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HomeMy WebLinkAboutInsurance Certificate AMND: Ashland Artisan Gallery & Art State Farm at CityLine U PO Box 853925 Richardson, TX 7¢085-3925 O5 CD StateFarm® AT2 001211 1200 01 State Farm Fire and Casualty Company CITY OF ASHLAND A stock company with home,.offices-in Bloomington, Illinois ; Mt 20 E MAIN ST . tkilkig ASHLAND OR.97520-1814 g . . .„. .. . . O Ni Alli'IIuiIIIIIIIIIirllilllhililllii111111IIIIIIIIIIIinllirinil ' .• . • Amended Declarations . ; . . ., , Policy number: 97 MA471-1Effective date: March 5,2021 . •,:-•"_• Policy period: 12 months Expiration date: June 13, 2021 ` .. • . , The policy period begins and 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, 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-bompliance witiiitfie policy"provisibr s or as required by law. - ' • " •- - - NAMED INSURED . • ASHLAND ARTISAN GALLERY&ART ' PO BOX 1123 ASHLAND OR 97520-0038 - • - " ENTITY _ _ Corporation REASONS FOR DECLARATIONS . Your policy is-amended effective March 5, 2021 due to some recent policy changes you requested.Enclosed is-a copy of your new endorsements,.,if any. - - 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: $1,232,00 ; Discounts applied: .. . • Business Experience Rating . Renewal Discount • - Protective Devices _ Years in Business Improvements and Betterments Enclosed Building or Shopping Center • Policy Number:97-AA-A471-1 Pagel of 5 Prepared:March 5,2021. ©Copyright,State Farm Mutual Automobile Insurance Company,2005. CMP Dec 3P OR 1009482 2002 153090 202 12-05-2020 CMP-4000 . . • 005162 090' StateFaring) . SECTION.I-PROPERTY SCHEDULE 1 • 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. 357 E MAIN ST No Coverage $263,400 • ; •,,25% , • , ASHLAND OR 97520-1834 *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 Impgx(Es) Coy A-Inflation Coverage Index: N/A Coy B-Consumer Price Index: 258 . , . . 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 cOVERAg# 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 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) Policy Number.97-M-A471-1 • Page 2 of 5 Prepared:March 5,2021 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 • CMP-4000 , LI • • oStateFarfl7 Coverage .. Limit of Insurance INMoney Orders and Counterfeit Money - " $1,000 . , , . ; Money and Securities. , On Premises $5,000 O Off Premises $2,000 vo ." , .. - Newly Acquired Business Personal Property(applies only if this'policy provides Coverage B-Business $100,000 V Personal Property) r 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) •.$15,000. •.' . . Signs . .$2,500.; - . • Valuable Papers and Records On Premises $10,000 • ' Off Premises V $5,000 • .• • Water Damage, Other Liquids,Powder or Molten Material Damage Includedi'• 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 12 Months Actual Loss Sustained'•'~ . ' SECTION II-LOCATION SCHEDULE V Location Location of described premises . number ' 001 357E MAIN ST ' ASHLAND ORI 97520-1834 SECTION II-LIABILITY Coverage Limit of Insurance ' . Coverage L-Business Liability Per Occurrence ,' • $2,000,000 . Policy Number:97-AA-A471-1 '' ' ' ' , ;Page 3 of 5 Prepared;March 5,2D21 0 Copyright,State Farm Mutual Automobile Insurance Company,2008 . CMP-4000 V 005163 099 StateFarm& • Coverage Limit of Insurance Coverage M-Medical Expenses $5,000 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 Coveragereduces the amount of insurancewe 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 of this policy: FORMS AND ENDORSEMENTS - CMP-4100 Businessowners Coverage Form CMP,4237.1 Amendatory Endorsement'(Oregon) .CMP-4527 . Marijuana Exclusion - . • - __. V * 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-4787 Waiver of Transfer of Rights of Recovery Against Others To Us . CMP14788 Additional Insured'-Managers or Lessors of Premises`' 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 " SCHEDULE OF ADDITIONAL INTEREST(S) Interest type: Designated Person or Organization" „ ,, Endorsement number: CMP-4543 'a ' °:+:y • ".;r: ,. ` Loan number N/A CITY OF ASHLAND 20 E Main St . Ashland OR 97520-1814 • FULL NAMED INSURED,' Named Insured: ASHLAND ARTISAN GALLERY&.ART CENTER INC "t .•�,i' 1 .. ., z,. 3'.`.{.'pit: • Policy Number:97-AA-A471-1 Page'4 of 5 Prepared:March 5,2021 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP-4000 u Q StateFarme 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. . s In Witness Whereof, the State Farm Fire arid Casualty.Company hascaused this policy to be signed by its President and Secretary at Bloomington, Illinois, President Secretary• Policy Number:97-AA-A4714 Page 5 of 5 Prepared:March 5,2021 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 ., CMP-4000 , 005164 State Farm at CityLine U PO Box 853925 Richardson, TX 75085-3925 O o State Farm® State Farm Fire and Casualty Company CITY OF ASHLAND A stock company with home offices in'Bloomington Illinois FA. 20 E MAIN ST ASHLAND OR. 97520-1814 p O O N Inland Marine Attaching Declarations Policy number: 97-AA-A471-1 Effective date: March 5, 2021 Policy period: 12 months Expiration date: June 13, 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 ARTISAN GALLERY&ART CENTER INC 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 $25,000 Included Policy Number:97-AA-A471-1 Page 1 o 2 Prepared:.March 5,2021 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 CIM Att Dec 3P OR 1008481 2001 153089 201 12-04-2018 FD-6007 005165 • Qo StateFarm®. Other limits and exclusions may apply:refer to your policy. , • • • • • • • E •. • • • • • • );. , .. • . -. . 't, • ,_ ,. • • • • Policy Number.97-AA-A471-1 Page 2 of 2'' Prepared.March 5,2021 ©Copyright;State farm Mutual Automobile Insurance Company,2008' ' FD-6007 ,• U CMP-4543 Pagel oft THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ..L :ADDITIONAL INSURED-DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: BUSINESSOWNER$COVERAGE FORM 'o SCHEDULE Policy Number: 97-AA-A471-1 ' Named Insured: ASHLAND ARTISAN GALLERY&ART CENTER INC 20EMain St Ashland OR 97520-1814 Name And Address Of Additional Insured Person Or Organization: CITY OF ASHLAND . 20 EMain St Ashland,OR 97520-1814 . . 1. SECTION II --WHO IS AN INSURED of SECTION Il LIABILITY is amended to include, as an additional insured; any person or organization shown in the Schedule, but only with respect to liability for "bodily injury",•"property'damage" or "personal and advertising injury" caused, in whole or in part, by: a. Premises And Ongoing Operations . Your acts or omissions or the acts or omissions of those acting on your behalf:' .' (1) In connection with your premises; or • (2) In the performance of your ongoing operations; or b. Products-Completed Operations "Your work' performed for that additional insured and included in the"products-completed•operations hazard". 2. Any insurance•provided to the additional insured shall only apply withrespect to a claim made or a"suit" brought for damages for which you are provided coverage. 3. Primary Insurance. The insurance afforded the additional insured shall be primary insurance. Any insurance carried by the additional insured shall be noncontributory with respect to coverage provided by you. ' All other policy provisions apply. CMP-4543 154981 04.17.2018 ©, Copyright, State Farm Mutual Automobile Insurance Company, 2018 Includes copyrighted material of Insurance Services Office, Inc;,with its permission. 005166 PROGRESSIVE PR®GREll/l/E® PO Box 94739 COMMERCIAL Cleveland,01-144101-4739 653827 1894 1 FP 0.460 PPACSO1 C 007 001894 THE CITY OF ASHLAND 20 R MAIN ST ASHLAND OR 97520 I1InIIiIIur111111In1111111111111IrnuIII111111111111"11Ii 0015U PROPEL INSURANCE PROOREll/N/E° PO BOX 936 COMMERCIAL MEDFORD,OR 97501 Policy number: 07814616-2 Underwritten by: Artisan and Truckers Casualty Co Insured: THE CITY OF ASHLAND BRIERVILLE FIRE& 20 R MAIN ST March 5,2021 ASHLAND,OR 97520 Policy Period:Jun 30,2020-Jun 30,2021 Mailing Address Artisan and Truckers Casualty Co PO Box 94739 Additional insured endorsement Cleveland,OH 44101 1-800-444-4487 Name of Person or Organization For customer service,24 hours a day, THE CITY OF ASHLAND 7 days a week 20 R MAIN ST ASHLAND,OR 97520 The person or organization named above is an insured with respect to such liability coverage as is afforded by the policy,but this insurance applies to said insured only as a person liable for the conduct of another insured and then only to the extent of that liability. We also agree with you that insurance provided by this endorsement will be primary for any power unit specifically described on the Declarations Page. Limit of Liability • Bodily Injury Not applicable Property Damage Not applicable ' • Combined Liability $1,000,000 each accident All other terms,limits and provisions of this policy remain unchanged. This endorsement applies to Policy Number:07814616-2 Issued to(Name of Insured):BRIERVILLE FIRE& FORESTRY INC. Effective date of endorsement:03/04/2021 Policy expiration date: 06/30/2021 Form 1198(01/04)