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HomeMy WebLinkAboutInsurance Certificate: Jeremy Maneker State Farm Insurance El PO Box 2915 Bloomington, IL 61702-2915 StateFarm AT1 000436 1200 01 State Farm Fire and Casualty Company CITY OF ASHLAND THE CITY OF AS A stock company with home offices in Bloomington, Illinois 20 E MAIN ST ASHLAND OR 97520-1814 M 8^ �$� Irinlli�rin�nll�l�lrlrinnllrllll�l'I'I�'I�I�I�Illlrll�illl�l Renewal Declarations Policy number:97-CR-B526-0 Effective date:September 9, 2025 Policy period: 12 months Expiration date:September 9, 2026 The policy period begins and ends at 12:01 am standard time at the premises location. AUTO SERVICES 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 compliance with the policy provisions or as required by law. NAMED INSURED JEREMY MANEKER ENTITY Sole Proprietorship-Individual 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: $5,284.00 Total Premium: $5,284.00 Discounts applied: Business Experience Rating Renewal Discount Years in Business IMPORTANT MESSAGE(S) Notice - Information concerning changes in your policy language is included. Please call your agent if you have any questions. Policy number:97-CR-B526-0 Page 1 of 6 ©Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP Dec 3P OR 1 CMP-4000 1009482 2014 153090 214 05-17-2025 Prepared:July 17,2025 State Farm" SECTION I-PROPERTY SCHEDULE Location Location of described premises Limit of Insurance* Limit of Insurance* Seasonal Increase- number Coverage A- Coverage B-Business Business Personal Property Buildings Personal Property 001 2001 NE Foothill Blvd Ste E4 No Coverage $248,400 25% Grants Pass OR 97526-4240 *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 INDEX(ES) Cov A-Inflation Coverage Index: N/A Cov B-Consumer Price Index: 321.5 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-LIMITOF 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 Back-up of Sewer or Drain $15,000 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 those premises provided Coverage B-Business Personal Property) Per Employee $500 Per Occurrence $2,500 Equipment Breakdown Included Fire Department Service Charge $5,000 Policy number.97-CR-B526-0 Page 2 of 6 ©Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 :. StateFarm Coverage Limit of Insurance Fire Extinguisher Systems Recharge Expense $5,000 Forgery or Alteration $10,000 Garagekeepers Insurance-Direct Coverage $25,000 S� co Glass Expenses Included m 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 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 B-Business Personal $100,000 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-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 Employee Dishonesty $10,000 Loss of Income and Extra Expense 12 Months Actual Loss Sustained Policy number.97-CR-B526-0 Page 3 of 6 ©Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 �StateFarm SECTION II - LOCATION SCHEDULE Location Location of described premises number 001 2001 NE Foothill Blvd Ste E4 Grants Pass OR 97526-4240 SECTION II-DEDUCTIBLES Property Damage: $250 Other deductibles may apply - refer to policy. SECT ION 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 Garage Liability Included in Coverage L Operation of Customers'Auto on Particular Premises Included Aggregate Limits Limit of 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 BUSINESSOWNERSCOVERAGE 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-4412 Operation of Customers Auto on Particular Premises CMP-4527 Marijuana Exclusion * CMP-4529 Policy Endorsement * CMP-4532 Exclusion -Cyber Incident CMP-4543 Additional Insured-Designated Person or Organization CMP-4683.1 Additional Insured-Owners,Lessees or Contractors (Blanket) CMP-4705.2 Loss of Income and Extra Expense 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 Tool Coverage CMP-4875 Loss Payable FD-6007 Inland Marine Attaching Declarations FE-3650 Actual Cash Value Endorsement FE-6999.3 Policyholder Disclosure Notice of Terrorism Insurance Coverage Policy number,97-CR-B526-0 Page 4 of 6 ©Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 StateFarm- *New Form Attached SCHEDULE OF ADDITIONAL INTEREST(S) Interest type: Designated Person or Organization Endorsement number: CMP-4543 Loan number: N/A 8 City of Ashland the City of Ashland,Oregon, its officers,agents,and 0,1 employees o 20 E Main St Ashland OR 97520-1814 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. President Secretary OTHER MESSAGE(S) 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 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. Policy number:97-CR-B526-0 Page 5 of 6 0 Copyright, State Farm Mutual Automobile Insurance Company, 2D08 CMP-4000 StateFarm- 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-B52M Page 6 of 6 ©Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP•4000 State Farm Insurance PO Box 2915 Bloomington, IL 61702-2915 State Farm A State Farm Fire and Casualty Company CITY OF ASHLAND THE CITY OF AS A stock company with home offices in Bloomington, Illinois 20 E MAIN ST ASHLAND OR 97520-1814 8� N CNi Inland Marine Attaching Declarations Policy number: 97-CR-B526-0 Effective date: September 9, 2025 Policy period: 12 months Expiration date: September 9,2026 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 Mortg agee/Lien holder 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: 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-1403 Exclusion-Cyber Incident FE-6867 Amendment of Inland Marine Conditions FE-8739 Inland Marine Conditions FE-8743.1 Inland Marine Computer Property Form "Kew Form Attached 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 $26,259 $500 $15 Policy number.97-CR-B526-0 Page 1 of 2 CIM Alt Dec 3P OR.1 ©Copyright, State Farm Mutual Automobile Insurance Company, 2008 FD-6007 1009481 2002 153089 202 03-06-2021 StateFarw Endorsement Coverage Limit of insurance Deductible amount Annual premium number 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 2 of 2 ©Copyright, State Farm Mutual Automobile Insurance Company, 2008 FD-6007