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HomeMy WebLinkAboutInsurance Certificate: Better View LLC (3) State Farm Insurance U PO Box 291, CG State Farms Bfoomfigtonton,,fL•617.02-29:15 AT1 000310 1200"01 State Farm..Fire and,,Casu7alty Company CITY OF ASHLAND FLEET SERVICES A stock company with home offices in Bloomington, Illinois 90 N•MOUNTAIN AVE • 1.• 'ASHLAND OR 97520-2014 a IIII11rlhIilllhihIII.I!IImIIIIIiiiliiiviilIIhuuliIIIII!!IIIII- - . .. Amended Declarations . :" .� : 1 Policy number:97-AA-B135-1 ' . ,Effective date:July 24, 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 isshown as;12„months, this;policy,willl 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 ' REASONS FOR DECLARATIONS , Your policy is amended effective July 24,2022 due to some recent policy changes you requested. Enclosed is a copy of,your new . endorsements, if any. _ . . ' POLICY PREMIUM . r 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 the policy period and policy characteristics as described in this Declarations. Increase in premium: $1.00 Discounts.applied: ' Business Experience Rating _ Renewal Discount : ' Years in Business Policy number:97-AA-B135-1 Page 1 of 5 Prepared:July 26,2022 ©Copyright, State Farm Mutual,Automobile Insurance Company, 2008 , CMP Dec 3P OR.1 CMP-4000 1009482 2006 153090 206 08.21-2021 001222 • o' fl State Farm' 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 limit due to'Inflation Coverage. SECTION,I-INFLATION COVERAGE INDEX(ES) Coy A-Inflation Coverage Index: N/A Cov B-Consumer Price Index: 281.1 . SECTION I—DEDUCTIBLES. BASIC DEDUCTIBLE $500 SPECIAL DEDUCTIBLES: Employee Dishonesty:, $250 "F ` Equipment Breakdown: ""$500 • Garagekeepers-Collision: $500 Garagekeepers-Comprehensive: $250 Money and Securities:, $250 Other deductibles may apply-refer to policy. `': ;° 'r- SECTIONI—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 correspondinglimit 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 ' 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 onlyto 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-8135.1 '• Page 2 of 5 Prepared:July 26,2022 ©Copyright, State Farm Mutuel Automobile'Irisurance Company,'2008 CMP-4000 u • . ©Q StateFarm® Coverage .Limit of Insurance:. r;. 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) :4 . 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•=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-LIMITOF INSURANCE-PER,POLICY . • 5...., • ,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-B135-1 Page 3 of 5 Prepared:July 26,2022 ©Copyright, State Farm Mutual Automobile,Insurance Company, 2008 CMP-4000 001223 • cQ 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 V . 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 otherforms'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 = - • - • - - V • . •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` •- V - - V ' - • . -• 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-8135-1 •, Page 4 of 5 Prepared:July 26,2022 ©Copyright, State Farm Mutual Autoriiobile Insurance Company,'2008 , GMP-4000 ' u .Q StateFarme *New Form Attached L" SCHEDULE OF ADDITIONAL.INTEREST(S) Interest type: Owners,Lessees,or Contractors(Schedul Endorsement number: CMP-4684.1 Loan number: N/A S CITY OF ASHLAND FLEET SERVICES/FACILITIES MAINTENANCE 90 N Mountain Ave ' o Ashland OR 97520-2014 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-8135-1 Page 5 of 5 Prepared:July 26,2022 ©Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 001224 S90tateN Farm Insurance AVE `J PO Box 2915 Bloomington, IL 61702-2915 090 StateFarme State Farm Fire and Casualty Company CITY OF ASHLAND FLEET SERVICES A stock company with home offices in Bloomington, Illinois M ASHLAND OR 97520-2014 •S O Inland Marine Attaching Declarations • • Policy number: 97-AA-B135-1 Effective date: July 24, 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:July 26,2022 ©Copyright, State Farm Mutual Automobile Insurance Company, 2008 CIM Att Dec 3P OR,1 FD-6007 1009481 2002.153069 202 03-06-2021 • 001225