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HomeMy WebLinkAboutInsurance Certificate: Better View LLC DBA Farrellls State Farm at CityLine 'J ' PO Box 853925 Richardson, TX 75085-3925 Q State Lean® • . AT2 001025 1200 01 State Farm Fire and Casualty Company CITY OF ASHLAND A stock company with home offices in Bloomington, Illinois. ' .. . 20 E MAIN ST • } ASHLAND OR 97520-1 81 4 S • 0 ; ill1n1ili11Illnlili1nl1illllii1111111111111'Iii111111ulllllull - vi 0 . Renewal Declaration . . s ' . . , . ;2- ... ...n.. -,... .: :., :-. „ Policy number: 97-AA-B135-1 • Effective date:June 27, 2021 Policy period: 12 months Expiration date: June 27, 2022 . 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 MortgageelLienholder written notice in-complianbe with-'the policy provisions-br as required'by law: --''-- r4 = -- NAMED INSURED , ' ' ' BETTER VIEW LLC DBA FARRELL'S ' . . , . . . , . . . 229 S FRONT ST MEDFORD OR 97501-7263 ENTITY - ' • Limited Liability Company . - . ' IMPORTANT MESSAGE(S) . ' . . ... ..-.. Notice --Information concerning changes in your policy language-is included,-Please call your agent if youhave 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. . Total Premium: $3,740.00 - . Discounts applied: . . .. . • .. . Business Experience Rating Renewal-Discount ' ' Protective Devices Years in Business • Policy Number:97-AA-B135-1 . . , • . Page 1 of 5 Prepared:April 30,2021 ©Copyright,State Farm Mutual Automobile,Insurance Company,2008 . - . CMP Dec 3P OR.1 1009462 2003 153090 203 03-06-2021 ' CMP-4000 004424 • • o Sta .F rnr • SECTION I-PROPERTY SCHEDULE • • • Location Location of described premises Limit of Insurance* Limit of Insurance* , ' ' ' -Seasonal,increase- number CoverageiA- Coverage,B-Business Business Personal Property Building Personal Property • 001 229 S FRONT ST $606,200 , $77.,800 • . •.25% ., MEDFORD OR 97501-7263 *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 COVERAQf~INpRX(ES) Cov A-Inflation Coverage Index: 192.9. . •Coy B-Consumer Price Index: 263 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 COV R,AtiI LIMIT OF INSURANCE-EACH DESCRIBED PREMISES • , , The coverages and corresponding limits shown below apply separately to each described premises shown in these Declarations,-., ,E-.„. V V 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. • - Coverage Limit of Insurance . V . Accounts Receivable `r On Premises $10,000 • . • • Off Premises . $5;000 _• , 7;! ,r;;'.. Arson Reward . _....... ....... . .._..: y ...-. . .... : $5,000..; _... . ..... Back-up of Sewer or Drain $15,000 •• ; , ' Collapse • V.• - 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 Employee • • $500 V Per Occurrence $2,500 • Equipment Breakdown . . Included • .Policy Number:97-AA-B135-1Page'2 of 5 • Prepared:April 30,2021 ©Copyright,State FarmMutual Automobile Insurance Company,2008 - CMP-4000 L • 090 State Farm'. Coverage Limit of Insurance' ' ' . • Fire Department Service Charge $5,000' Fire Extinguisher Systems Recharge Expense $5,000 • • Forgery or Alteration $10,000 . , Garagekeepers Insurance-Direct Coverage $25,000 (0 0 Glass Expenses Included 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 . 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 Property) $2,500 • . • Signs $5,000 f Valuable Papers and Records On Premises 110,000' .. . .. .. ' , 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 Income and Extra'Expense 12 Months,Actual Loss'Sustained Policy Number:97-AA-B135-1 • - Page 3 of 5, Prepared:April 30,2021 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP-4000 ' 004425 . 00 State arm SECTION II-LOCATION SCHEDULE Location ' Location of described premises . , 0• , number . - .. `. 001 229 S FRONT ST - ' MEDFORD OR 97501-7263 ' • 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 - $300,000 - Garage Liability Included in Coverage L . • , . Operation of Customers'Auto on Particular Premises Included , , Aggregate Limits : - Limit of Insurance - Products/Completed Operations Aggregate $2,000,000 - General 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-4788 - Additional Insured-Managers or Lessors of Premises CMP-4827.1 Employee Tool Coverage ' ' ' FD-6007 Inland Marine Attaching Declarations FE-3650 Actual Cash Value`Endorsement' Policy Number:97-AA-B135-1 Page 4 of 5 Prepared:April 30,2021 ©Copyright,State Farm Mutual'Automobile'Insurance Company;2008 CMP-4000 6 StateFarrn® * FE-6999.3 Policyholder Disclosure Notice of Terrorism Insurance Coverage *New Form Attached •SCHEDULE OF ADDITIONAL'INTEREST(S) Interest type: Owners,Lessees,or Contractors(Schedul • Endorsement number: CMP-4684.1 S Loan number: . N/A CITY OF ASHLAND c0 20EMain St Ashland OR 97520-1814 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. ,wL _ m President Secretary 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 toyou 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 toinsured property, or have..any.. -. - questions about your insurance coverage, contact yourState 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 30,2021 .©Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP-4000 004426