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HomeMy WebLinkAboutInsurance Certificate: Better View LLC State Farm Insurance U PO Box 2915 Bloomington, IL 61702=2915 O State I a arm AT2 000677 1200 01 State Farm.Fire and,Casualty Company CITY OF ASHLAND A stock company with home offices in Bldomington,'Illinbis gfi20EMAIN ST • , ASHLAND'OR 97520-1814 , lIIIIull� llnl!��IIlIiIiliIillllniIIiIillliuIiiiIiiIuiIrl .�1-...coo • _ Renewal Declarations :: . r, w .. _ Policy number:97-AA-B135-1 Effective date:June 27, 2022 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 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 BETTER VIEW LLC ENTITY .. - . _. . . _ _ ._ . . .- Limited Liability Company - - IMPORTANT MESSAGE(S) 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: $2,570.00 . _ . Total Premium: $2,570.00 • , , Discounts applied: J , Business Experience Rating Renewal Discount Years in Business Policy number:97-AA-8135-1 Page 1 of,5 Prepared:April 19,2022 ©Copyright, State Farm Mutual Automobile Insurance Company,,2008 CMP Dec 3P OR.1 CMP-4000 1009482 2005 153090 205 08-21-2021 002845 . o o 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 $78,000 25% Medford OR 97501-3118 *As of the effective date of this policy, the Limit of Insurance as shown includes anyincrease 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: 281.1 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. .; .i ,; '• ' -. SECTION I.,EXTENSIONS OF COVERAGE-LIMITOF I(<I URANCE-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 a corresponding limit shouun 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 ' 0 . • • • $5,000 '' ' 0 ' • ' ' Back-up of Sewer or Drain • ,- - .... .... .. $15,000. ... 'hr'...4 Collapse - - Included, Damage to Non-owned Buildings from Theft,Burglary or Robbery ' Coverage IS Limit ; Debris Removal 25%of covered loss . o 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 Polioy number:97-AA-8135-1 Page 2 of 5 Prepared:April 19,2022 ©Copyright, State Farm Mutual Automobile Insurance Company, 2008 ' CMP-4000 . U •&StateFarm Coverage Limit of insurance , , 4,. •,n , Forgery or Alteration $10,000•. . , .. Garagekeepers Insurance-Direct Coverage -- . $25,000 • • - Glass Expenses - included • 1 Increased Cost of Construction and Demolition Costs(applies only when buildings are insured on a 10% -. o replacement cost basis) Money Orders and Counterfeit Money $1,000 Money and Securities • . , . . On Premises $10,000 , i ; ' 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 . . 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 , 1 . • SECTION I—EXTENSIONS OF COVERAGE-LIMIT OF INSURANCE-PER POLICY The coverages and corresponding limits shown beloware the'most we will pay regardless of the lumber 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:April 19,2022 ©Copyright, State,Farm Mutual Automobile Insurance Compahy, 2008 •. CMP-4000 • , 002846 • ' 096 StateFarm® 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 , CoverageLimit 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 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 Businessowners Coverage Form • - • CMP-4237.1 Amendatory Endorsement(Oregon) • • • -• CMP-4412-• Operation.of•Customers'•Auto-on•ParticularPremises • - • . .., . •- . . -.. - _ .-:....-- . CMP-4527 Marijuana Exclusion :. ' ,•• 0 , . - ' • . ' CMP-4543 - •Additional Insured-Designated Person or Organization - - - , - . CMP-4561.1 Policy Endorsement CMP-4683.1 Additional Insured-Owners,Lessees or Confractors(Blanket)" .•• = CMP-4684.1 . . Additional Insured-Owners,Lessees or,Contractors(Scheduled)• . 1 . , 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-4787 Waiver of Transfer of Rights of Recovery Against Others To Us • , . - • 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 Insurance Coverage • . Policy number:97-AA-B135-1 Page 4 of 5 Prepared:April 19,2022 . ©Copyright;State Farm Mutual Autbrnobile Insurance Company, 2008 • CMP-4000 ' . . Li o StateFarme • SCHEDULE OF ADDITIONAL INTEREST(S) IN 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 O O i o FULL NAMED INSURED Named Insured: BETTER VIEW LLC DBA FARRELL'S GLASS SERVICE This policyis 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. *frt44.011:}10,444 . President ' ' Secretary OTHER MESSAGE(S) 0 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 or as an endorsement to your policy. Billing for any additional premium for such changes will be mailed at dieter date. If,.during the past year,..you've..acquired..any.valuable.property items,.madeany..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-B135-1 Page 5 of 5 Prepared:April 19,2022 ©Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 ' 002847 State Farm Insurance• u Bon o Bloomington, IL 61702-2915 • CO StatGeFarnr State Farm.Fire and Casualty Company CITY OF ASHLAND A stock company with home offices in Bloomington, Illinois 20EMAIN ST ASHLAND OR 97520-1814 o , 0 O p t 0 1,7,E • • Inland Marine Attaching Declarations Policy number: 97-AA-B135-1 Effective date: June 27,2022 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:April 19,2022 ©Copyright, State Farm Mutual Automobile Insurance Compahy, 2008 CIM Att Dec 3P OR.1 • FD-6007 • 1009481 2002 153089 202 03-05-2021 002848 CMP-4684.1 Page 1 of THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 7mh., ADDITIONAL INSURED—OWNERS, LESSEES, OR CONTRACTORS (Scheduled) This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM Cr)Lr) SCHEDULE Policy Number: 97-AA-B135-1 Named Insured: BETTER VIEW LLC DBA FARRELL'S GLASS SERVICE Name And Address Of Additional Insured Person Or Organization: . CITY OF ASHLAND 20 E Main St Ashland OR 97520-1814 1. SECTION II —WHO IS AN.INSURED of SECTION II - • LIABILITY is amended to include,.as an additional insured, any person or organization shown in the Schedule, but only: a. Ongoing Operations , Withrespect to liability for "bodily injury", "property damage", or "personal and advertising injury" caused by,your ongoing operations for that. additional insured and only to the•extent that such "bodily injury", "property damage" or"personal and advertising injury" is caused by your negligence or the negligence of those performing-operations on your behalf; or b. Products-Completed Operations . To the extent that the liability for "bodily injury" or"property damage" is caused by "your work" performed for that additional insuredand included in the"products-completed operations hazard", 2. Any insurance provided to the additional insured shall only apply with respect to a claim made or a"suit" brought for damages for which you are provided coverage. 3. Primary Insurance, The insurance afforded the additional insured shall be primary insurance. Any insurance carried by the additional insured shall be noncontributory with respect to coverage provided by you. All other policy provisions apply. CMP-4684.1 ©, Copyright, State Farm Mutual•Automobile Insurance Company, 2016 Includes copyrightedmaterial of Insurance Services Office, Inc.,with Its permission. • 002849 `