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HomeMy WebLinkAboutInsurance Certificate: Emerging Futures Youth NetworkState Farm at CityLine PO Box 853925 Richardson, TX 75085-3925 ..► StateFarm- ❑■ 000304 1200 AT1 CITY OF ASHLAND ti� 20 E MAIN ST ASHLAND OR 97520-1814 0 0 0 �o III"'II'IIIIIIIIIrIII'llllll'11'lllllll'lll"'ll"IIIIIIIIIII'll �o Amended Declarations State Farm Fire and Casualty Company A stock company with home offices in Bloomington, Illinois Policy number: 97-CK-S482-9 Effective date. December 29, 2019 Policy period: 12 months Expiration date: October 16, 2020 The policy period begins and ends at 12:01 am standard time at the premises location. QUSINESSOWNERS POLICY Automatic renewal - If the State Farm' 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 required by law. NAMED INSURED EMERGING FUTURES YOUTH NETWORK 1180 PARK ST ASHLAND OR 97520-3535 ENTITY Nonprofit REASONS FOR DECLARATIONS Your policy is amended effective December 29, 2019 due to some recent policy changes you requested. Enclosed is a copy of your new endorsements, if any. POLICY PREMIUM This is not bill. if an amount is due, then a separate statement will be sent prior to the due date. The premium(s) shown below is the 12 months premium(s) for the characteristics of the policy as described in this Declarations. Total Premium: $354.00 Minimum Premium Discounts applied: Business Experience Rating Policy Number: 97-CK-S482-9 Prepared: December 17, 2019 Business in Residence Premises C Copyright, State Farm Mutual Automobile Insurance Company, 2008 Page 1 of 4 CMP Dec 3P OR 1009452 2001 153090 201 03-08-2019 CMP-4000 001489 . - StateFarm" 0■ Coverage Limit of Insurance Money Orders and Counterfeit Money $1,000 Money and Securities 8 On Premises $5,000 Off Premises $2,000 �o Newly Acquired Business Personal Property (applies only if this policy provides Coverage B - Business Personal Property) $100,000 Newly Acquired or Constructed Buildings (applies only if this policy provides Coverage A - Buildings) $250,000 Ordinance or Law - Equipment Coverage Included Outdoor Property $5,000 Personal Effects (applies only to those premises provided Coverage B - Business Personal Property) $2,500 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 Personal Property) $2,500 Signs $2,500 Valuable Papers and Records On Premises $10,000 Off Premises $5,000 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 Coverage Limit of Insurance Loss of Income and Extra Expense 12 Months Actual Loss Sustained SECTION II - LOCATION SCHEDULE Location Location of described premises number 001 1180 Park St Ashland OR 97520-3535 SECTION II - LIABILITY Coverage Limit of Insurance Coverage L - Business Liability Per Occurrence $2.000,000 Policy Number. 97-CK-S482-9 Page 3 of 4 Prepared, December 17, 2019 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 001490 State Farm at CityLine PO Box 853925 Richardson, TX 75085-3925 • StateFarm- CITY OF ASHLAND p, 20 E MAIN ST ASHLAND OR 97520-1814 State Farm Fire and Casualty Company A stock company with home offices in Bloomington, Illinois Inland Marine Attaching Declarations Policy number: 97-CK-S482-9 Effective date: December 29, 2019 Policy period: 12 months Expiration date: October 16, 2020 The policy period begins and ends at 12:01 am standard time at the premises location. ATTACHING INLAND MARINF Automatic renewal - If the State Farm' 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 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 subsequent to the issuance of this policy. FORMS, OPTIONS AND ENDORSEMENTS FE-6867 Inland Marine Amendment of Inland Marine Conditions FE-8739 Inland Marine Conditions FE-8743.1 Inland Marine Computer Property Form See below for schedule page with limits ATTACHING INLAND MARINE SCHEDULE PAGE Endorsement Coverage Limit of insurance Deductible amount Annual premium number FE-8743.1 Inland Marine Computer Property Form $25,000 $500 Included Loss of Income and Extra Expense $25,000 Included Other limits and exclusions may apply - refer to your policy. Policy Number: 97-CK-S482-9 Prepared: December 17, 2019 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 Page 1 of 1 CIM Att Dec 3P OR 1009481 2001 153089 201 12-04-2018 FD-5007 001491