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HomeMy WebLinkAboutInsurance Certificate: Ashland Culture of Peace Commission State Farm at CityLine U PO Box 853925 Richardson, TX 75085-3925 Q( State Farm — 000713 1200 • .. AT1 State Farm Fire and Casualty Company CITY OF ASHLAND INCLUDING ITS A stock company with home:offices'in:Blobrnington;'Illinois 20EMAINST ;I' •: ASHLAND OR.97520-1814' 1 • S .... . _ . _ '_ - -- . -- - . i _. -- ,. FII1IIIIIIIiilllnlillrlII111"1"IIIIII'IIIilnlilni,1Iu'rl1lllln 0. , 1::-.'s:1:—.7.(.- :.. (.- , =1; ,'':. , i.''.. 1` ,,'•`...',.+ 1i..': Renewal Declarations , . ., :.,., „. ,:,_.,:,-,- .. „, i:.-....-:..1Policy number: 97-AA-A892-4 Effective date: July 1;2020 Policy period: 12 months Expiration date: July 1, 2021 ` The policy period begins and ends at 12:01 am standard time at the premises location. � • . I BUSINESSOWNERS POLICY Automatic renewal -If the State Farni®policy period is shown as 12 months, this policy will be renewed autom`atically 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 incompliance with the policy provisions or as required by law. ` - ' NAMED INSURED ASHLAND CULTURE OF PEACE COMMI _. . ' ' 2305C ASHLAND ST#337 ASHLAND OR 97520-1407 _. - ENTITY • Corporation . ._ IMPORTANT MESSAGE(S) Notice -Information concerning changes in your policy language is included. Please call your agent if you have any questions. Construction: frame Zone:64 Subzone:02 - -' , .. -. . • 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: $465.00 , •' ' Minimum Premium - - Discounts applied: , " • Business Experience Rating • - . - • Renewal Discount • ` • - - - -- Years in Business f Policy Number:97-AA-A892-4 -Page 1 of 5 Prepared:April 22,2020 ' '©Copyright,State Farm Mutual Automobile Insurance Company,2008 . . CMP Dec 3P OR 1009482 2001 153090 201 03-06-2019 CMP-4000 0032.77 £StateFarm® ..; SECTION I-PROPERTY SCHEDULE . • • Location Location of described premises Limit of Insurance* Limit of Insurance* Seasonal increase-' number Coverage A- Coverage B-Business Business Personal Property Building Personal Property 001 33 N 1ST ST No Coverage $52,800 , 25% ASHLAND OR 97520-1918 " *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: 258 SECTION I—DEDUCTIBLES • BASIC DEDUCTIBLE $500 SPECIAL DEDUCTIBLES: ; , , • - • - • Equipment Breakdown: $500 . , 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 pot have,acorresporiding limit,shpwp belpw,.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 Collapse Included . , Damage to Non-own'ed.Buildings from Theft,'Burglary'or Robbery Cve'rdge Limit• , . Debris Removal 25%of covered loss • Equipment Breakdown Included Fire Department Service Charge $2 500 Fire Extinguisher Systems Recharge Expense • • $5,000 • • Forgery or Alteration • • $10,000 • • • Glass Expenses • Included • • Increased Cost of Construction and Demolition Costs(applies only when buildings are insured on a 10% replacement cost basis) • • • ' • • • • Policy Number:97-AA-A892-4 • ' Page 2 of 5 Prepared:April 22,2020 •©Copyright,State Perin Mutual Automobile Insurance Company;2008 CMP-4000' • • • .• . , lI • -• :• I aoStateFanno Coverage . . • . ' , Limit of Insurance . Mr Money Orders and Counterfeit Money ,. $1,000 . Money and Securities • • On Premises $5,000 ..., 4 Off Premises . -• -.. .. . . .. . . -. ..- • - - -$2,000- • . .. . ... _`• . -._ IL 0 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 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 . , . : . ,$10,000. :'• -' • .. Preservation of Property. . . - . , .30,days' .• -:. Property of Others(applies only to those premises provided Coverage B-Business Personal Property) 42;500:,.• , - . , ,, • t • . . Signs . •;$2;500...;: .,', 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 • The coverages and corresponding limits shown below are the most we will pay regardless of the number of described premises shown in these Declarations. ' :00:a;:'".` I, 1 .,'.'-i . Coverage `Limit of Insurance - . Loss of Income and Extra Expense , 12 Months Actual Loss Sustained, _ , SECTION II-LOCATION SCHEDULE 5 Location Location of described premises . - , number , 001 33 N 1ST ST - ASHLAND OR 97520-1918 • SECTION II-LIABILITY • • • Coverage ' ' Limit of Insurance • . Coverage L-Business Liability Per Occurrence ,' $2,000,000 Policy Number:97-AA-A892-4 - .: "• , Page 3 of 5 Prepared:April 22,2020 ©Copyright;'State Farm Mutual Automobile Insurance.Compahy,2008 ' CMP-4000 • • 003278 . • oo State Farme Coverage - Limit of Insurance , 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 Aggregate ' -- • $4,000,000 • - - 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 Il Liability in the Coverage Form and any attachedendorsements. . ' . 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-4543 Additional Insured-Designated Person or Organization •-! CMP-4561.1 - Policy Endorsement - . . " . • CMP-4705.2 Loss of Income and Extra Expense - . • CMP-4709 Money and Securities -. • - CMP-4804 Additional Insured-Club Members , • FD-6007 Inland Marine Attaching Declarations - ' FE-3650 . Actual Cash Value Endorsement '' ' ' FE-6999.2 " Policyholder Disclosure Notice of Terrorism Insurance Coverage" - • - . - _ *New Form Attached . . ,._ - FULL NAMED INSURED ' Named-Insured: ASHLAND CULTURE-OF PEACE COMMISSION ... . .• ,. "" - " . - . ' . • . . . 7: ,'F't-..ii .;, ' .?,'„,;7,I t' - .,\ r..I.I. -Y; ' E -, 'Irl'I; This policy is issued by the State Farm Fire and Casualty Company," PARTICIPATING POLICY i 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 policy to be signed by its`President'and'Secre tary at Bloomington, Illinois. .,7 - President Secretary ` ' ' i. .r •.:.. f'4 , Policy Number:97-AA-A892-4 - • • Page 4 of 5 Prepared:April 22,2020 ` ©Copyright,State Farm Mutual Automobile Insurance Company,2008 . CMP 4000 • • 0)StateFarm® • i • NOTICE TO POLICYHOLDER: • . 1'{:For a comprehensive description of coverage and forms, please refer to your policy. • 1.11 For 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 g are also effective on the Renewal Date of this policy. 0 • Policy changes requested after the"Date Prepared"will,be sent to you as an amended declarations or as an endorsement to your . CO 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. • 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 bathe 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-A892-4 • Page 5 of 5 Prepared:April 22,2020 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP-4000 - • 003279 State Farm at CityLine PO Box 853925 Richardson,-FX 7,5085-3925 • Sta feFar r State Farm Fire and,Casualty Company CITY OF ASHLAND INCLUDING ITS A stock company with home offices in Bloomington, Illinois 20 E MAIN ST 1. ASHLAND OR 97520-1814 O O Inland Marine Attaching Declarations Policy number: 97-AA-A892-4 Effective date: July 1, 2020 Policy period: 12 months Expiration date: July 1, 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: ASHLAND CULTURE OF PEACE COMMISSION 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-A892-4 Page 1 of 2 Prepared:April 22,2020 0 Copyright,State Farm Mutual Automobile Insurance Company,2008 CIM Att Dec 3P OR 1009481 2001 153089 201 12-04-2018 FD-6007 003280 ! • • . • • : t�StateFarrm® •Other limits'and-exclusions;may apply=refer to your policy. -. . • a • ..:tl r.+.'3 . Vim. t\ !.1 d.i ti"j..• rF.t� .. . g• a #., r7,.. ,,,:,_•:,•11--,,., s ,:ori • • •Policy Number.97-AA-A892-4 • Page 2 of 2 Prepared:April 22,2020 ©'Copyright,State Farm Mutual Automobile Insurance Company,2008 • FD-6007' • .