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HomeMy WebLinkAboutInsurance Certificate: Emerging Futures Youth Network LJ State Farm Insurance I PO Box 2915 , Bloomington; IL. 61702 CRD StateFarm. . . . . . Farp.Fire.andcasualty.company AT1 000087 1200 01 State• CITY OF ASHLAND A stock company with home offices in Bloomington, Illinois .. .. 1.:,.. 20 E•MAIN-ST-' e.:4'.• : • ASHLAND OR '97520-1814 ' ''-," . •,:' ". ' ,.,, e ... . 0 0 111111111.10111111111.111i1111111111411111111111111111111111i I I — ' - .... . . . . . , . . . , • , . .. , • , . '. , • Renewal Declarations . : • • . . '..,,V,,',-f"-.:,1I'' • :1,(.,41 1 ,-.' • . . - Policy number:97-CK-S482-9 Effective date:October 16, 2023 Policy period: 12 months . Expiration date:October 16, 2024 The policy period begins and ends at 12:01 am standard time at the premises location. . 'J.'.- .;?:-, '1::‹1,:".111:':.i".' oa:1.1 *:,' '. P,I ;•.',; "- : ' ; • Jr ,,F -.;'H.) ' , — •,.. : i.,74 • •%.',: UUSINESSOWNERS,p.OLICY . . • . • ,, . . 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. NAMED INSURED ' •' - - -- .... •- ' • - - • ' . ' . . ,. . . EMERGING FUTURES YOUTH NETWORK - -- , , , _ • . ENTITY . . . . . Nonprofit . . _ . . . IMPORTANT MESSAGE(S) . ' • . . Notice - Information concerning changes in your policy,language is included. Please call your agent if you have any questions. • ,. - . , . „. , , • 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. • Premium: $225.00 ,„ , Total Premium: $225.00 - - .., - , . , . . _ , - • _ Minimum Premium _ . . . Discounts applied:• , . ' • - ' . Business Experience Rating . - Renewal Discount - Years in Business , . , , .-,- . • Business in Residence Premises , •.. , ,, . , . , . . . - . . • - - ' Policy number:97-CK-S482-9 ' .. . Page 1 of 5 Prepared:August 8,2023 ©Copyright, State Farm Mutual Automobile Insurance Company, 2008 . CMP Dec 3P OR.1 CMP-4000 • , 5 1009482 2006 153090 206 08-21-2021 • • StateFa• rm® SECTION I'=PROPERTY SCHEDULE ' `• Location Locatiori of described premises •' ' Limit of Insurance* Limit of Insurance* Seasonal Increase- - number Coverage A- Coverage B•Business Business Personal Property, Buildings Personal Property 001 1180 Park St No Coverage $1,500 25% Ashland OR 97520-3535 . . - *As of the effective date of this policy, the Limit of Insurance as shown includes'any.'increese'in the lirnif due'to Inflation Coverage. SECTION I—INFLATION COVERAGE INDEX(ES) • - Coy A-Inflation Coverage Index: N/A Coy B-Consumer Price Index: 304.1 SECTION I-DEDUCTIBLES • ' BASIC DEDUCTIBLE $1,000 ' SPECIAL DEDUCTIBLES: ' ' 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 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 ' 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 • $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) Money Orders and Counterfeit Money $1,000 Policy number:97-CK-S482-9 Page 2 of 5 Prepared:August 8,'2023 ©.Copyright, State Farm Mutual Automobile Insurance Company,.2008 • CMP-4000 . . u • - q StateFarm Coverage Limit of Insurance ,.'4i •,'. .,..,4... kri Money and Securities On Premises $5,000 - Off Premises . $2,000 8 Newly Acquired Business Personal Property(applies only if this policy.provides Coverage B-Business $100,000 ,• ' — Personal Property) - . . . - -- . . . . , . . . ..... . Newly Acquired or Constructed-Buildings(appliies only if this policy provides Coverage.A-Buildings) .$250,000 . , • _ ' _ _ Ordinance or Law Equipment.Coverage. . _ Included . . _ . .. Outdoor Property .. $5000', • • 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 ; - $2,500 . . . Property) 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'df the number of'd'escribed'premises"shown in these Declarations. Coverage Limit of Insurance Loss of Income and Extra Expense 12.Months Actual Loss Sustained SECTION II-LOCATION SCHEDULE Location Location of described premises number . 001 1180 Park St ' • Ashland OR 97520-3535 , • Policy number:97-CK-S482-9 ' , Page 3 of 5 Prepared:August 8,2023 ©Copyright, State_Farm Mutual Automobile Insurance Company, 2008 CMP-4000 • • • , 090 StateFarme . . . .... . . ... .. SECTION II-LIABILITY ,. Coverage Limit of Insurance . .' • Coverage L-Business Liability Per Occurrence; •. $2,000,000 • . , Coverage M-Medical Expenses . $5,000 Any One Person . . Damage to Premises Rented to You : $300,000 , ., •- • ', '.'.- Aggregate Limits . ._ Limit of Insurance ' ., . . General'Aggregate " $4,000,000 Products/Completed Operations Aggregate ••• ' —14,000,000- . . 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.BUSIN ESSOWN ERS COVERAdE 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-4237.2 Amendatory Endorsement(Oregon) CMP-4527 Marijuana Exclusion - -- . , . . CMP-4543 Additional Insured-Designated Person or Organization * CMP-4561.4 Policy Endorsement - • •• , •• . • . - • CMP-4705.2 Loss of Income and Extra Expense ' CMP-4709 Money and Securities' • - CMP-4787 Waiver of Transfer of Rights of Recovery Against Others To Us . CMP-4788 Additional Insured-Managers or Lessors of Premises ' ' • . ... FD-6007 Inland Marine Attaching Declarations FE-3650 • Actual Cash Value Endorsement ' ' • - " ' - FE 6999 Policyholder Disclosure Notice of Terrorism Insurance Coverage . . . .... • . . f.... • ••-. . • • i. . • , - + .. • • . ••,-...-• •*New Foim Attached , . ' ' :..:"-:‘,4"..],: .;'...'1. s.',.:-Iii:'. : '1',•., '...' - :',"`•:',. •;'' ' , ' -!,-•-'; : '1- ', ',..—•.;...,:: SCHEDULE OF ADDITIONAL INTEREST(S), ,. .,, • , .., : . . , , . •• . . Interest type: Designated Person or Organizaiion • ,, Endorsement number: CMP-4543 Loan number: N/A • City of Ashland ' — • ' . -.. . — " . „ . ._ , . -. • ,- - • 20 E Main St :.... • Ashland OR 97520-1814 - • ".;...).L . ••, f . . .- . . . . ... ._ . .. . . • . . .. . , . . ' . - " . • -- . . . • • . , . • . . Policy number:97-0K-S482-9 • . • • • Page 4 of 5 Prepared:August 8,2023 ©Copyright, State:Farm.Mutual'Automobile Insurance Company, 2008 GMP-4000 ' , . - U cFoStatearm. This policy is issued by the State Farm Fire and Casualty Company. pxPARTICIPATING POLICY You are entitled to participate in a distribution of the earnings of,the company as determined byour Board of Directors in accordance P P 9 P Y 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. tom - President Secretary • OTHER MESSAGES) • 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 or as an endorsement to your policy. Billing for any additional premium for such changes will be mailed ata 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-CK-S482-9 Page 5 of 5 Prepared:August 8,2023 ©Copyright, State.Farm Mutual"Automobile Insurance Company, 2008 CMP-4000 - State Farm Insurance u • PO Box 2915 • - • f Bloomington, IL 61702-29 15 - -• ` C '0 State Farms State Farm Fire'and Casualty Company CITY OF ASHLAND A stock company with home offices in Bloomington, Illinois gil20 E MAIN ST ASHLAND OR 97520-1 81 4 S • , I- . . Inland Marine, Attaching Declarations • . . , • . . . . Policy.number: 97-CK-S482-9 • • . • Effective date: October 16,2023 . Policy period: 12 months • Expiration date: October 16, 2024 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. 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 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 Other limits and exclusions may apply-refer to your policy. Policy number:97-CKS482-9 ' Page 1 of 1 Prepared:August 8,2023 ©Copyright, State Farm Mutual Automobile Insurance Company, 2008 , CIM Att Dec 3P OR.1 • FD-6007 1009481 2002 153069'202 03-06-2021