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HomeMy WebLinkAboutInsurance Certificate: Ashland Culture of Peace (2) aIdlerau n 5I A I t I-AMM I Hit AIVU GAJUAL I Y UUMF'AN Y L1 O A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON,, ILLINOIS DECLARATIONS AMENDED OCT 21 2019 Po Box 853925 . Policy Number 97-B9-J284-2 Richardson, TX 75085=3925 Addl Insured-Section II Only Policy Period Effective.Date Ex iration Date M-15-097C-FAE6 F N 12 Months JUL 1 2019 JUL 1 2020 001787 3123 •The policy period begins and ends at 12:01'am standard CITY OF ASHLAND INCLUDING ITS time atthe premiseslocation. OFFICERS EMPLOYEES & AGENTS .',F: 20 E MAIN ST Named Insured ASHLAND OR 97520-1814 ASHLAND CULTURE OF PEACE COMMISSION - 1.11-11. 11111111111 ASHLANDTORT 97520-1918 S o _ 00 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 effect for each succeeding policy period.If this policy is terminated,we will give you and the Mortgagee/Genholde'written notice in compliance with the policy.provisions or as required by law.. Entity: Corporation Reason for Declaratipns: Your policy is amended OCT 21 2019 • • SECTION II COVERAGE LIMITS CHANGED • • • • • • Endorsement Premium None Discounts Applied: Claim Record • Prepared OCT 29 2019 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP-4000 OR Includes copyrighted material of Insurance Service's Office,Inc.,with its permission. 013355 290 Al Continued on Reverse Side of Page Page 1 of 6 NI DECLARATIONS(CONTINUED) Businessowners Policy for CITY OF ASHLAND INCLUDING ITS • Policy Number 97-B9-J284-2 SECTION I- PROPERTY SCHEDULE ._ Location 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 33 N 1ST ST No Coverage $ 52,000 25% ASHLAND OR 97520-1918 • *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 INDEXIES) Coy A- Inflation Coverage'Index: N/A Coy B - Consumer Price Index: 254.2 SECTION I- DEDUCTIBLES Basic Deductible $500 Special Deductibles: Money and Securities $250 Equipment Breakdown $500 • Other deductibles may apply- refer to policy. Prepared S OCT 29 2019 ©Copyright,State Farm Mutual Automobile Insurance,Company,2008 CMP-4000 OR Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 013355 Continued on Next Page Page 2 of 6 srarerarm u 0 o'o® DECLARATIONS(CONTINUED) Businessowners Policy for CITY OF ASHLAND INCLUDING ITS Policy Number 97-B9-J284-2 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, 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 $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._ 10% insured on a replacement cost basis) Money And Securities (Off Premises) $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 OCT 29 2019 ©Copyright,.State Farm Mutual Automobile Insurance Company,2008 . CMP-4000 OR Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 013356 290 Continued on Reverse Side of Page . Page 3 of 6 DECLARATIONS(CONTINUED) Businessowners Policy for CITY OF ASHLAND INCLUDING ITS Policy Number 97-B9-J284-2 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 Clean Up And Removal $10,000 Preservation Of Property 30 Days Property Of Others (applies only to those premises provided Coverage B Business $2,500 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 OCT 29 2019 O Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP-4000 OR Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 013356 Continued on Next Page Page 4 of 6 3rarerarm u O QQ® DECLARATIONS(CONTINUED) Businessowners Policy for CITY OF ASHLAND INCLUDING ITS . • .• Policy Number 97-B9-J284-2 • Coverage M - Medical Expenses (Any One Person) $10;000 1 . ;•.;:, Damage To Premises Rented To You , $300;000 LIMIT OF AGGREGATE LIMITS INSURANCE s Products/Completed Operations Aggregate . . $4',000;000 'o General Aggregate $4,000,000 Each paid claim for Liability Coveragereduces 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 13USINESSOWNERS 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 FE-6999.2 Terrorism Insurance Coy Notice CMP-4237.1 Amendatory Endorsement FE-3650 Actual Cash Vlue Endorsement CMP-4705.2 Loss of Income & Extra Expnse CMP-4709 Money and Securities CMP-4804 Addl Insd Club Members CMP-4860 Al Design Person Org . CMP-4561.1 Policy Endorsement CMP-4527 Excl Ctrl Substances FD-6007 Inland Marine Attach Dec Prepared 0 OCT 29 2019 ©Copyright,State Farm.Mutual Automobile Insurance Company,2008 CMP-4000 OR Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 013357 290 Continued on Reverse Side of Page Page 5 of 6 r.i DECLARATIONS(CONTINUED) Businessowners Policy for CITY OF ASHLAND INCLUDING ITS. Policy Number 97-B9-J284-2 This policy is issued by the State Farm Fire and Casualty Company. • Participating Policy You are entitled to participate ina 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. ' )111/0441.111, Secretary President Prepared' ' OCT 29 2019 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP-4000 OR Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 013357 290 Page 6 of 6 N .5rarerarm STATE FANM FIRE AND CASUALTY UUMI'ANY ' O ASTOCK COMPANY.WITH HOME;OFFICES INBLOOMINGTON,ILLINOIS INLAND.MARINE ATTACHING DECLARATIONS O-O® BB 2255 R Fox 85 9TX 75085-3925 Policy'Number 97-B9-J284-2 Named Insured Policy Period Effective Date Expiration Date M-15-097C-FAE6 F N 12 Months JUL 1 2019 JUL 1 2020 The policy period begins and ends at 12:01 am standard ASHLAND CULTURE OF PEACE time atthce premisesTocation. COMMISSION 33 N '1ST ST { ASHLAND. OR 97520-1918 - 0 ATTACHING INLAND MARINE Automatic Renewal-If the policy period is shown és 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 policy provisions oras 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'subsequentto.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 OCT 29 2019 ®Copyright,State Farm Mutual Automobile Insurance Company,2008 . • • FD-6007 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 013358 530-e0fi i7 05-71-71111 Int f3737r1 el-Y�7-V LV'I-L ' 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 S 25,000 $ 500 Included Loss of Income and Extra Expense $. 2 5,0 0 0 Included OTHER LIMITS AND EXCLUSIONS MAY APPLY-REFER TO YOUR POLICY Prepared OCT 29 2019 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 FD-6007 Includes copyrighted material of Insurance Services.Office,Inc.,with its permission. 013358 530.606 e.2 05-31-2011(o1f323,