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HomeMy WebLinkAboutAmended Insurance Certificate: Better View LLC (3) State Farm Insurance PO Box 2915 }Bloomington, IL.61702-29.15 ( .0 State Farm. ATI 000608 1200 01 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 IrllIlrhI,Iili1Ill'fllnriil1liIIiIIull1Il1i1'11111IIiiiiliiili coo Amended Declarations Policy number:97-AA-8135-1 Effective date:June 27,2023 Policy period: 12 months Expiration date:June 27,2024 - • 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°polioy,p..eriod.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 Jaw. • NAMED INSURED . BETTER VIEW LLC ENTITY ,.. .. .. .�. _ .. . . ... . . . . , .. ,-". . .. Limited Liability Company . REASONS FOR DECLARATIONS Your policy is amended effective June 27,: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, then'a separate statement will be sent prior to the due date. The premium(s)shown below are for thepolicy period and policy characteristics as described in this Declarations.. Decrease in premium: ($252:00) Discounts applied: - " . Business Experience"Rating '. . . Renewal Discount Years in Business Policy number:97-AA-8135-1 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: StateFarm® SECTION I.PROPERTY SCHEDULE - , • Location Location of described premises- ' Limit of Insurance* Limit of Insurance* Seasonal Increase number Coverage A• Coverage B•Business Business Personal Property • Buildings Personal Property 002 204 S Fir St No Coverage $82,300 25% Medford OR 97501-3118 *As of the effective date of this policy, the Limit of Insurance as shown includes'any increase iri the`liMit due to Inflation Coverage. SECTION I—INFLATION COVERAGE INDEX(ES) Coy A-Inflation Coverage Index: N/A Coy B-Consumer Price Index: 299.2 • SECTION I—DEDUCTIBLES BASIC DEDUCTIBLE $500 SPECIAL DEDUCTIBLES: Employee Dishonesty: $250 ' Equipment Breakdown: '$500 • Garagekeepers-Collision: $500 ' • Garagekeepers-Comprehensive: ' $250 • Money and Securities: $250 • Other deductibles may apply-refer to policy. • . # 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 icorresponding'limit shown 1561OW:but has 'Included" indicated, refer •to that policy provision for an explanation of that coverage. Coverage Limit of Insurance Accounts Receivable On Premises. • $10,000 Off Premises $5,000 ' ' • Arson Reward l $5 000 Back-up of Sewer or Drain $15,000 • Collapse Included Damage to Non-owned Buildings from Theft,Burglary or Robbery Coverage.BLimit 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 • Fire Department Service Charge $5,000 Fire Extinguisher Systems Recharge Expense ' $5,000 • Policy number:97-AA-B135-1 . Page 2 of 5 Prepared:May 20,2023 ©Copyright, State.Farm Mutual Automobile Insurance Company, 2008' CMP-4000 u 00$tateFErm® Coverage Limit of lnsaance•'•.,.,.;'`'•:,' •. !,:*: '.... ,., • Lµµ;.�; Forgery or Alteration -1.,$10,000., .. . Garagekeepers Insurance-Direct Coverage $25,000 Glass Expenses Included , S . — gog Increased Cost of Construction and Demolition Costs(applies only when buildings are insured on a 10% I-o replacement cost basis) +r:1;i:.:I, , Money Orders and Counterfeit Money $1,000 , Money and Securities • - , . On Premises $10,000 `' 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(applie§only'to those prefnises provided Coverage B-Business Personal Property), "$2,500' . 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 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 . SECTION I—EXTENSIONS OF.COVERAGE-LIMIT OF INSURANCE•PER POLICY,". The coverages and corresponding limits shown below'ar '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-M-8135-1 ' , • Page 3 of 5 Prepared:May 20,2023 ©Copyright, State Farm Mutual-Automobile Insurance Company, 2008 • CMP-4000 • Q StateFarme 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,Q00 . 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 f $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 Il— 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-41'00 Businessowners Coverage Form - _ _ CMP-4237.1 Amendatory Endorsement(Oregon) , CMP-4412 Operation of Customers Auto on ParticularPremisaes, . - ,. _ 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)' ' • ' - ' ' ,','.' - ' CMP-4684.1 Additional Insured-,Owners,Lessees or Contrsetors(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 Insgrance Coverage - - *New Form Attached . Policy number:97-AA-B135-1 , • Page 4 of 5 Prepared:May 20,2023 ©Copyright, State Farm,MutualAutomobile Insurance Company, 2008 CMP-4000 ' u StaiteFarm SCHEDULE OF ADDITIONAL INTEREST(S) ' • • ;' Interest type: Owners,Lessees, or Contractors(Schedul Endorsement number: CMP-4684.1 Loan number: NIA CITY OF ASHLAND 20 E Main St Ashland OR 97520-1814 ‘7, 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 • CJ9'C7 StateFarme • State Farm Fire and Casualty Company CITY OF ASHLAND A stock company with home offices in Bloomington, Illinois SI.-:1 20 E MAIN ST •Y' - ASHLAND OR 97520-1814 . , 8 ' O Inland Marine Attaching Declarations . . . . . • . . . , . . Policy number: 97-AA-B135-1 ' Effective date: June 27, 2023 Policy period: 12 months Expiration date: June 27, 2024 , 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 Omits ., . 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-8135-1 Page 1 of 1 Prepared:May 20,2023 ' ©Copyright, State Farm Mutual Automobile Insurance Company, 2008 ' CIM Att Dec 3P OR.1 , FD-6007 1009481 2002 153089 202 03-06-2021