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HomeMy WebLinkAboutInsurance Certificate: Cascade Charter Company, LLC State Farm Insurance PO Box 2915 Bloomington, If_ 61702-2915 StateFarw AT1 001195 1200 01 State Farm Fire and Casualty Company CITY OF ASHLAND A stock company with home offices in Bloomington, Illinois 20 E MAIN ST ASHLAND OR 97520-1814 a 8 N N �g� 'Illlllll'1111111"I'llllllill�llll'Illlllllllllll'Il'Illl"Illrl Amended Declarations Policy number:97-CP-R296-3 Effective date:January 5,2026 Policy period: 12 months Expiration date:April 1, 2026 The policy period begins and ends at 12:01 am standard time at the premises location. OFFICE 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 MortgageeiLienholder written notice in compliance with the policy provisions or as required by law. NAMEDINSURED CASCADE CHARTER COMPANY, LLC ENTITY Limited Liability Company 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 are for the policy period and policy characteristics as described in this Declarations. Change in premium: none Discounts applied: Business Experience Rating Renewal Discount Years in Business REASONS FOR DECLARATIONS Your policy is amended effective January 5, 2026 due to some recent policy changes you requested, Enclosed is a copy of your new endorsements, if any. Policy number:97-CP-R296-3 Page 1 of 5 ©Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP Dec 3P OR 1 CMP-4000 1009482 2014 153090 214 05-17-2025 Prepared:January 5,2026 StateFarn SECTION 1,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 2800 BIDDLE RD $745,000 $44,900 25% MEDFORD OR 97504-4115 *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: 246.8 Cov B-Consumer Price Index: 315.7 SECTION I DEDUCTIBLES BASIC DEDUCTIBLE $1,000 SPECIAL DEDUCTIBLES: Employee Dishonesty: $250 Equipment Breakdown: $1,000 Money and Securities: $250 Other deductibles may apply- refer to policy. SECTION I,EXTENSIONS OF COVERAGE-LIMIT OF INSURANCE-EACN DWRIBED 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 $50,000 Off Premises $15,000 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 Equipment Breakdown Included Fire Department Service Charge $5,000 Fire Extinguisher Systems Recharge Expense $5,000 Forgery or Alteration $10,000 Glass Expenses Included Policy number:97-CP-R2963 Page 2 of 5 ©Copyright. State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 StateFarw Coverage Limit of Insurance 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 a S N 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) $5,000 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 $2,500 Property) Signs $2,500 Unauthorized Business Card Use $5,000 Valuable Papers and Records On Premises $50,000 Off Premises $15,000 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 Dependent Property-Loss of Income $5,000 Employee Dishonesty $10,000 Loss of Income and Extra Expense 12 Months Actual Loss Sustained Utility Interruption-Loss of Income $10,000 Policy number:97-CP-R296-3 Page 3 of 5 ©Copyright, State Farm Mutual Automobile Insurance Company, 2008 GMP-4000 &StateFarml' SECTION II-LOCATION SCHEDULE Location Location of described premises number 001 2800 BIDDLE RD MEDFORD OR 97504-4115 SECTION II- LIABILITY Coverage Limit of Insurance Coverage L-Business Liability Per Occurrence $2,000,000 Coverage M-Medical Expenses $10,000 Any One Person Damage to Premises Rented to You $300,000 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 BUSI NESSOWNERS 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-4237.2 Amendatory Endorsement(Oregon) CMP-4527 Marijuana Exclusion CMP-4529 Policy Endorsement CMP-4532 Exclusion-Cyber Incident CMP-4683.1 Additional Insured-Owners,Lessees or Contractors(Blanket) CMP-4684.1 Additional Insured-Owners,Lessees or Contractors(Scheduled) CMP-4703.1 Utility Interruption-Loss of Income CMP-4704.1 Dependent Property-Loss of Income CMP-4705.2 Loss of Income and Extra Expense CMP-4706 Backup of Sewer or Drain CMP-4709 Money and Securities CMP-4710 Employee Dishonesty CMP-4787 Waiver of Transfer of Rights of Recovery Against Others To Us CMP-4819.1 Unauthorized Business Card Use FD-6007 Inland Marine Attaching Declarations FE-3650 Actual Cash Value Endorsement FE-6999.3 Policyholder Disclosure Notice of Terrorism Insurance Coverage SCHEDULE OF ADDITIONAL INTERESTS) Interest type: Owners,Lessees, or Contractors(Schedul Endorsement number: CMP-4684.1 Loan number. NIA CITY OF ASHLAND 20 E Main St Ashland OR 97520-1814 Policy number:97-CP-R296-3 Page 4 of 5 m Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP•4000 ❑ ' StateFarml" 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. a 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. wOcon President Secretary Policy number:97-CP-R296-3 Page 5 of 5 ®Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 State Farm Insurance PO Box 2915 Bloomington, IL 61702-2915 StateFarm State Farm Fire and Casualty Company CITY OF ASHLAND A stock company with home offices in Bloomington, Illinois 20 E MAIN ST ASHLAND OR 97520 1814 Q N 8a N Inland Marine Attaching Declarations Policy number: 97-CP-R296-3 Effective date: January 5, 2026 Policy period: 12 months Expiration date: April 1, 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. 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 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 Other limits and exclusions may apply-refer to your policy, Policy number:97-CP-R296-3 Page 1 of 1 CIM Att Doc 3P OR.1 ®Copyright, State Farm Mutual Automobile Insurance Company, 2008 FD-6007 1009481 2002 153089 202 03-06-2021