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HomeMy WebLinkAboutInsurance Certificate: Ashland Food Angels State Farm at CityLine U PO Box 853925 Richardson, TX 75085-3925 o StateFarme 000126 1200 �r 6i/ ATI State Farm Fire and Casualty Company CITY OF ASHLAND ITS OFFICERS& A stock company with home:offces'in Bloomington; Illinois_- 20 E MAIN ST ASHLAND OR 97520-1814\ d . _ , 1"11111111111111111111111111111111111'1111111111111111111111111 m O _t Renewal Declarations : • . • Policy number: 97-AA-C018-4 Effective date: July 29, 2020 Policy period: 12 months Expiration date: July 29, 2021 _ • "• The policy,period beginsand ends at 12:01 am standard time at the premises location. BUSINESSOWNERS POLICY Automatic renewal -If the State Farm®policy period is shown as 12 months,tliis'policy will be renewed'automatiaally"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/Lienholderwritten no`ticeincomplinoe with'the,policy provisionsor.as'required by;law.; - NAMED INSURED ASHLAND FOOD ANGELS 1 • 472 WALKER AVE ASHLAND OR 97520-2324 ENTITY . Nonprofit IMPORTANT MESSAGES) • Notice -Information concerning changes in your policy language is included. Please call your agent if you have any'questions Construction: MasonryNonCombustible Zone:64 Subzone:02 POLICY PREMIUM This is nota bill.if an amount is due, then a separate statement will be sent prior to the due date. The 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. . • Protective Devices Years in Business • Policy Number:97-AA-C018-4 Page 1 of 5 Prepared:May 20,2020. . •©.Copyright,State Farm Mutual Automobile Insurance Company,2008, CMP Dec 3P OR 1009482 2002 153020 202 03-22-2020 CMP-4000 000532 •• 090 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 • 001 472 WALKER AVE No Coverage $10,200 25% , ASHLAND OR 97520-2324 '— *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: 258.7 SECTION I—DEDUCTIBLES BASIC DEDUCTIBLE , $1,000 SPECIAL DEDUCTIBLES: r.) Equipment Breakdown: $1,000 , 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-seRarately 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 Receiv,able On Premises $10,000 .„, Off Premises . $5,000 Arson Reward $5,000 Collapse Included Damage to Non owned Buildings from Theft,Burglary or Robbery Coverage B Limit , • , Debris Removal 25%of covered loss Equipment Breakdown Included Fire Department Service Charge 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) PoliGy Number:97-AA-0018-4 - ' Page 2 of 5 Prepared:May 20,2020 ID Copyright,State Farm Mutual Automobile Insurance CoMpany,2008 CMP-4000 I-1 • State Farm! Coverage 'Limit of Insurance --tib Money Orders and Counterfeit Money , ;.. $1,000 Money and Securities On Premises $5,000 Off Premises . . _ 1 - .' $2,000 . . no 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 . , ,;$10;000; . , .,• , • Preservation of Property 30 days Property of Others(applies only to those premises provided Coverage B-Business Personal Property) $2,500 .. , .. -, 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. Coverage Limit of Insurance Loss of Income and Extra Expense .1 . 12•Months Actual Loss Sustained . SECTION II-LOCATION SCHEDULE ' . • Location Location of described premises number . . 001 472 WALKER AVE , ASHLAND OR 97520-2324 . SECTION II-LIABILITY , CoverageLimit of Insurance Coverage L-Business Liability Per Occurrence $1,000,000 . Policy Number:97-AA-0018-4 Page 3 of 5 Prepared:May 20,2020 ©Copyright,State,Farm Mutual.Automobile,Insurance Company,2008. CMP-4000 000533 . } 00 StateFarm® Coverage Limit of Insurance , • Coverage M-Medical Expenses - $5,000 Any One Person' ' Damage to Premises Rented to You $300,000 Aggregate Limits ' , • ' - `' " L 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 insurancewe provide during the'applicable annual period, Please refer to Section Il— Liabilityin 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 thoselssued subsecuent_to-the issuance ofthis"policy, FORMS AND ENDORSEMENTS - " • CMP-4100 Businessowners Coverage Form' - , CMP-4237.1 Amendatory Endorsement(Oregon) :CMP-4527' - Marijuana Exclusion , ' " ' "`' ' ' CMP-4561.1 ' Policy Endorsement'-'' * CMP-4705,2 Loss of Income and Extra Expense "- • • - "' - CMP-4709 , Money and Securities ' f' `l ;'fr- ' -' •-,' CMP-4798 Additional Insured-Grantor of Franchise' FD-6007 Inland Marine AttachingDeclarations ' ' FE-3650' Actual Cash Value Endorsement _'FE-6999.2 , Policyholder Disclosure Noti•ce of Terrorism Insurance Coverage - , "New Form Attached This policy is issuedby the.State.,Farm Fire arid Casualty Company,. , ' PARTICIPATING POLICY - You are entitled'to participate in a distributionof the earnings•ofthe'company a&determinetl byour•Board'ofDireators'in?accordance ::,. with.the Company's Articles of Incorporation,.as.amended;,--' `. , .. a'. ,., ;, ,,'.;, -.}; ' . 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. s . .,.,.. :k . 4; President Secretary < ,.,;,' .a k,.. ,:;�.: :: ''''•7•-t-• f �:ill;:... : Policy Number:97-AA-0018-4 Page 4 of 5 , Prepared May 20,2020 ©Copyright,State Farm Mutull Automobile Insurance Company;2008 CMP-4000 `' U 0°8 StateFarm® NOTICE TO POLICYHOLDER: CA 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 g 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 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. 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-C018-4 Page 5 of 5 Prepared:May 20,2020 ©Copyright,State Farm Mutual Automobile.Insurance Company,2008 CMP-4000 ' 000534 ' State Farm at CityLine U. PO Box 853925 Richardson, TX 75085-3925 09,0StateFarine • State Farm Fire and Casualty Company CITY OF ASHLAND ITS OFFICERS& A stock company with home offices in Bloomington, Illinois 20 E MAIN ST 44"...• ASHLAND OR 97520-1814 C Inland Marine Attaching Declarations Policy number: 97-M-0018-4 Effective date: July 29, 2020, Policy period: 12 months Expiration date: July 29, 2021 The policy period begins and ends at 1201 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. 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 premiuin number FE-8743.1 Inland Marine Computer Property Form $25,000 $500 Included Loss of Income and Extra Expense $25,000 Included Other limits and exclusions may apply-refer to your policy. • Policy Number:97-AA-0018-4 Page 1 of 1 Prepared:May 20,2020 ' Copyright,State Farm Mutual Automobile Insurance Company,2008 CM Att Dec 3P OR 1009481 2001 153089 201 12-04-2018 FD-6007 000535