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HomeMy WebLinkAboutInsurance Certificate: BetterView dba Farrells u State Farm at CityLine PO Box 853925 c Q e y/�y Richardson,.TX 75085-n25.085. 25 090 State/a I e ' I -0003251200• - . . AT1 State Farm Fire and Casualty Company. CITY OF ASHLAND A stock company with home,offices'in,Bloomingtori;,'.Iilinois.: IN20EMAINST • Wti ASHLAND OR 97520-1814 , , �IliIIIIIIIIIIIIIIiiIll'llll'llililliiriilluilllilrlilililll'Illi . ' Renewal Declarations . . ,, ,. . ., , , ., ,„ ,:-., ,,,,,7.:...i . „,),-.. .)...i, , . . . . . 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. AUTO SERVICES POLICY Automatic renewal -If the State Farni®policy period is shown as 12 months, this policy willbe,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 fhe*licy.ptovisions=or as req iiired,by law.' . • - ,: ' 1:;-:— ;; "-S NAMED INSURED BETTER VIEW LLC DBA FARRELL'S 229 S FRONT ST MEDFORD OR 97501-7263 , ENTITY Limited Liability Company j , ' IMPORTANT MESSAGE(S) Notice -Information concerning changes in your policy language is included. Please call your agent if you have any questions, • . ' Construction: NonCombustible Zone:64 Subzone:02 . ' - r 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: $5,167.00 . -- -- .- , - . _ .. , .. , .. Discounts applied: . - - . .. . .. i Business Experience Rating . Renewal Discount Protective Devices Years in Busiriess ,, . . . , - Policy Number:97-AA-8135-1 Page 1,of 5 Prepared:April 1B,2020 •©Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP Dec 3P OR 1009482 2001'153090 201 03.06.2019 CMP-4000 001539 • '`(:)• 90Stateatinr 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 001 229 S FRONT ST $589,700 $76,900 . 25%, , MEDFORD OR 97501-7263 *As of the effective date of this policy, the Limit of'lnsurance,as shown includes any increase in the limit due to Inflation Coverage. 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: ; , 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 limits shown below apply separately to each described premises shown in these Deplp,fa,ticpsn,t,,, unless indicated by"See schedule". If a coverage does not have a corresponding limit shown below, but has"Included" indiCated;"feifer. to that policy provision for an explanation of that coVerage. Coverage • Limit of Insurance Accounts Receivable ';• On Premises $10,000 Off Premises • $5,000 !C• Arson Reward • 1 :c $5,000, . Back-up of Sewer or Drain $15,000'' s: Collapse Included ' 1., V: Damage to NonownedBuildings from Theft;Burglary or Robbery' - - ''; Coverage B Limit 'Debris Removal 25%of covered loss Employee Tools(applies only to those premises provided Coverage.B-Businees Personal Property) Per Employee $500 Per Occurrence $2,500 Equipment Breakdown Included . . 3 Policy NIUmber:97-AA-B135-1 Page 2 of 5 Prepared:April 18,2020 Cepyright,Stdte Far*"Mutual Automobile Insuranbe-ComPaq, 2008 CMP-4000 U . • State Farm' Coverage Limit of Insurance ` s. _ :+ Fire Department Service Charge $5,000= - Fire Extinguisher Systems Recharge Expense " $5,000 Forgery or Alteration $10,000 a ' 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% 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 . . . , 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 r,Business Personal Property) , $2,500 , • Signs $5,000 :`, . ?l', • ,';, Valuable Papers and Records . On Premises • ,$10,000' Off Premises h ' $5,000 :a •. • Water Damage, Other Liquids,Powder or Molten.Material Damage ' : • '_2 Included. ' SECTION I-EXTENSIONS.OF COVERAGE-LIMIT OF INSURANCE-PER POLICY 1 • ' ; 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 $16,000 Loss of Income and Extra Expense 12'Months Actual Loss Sustained Policy,Number:97-AA-8135-1 Page 3 of 5 Prepared:April 18,2020 ©Copyright,State Farm Mutual'Automobile Insurance Company,2008 CMP-4000 • 001540 Qa Starr SECTION II-LOCATION SCHEDULE . Location Location of described premises _,;. . 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 . r;, , • 'Aggregate Limits ' • - - Limit of Insurance . Products/Completed Operations Aggregate .• 2. . • - -• • - $2,000,000. • ' General Aggregate ._. . - . ' $2,000,000 - - Each paid claim for Liability Coverage reduces the amount ofinsurance 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 BUSIANESSOWNERS 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 , • -;, r,.•„ :,, ,•, ,.¢•,,:, r,f.: 'rt'+ CMP-4706 Back-up of Sewer or Drain ? 't CMP-4709 ' Money arid Securities . , _ , • _ ' r' -_ . , . ' 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-6067 , .Inland Marine Attaching Declarations . . • , FE-3650„ , _ } Actual`CashValue •Endorsement • . . Policy Number:97-AA-B135-1Page 4 of 5 Prepared:April 18,2020 . O Copyright;State Farm Mutual Automobile Insurance Company,'2008' , CMP-4000 • U • • as StateFarme • FE-6999.2 Policyholder Disclosure Notice of Terrorism Insurance Coverage *New Form Attached FULL NAMED INSURED • Named Insured: BETTER VIEW LLC DBA FARRELL'S GLASS SERVICE a c This policy is issued by the State Farm Fire and Casualty Company. PARTICIPATING POLICY I ' 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: 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 amended declarations oras 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. • 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-8135-1 • Page 5 of 5 Prepared:April 18,2020 ©Copyright,State Farm Mutual Automobile lnsuranceHC'ompany,2008 ' CMP-4000 • • 001541 Li State Farm at CityLine PO Box 853925 Richardson, 1X•75085-3925 090 StateFarm' State Farm Fire and Casualty Company CITY OF ASHLAND A stack company with home offices in'Bloomington, Illinois „'' 20 E MAIN ST • .•} ASHLAND OR 97520-1814 S o 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-B135-1 Page 1 of 2 Prepared April 18,2020 ©Copyright,State.Farm Mutual Automobile Insurance Company,2008 - CIM Att Dec 3P OR 1009451 2001 153089 201 12-04-2018 FD-6007 ' 001542 O StateFarnr Other,limits and exclusions may apply-refer to your policy, • • • • • • • • • • Policy Number:97-AA-8135-1 • Page 2 of 2 Prepared:April 18,2020 ©Copyright;StateFarm Mutual'AUtomdbile Insurance Company,2008 . FD-6007 . • -1