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HomeMy WebLinkAboutInsurance Certificate: Better View LLC (2) State Farm Insurance U PC Box 2915 CPC)StatteFar e Bloomington; IL 61702-2915 AT2 000678 1200 01 State Farm.Flre.and Casualty Company •, CITY OF ASHLAND FLEET SERVICES A stock company with home offices in`Bloofriington, Illinois 90 N MOUNTAIN AVE = ASHLAND OR '97520-2014' g I'VIII'IlllltllrlliilrrlIIIIIIIII'IIIIj'lllllII'1I'IIIIIl1l"IIII Renewal 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. • AUTO SERVICES POLICY Automatic renewal -If the State Farm policy period is shown as 12,months, this policy;will<be-renewed automatically subject•tothe - - 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 a • s 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./fan amount is due,then a separate statementwilt be sent prior to the due date. The'premium(s)shown below'is the 12 months premiums)for the characteristics of the policy as described in this Declarations. Premium: $2,570.00 • Total Premium: $2,570.00 . Discounts applied; 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, 002850 &StateFarm oe 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 any increase in the litnit due fo Inflation'Coverage. • SECTION.I—INFLATIONCOVERAGE 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. 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 a corresponding limit shown below, but has"Included" indicated, refer to that policy provision for an explanation of that coverage. ::' u., .! : • Coverage ' •Limit of Insurance • , • Accounts Receivable r ' 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 •' • • • . $500 Equipment BreakdownIncluded Fire Department Service Charge $5,000 • Fire Extinguisher Systems Recharge Expense • $5,000 Policy number:97-AA-8135-1 Page 2 of 5'' Prepared:April 19,2022 ' ' ©Copyright, State Farm'Mutual Automobile Insurance Company;'2008 ' CMP-4000 ' • Ll . . • I - o Statefarmo Coverage Limit of Insurance,-.-. '• '- ', . -,! ,' •i - rti Forgery or Alteration • :•$10,000 • • • Garagekeepers Insurance-Direct Coverage •. $25,000 ' _ •. Glass Expenses Included S eg Increased Cost of Construction and Demolition Costs(applies only when buildings are insured on a 10% -. - - - - . "- o replacement cost basis) 1 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(applies only to those premises provided Coverage B=BusinessPersonal 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 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'lncome and Extra Expense . ' , • ' . '- 12'Months Actual Loss Sustained . • • • • • Policy number:97-AA-B135-1 Page 3 of;5 Prepared:April 19,2022 ©Copyright,.State Frm Mutual Automobile Insurance Company, 2008 CMP-4000 002851 • • • • ocb 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 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 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-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) ' . CMP-4684.1 ' Additional-Insured-Owners,Lessees or Contractors(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-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-B135-1Page 4 of 5 Prepared:April 19,2022 ©Copyright;-State Farm Mutual-Automobile Insurance'Cornpany, 2008 • ' CMP-4000 • u • • • • Q0 State Farm • SCHEDULE OF ADDITIONALINTEREST(S) • ,`551-y, ` Interest type: Owners,Lessees,or Contractors.(Schedul Endorsement number: CMP-4684.1 • • Loan number: N/A CITY OF ASHLAND FLEET SERVICES/FACILITIES MAINTENANCE 90 N Mountain Ave g Ashland OR 97520-2014 O • c 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. frit L. • m.. • President 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 or as 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 areavailable 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 Compahy, 2008 CMP-4000 002852 • State Farm Insurance Li PO Box 2915 State Bloomington, IL 61702-2915 CFO State Farm® State Farm Fire and Casualty Company CITY OF ASHLAND FLEET SERVICES A stock company with home offices in Bloomington, Illinois 90 N MOUNTAIN AVE }• ` ASHLAND OR 97520-2014 C I(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-8135-1 Page 1 of 1 Prepared:April 19,2022 ©Copyright, State Farm Mutual Automobile Insurance Company, 2006 CIM Att Dec 3P OR.1 FD-6007 1009431 2002 153069 202 03.06-2021 002853 ' u CMP-4684.1 Page 1 of 1 THIS.ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. � f. '� ' ADDITIONAL INSURED —OWNERS, LESSEES, OR CONTRACTORS(Scheduled) This endorsement modifies insurance provided under the following: 528 BUSINESSOWNERS COVERAGE FORM , yo 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 FLEET SERVICES/FACILITIES MAINTENANCE 90 N Mountain Ave Ashland OR 97520-2014 V 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 - - With respect 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 insured and 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 providedby you. All other policy provisions apply. CMP-4684.1 ©, Copyright, State Farm Mutual Automobile Insurance Company, 2018 ' Includes copyrighted material of Insurance Services Office, Inc.,with its permission. 002854 '