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HomeMy WebLinkAboutAmended Insurance Certificate: Better View LLC State Farm Insurance • W PO Box 2915 �gFarm. Bloomington,.IL 61702-2915 c '`G>State AT1 000594 1200 01 State Farm Fire,and,Casualty Company CITY OF ASHLAND A stock company with home offices in Bloomington, Illinois 20 E MAIN'ST ' ASHLAND OR' '97520-1814 g 11111111111101'111111111.1"11,111111""111111"11111111191111—,u No :; � � • , - " . . Amended Deciarations :I,., Policy number:97-AA-B135-1 Effective date:May;3,2023 Policy period: 12 months Expiration date:June 27, 2023 The policy period begins and ends at 12:01.am standard time at the premises location. AUTO SERVICES 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 policyis terminated,.we will give you and'the. Mortgagee/Lienholder written notice in with the policy provisions or as required by law+ . NAMED INSURED BETTER VIEW LLC ENTITY Limited Liability.Company REASONS FOR DECLARATIONS ; Your policy is amended effective May 3, 2023 due to some recent policy changes you requested. Enclosed is a copy of your new endorsements, if any. POLICY PREMIUM This is not a bill.if an amount is due, thena a separate statement will be sent prior to the due date. The premium(s)shown below are for the policy period and policy characteristics as described In this Declarations. Decrease in,premium: ($28.00) ' Discounts applied: Business Experience.Rating Renewal Discount. Years in Business Policy number:97-AA-B135-1 Page 1 of 5 Prepared:May 20,2023 ©'Copyright, State Farm.Mutual Automobile•Insurance Company, 2008 CMP Dec 3P OR.1 CMP-4000 1009482 2006 153090 206 08-21-2021+ , (D9c State Farm. , . . . . SECTION I-PROPERTY SCHEDULE ' . . Location Locaticin of described premises Limit of Insurance* Limit of Insurance* Seasonal.Increase- number Coverage A- Coverage B-Business Business Fersonal,Property"c- , ,.., • — _ • Buildings Personal Property ' 002 204 S Fir St No Coverage ' $78,00.0 25% Medford OR 97501-3118 *As of the effective date Of this policy, the Limit of Insurance as shown includes any increase in the limit due to Inflation'Ooverage. • SECTION I—INFLATION COVERAGE INDEX(ES) • Coy A-Inflation Coverage Index: 0N/A Coy B-Consumer Price Index: 281.1 • SECTION I-.-DEDUCTIBLES . . • BASIC DEDUCTIBLE $500 SPECIAL DEDUCTIBLES: . , . 0 Employee Dishonesty: ..$250 ' ' , . Equipment Breakdown: , • . $500 '• 0 ". ' •, • - Garagekeepers-Collision: $500 . ., - .. . 0 , Garagekeepers-Comprehensive: $250 Money and Securities: $250 . . , Other deductibles may apply-refer to policy. ' . ,,.: ;" • , SEtTION I—EXTENSIONS OF COVERAGE-LIMIT OF INSURANCE-'EACH DESCRIBED PREMISES . - ' 0 • .-o . . ' The coverages and corresponding limits shown bel6W apply separately to each described premises shown in these Declarations, O unless indicated by"See schedule". If a coverage does not have a correspOnding limit shown beloW, but has"InCluded" indicated', refer to that policy provision for an explanation of that coverage. Coverage . 0 0 0 Limit of Insurance Accounts Receivable .'':•::,' . On Premises ' .$10,000 O Off Premises $5,000 7,-' . ,, • - . . •-:.,• ,, : : •Arson Reward '0 0 • ' .' , ''' , ' . 'r• $5000' Back-up-of Sewer or Drain $1,5,000 • , . CollapseIncluded , . , . ...• ,. . 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 $500 . • Equipment Breakdown Included 0 ' 'Fire Department Service Charge $5,000 Fire Extinguisher Systems Recharge Expense $5,000 , Policy number:97-AA-B135-1 , Page 2 of 5 Prepared May 20,2023 ©Copyright,• 8tate Farm Mutual Automobile Insurance Company, 2008 CMP-4000 creStateFarm. Coverage Limit of Insurance : ., =`i?'"_- ` ` Forgery or Alteration $10,000. •. , • Garagekeepers Insurance-Direct Coverage • $25,000 Glass Expenses Included • S Increased Cost of Construction and Demolition Costs(applies only when buildings are insured on a 10%• - • - replacement cost basis) co 0 Money Orders and Counterfeit Money $1.,000 Money and Securities On Premises $10,000 ':i_ r ._ ' Off Premises $5,000 Newly Acquired Business Personal Property(applies only if this policy provides Coverage B-Business $100,000 Personal Property) 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 • - $20,000 V ' Preservation of Property . :,. • .. . 30 days ..,,- . _ . -. . `Property of Others(applies only to those preinises'provided'Coverage B-;Business Personal $2,500 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 r , 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 ' Employee Dishonesty $10,000 Loss of Income and Extra Expense 12 Months'Actual Loss Sustained • Policy number:97-AA-8135-1 Page 3 of 5 Prepared:May 20,2023 '©Copyright, State Farm'Mutual'•Automobile Insurance Company, 2008' , . . CMP-4000 l cF0 StateFaarm! SECTION II-LOCATION SCHEDULE. , . _ Location Location of described premises'. • number • , . - , , 002 204 S Fir St . _ . .Medford OR 97501-3118 ._ , . .. . , . . SECTION II-_DEDUCTIBLES . Property Damage: $250 Other deductibles may apply-refer to policy. • ., SECTION II-LIABILITY Coverage Limit of Insurance Coverage L-Business Liability Per Occurrence , , ' , . $1,000,000 • Coverage.M-Medical Expenses -. - $5,000 Any One Person- Damage to Premises Rented to You $500;000 • Garage Liability Included in Coverage L • Operation of Customers'Auto on Particular Premises` _ included - . -Aggregate Limits •Limit of Insurance ' • General Aggregate • - - - $2,000,000 • Products/Completed Operations 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.li- 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-4237.1 Amendatory Endorsement(Oregon) -. CMP-4412 Operation of Customers'Auto on Particular Premises - CMP-4527 Marijuana Exclusion..., CMP-4543 ... Additional Insured-Designated,Person or Organization . . . , CMP-4561.1 . Policy Endorsement CMP-4683.1 Additional Insured-'Owners,Lessees or Contractors(Blanket) 1r, '. ' - - -- ` -', ., .'i t`'• i • ', _ CMP-4684.1 ,Additional Insured-Owners,Lessees,or.Contradtors(Scheduled) , , CMP-4705.2 Loss of Income and Extra Expense', CMP-4706 .Back-up of Sewer or Drain . . . CMP-4709 . Money and Securities - .CMP-4710 . . Employee Dishonesty CMP-4742.1 Garage Liability • , , CMP-4744 ' Garagekeeper's Insurance—Direct Coverage .-- . - . CMP-4827.1 Employee.Tool Coverage _ - FD-6007 .Inland Marine Attaching Declarations - FE-3650 Actual Cash Value Endorsement . FE-6999.3 Policyholder Disclosure Notice of Terrorism Inyrance Coverage . . Policy number:97-AA-B135-1 • ; Page 4 of 5 Prepared:May 20,2023 OO Copyright, State Farm Mutual'A4tomobile Insurance Company, 2008 CMP-4000 • c9 7 Statearm • SCHEDULE OF ADDITIONALINTEREST(S)' ,; Interest type: Owners,Lessees, or Contractors"(Schedul Endorsement number: CMP-4684.1 • Loan number: N/A CITY OF ASHLAND 20 E Main St Ashland OR 97520-1814 FULL NAMED INSURED Named Insured: BETTER VIEW LLC DBA FARRELL'S GLASS SERVICE 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. • President . Secretary • • • • • • Policy number:97-AA-B135-1 Page 5 of 5 Prepared:May 20,2023 ©Copyright, State Farm Mutual Automobile Insurance Company, 2008• CMP-4000 State Farm Insurance • PO Box 2915 Bloomington, IL 61702-2915 b StateFarm® State Farm Fire and Casualty Company CITY OF ASHLAND A stock company with home offices in Bloomington, Illinois 20EMAIN ST ASHLAND OR 97520-1814 S • 0 0 E • • • Inland. Marine AttachingDeclarations• Policy number: 97-AA-B135-1 • Effective date: May 3, 2023 Policy period: 12 months Expiration date: June 27,2023 The policy period begins and ends.at 12:01 am standard time at the premises location. • ATTACHING INLAND MARINE 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. • FULL NAMED INSURED ' Named Insured: BETTER VIEW LLC DBA FARRELL'S.GLASS SERVICE • 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 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-AA-B135-1 Page 1 of 1 Prepared:May 20,2023 ' ©Copyright, State Farm Mutual Automobile Insurance Company, 2008 CIM AttDec 3P OR.1 FD-6007 1009481 2002 153089 202 03-06-2021