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HomeMy WebLinkAboutInsurance Certificate: Jeremy Maneker State Farm Insurance ,P0 Box 2915 - • Bloomington, IL 61702-2915 090 StateFarm® All 000782 1200 01 State Farm Fire and:Casualty Company CITY OF ASHLAND THE CITY OF AS _ A stock company with home offices in Bloomington, Illinois 20 E MAIN ST ASHLAND OR 97520-1814 .• , illiklidp11111w1111111111111111111111111111411111111111 • ,._ 0)0 ,c:c; 'P P ' • ;14( Renewal Declarations Policy number:97-CR-B526-0 Effective date September 9, 2023 ; • . Policy period: 12 months Expiration date:September 9, 2024 • The policy period begins and ends at 12:01 am standard time at the premises location. AUTO SERVICES POLICY Automatic renewal -If the State Firmo',Poliby Period is,ehaWn'as 12 riiiintl* this policy will beTaneWed automatically subject•totthe premiums, rules and forms in effect for each succeeding policy peripd. If this policy is terminated,.we will give you and the Morrgagee/LienholderWritten notice in.cOm-plianCe with the policy proVisions o1.ás required by,1a . NAMED INSURED JEREMY MANEKER • ENTITY Sole Proprietorship-Individual 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.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. i Premium: $3,229.00 Total Premium: $3,229.00 Discounts applied: . . - f Business Experience Rating Renewal Discount Protective Devices Years in BUsiness • - I • Policy number:97-CR-B526-0 , Page 1 of 6 Prepared:July 2,2023 ©'Copy'right, State Farm Mutual Automobileinsurance'CoMpany, 2008 CMP Dec 3P OR 1 CMP-4000 1009482 2006 153090 206 08-21-2021 • . , . . . . C -StOtelFarm. ;SECTION I-PROPERTY SCHEDULE .,,:•.' ", , 'Location •Location of described premises '' ' Limit of Insurance* Limit of Insurance* -' ' SeasonalIncreaie'- number Coverage A• Coverage p-Business Business Personal Property Buildings Personal Property 001 2001 NE Foothill Blvd Ste E4 No Coverage $234,300 25% Grants Pass OR 97526-4240 . *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: 303.4 . . ` SECTION I-DEDUCTIBLES , . . BASIC DEDUCTIBLE ' $1,000 ' SPECIAL DEDUCTIBLES: Employee Dishonesty: - . . $250 :.' r ') ' , ' Equipment Breakdown: ', -- ,$1,000 '. ,-, ,, -- , Garagekeepers-Collision: $500 Garagekeepers-Comprehensive: $250 Money,and Securities: $250 Other deductibles may apply-refer to policy, 'Ji: , SECTION 1,7 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, . Coverage Limit of Insurance , . . • ,. . Accounts Receivable , , . . ' On Premises $10,000 , '• • . Off Premises $5,00.0 • y,-.7,, .. s .'' : •',,.q:-.-,, Arson Reward • ' ,••• '..• . - ' 2 ', ,$5,000 : ' -, - • - , ' — ,-, Back-up of Sewer or Drain si6Agoo '„,..••. -.,, ,, . , ,-- Collapse, ' ' •- :. • '' ' •.- ' ' . . Included-,-, . ,..•, . • , , Damage to Non owned Buildings from Theft,Burglary or Robbery Coverage B Limit Debris Removal , 25%pf covered loss . , , • • ,. Employee Tools(applies only to those premises provided Coverage B-Busino$s Personal Property) - , _ - Per Occurrence $500 ,,,-- Equipment Breakdown • Inclu,cled •, , 7- . Fire Department Service Charge • $5,000 ' • Fire Extinguisher Systems Recharge Expense $5,0Q0 ,, .._ . . — ........:. . , Policy number:97-CR-B526-0 Page 2 of 6 Prepared:July 2,2023 , ©Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 , , ', StateFarm. I Coverage Limit of Insurance pForgery or Alteration l $10,000 Garagekeepers Insurance-Direct Coverage I , $25,000 - Glass Expenses - • ' .I Included • Increased Cost of Construction and Demolition Costs(applies only when buildings are insuredlon a 10% replacement cost basis) I " -Li:4 c ;.! Money Orders and Counterfeit Money $1,000 Money and Securities , I On Premises $10,000 Off Premises, . ... _ . -_ , . . _$5,000. _. - Newly Acquired Business Personal Property(applies only if this policyprovides.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 ,I; { Included . Outdoor Property 1 $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;'. ,...$100,000 •"' Property) , , Signs •, i $5,000 : • Valuable Papers and Records On Premises . i ,. . $10,000 , " Off Premises ' :1 „ . $5,000 �.:�:,:�. �.�. , " - •.,..: --, Water Damage, Other Liquids,Powder or Molten Material Damage Included . , SECTION I—EXTENSIONS OF COVERAGE-LIMIT OF INSURANCE-PER POLICY s' 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 h Limit of Insurance Employee Dishonesty i ' $10,000 Loss of Income and Extra Expense 12 Months Actual Loss Sustained . Policy number:97-CR-B526-0 j, Page 3 of 6 Prepared:July 2,2023 '©Copyright;State.Farm Mutual Automobile Insurance'Compan '2008 . CMP-4000 ' 090 State Farm'. . ,. . , • . • SECTION II-LOCATION SCHEDULE • Location Location of described,premises . .. _ ... . . . . . 001 . 2001 NE Foothill Blvd Ste E4 • , ,_ . . - - . . . , Grants Pass OR 97525-4240 ' • , , I SECTION II-DEDUCTIBLES • Property Damage: $250 . , ' • — , . , Other deductibles may apply-rekir to policy. " .., . . • SECTION II-LIABILITY - -• '- • Coverage , - - * Limit of Insurance - Coverage L-Business Liability Per Occurrence, ' - $2,000,000 Coverage M-Medical Expenses $5,000 Any One Person Damage to Premises Rented to You ,' - ' ' - • ' , ' $300,000 ' . ' ''. • , . , Garage Liability , Included in Coverage L " ' 1 -' • •' Operation of CustomersAuto on Particular Prernises Included • • .. , , , _ _ • , , . . Aggregate Limits , . . ' ' . Limit of Insurance General Aggregate . . $4,000,000 Products/Completed Operations 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 II- Liability in the Coverage Form and any attached endorsements.' "' . ' ' • • .' ' ' - . •' '-' ' ' • Your policy consists of these Declaiatiohs,the BUSINESSOVVNERS 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 -•- , . .. .•- * 553.4442 Organizational Customer Online Enablement. ' CMP-4100 Businessowners Coverage Form ` . . . ,* CMP-4237.2 Amendatory Endorsemant(Oregon) , CMP-4412 ()Oration of Customers Auto on Particular Premises CMP-4527 Marijuana Exclusion - ' CMP-4543 — Additiorialilisured-,Designated Person or Organizatioil - - . ' • . * CMP-4561.4 Policy Endorsement• CMP-4683.1 Additional Insured-Owners,Lessees or Contractors(Blanket) CMP-4705.2 ' Loss of Inccifne'ind Extra Expense' , ' CMP-4706 Back-up of Sewer or Drain . . , CMP-4709 Money and Secprities • • CMP-4710 Employee Dishonesty CMP-4742.1 Garage Liability _,,, , • - CMP-4744 Garagekeeper's Insurance-Direct Coverage . . . , CMP-4827.1 •Employee Tool Coveraga, • FD 6007 .IniandMaringAttdching Declarations • FE-1313 Form 438BFU NS-Lenders Loss Payai;le Endorsement - "• ,FE-3650 Actual Cash Value Endorsement • ' , . FE-6999.3 Policyholder Disclosure Notice of Terrorism Insurance Coverage • • • • Policy number:97-CR-B526-0 , • Page 4 of 6 Prepared:July 2,2023 ©Copyright, State Farm Mutual Automobile Insurance Company, 2008, , • CMP-4000 • 8.?c)StateFarm *New Form Attached M. SCHEDULE OF ADDITIONAL INTEREST(S) • • ' Interest type: Designated Person or Organization Endorsement number: CMP.4543 City of Ashland the City of Ashland,Oregon, its officers,agents,and, . ' employees i - 20 E Main St Ashland OR 97520-1814 FULL NAMED INSURED Named Insured: JEREMY MANEKER DBAWRAP IT UP GRAPHICS,CITY OF ASHLAND 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' 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 emended 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. Policy number:97:CR-13526-0Page 5 of 6 Prepared:July 2,2023 ©Copyright, State Farm Mutual Automobile insur rice C'ompany,-.2008 CMP-4000 0& StFarm 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 availablefrom building contractors ands replacement cost appraisers, or, your agent can provide an estimate from Xactware".Ino.=using"information you provide about your structure, State Farm does not guarantee that any estimate will the the actual future cost torebuild your structure. Higher limits are available at higher premiums. Lower limits are also available, as long as the:'amountof.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, r.. • Policy number 97-CR-B526-0 Page 6 of 6 Prepared:July 2,2023 ©Copyright,.State.Farm Mutual•Automobile InsuranceC,ompany, 2006 CMP-4000 State Farm Insurance I u . PO Box 2915 Bloomington, IL 61702-2915 { £StateI Arm® . . State Farm Fire and Casualty Company .r M„ 1 CITY OF ASHLAND THE CITY OF AS A stock company with home offices in Bloomington, Illinois . •20 E MAIN ST •• ! • ASHLAND OR 97520-1814 - • I • C CO o I • • Inland Marine Attaching Declarations I . , . . Policy number: 97-CR-B526-0 Effective date: September 9, 2023 Policy period: 12 months Expiration date: September 9,2024 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 by law. • • Annual policy premium: Included ' The above premium amount is included in the Policy Premium shown on.the Declarations. • 1 FULL NAMED INSURED , • Named Insured: JEREMY MANEKER DBA WRAP IT UP GRAPHICS, CITY SOF ASHLAND • 1 . Yourpolicy 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, I. FORMS,OP-TIONS AND ENDORSEMENTS 1..... 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 I . . ATTACHING INLAND MARINE SCHEDULE PAGE Endorsement ' Coverage Limit of insurance Deductible amount Annual premium number I FE-8743.1 Inland Marine Computer Property Form $26,259 • $500 $12 . 1 Loss of Income and Extra Expense • -$25,000 ' . . Included. ' Other limits and-exclusions may apply-refer to your policy. . 1 . 1 . Policy number:97-CR-8526-0 ' Page l of 1 Prepared:July 2,2023 ,. ©Copyright, State Farm.Mutual Automobile Insurance Company, 2008 . CIM Att Dec 3P OR.1 I . . FD-6007 • ,, 1009481 2002 153089 202.03.06-2021 1