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HomeMy WebLinkAboutInsurance Certificate: DJ Hope LLC BUSINESSOWNERS BP 12 01 08 10 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESSOWNERS POLICY CHANGES THIS ENDORSEMENT FORMS A PART OF THE POLICY NUMBERED BELOW. POLICY NUMBER POLICY CHANGES EFFECTIVE COMPANY AUTHORIZED REPRESENTATIVE BOP1021592 10/26/2019 RLI Insurance Company NAMED INSURED DJ Hope LLC CHANGES • Cancellation at insured's request. 9/27/2019 liaa/OR/34688 Insurance Marketplace, Inc./39607 BP 12 01 08 10 © Insurance Services Office, Inc., 2009 Page 1 of 2 POLICY AMOUNT AND PREMIUM ADJUSTMENT Limits of Insurance Premiums Coverage Previous Limit New Limit Previous New ❑ Add'1 Premium Description of Insurance of Insurance Premium Premium ® Return Premium BPP Limit Primary Loc $7,115 $30 -$30 Base Premium $159 -$159 Additional Insured $20 -$20 OPTIONAL COVERAGES The following optional coverages are added under this policy when ❑ AddT Premium designated by an "X" in the box(es) shown below. ❑ Return Premium Limits of Insurance ❑ Outdoor Signs ❑ Burglary and Robbery (Named Peril Endorsement only) Inside the Premises or ❑ Money and Securities Outside the Premises ❑ Employee Dishonesty Each Occurrence ❑ Equipment Breakdown TOTAL PREMIUM ADJUSTMENTS PREMIUM DUE AT POLICY CHANGE EFFECTIVE DATE ADDITIONAL RETURN REMOVAL If Covered Property is removed to a new location that is described on this Policy Change, you may extend this PERMIT insurance to include that Covered Property at each location during the removal. Coverage at each location will apply in the proportion that the value at each location bears to the value of all Covered Property being removed. This permit applies up to 10 days after the effective date of this Policy Change: after that, this insurance does not apply at the previous location. Authorized Representative Signature BP 12 01 08 10 © Insurance Services Office, Inc., 2009 Page 2 of 2