 97-132-13064-9 CMP-4787 Waiver of Trans Rgt of Recov FD-6007 Inland Marine Attach Dec This policy is issued by the State Farm Fire and Casualty 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 Fire and Casualty Company has caused this policy to be signed by its President and Secretary at Bloomington, Illinois. Secretary President Prepared AUG 29 2016 r> Copyright, State Farm Mutual Automobile insurance Company, 2008 CMP-4000 OR Includes copyrighted material of Insurance Services Office, Inc., with its permission. 014469 290 Page 6 of 6 N its ' STATE FARM FIRE AND CASUALTY COMPANY A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS INLAND MARINE ATTACHING DECLARATIONS P.O. Bo7 79910p Dallas, X 75 3 9-9 100 Policy Number 97-E42-13064-9 Policy Period Effective Date Expiration Date M-15-2155-FAE6 F N 1 Year MAR 1 2016 MAR 1 2017 The policy period begins and ends at] 2:01 am standard Named Insured time at the premisesTocatlon. CASCADE RESEARCH LLC 27 W HERSEY ST ASHLAND OR 97520-1158 ATTACHING INLAND MARINE Automatic Renewal - If the policy period is shown as 12 months , this policy vvill be renewed automatically subjectto the premiums, rules and forms in effect for 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. Annual Policy Premium Included The above Premium Amountis 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. Fortes, Options, and Endorsements FE-8739 Inland Marine Conditions FE-6867 Amend of Inland Marine Condtns FE-8743 Inland Marine Computer Prop See Reverse for Schedule Page with Limits Prepared AUG 29 2016 n Copyright, State Farm Mutual Automobile Insurance Company, 2008 FD-6007 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 014470 530 6136 0 05 31 2011 101132320 07-132-13064-9 ATTACHING INLAND MARINE SCHEDULE PAGE ATTACHING INLAND MARINE ENDORSEMENT LIMIT OF DEDUCTIBLE ANNUAL NUMBER COVERAGE INSURANCE AMOUNT PREMIUM FE-8743 Inland Marine Computer Prop $ 2 5, 0 0 0 $ 500 Included Loss of Income and Extra Expense $ 2 5 , 0 0 0 Included OTHER LIMITS AND EXCLUSIONS MAY APPLY - REFER TO YOUR POLICY Prepared AUG 29 2016 Copyright, State Farm Mutual Automobile insurance Company, 2008 FD-6007 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 014470 530 685 ill 05 31 2011 (013233c)