Loading...
HomeMy WebLinkAboutInsurance Certificate: Better View LLC State Farm Insurance PO Box 2915 • ?Bloomington, .112,61702-2915 - CTS ) State Farm' • AT1 000585 1200 01 State Farm Fire,,and•Casualty Company ,rCITY OF ASHLAND FLEET SERVICES A stock company with home offices in Bloomington, Illinois,,,___....:*i 90'N MOUNTAIN AVE > wil ' -ASHLAND'OR 97520-2014'" ' ' ` O �-7 �IIIIi���I�iIIiiiiiiiiiillil,�l.rl�illiiiililiIiiIl�ilhlllI � i'Iiii , . • . Amended Declarations . , „ . Policy number:97-AA-8135-1 Effective date:May 3, 2023 Policy period: 12 months Expiration date:June 27, 2023 • The policy period begins_andends at 12:01 am standard time at the premises location, AUTO SERVICES POLICY Automatic renewal -If the State Farmpolicy.period.is,shown_.as 12=months;lhis policy will,,be:renewed;sutorriatically 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 ; - MortgageelLienholder written,notice in with the policy provisions or as required bylaw . . , NAMED INSURED , . , , 5 . . . BETTER VIEW LLC ENTITY -, . _ -. ', Limited Liability Company REASONS FOR DECLARATIONS , • Your policy is amended effective May 3, 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 the policy period and policy characteristics as described.in this Declarations. Decrease in premium: ($28:00) Discounts applied: .Business Experience Rating - ' Renewal Discount ' Years in Business . Policy number:97-AA-B135-1 ' ' Page 1 of 5 Prepared:May 20,2023 ©Copyright,State Farm:Mutual.Automobile insurance Company;.2008 . CMP Deo 3P OR.1 ` CMP-4000 5 - ' 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-BusinessBusiness 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 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 Piave a corresponding 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 - 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 premise's 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:May 20,2023 ©Copyright, State Farm Mutual•Automobile Insurance Company, 2008 CMP-4000 u. • Coverage Limit of Insurance :" Forgery or Alteration • $10,000' ori 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% -- • N replacement cost basis) Wir 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 tyOff 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 t The coverages and corresponding limits shown below are,the most we will pay regardless of thenumber 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:May 20,2023 ©Copyright, State Farm Mutual.Automobile Insurance,Company,-2008 CMP-4000 c 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 . Otherdeductibles 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 $500000; 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 insurange we provide duringthe applioable.annual period. Please refer to Section II-- Liability Liability in the Coverage Form and any attached endorsements. , Your policy consists of these Declarations,the BUSINESSOWNERS CQVERAGE'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 Contracors(Blanket)'' ' '' ".+ - ' ' °' -''' CMP-4684.1 . . "Additional.Insured Owners,Lessees or.Contractors,(Scheduled) ' CMP-4705.2 Los's 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 Insurance Coverage Policy number:97-AA-B135-1 Page 4 of 5 PreparedMay 20,2023 ©Copyright, State Farm Mutual Automobile Insurance'Company, 2008' CMP-4000 - • C&State Farm SCHEDULE OF ADDITIONAL INTEREST(S) Interest type: Owners,Lessees, or Contractors(Schedul Endorsement number: CMP-4684.1 Loan number: NIA CITY OF ASHLAND FLEET SERVICES/FACILITIES MAINTENANCE 90 N Mountain Ave Ashland OR 97520-2014 G o • 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. ///k e d4,7 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, lL 61702-2915 0°0 State Farm. State Farm Fire and Casualty Company CITY OF ASHLAND FLEET SERVICES A stock company with home.of rices in Bloomington, Illinois p 90 N MOUNTAIN AVE • ASHLAND OR 97520-2014 • • • •2 to • • • • • Inland Marine Attaching Declarations Policy number: 97-AA-B135-1 Effective date: May 3, 2023 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:May 20,2023 ©Copyright, State Farm Mutual Automobile Insurance Company, 2008 CIM Att Dec 3P OR.1 . FD-6007 V 1009481.'2002 153089 202 03-06-2021