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HomeMy WebLinkAboutInsurance Certificate: Ashland Food Angels State Farm Insurance . ' u PO Box 2915 'Bloomington, IL 61702-29,15 CFO StateFarme AT1 000660 1200 01 State Farm.Fire and;Casualty Company CITY OF ASHLAND ITS OFFICERS&DA stock company with home offices in Bloomington, Illinois .. 20 E MAIN ST ..: . , ASHLAND OR 97520-1814 ' ' •- . rr . G O . �o 1"0"1'11,"191-10111111111"112111111111,"111'11111,11,111.1111 .. . . ' Renewal Declarations • tii Policy number:97-AA-C018-4 Effective date:July 29,2023 Policy period: 12 months Expiration date:-July 29,2024 . The policy period begins and ends at 12:01 am standard time at the premises location. BUSINESSOWNERSPOLICY . . 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 poIicyperiod If this policy is-terminated,-we will give you and the, __ -- `MortgageelLienholder written notice in compliance with the policy provisions or as required by law. NAMED INSURED ASHLAND FOOD ANGELS - gNTITY . . . . . ._ . Nonprofit . IMPORTANT MESSAGE(S) 0 Notice -Information concerning changes'in your policy language is included.• Please call your agent if you have any questions. ........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 is the 12 months premium(s)for the characteristics of the policy as described in this Declarations. Premium: $440.00 Total Premium: $440.00 - Minimum Premium `. _ Discounts applied: • , • Business Experience Rating . ..Renewal Discount Protective Devices 0 • Years in Business ' Policy number:97-AA-C018-4 Page 1 of 5 Prepared:May 22,2023 ©Copyright, State Farm Mutual Automobile Insurance Company,:2008 CMP Dec 3P OR.1 ' CMP-4000 1009462 2006 153090 206 08-21-2021 : d,StateFarm® SECTION t-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 001 472 WALKER AVE' No Coverage $12,000 25% ASHLAND OR 97520-2324 . *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 INDEX(ES) . Coy A-Inflation Coverage Index: N/A Coy B-Consumer Price.Index: 300.8 SECTION I-DEDUCTIBLES BASIC DEDUCTIBLE $1,000 . SPECIAL DEDUCTIBLES: Equipment Breakdown: $1,000 • 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 hot have acorresponding limit shown below, 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 $5,000 Collapse . , .Included . Damage to Non-owned Buildings from Theft,Burglary or Robbery Coverage B Limit Debris Removal 25%of covered loss Equipment Breakdown. • . ., . . _ Included, . .; .. . . , Fire Department Service Charge $2,500 ' . Fire Extinguisher Systems Recharge Expense $5,000 Forgery or Alteration . $10,000 . Glass Expenses . Included Increased Cost of Construction and Demolition Costs(applies only when buildings are insured on a • 10% replacement cost basis) Money Orders and Counterfeit Money $1,000 Policy number:97-AA-C018-4 Page 2 of 5 Prepared.May 22,2023 • • .©Copyright, State,Farm.Mutual Automobile.Insurance,Company, 2008 CMP-4000 • u • StateFarno • • Coverage , . Limit of insurance !"s- • • ti Money and Securities • On Premises $5,000 - Off Premises " $2;000 — Newly Acquired Business Personal Property(applies only if this policy provides Coverage B-Business $100,000 Personal Property) - • - • co • Newly Acquired or Constructed Buildings(applies only if thispolicy provides Coverage A-Buildings) "$250,000 Ordinance or Law-Equipment Coverage _ ••_ Included . - Outdoor Property. • . • $5,000 V . • - V . • Personal Effects(applies only to those premises provided Coverage B-Business Personal Property)• '$2;500 •' ' Personal Property Off Premises V $15,000 Pollutant Clean Up and Removal _ $10,000 r Preservation of Property 30 days Property of Others(applies only to those premises provided Coverage B-Business Personal .. $2,500.• • • Property) Signs $2,500' ' • ' Valuable Papers and Records On Premises . . $10,000• • ., Off Premises „$5;000 • V Water Damage, Other Liquids,Powder or Molten Material Damage Included' •' V 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 V 12 Months Actual Loss Sustained ' SECTION II-LOCATION SCHEDULE Location Location of described premises ' number 001' 472 WALKER.AVE ASHLAND OR 97520-2324 V V ' • • Policy number:97-AA-C018-4 • Page 3 of 5 Prepared:May 22,2023 ©Copyright, State Farm Mutual Automobile Insurance•Company, 2008 V CMP-4000 • o•StateFarme • SECTION II-LIABILITY ' Coverage Limit of Insurance. , Coverage L-Business Liability Per Occurrence $1,009,000 • - Coverage M-Medical Expenses $5,000 Any One Person • Damage to Premises Rented to You • $300,000 , Aggregate Limits .., Limp of Insurance General Aggregate ` - $2,000,000 , -- Products/Completed Operations Aggregate - " •-- $2,000,000 - Each paid claim for Liability Coverage reduces the amount of insuranrgewe provideduring the applleable,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-4100 Businessowners Coverage Form , ,. * CMP-4237.1 . Amendatory Endorsement(Oregon) • - CMP-4527 Marijuana Exclusion • . . . * CMP.-4561.1 Policy Endorsement' -CMP-4705.2. Loss of Income and Extra Expense •" - • - CMP-4709 . Money and Securities • CMP-4798 - Additional Insured-Grantor of-Franchise - - FD-6007, Inland Marine Attaching'Declarations • ' FE-3650 • Actual Cash Value'Endorsement ' FE-6999.3 Policyholder Disclosure Notice of Terrorism Insurance Coverage ' *New Form Attached SCHEDULE OF ADDITIONAL INTEREST(S) • r. Interest type: Grantor of Franchise Endorsement number: CMP-4798 ... Loan number: N/A , CITY OF ASHLAND ITS OFFICERS&EMPLOYEES 20 E Main St - Ashland OR 97520-1814 - d Policy number:97-AA-C018-4 Page 4 of 5 " Prepared:May 22,2023. ©-.Copyright,,State Farm Mutual A4ltpmobile Insurance Comparny,.2008 CMP-4000 ' u c) State rmo • This policy is issued by the State Farm Fire and Casualty Company. • PARTICIPATING POLICY '4 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. Fs In Witness Whereof, the State Farm Fire and Casualty Company has caused this policy to be signed by its President and Secretary at 0 N Bloomington, Illinois. ,AL`5 • rn. /vr President 0 • Secretary • OTHER MESSAGE(S) , NOTICE TO POLICYHOLDER: • For a comprehensive description of coverage and forms, please refer to your policy. Policy changes requested before the "Date Prepared", which appear on this notice, are effective on the Renewal Date of this policy unless otherwise indicated by a separate endorsement, binder, or amended declarations. Any coverage forms attached to this notice are also effective on the Renewal Date of this policy. Policy changes requested after the "Date Prepared"will be sent to you as an amended declarations oras an endorsement to your policy. Billing for any additional premium for such changes will be mailed at a later date. If, during the past year, you've acquired any valuable property items, made any improvements to insured property, or have any questions about your insurance coverage, contact your State Farm agent. Please keep this with your policy. Your coverage amount.... It is up to you to choose the coverage and limits that meet your needs. We recommend that you purchase a coverage limit equal to the estimated replacement cost of your structure. Replacement cost estimates are available from building contractors and replacement cost appraisers, or, your agent can provide an estimate from Xactware, Inc: using information you provide about your structure. State Farm does not guarantee that any estimate will be the actual future cost to rebuild your structure. Higher limits are available at higher premiums. Lower limits are also available, as long as the amount of coverage meets our underwriting requirements. We encourage you to periodically review your coverages and limits with your agent and to notify us of any changes or additions to your structure. • • • • Policy number:97-AA-C018-4 Page 5 of 5 Prepared:May 22,2023 ©Copyright, State'Farm Mutual Automobile Insurance Company, 2008 CMP-4000 ' State Farm Insurance Li PO Bono p StateFarlfl® Bloomingtton,, IL 61702-2915 State Farm Fire and Casualty Company CITY OF ASHLAND,ITS OFFICERS & . A stock company with home offices in Bloomington, Illinois 20EMAIN ST 'T"'':. ASHLAND OR 97520-1814 ' . O ••0 • • Inland Marine Attaching DeOIaratión.s ... . - , . - • . . Policy number:.97-AA-C018-4 • ' Effective date: July 29, 2023 Policy period: 12 months Expiration date: July 29,2024 . 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 pn 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 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-M-C018-4 Page 1 of 1 Prepared:.May 22,2023 . . ©Copyright„State Farm Mutual Automobile Insurance Company, 2008 • . CIM Att Dec 3P.OR.1 F0-6007 . 1009481 2002 153089 202 03-06-2021