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HomeMy WebLinkAboutInsurance Certificate: Ashland Artisan Gallery & Art Center marerarm STATE FARM FIRE AND CASUAL I Y UUMPANY LI O A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON,ILLINOIS DECLARATIONS AMENDED JUL 8 2019 OO® BB 2266 R cha°rdson9TX 75085-3925 Policy Number 97-E2-0940-2 Addl Insured-Section II Only Policy.Period Effective Date ExiratiOn Date M-15-090B-FAE6 F Z 12 Months JUN 13 2019 JUN 13 2020 001444 3123 The policy period begins and ends at 12:01 am standard CITY OF ASHLAND time atthe premises location. 20 E MAIN ST ASHLAND OR 97520-1814 Named Insured ri ASHLAND ARTISAN GALLERY & ART CENTER. INC . T II'IIIIIIIIIIIII'IMI'IIIIIIII'IIII'IIII"'IIIIII'III'I'IIIIIIII ASHLAND AOR IN 597520-1834 O o o _ � • Businessowners-Policy Automatic Renewal-If the.policy period is shown as 12 months,this policy will be renewed automatically subjectto the premiums,rules and forms in effectfor each-succeeding policy period.If this policy is terminated,we will give you and the Mortgagee/Lienholder written notice in compliance with the p,olicy,provisions or as required bylaw. Entity: Corporation Reason for Declarations: Your policy is amended JUL 8 2019 ADDITIONAL INSURED ADDED SECTION II COVERAGE LIMITS CHANGED FORM CMP-4860 ADDED • - Endorsement Premium Increase . $ 117.43 Discounts Applied: Renewal Year . Years in Business Enclosed Building Protective Devices Claim Record Prepared ' AUG 08 2019 O Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP-4000 OR Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 012468 290 Al Continued on Reverse Side of Page Page' 1 of 6 Al r. DECLARATIONS(CONTINUED)' Businessowners Policy for CITY OF ASHLAND - Policy Number 97-E2-0940-2 • SECTION I- PROPERTY SCHEDULE Location V Location of Limit of Insurance*. Limit of Insurance* Seasonal Number Described Increase- Premises Coverage A- Coverage B Business Buildings Business Personal' ;Personal ,.,.Property • Property - 001 357 E MAIN ST No Coverage $ 258,100- 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 INDEXES) Coy A- Inflation Coverage Index: N/A Coy B -Consumer Price Index: 252.9 SECTION I- DEDUCTIBLES Basic Deductible $1,000 Special Deductibles: Money and Securities $250 V Equipment Breakdown , ' $1,000 _ Other deductibles may apply- refer to policy. • Prepared AUG 08 2019 ®Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP-4000 OR Includes copyrighted material of Insurance Services Office,Inc.,with its permission. ' 012468 . , Continued on Next.Page Page 2 of 6 5tatefarm U 0 cQ® DECLARATIONS(CONTINUED) • Businessowners Policy for CITY OF ASHLAND Policy Number 97-E2-0940-2 F• SECTION I- EXTENSIONS OF COVERAGE-LIMIT OF INSURANCE- EACH DESCRIBED PREMISES g 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, ��o but has"Included" indicated, please refer to that policy provision for an explanation of that coverage: LIMIT.OF COVERAGE INSURANCE Accounts Receivable On Premises $1'0,000 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 - . . • 10% insured on a replacement cost basis) Money And Securities (Off Prerinises) • $2,000 Money And Securities (On Premises) $5,000 Money Orders And Counterfeit Money $1,000 Newly Acquired Business Personal Property(applies only if this policy provides • - $100,000 Coverage B- Business Personal Property) Newly Acquired Or Constructed Buildings (applies only if this policy provides $250,000 Coverage A- Buildings) • Prepared AUG 08 2019 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP-4000 OR Includes copyrighted material of Insurance Services Office,Inc.,with its permission. • 012469 290 Continued on Reverse Side of Page Page 3 of 6 DECLARATIONS(CONTINUED) Businessowners Policy for CITY OF ASHLAND Policy Number. 97-E2-0940-2 Ordinance Or Law-Equipment Coverage Included Outdoor Property $5,000 Personal Effects (applies only to those premises provided Coverage B- Business $2,500 Personal Property) Personal Property Off Premises $15,000. -- Pollutant Pollutant Clean Up And Removal $10,000 Preservation Of Property 30 Days Property Of Others (applies only to those premises provided Coverage B - Business $15,000 Personal 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 of the number of described premises shown In these Declarations. • LIMIT OF COVERAGE, INSURANCE Loss Of Income And Extra.Expense Actual Loss Sustained- 12 Months SECTION II-.LIABILITY • LIMIT OF COVERAGE INSURANCE Coverage L- Business Liability $2,000,000 Prepared AUG 08 2019 ©Copyright,State Farm Mutual Automobile.Insurance Company,2008 CMP-4000 OR Includes copyrighted material of Insurance Services Office,Inc„with its permission. 012469 Continued on Next Page Page 4 of 6 Jrarerarm u o oo® DECLARATIONS(CONTINUED) Businessowners Policy for CITY OF ASHLAND Policy Number , 97-E2-0940-2 Coverage M - Medical Expenses (Any One Person) $5,000 Rt, Damage To Premises Rented To You • • $300,000 • LIMIT OF AGGREGATE LIMITS INSURANCE S ' Products/Completed Operations'Aggregate - $4,000,000 • '� General Aggregate $4,000,000 • • • • 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 of this policy. FORMS AND ENDORSEMENTS CMP-4100 Businessowners Coverage Form CMP-4860 *Al Design Person Org CMP-4237.1 Amendatory Endorsement ' FE-6999.2 • Terrorism Insurance Cov Notice CMP-4709 Money and Securities CMP-4705.2 Loss of Income & Extra Expnse CMP-4788 Addl Insd Mgrs Lessor of Prem FE-3650 Actual Cash Vlue Endorsement CMP-4561.1 Policy Endorsement CMP-4527 Exci Ctrl Substances FD-6007 Inland Marine Attach Dec * New Form Attached • • • • Prepared AUG 08 2019 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 • CMP-4000 OR Includes copyrighted material of Insurance Services'Office,Inc.,with its permission. .. • 012470 290 Continued on Reverse Side of Page Page 5 of 6 DECLARATIONS{CONTINUED) Businessowners Policy for CITY OF ASHLAND Policy Number 97-E2-0940-2 This policy is issued by the State Farm Fire and Casualty.Company. • Participating Policy Youare'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. • Secretary President • • • Prepared AUG 08 2019 . ©Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP-4000 OR Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 012470 290 Page 6 of 6 N StateFarm STATE FARM FIRE AND CASUALTY COMPANY —n O A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON,ILLINOIS INLAND.MARINE ATTACHING DECLARATIONS' c D® P9 g8ox 85392255� Richardson, TX 75085-3925 Policy Number 97-E2-0940-2' Named Insured Policy Period Effective Date Expiration Date M-15-090B-FAE6 F Z 12 Months JUN 13 2019 JUN 13 2020 The policy period begins and ends at 12:01 am standard ASHLAND ARTISAN GALLERY & time attfie premises location. ART CENTER INC 357 E MAIN ST . - ASHLAND OR 97520-1834 0 0 . Co . ATTACHING INLAND MARINE . Automatic Renewal-If the policy period is shown as 12 months,this policy will be renewed automatically subjectto 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-8739 Inland Marine Conditions FE-6867 Amend of Inland Marine.Condtns . FE-8743.1 Inland Marine Computer Prop See Reverse for Schedule Page with Limits Prepared AUG 08 2019 ©Copyright,State,Farm•Mutual Automobile Insurance Company,2008 - FD-6007 ' Includes copyrighted material of Insurance•S'ervices Office,Inc.,with its permission. .. 012471 ATTACHING INLAND MARINE`SCHEDULE PAGE - ATTACHING INLAND MARINE ENDORSEMENT LIMIT OF DEDUCTIBLE ANNUAL NUMBER. COVERAGE INSURANCE AMOUNT PREMIUM FE-8743,1 Inland Marine Computer Prop $ 25,000 $ 500 Included ., Loss of Income and Extra Expense $' 25,000 Include d • OTHER LIMITS AND EXCLUSIONS-MAY APPLY-REFER TO YOUR POLICY Prepared. AUG 08 2019 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 FD-6007 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 012471 530-506 a.2 05-31-2011(o11323i Jrarerarm 97-E2-0940-2 012472 CMP-4860 u Page 1 Of 1 0-0® . THIS ENDORSEMENT CHANGES THE POLICY: PLEASE READ IT CAREFULLY. • • ran M 0)S CMP-4860 ADDITIONAL INSURED—DESIGNATED PERSON OR ORGANIZATION 1NtVRAN<�, This endorsement modifies insurance provided under the following: • BUSINESSOWNERS COVERAGE FORM • SCHEDULE Policy Number: 97-E2-0940-2 • o Named Insured: ASHLAND ARTISAN GALLERY & ART CENTER INC 357EMAINST ASHLAND OR 97520-1834 Name And Address Of Additional.Insured Person Or Organization: CITY OF ASHLAND 20 E MAIN ST • ASHLAND OR 97520-1850 • • 1. SECTION II — WHO IS AN INSURED of SECTION II — 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 Youracts 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 opera • - tions hazard". 2. Any insurance.provided to the additional insured shall only apply with respect 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 provid- ed by you. There will be no refund of premium in the event this endorsement is cancelled. All other policy provisions apply. CM P-4860 ©,Copyright,State Farm Mutual Automobile Insurance Company,2008 Includes copyrighted material of Insurance Services Office, Inc.,with its permission.