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HomeMy WebLinkAboutAmended Insurance Certificate: Kencairn Landscape Architecture State Farm at CityLine U. PO Box 853925 , Richardson, TX 75085-3925 , 090 State Farina AT2 000923 1200 01 _ State Farm Fire and Casualty Company 4.0 CITY OF ASHLAND A stock company with homeioffices"in`Bloomington, Illinois ATTN: TAMI DEMILLE-CAMPOS •20 E.MAIN ST ' ASHLAND OR 97520-1814 g . .. .. i iIIlliI0il1liliillri1li111111ulllrir'I'Illll'I'1111111llll 10 0. Amended Declarations . . ., . ': - H , - - : -,: ' " , " ,,,;:„...,(,,-.„:„ ,i,,,,,,,,H7;. , , . ,. , , J Policy number: 97-AA-G018-8 Effective date: March 1, 2021 Policy period: 12 months Expiration date: October 29, 2021 -' ' - ' The policy period begins and ends at 12:01 am standard,time at the premises location. . OFFICE POLICY Automatic renewal If the State Farm°:policy,per io.d ssliowni as 12_months,,this policy,will be renewe.d 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 coinpliance'with the policy provisions or as required by law: ' NAMED INSURED . _ ' KENCAIRN LANDSCAPE ARCHITECTUR 545 AST STE.3 . . _ _ . . _ .� . . . ASHLAND OR 97520-2051 • ENTITY Limited Liability Company REASONS FOR DECLARATIONS - ' Your policy is amended effective March 1, 2021 due to some recent policy changes you requested: Enclosed is a copy of your new endorsements, if any. ' , POLICY PREMIUM , . This is not shill.lf an amount is due, then a separate statement will be sent prior to the due date. Pie preinium(s)shown below is the 12 months ' premium(s)for the characteristics of the policy as described in this Declarations. ..: Total Premium:$373:00 . . ' Minimum Premium Discounts applied: - , Business Experience Rating . ,' ' 'Renewal Discount .' ' -Yearsin Business - - Business in Residence Premises . ., . Policy Number:97-AA-G018-8 : Page 1 of 5 Prepared:February 10,2021 ©Copyright,State.Farm.Mutual Automobile Insurance Company,2008 ' CMP Dec 3P OR 1009462 2002 153090 202 12-05-2020 CMP-4000 004163 . ,; • • 0°0StateFari • 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 Building Personal Property 002 147 Central Ave No Coverage $31;600 25% Ashland OR 97520-1714 *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: 260.5 SECTION I-DEDUCTIBLES • BASIC DEDUCTIBLE $1,000, SPECIAL DEDUCTIBLES: Employee Dishonesty: Equipment Breakdown: . $1,000 Money and Securities: $250 Other deductibles may apply-refer to policy. .;r 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. r ,: .:.; . ,,:':., ; Coverage Limit of Insurance Accounts Receivable • 1 On Premises $50,000 Off Premises $15,000 • Arson Reward $5,000 • • - Back=up of Sewer pr Drain $T5,000 Collapse Included Damage to Non-owned Buildings from Theft,Burglary or Robbery Coverage B Limit H4. Debris Removal "" 25%;of covered loss Equipment Breakdown Included • Fire Department Service Charge • $5,000 Fire Extinguisher Systems Recharge Expense $5,000 Forgery or'Alteration $10,000 • Glass Expenses Included . Policy Number:97-AA-G018-8 Page 2 of 5 Prepared:February 10,2021 ©Copyright',State Farm Mutual Automobile Insurance Company,2008 ' CMP-4000 u ao StateFartn® Coverage • . Limit of Insurance "ti "' ` 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 ' Money and Securities CO o 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) $5;000 Personal Property Off Premises $15,000 Pollutant Clean Up and Removal $10,000 . Preservation of Property • 30 days Property of Others(applies only to those premises provided Coverage B-Business Personal Property). •$2,500 "- • ' • • Signs $2,500 • Unauthorized Business Card Use $5,000 Valuable Papers and Records On Premises $50,000 • Off Premises 0. • $15;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'flagrance • Dependent Property-Loss of Income $5,000 Employee Dishonestya $10,000 ., ,, • . Loss of Income and Extra Expense• 12 Months Actual Loss Sustained Utility Interruption-Loss of Income . . . $10,000 . Policy Number:97-AA-6018-8 • 0 Page 3 of 5 Prepared:February 10,2021 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 - • , CMP-4000 . 004164 • • 0 State Farm SECTION II-LOCATION SCHEDULE, ," Location Location of described premises . . . number • • 002 147.Central Ave , •• Ashland OR 97520=1714 ' SECTION II-LIABILITY - - . Coverage , Limit of Insurance , Coverage L-Business Liability Per Occurrence. $2;000,000,, ;. , ,, , Coverage M-Medical Expenses; ,. . , .. . . $10,000.Any One Person , ` Damage.to.Premises Rented to You : • . $300,000, , Aggregate Limits , , . Limit of Insurance Products/Completed Operations Liability-Annual Aggregate • , , .Excluded- ,. , General Aggregate $4,000,000 Each paid claim for.Liability Coverage reduces the amount of insurance we provide during the applicable annual period. Please refer to Section'll- . 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-4683.1 Additional Insured-Owners,Lessees or Contractors,(Blanket) . . . . -CMP-4684.1 Additional Insured-Owners,Lessees or Contractors(Scheduled) CMP-4703.1 Utility Interruption-Loss of Income -. • " CMP-4704.1. Dependent Property-Loss of Income - CMP-4705.2 -•Loss.of Income and Extra Expense.- •- •-- - --• • - . ..... -• CMP-4706 Back-up of Sewer or Drain ,!_s, ,,,i , ,. .-„ , :,r. . , :.t Iii' )1-; • CMP-4709 . Money and Securities • CMP-4710 19':1s Employee Dishonesty. , , Unauthorized Business Card Use ', CMP-4845 Exclusion=Products=Completed Operations Hazard • . . . ' FD-6007 Inland Marine Attaching.Declarations . • _ ' . FE-3650 Actual Cash'ValueEndorsement - FE-6999:2 ' Policyholder Disclosure Notice of Terrorism Insurance Coverage' ' - " ' SCHEDULE OF ADDITIONAL INTEREST(S) " Interest type: Owners,Lessees,or Contractors(Schedul' Endorsement number CMP-4684.1 , Loan number: N/A CITY OF ASHLAND .,_., _. , 20EMain St Ashland OR 97520-1814 . Policy Number:97-AA-G018-8 S Page 4`of5 Prepared:February 10,2021 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 • CMP-4000 u . Q c State Farina ,.., FULL NAMED INSURED Named Insured: KENCAIRN LANDSCAPE ARCHITECTURE LLC This policy is issued by the State Farm Fire and Casualty Company. 6 PARTICIPATING POLICY too 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 policyto be signed by its President and Secretary at Bloomington, Illinois. /vr e d eY►�,.. President Secretary Policy Number 97-AA-G018-8 Page 5 of 5 Prepared:February 10,2021 @ Copyright,State Farm Mutual Automobile•Insurance Company,2008 CMP-4000 004165 State Farm at CityLine Li PO Box 853925 - Richardson,.TX 75085-3925 CO ' Q90 StateFarmo State Farm Fire and Casualty Company CITY OF ASHLAND A stock company with home offices'in Bloomington, Illinois ATTN: TAMI DEMILLE-CAMPOS 20 E MAI N ST ASHLAND OR 97520-1814 S co 0 Inland Marine Attaching Declarations Policy number: 97-AA-G018-8 Effective date: March 1; 2021 Policy.period: 12 months Expiration date:October 29, 2021 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 MortgageelLienholder written notice in compliance with the policy provisions or as required bylaw. Annual policy premium: Included The above premium amount is included in the Policy, Premium shown on the Declarations, FULL NAMED INSURED 'Named Insured: KENCAIRN LANDSCAPE ARCHITECTURE LLC _ 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 thispolicy. FORMS,OPTIONS AND ENDORSEMENTS FE-6867 Inland Marine 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 Policy Number:97-AA-G018-8 Page 1.of 2 Prepared:February 10,2021 . •©Copyright,State FarmMutual Automobile Insurance Company,2008 . , CIM Att Dec 3P OR 1009481 2001 153089 201 12-04-2018 FD-6007 004166 • StateFarme Other limits and exclusions may apply-refer to your policy, • • • • , • • Policy Number 97-AA-G018-8Page 2 of 2 Prepared:February 10,2021 CO Copyright,State Farm Mutual Automobile Insurance Company,2008 FD-6007 u CMP-4684.1 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY: PLEASE READ IT CAREFULLY. r.. 1 • !" ADDITIONAL INSURED—OWNERS, LESSEES, OR CONTRACTORS(Scheduled) . . This endorsement modifies insuranceprovided under the followings § BUSINESSOWNERS COVERAGE FORM SCHEDULE Policy Number: 97-AA-G018-8 Named Insured: KENCAIRN LANDSCAPE ARCHITECTURE LLC ATTN; TAMI DEMILLE-CAMPOS 20 E Main St Ashland OR:97520-1814 Name And Address Of Additional Insured.Person Or Organization: CITY OF ASHLAND ATTN; TAMI DEMILLE-CAMPOS 20EMain 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 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 lby"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 provided by you. • All other policy provisions apply, , CMP-4684.1. 155042 03-20-2019 ©, Copyright, State Farm'Mutual Automobile Insurance'Company, 2018. Includes'copyrighted material of Insurance Services Office, Inc.,with its permission. • 004167 • . . .ry1 Vit,. . i k .. .. >S. { ..... .., . A ,- �.: ' . .. ___. ._._ .., ......_ ..._:_:. _.. .. t,