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HomeMy WebLinkAboutInsurance Renewal: Maneker, Jeremy State Farm Insurance U PO Box 2915 ,/9 Bioomington; IL 61702-2915 . . Q Statesl army AT2 001576 1200 01 State:Farm.Fire and CasualtyiCompany CITY OF ASHLAND THE CITY OF AS A stock company with home offices in Bloomington, Illinois ti' 20 E MAIN ST "'. ASHLAND OR 97520-1814 S 1-o ,rrIuIIIIirn,rlllluIIIIIllrliIn1Ilfllnli,llllIIIIii!IIIIIIII1III •' - • - . ' ,,"1: . Renewal Declarations , :: .(- ,:, - : ,, .e . . Policy number:97-CR-B526-0 Effective date:September 9,2022 Policy period: 12 months Expiration date:,September 9, 2023 . . The policy period begins and ends at 12:01 am standard time at the premises location, AUTO SERVICES POLICY . , 4 • I . Automatic renewal -If the State Farm®policy,:period is-shown,as I2;months, thispolicy willbe=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•conipliar ce with the policy provisions oras required by-law. , ' -- , . '_. • NAMED INSURED . JEREMY MANEKER . . . . ENTITY • • •.: Sole Proprietorship-Individual • IMPORTANT MESSAG E(S) . .. Notice - Information concerning changes in your..policy language is included. Please call your agent if you have any questions., • P.OLICY,PREMIUM .._ This is not a bill-Ifan 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: $2,687.00 . _ Total Premium: $2,687.00 ' ' Discounts applied: . • . • _ '. . . • Business Experience Rating Protective Devices Years in Business ' Policy number:97-CR-B526-0 Page 1 of 5 Prepared:July 2,2022 ©-Copyright,State Farm Mutual Automobile'Insurance Company,.:2008 CMP Dec 3P OR.1 . CMP-4000 1009482 2005 153090 205 08-21-2021 006820 • StateFareno ` SECTION I-PROPERTY SCHEDULE ' Location Location of. described premises Limit of lnsurance* Limit of lnsurance* Seasonal Increase number Coverage A- Coverage B-Business . . .Business Personal Property:, . , Buildings Personal.Property ' ' 001 2001 NE Foothill Blvd Ste E4 No Coverage $223,200 25% Grants Pass OR 97526-4240 *As of the effective date of this policy, the Limit of Insurance as shown includes iany increase in the'limit due to Inflation•Coverage. SECTION I—INFLATION COVERAGE INDEX(ES) Coy A-Inflation Coverage Index: N/A Coy B-Consumer Price Index: 289.1 SECTION I—DEDUCTIBLES • • BASIC DEDUCTIBLE $1,000 . SPECIAL DEDUCTIBLES: Employee Dishonesty: '$250 .. . • Equipment Breakdown: • , $1;000 , . , • .' 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 l'imits'•shown below apply separately to each described premises shown in-these Declarations, unless indicated by"See schedule", If a coverage'does not have acorresponding limit'shown below, but has"Included" indicated;refer to that policy provision for an explanation of that coverage. _ ;r4. Coverage Limit of Insurance Accounts Receivable On Premises $10,000 Off Premises .. $5,000 . 1' •``,;t i'.Y3(Y, •,1 Arson Reward' $5,000 „ Back-up of Sewer or Drain .. $15,000... . . >t' .iiho......:,. 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 thosepremises provided Coverage B-Business Personal Property) Per Occurrence , , $500 Equipment Breakdown Included ' Fire Department Service Charge $5,000 Fire Extinguisher Systems Recharge Expense $5,000 Policy number:97-CR-B526-0 Page 2 of 5 Prepared:July 2,2022 •©Copyright, State:Farm-Mutual,Automobile Insurance Company, 2008 CMP-4000 . u• 090 StateFarm® Coverage Limit of Insurahce-; •`-•• ; .r - i'vi " -i' El' Forgery or Alteration : $10,000 - _. Garagekeepers Insurance-Direct Coverage • --$25,000 - • - . Glass Expenses Included S Increased Cost of Construction and Demolition Costs(applies only when buildings are insured on a 10% . . N o 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 Property • - - • - -- --- - -- - 30 days - .. - Property of Others'(applies Only to those'premises provided Coverage I3'-Business Personal $106000 • ' Property) . Signs . . $5,000 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-?ER POLICY . ' t 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 ' 4.- Employee Dishonesty - • . $10,000- • Loss of Income and Extra Expense .. • 12 Months-Actual Loss Sustained • Policy number:97-CR-B526-0 - Page 3 of 5 Prepared:July 2,2022 ©Copyright--State-Farm Mutual Automobile Insurance Company, 2008 CMP-4000 . 006821 StateFarmo SECTION Il-LOCATION SCHEDULE , Location Location of described premises number , • • . 001 2001 NE Foothill Blvd Ste E4 V - ' Grants Pass OR 97526-4240 . • SECTION II-DEDUCTIBLES Property Damage: $250 ' • Other deductibles may apply-refer to policy. SECTION II-LIABILITY • , Coverage ' Limit of Insurance Coverage L-Business Liability Per Occurrence ,. . : . , , , , $2,00.0,000 - ,, • 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 ' • n - -Limit oi'Insurance ' General Aggregate $4,000,000 Products/Completed Operations 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. V 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•(Blankat) ; V. ' CMP-4705.2 , Loss of Income and-Extra Expense ; V - CMP-4706 Back-up of Sewer or Drain CMP-4709 Money and Securities CMP-4710 Employee.Dishonesty ' .CMP-4742.1 Garage Liability CMP-4744 Garagekeeper's Insurance-Direct Coverage - CMP-4827.1 Employee ToolCoverage FD-6007 . Inland Marine Attaching Declarations V FE-1313 • Form 438BFU NS-Lenders Loss Payable Endorsement V -- - - ... FE-3650 Actual Cash Value Endorsement . FE-6999.3 Policyholder Disclosure Notice of Terrorism Insurance Coverage • Policy number:97-CR-8526-0 - Page 4 of 5 Prepared:July 2,2022 ©Copyright, State,Farm Mutual Automobile'Insurance Company; 2608 CMP-4000 u • • o State Farme • SCHEDULE OF ADDITIONAL INTEREST(S) ;', Interest type: Designated Person or Organization Endorsement number: CMP-4543 Loan number: N/A City of Ashland the City of Ashland,Oregon, its officers,agents,and employees ' 20EMain St Ashland OR 97520-1814 No. FULL NAMED INSURED ' Named Insured: JEREMY MANEKER DBA WRAP IT UP GRAPHICS,CITY OF ASHLAND 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. e -d )1/Cy4WALL President • Secretary • OTHER MESSAGE(S) NOTICE TO POLICYHOLDER: ' For a comprehensive description of coverageand 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, oramended 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 at a 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-CR-B526-0 Page 5 of 5 Prepared:July 2,2022 ©Copyright;State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 006822 - • State Farm Insurance • U • PO Box 2915 • • Bloomington, IL 61702-2915 090 State Farm® State Farm Fire and Casualty Company CITY OF ASHLAND THE CITY OF AS A stock company with home offices in Bloomington, Illinois kri 20EMAIN ST ASHLAND OR 97520-1814 • S O O • ( Inland Marine AttachingDeclarations Policy number: 97-CR-B526-0 Effective date: September.9, 2022 Policy period: 12 months. Expiration date: September 9, 2023 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: $12.00 The above•premium amount is included in the Policy Premium shown on the Declarations. FULL NAMED INSURED • Named Insured: JEREMY MANEKER DBA WRAP IT UP GRAPHICS, CITY OF ASHLAND 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 pagewith,limits ATTACHING INLAND MARINE SCHEDULE PAGE Endorsement Coverage Limit of insurance Deductible amount Annual premium number FE-8743.1 Inland Marine Computer Property Form $26,259 $500 $12 Loss of Income and Extra Expense $25,000 Included Other limits and exclusions may apply-refer to your policy. • Policy number:97-CR-8526-0 Page 1 of 1 Prepared:July 2,2022 ©Copyright, State.Farm Mutual Automobile Insurance Company, 2008 CIM Att Dec 3P OR.1 FD-6007 1009481 2002 153089 202 03-06-2021 006823 u • CMP-4543 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. _tri ADDITIONAL INSURED —DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: , BUSINESSOWNERS COVERAGE FORM ;o • SCHEDULE Policy Number: 97-CR-B526-0 Named Insured: JEREMY MANEKER DBA WRAP IT UP GRAPHICS, CITY OF ASHLAND Name And Address Of Additional Insured Person Or Organization: City of Ashland the City of Ashland, Oregon, its officers, agents, and employees 20EMain St - Ashland OR 97520-1814 • 1. SECTION II —WHO IS AN INSURED of SECTION II —LIABILITY is amended toinclude, 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 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 provided by you, All other policy provisions apply... • • • CMP-4543 154961 04-17-2018 ©, Copyright, State Farm Mutual Automobile Insurance.Company, 2018 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. 006824 .