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HomeMy WebLinkAboutInsurance Certificate: Rogue Boiler Works LLC Sfafear l STATE FARM FIRE AND CASUALTY COMPANY � A STOCK COMPANY WITH HOME OFFICES INBLOOMINGTON, ILLINOIS DECLARATIONS AMENDED JAN22026 Po Box 2915 Policy Number 97-Cl-C236-8 Bloomington IL 61702-2915 Replaces Number 97-CO-Z854-2 Addl Insured-Section II Only Policy Period Effective Date Expiration Date M-15-2275-FAE6 F E 1 Year ,JAN 2 2026 JAN 22027 000645 3123 The policy period beggins and ends at 12:01 am standard THE CITY OF ASHLAND, OREGON time at the premisesTocation. ITS OFFICERS, AGENTS AND EMPLOYEES Named Insured r;• 90 N MOUNTAIN ANTE ASHLAND OR 97520-20I4 ROGUE BOILER WORKS LLC 11116IIIII'I 'II"IllllllllIII'I'rllll'IlElllllll'�ll'I'I'I"III a 0 a �a C/J o Artisan And Service Contractor 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/Lienholder written notice in compliance with the policy provisions or as required by law. Entity: Limited Liability Company Reason for Declarations: Your policy is amended JAN 2 2026 This amendment declaration is a result of an audit. It contains updated coverage and exposure information. Endorsement Premium Decrease $ 63.00 Audit Period: Annual Discounts Applied: Renewal Year Years in Business Claim Record Prepared APR 06 2026 O Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP-4000 OR Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 004332 790 Al Continued on Reverse Side of Page Page 1 of 6 N S30 W a Q5 39 2UI I b�Tt322I Statefar DECLARATIONS (CONTINUED) Artisan And Service Contractor Policy for THE CITY OF ASHLAND, OREGON Policy Number 97-C7-C236-8 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. s 0 0 0 �4 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-4600 Artisan and Service Contractor FE-6999.3 Terrorism Insurance Cov Notice CMP-4237.2 Amendatory Endorsement FE-3650 Actual Cash Value Endorsement CMP-4683.1 Addl Ins Owners Lessee Blkt CMP-4684.1 Addl Insd Owners Lessee Sched CMP-4787 Waiver of Trans Rgt of Recov CMP-4527 Excl Ctrl Substances CMP-4529 Policy Endorsement CMP-4532 Exclusion Cyber Incident CMP-4587 Exclusion Silica FD-6007 Inland Marine Attach Dec Prepared APR 06 2026 O Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP-4000 OR Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 004334 790 Continued on Reverse Side of Page Page 5 of 6 N DECLARATIONS(CONTINUED) Artisan And Service Contractor Policy for THE CITY OF ASHLAND, OREGON Policy Number 97-C1-C236-8 R 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, �N 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 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) Ordinance Or Law- Equipment Coverage Included Outdoor Property $5,000 Prepared APR 06 2026 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP-4000 OR Includes copyrighted material of Insurance services Office,Inc.,with its permission. 004333 790 Continued on Reverse Side of Page Page 3 of 6 N 5tatefarm- STATE FARM FIRE AND CASUALTY COMPANY A STOCK COMPANY WITH HOME OFFICES INBLOOMINGTON,ILLINOIS INLAND MARINE ATTACHING DECLARATIONS Po Box 2915 Policy Number 97-Cd-C236-8 Bloomington IL 61702-2916 Replaces Number 97-CO-ZS54-2 Named Insured Policy Period Effective Date Ex %ration Date M-15-2275-FAE6 F E 1 Year JAN 2 2026 JAN 22027 The oli y period begins and ends at 12:01 am standard ROGUE BOILER WORKS LLC 11me att a premises location. i Q n 0 h v~i'o 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 effectfor each succeeding policy period.If this policy is terminated,we will give you and the Mortgagee/ ienholder written notice in compliance with the policy provisions or as required by law. Annual Policy Premium $ 110.00 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-6867.1 Amend of Inland Marine Condtns FE-8743.1 Inland Marine Computer Prop FE-8756.1 Installation Endorsement FE-8760 Mobile Equipment Form FE-1403 Exclusion Cyber Incident See Reverse for Schedule Page with Limits Prepared APR 06 2026 Q Copyright,State Farm Mutual Automobile Insurance Company,2008 FD-6007 Includes copyrighted material of Insurance Services Office,lnc.,with its permission. 004335 530-686a.2 05-31-2011 WF3232c)