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HomeMy WebLinkAboutInsurance Certificate: Better View LLCStateFarm • STATE FARM FIRE AND CASUALTY COMPANY ❑ A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS DECLARATIONS AMENDED DEC 62019 Rlchaid8on R75085-3925 Addl Insured -Section II Only M-15-2134-FAE6 F N 001162 3123 CITY OF ASHLAND 20 E MAIN ST ASHLAND OR 97520-1814 rlllrllllrlllllllrllrlllllrlllllllll"IIIII'I'Ill'rlrrlllll'Ill'I Auto Services Policy Policy Number 97-E6-2511-4 Policy Period Effective Date Expiratian Date 12 Months JUN 27 2019 JUN 27 2020 The oliGGy period begpins and ends atl2:01 am standard time atihe premisesTocatton. Named Insured BETTER VIEW LLC DBA FARRELL'S GLASS SERVICE PO BOX 849 MEDFORD OR 97501-0061 Automatic Renewal - If the policy period is shown as 12 months, this policy will be renewed automatically subjectto the premiums, rules and forms in effectfor each succeeding policy period. If this policy is terminated, we will give you and the Mortgagee/Lienholderwritten notice in compliance with the policy provisions or as required by law. Entity: Limited Liability Company Reason for Declarations: Your policy is amended DEC 6 2019 ADDITIONAL INSURED ADDED FORM CMP-4684 ADDED Endorsement Premium Discounts Applied: Renewal Year Years in Business Protective Devices Claim Record None Prepared JAN 06 2020 © Copyright State Farm Mutual Automobile Insurance Company, 2000 CMP-4000 OR Includes copyrighted material of Insurance Services Office, Inc., with its permission. 009397 290 Al Continued on Reverse Side of Page Page 1 of 6 N 530 605..2 05-31.2011 I03231d DECLARATIONS (CONTINUED) Auto Services Policy for CITY OF ASHLAND Policy Number 97-E6-2511-4 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 001 229 S FRONT ST $ 554,700 $ 75,700 25% MEDFORD OR 97501-7263 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 INDEVES) Cov A - Inflation Coverage Index: Cov B - Consumer Price Index: SECTION I - DEDUCTIBLES Basic Deductible $500 Speclial Deductibles: Money and Securities $250 Garagekeepers - Comprehensive $250 Equipment Breakdown $500 Other deductibles may apply - refer to policy. 174.4 254.2 Garagekeepers - Collision $500 Employee Dishonesty $250 Prepared JAN 06 2020 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 OR Includes copyrighted material of Insurance Services Office, Inc.,with its permission. 009397 Continued on Next Page Page 2 of 6 StateFarm • ••o DECLARATIONS (CONTINUED) Auto Services Policy for CITY OF ASHLAND Policy Number 97-E6-2511-4 SECTION I - EXTENSIONS OF COVERAGE - LIMIT OF INSURANCE - EACH DESCRIBED PREMISES s 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, No but has "Included" indicated, please refer to that policy provision for an explanation of that coverage. LIMIT OF COVERAGE INSURANCE Accounts Receivable On Premises $10,000 Off Premises $5,000 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 Employee Tools (applies only to those premises provided Coverage B - Business Personal Property) Per Occurrence $2,500 Per Employee $500 Equipment Breakdown Included Fire Department Service Charge $5,000 Fire Extinguisher Systems Recharge Expense $5,000 Forgery Or Alteration $10,000 Garagekeeper's Insurance - Comprehensive And Collision $25,000 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 Prepared JAN 06 2020 CMP-4000 OR © Copyright, State Farm Mutual Automobile Insurance Company, 2000 Includes copyrighted materiel of Insurance Services Office, Inc., with its permission. 009398 290 N Continued on Reverse Side of Page Page 3 of 6 DECLARATIONS (CONTINUED) Auto Services Policy for CITY OF ASHLAND Policy Number 97-E6-2511.4 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) Ordinance Or Law - Equipment Coverage Included Outdoor Property $5,000 Personal Effects (applies only to those premises provided Coverage B - Business $2,500 Personal Property) Personal Property Off Premises $15,000 Pollutant Clean Up And Removal $20,000 Preservation Of Property 30 Days Property Of Others (applies only to those premises provided Coverage B - Business $2,500 Personal Property) Signs $5,000 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 Employee Dishonesty LIMIT OF INSURANCE $10,000 Loss Of Income And Extra Expense Actual Loss Sustained - 12 Months Prepared JAN 06 2020 © Copyright. State Form Mutual Automobile Insurance Company, 2008 CMP-4000 OR Includes copyrighted material of Insurance Services Office, Inc., with its permission. 009398 Continued on Next Page Page 4 of 6 Stat Farm A. DECLARATIONS (CONTINUED) I Auto Services Policy for CITY OF ASHLAND Policy Number 97-E6-2511-4 SECTION II - DEDUCTIBLES Business Liability - Property Damage $250 Other deductibles may apply - refer to policy. 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 CMP-4684 CMP-4412 CMP-4827.1 FE-6999.2 CMP-4237.1 Prepared JAN 06 2020 CMP-4000 OR Businessowners Coverage Form 'Addl Insd Owners Lessee Sched Operation of Customers Auto Employee Tool Coverage Terrorism Insurance Cov Notice Amendatory Endorsement © Copyright State Farm Mutual Automobile Insurance Company, 2008 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 009399 290 N Continued on Reverse Side of Page Page 5 of 6 DECLARATIONS (CONTINUED) Auto Services Policy for CITY OF ASHLAND Policy Number 97-E6-2511-4 CMP-4705.2 Loss of Income & Extra Expnse CMP-4710 Employee Dishonesty CMP-4709 Money and Securities CMP-4744 Garagekeepers Direct Coverage CMP-4706 Back -Up of Sewer or Drain CMP-4683 Addl Ins Owners Lessee Blkt CMP-4788 Add] Insd Mgrs Lessor of Prem FE-3650 Actual Cash Vlue Endorsement CMP-4742.1 Garage Liability CMP-4561.1 Policy Endorsement CMP-4527 Excl Ctrl Substances CMP-4860 Al Design Person Org CMP-4787 Waiver of Trans Rgt of Recov FD-6007 Inland Marine Attach Dec New Form Attached 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 JAN 06 2020 CMP-4000 OR ©Copyright, State Form Mutu a[ Automobile Insurance Company,2000 Includes copyrighted materiel of Insurance Services Office, Inc., with its permission. 009399 290 Page 6 of 6 N STATE FARM FIRE AND CASUALTY COMPANY A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS INLAND MARINE ATTACHING DECLARATIONS StateFarm • . Richardson 94 75085-3925 Named Insured M-15-2134-FAE6 F N BETTER VIEW LLC DBA FARRELL'S GLASS SERVICE PO BOX 849 MEDFORD OR 97501-0061 8 0 a N� ATTACHING INLAND MARINE Policy Number 97-E6-2511-4 Policy Period Effective Date Exppiration Date 12 Months JUN 27 2019 JL1N 272020 The oliG period beggins and ends atl2:01 am standard time atthe premisesTocation. Automatic Renewal - If the policy period is shown as 12 months, this policy will be renewed automatically subjectto the premiums, rules and forms in effectfor each succeeding policy period. If this policy is terminated, we will give you and the Mortgagee/Lienholderwritten 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. Forms, Options, and Endorsements FE-8739 Inland Marine Conditions FE-6867 Amend of Inland Marine Condtns FE-8743.1 Inland Marine Computer Prop See Reverse for Schedule Page with Limits Prepared JAN 06 2020 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 FD-6007 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 009400 530-689s.2 0531-ZDII I0132320 97-E6-2511-4 ATTACHING INLAND MARINE SCHEDULE PAGE ATTACHING INLAND MARINE ENDORSEMENT NUMBER FE-8743.1 Prepared JAN 06 2020 FD-6007 COVERAGE Inland Marine Computer Prop Loss of Income and Extra Expense LIMIT OF INSURANCE 25,000 25,000 DEDUCTIBLE AMOUNT OTHER LIMITS AND EXCLUSIONS MAY APPLY - REFER TO YOUR POLICY ©Copyright, State Farm Mutual Automobile Insurance Company,2008 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 500 ANNUAL PREMIUM Included Included 009400 530 605 a.2 0531 2011 1e113233c