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HomeMy WebLinkAboutInsurance Certificate Amnd: Better View LLC DBA Farrell's Glass Service (2) State Farm at CityLine u PO Box 853925 Richardson, TX 75085-3925 . ) Fanny 000341 1200-" I i�i I ATI State Farm Fire and Casualty Company CITY OF ASHLAND A stock company with home offices in Bloomingtori, Illinois 20 E MAIN ST ASHLAND OR 97520-1814 o o �o 111111111111111111111111111111111111'"1111111111011"1111117)o •Amended Declarations ,kr: : • • {:'' 't,'i:i'..f t'IY. Mi_,r t.,:{i,., �. i i ' r'. 'f, - l.l•l('�"i;"�� Policy number: 97-AA-8135-1 Effective date: June 27, 2020 Policy period: 12 months , Expiration date: June 27, 2021 The policy period begins and ends at 12:01 am standard time at the premises location: -; C'; .i f Cs 1,`:r_1:2 • 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-compliance with-the policy provisions`or as required by law-. " •_ NAMED INSURED .. - ' BETTER VIEW LLC DBA FARRELL'S , ; ., . 1, '�'.. :a' +;=,;_4: ti.; �c.. , , : :'.', ., °^..;, _. ,i +:a. 229SFRONTST • MEDFORD OR 97501-7263' ' - ENTITY Limited Liability Company IMPORTANT MESSAGE(S) Construction: NonCombustible Zone:64 Subzbne:02 - REASONS FOR DECLARATIONS • Your policy is amended effective June 27,:2020 due to some recent policy changes you requested, Enclosed is a copy of your new endorsements,,if any. • I POLICY PREMIUM This is not a:bill./fan amount is due then:a;se arate statement will;be sent prior to the due date,The premiums)shown below is the 12 months• premium(s)for the characteristics of the policy as described in this Declarations. , •: , , Total Premium: $5,175.00 . II Policy Number:97-AA-B135-1 ' Page 1 of 5 Prepared:April 27,2020 ©Copyright,State Farm Mutual Automobile Insurance.Company,2008 CMP Dec 3P OR 1009482 2002 153090 202 03.22-2020 I CMP-4000 . 001646 • c 7itate a m Discounts applied: Business Experience Rating Renewal Discount Protective Devices Years in Business SECTION I-PROPERTY SCHEDULE Location Location of described premises Limit of Insurance* •. Limitof,lnsurarice* • Seasonal increase-. number Coverage A- Coverage B Business Business Personal Property Building Personal Property. 001 229 S FRONT ST $589,700 $76,900 25% MEDFORD OR 97501-7263 "As of the effective date of this policy, the Limit of Insurance as shown includes any increase'in the limif.due to Inflation.Cove'rage,' SECTION I-INFLATION COVERAGE INDEX(ES) Coy A-Inflation Coverage Index: : , 185.4 Coy B-Consumer Price Index: ' 258.7 SECTION I-DEDUCTIBLES BASIC DEDUCTIBLE, $500 SPECIAL DEDUCTIBLES: :'";LJrr 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 limitsshown 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 $5,000 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 Debris Removal 25%of coveredloss Policy Number:97-AA-B135-1 Page•2 of 5 Prepared:April 27,2020 '©Copyright,State Farm Mutual Automobile Insurance Company'2008 ' CMP-4000 LJ ' CRD Stat eFarm! Coverage "O1•;(..'' , -:);-1- ;i,' ''' ' IL'iniit01insuranc'e1 -'- ''" - ;V;='; •`- • • •":,;: II Employee Tools(applies only to those premises provided Coverage;B:-Business Personal Property) ' ' • '' ' • " ' ' •• � Per Employee $500 • . Per Occurrence . - .. _ _ : $2,500 8 II ci Equipment Breakdown .. . .. . Included . . . .Fire Department Service Charge. . . _ ..'_ .. . . _ .. . .. _., , $5,000. . • Fire Extinguisher Systems Recharge Expense 1 $5,000 .-:••.- . - Forgery or Alteration $10,000 ' ` Garagekeepers Insurance-Direct Coverage $25,000 Glass Expenses Included . • , Increased Cost of Construction and Demolition Costs(applies only when buildings are insured on a 10% c,--__!c-'',1.'");_117-0.1_I'`,.,r__:? , replacement cost basis) Money Orders and Counterfeit Money $1,000 , . . • . . . Money and Securities ,;_n. i' 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(appliee'only if this policy provides Coverage A-Buildings) $250,000 . , _ . Ordinance or Law-Equipment Coverage . . Included _ - _ . Outdoor Property ' 0 . ._.. .. . ._ . $5, 00 Personal Effects(applies only to those premises provided Coverage B-Business Personal Property) $2,500 Personal Property Off Premises j $15,000 Pollutant Clean Up and Removal $20,000 Preservation of Property.- 30 days Property of Others(applies only to thosepremises provided Coverage B-Business Personal,Property).,:$2,500 • .k,- , ,.,. , . ,, . Signs; , . $5,000 - . . Valuable Papers and Records - On Premises • I $10,000 ':i l;..:17,,: .,,.(.;f, 's;:rut?i? • Off Premises $5,000 ' Water Damage, Other Liquids,Powder or Molten Material Damage ' ' l . ' Included • I••J. . . -Policy Number:97-AA-B135-1 ' Page 3 of 5 Prepared:April 27,2020 • ©Copyright,State Farm Mutual Automobile Insurance Company,2008 . ,.• ' . CMP-4000 , 001647 Qo StateFarm® SECTION I-EXTENSIONS OF COVERAGE,-LIMIT OF INSURANCE-PER POLICY The coverages and corresponding limits shown below,arel.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 SECTION II-LOCATION SCHEDULE • ;.. Location Location of described.premises ' . _ ' number ' 001 . 229 8 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 S '" " "$5,000 Any One Person Damage to Premises Rented to You $300,000 Garage Liability 'Included in Coverage L , is Operation of Customers'Auto on Particular Premises Included V , Aggregate Limits - Limit ofInsurance . 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 SUSINESSOWNERSCOVERAGE 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-4527vv, 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) Policy Number:97-AA-B135-1Page 4 of 5 Prepared:April 27,2020 ©Copyright,State Farm Mutual Automobile,lnsurance Company,2008 CMP-4000 LJ 00 State Farm® • 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 cri FE-3650 Actual Cash Value Endorsement ' FE-6999.2 Policyholder Disclosure Notice of Terrorism Insurance Coverage 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'adistribution 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. /0Z0-1-67?- 1-Lo-isp * i-g')/1".11d4444alt President Secretary Policy Number:97-AA-B135-1 Page 5 of 5 Prepared:April 27,2020 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP-4000 • 001648 • State Farm at CityLine LJ PO Box 853925 Richardson,TX 75385-3925 Stat86Fapm® State Farm Fire and Casualty Company CITY OF ASHLAND - A stock company with home offices in Bloomington, Illinois 20 E MAIN ST ASHLAND OR 97520-1814 S too Inland Marine Attaching Declarations Policy number: 97-AA-B135-1 Effective date: June 27, 2020 Policy period: 12 months Expiration date: June 27, 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 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 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-8135-1 • Page 1 of 2 Prepared:April 27,2020 ©Copyright;State:Farm Mutual Automobile Insurance Company,2008 CIM Att Dec 3P OR 1009481 2001 153089 201 12-04-2018 FD-6007 001649 •o o State Farms Other limit's''and exclusions may apply-refer to your policy" • • .. .. .. k 3 V.i4 l/ea.�(. .,1itt", `v l., s f✓1 • • • ';' Policy Number:97-AA-B135-1 Page;2 of 2 Prepared:April 27,2020 ©Copyright,State Farni Mutual Automobile Insurance Company,2008 ' FD-6007