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HomeMy WebLinkAboutInsurance Certificate Amnd : Better View LLC dba Farrells State Farm at CityLine 0 PO Box 853925 , . . $• Richardson, TX 75085-3925 apyo® C 'C C7 tat �aI 1/1 All 000553 1200 01 State Farm Fire and Casualty Company . CITY OF ASHLAND A stock company with Iiome offices'in�Bloormington,illliriois 20EMAIN ST ••44. ASHLAND OR 97520-1814 S .'-i).'-i) 111111111111'111111111111111111111111111"111111111111111111i111 coo . ` . • Amended Declarations , . „ . .., •„,...„ ::.;:-, ,: ,,,, ...,. Policy number: 97-AA-B135-1 0 Effective date: September 22, 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 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 corr'ipliance.- itli.the policy pTovlsions'ores required bylaw: 'a;; lc) .. "' ^ ''-''• NAMED INSURED BETTER VIEW LLC DBA FARRELL'S 229 S FRONT ST MEDFORD OR 97501-7263 -,," ,. ENTITY Limited Liability Company • ' REASONS FOR DECLARATIQNS Your policy is amended effectiveSeptember 22,`2020 due to some recent policy changes you requested. Enclosedis`e copy of your' new endorsements, if any. • POLICY PREMIUM ' This is not a bill.If an amount is clue, then a separate statemenfwilibe sent prior to the tlue 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: $5,1.81.00 ,. _ . . . Discounts applied: .. Business.Experience Rating' Renewal Discount' . . ' Protective Devices 0 • .- Years in Business Policy Number:97-AA-B135-1 Page 1 of 5 Prepared:October 2,2020 • ©Copyright,State Farm.Mutual Automobile Insurance Company,2008 • . . CMP Dec 3P OR 1009482 2002 153090 202 08-05-2020 CMP-4000 002195 - Q State Farnle 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 Insurance 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 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 Limit Debris Removal , 25%of covered loss; Employee Tools(applies only to those premises provided Coverage B-Business Personal Property) Per Employee r. $500 , r . ' Per Occurrence $2,500 Equipment Breakdown Included Policy Number:97-AA-8135-1 Page 2 of 5 Prepared:October 2,2020 ©Copyright;State Farm Mutual Automobile Insurance Company,2008 CMP-4000 • u 0°0 StateFarm® Coverage Limit of Insurances-' • '.r'' +'`' . •'. "'__0'. ', FRFire Department Service Charge . $5,000'' ` . • . ' : Fire Extinguisher Systems Recharge Expense $5,000 Forgery or Alteration $10,000- Garagekeepers Insurance-Direct Coverage $25,000 o (D 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.. , . . _ -. .. . . . . _ _ - -.. _ _.. ., ,. :$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 Property30 days• Property of Others(applies only to those premises provided Coverage B-Business Personal Property). '$2,500- • + • ' , Signs $5,000 ' •. . ."IS '',•";\ A. ', 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 regardlessof 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 .. Policy Number:97-AA-B135-1 , ., • Page 3 of 5 Prepared:October 2,2020 ' ©Copyright,State Farm Mutual Automobile Insurance Company,2008 ' CMP-4000 ' 002196 090S tateFarm SECTION II-LOCATION SCHEDULE Location Location of described premises ,; ,• ,,. ,,, ",- *- "' number:. ' •MEDFORD OR 97501-7263 `; SECTION II-DEDUCTIBLES Property-Damage: $250' .1 Other deductibles may apply-refer to policy::, -•SECTION II-LIABILITY Coverage .: .., Limit of Insurance Coverage.L-BusinessLiabilityPer 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 -Aggregate Limits.: ,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 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 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 ofthis:pol cy '. .f• 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) • . . , , , , • • . V ' • CMP-4684.1 , .. Additional Insured-Owners,Lessees or Contractors(Scheduled) •-- • - -:-V CMP-4705.2 Loss of Income and Extra Expense ; CMP-4706 Back-up-of Sewer or Drain r.,:,.t, L.'?, ". �p 's"a.' „ i,; ,r ' 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 `- FE-3650 r' 'Actual Cash Value,Endorsement • 'Policy Number:97-AA-B135-1 Page 4 of 5. Prepared October 2,2020 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP-4000 II 090 StateFanne FE-6999.2 Policyholder Disclosure Notice of Terrorism Insurance Coverage; SCHEDULE OF ADDITIONAL,INTEREST(S) Interest type: Owners,Lessees,or Contractors(Schedul Endorsement number: CMP-4684.1 Loan number: N/A CITY OF ASHLAND FL 20 E Main St co 0 Ashland OR 97520-1814 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 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, ///fteLl 1d44441 OE, President Secretary • • Policy Number:97-AA-B135-1 Page 5 of 5 Prepared:October 2,2020 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP-4000 002197 u State Farm at CityLine PO Box 853925 • Richardson; TX 75085-3925 090 State I tate Farina State Farm Fire and.Casualty.Company CITY OF ASHLAND A stock company with home offices in. Bloomington, Illinois 7 20 E MAIN ST ti . ` ASHLAND OR 97520-1814 .. g o O O �$ Inland Marine Attaching Declarations Policy number: 97-AA-B135-1. Effective date: September 22, 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 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. 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. V 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 , V • ATTACHING INLAND MARINE SCHEDULE PAGE ' Endorsement Coverage Limit of insurance Deductible amount Annual premium number - FE-8743.1 Inland Marine Computer Property Form V $25,000 '' $500 Included Loss of Income and Extra Expense $25,000 Included Policy Number:97-AA-13135-1 ' , . ,Page 1.of 2 Prepared:October 2,2020 ' ©Copyright,State,Farm Mutual Automobile`Insurance Company,2008 CIM Att Dec 3P OR 1009481 2001 153089 201 12-04-2018 FD-6007 002198 V . • , .Qa StateFarm® Other limits and exclusions may apply' refer to your policy, • • • • Policy Number:97-AA-8135-1 Page 2 of 2 . Prepared:October 2,2020 ©Copyright;State Farm Mutual Automobile Insurance Company;2008 FD-6007 .