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Home My WebLink AboutCenter for Non-Profit Legal Services AMERICAN ECONOMY INSURANCE COMPANY SEATTLE, WASHINGTON ULTRA OFFICE POLICY r"M\JL I RENEWAL DECLARATIONS lAMED ~SURED ,NO nAILING \DDRESS CENTER FOR NON-PROFIT LEGAL SERVICE, INC. PO BOX 1586 MEDFORD, OR 97501 POLICY NUMBER 02-BO-437026-4 RENEWAL OF 02-BO-437026-3 05-93 JOlley PERIOD FROM 05-15- 0 6 TO 05-15- 0 7 12:01 AM STANDARD TIME AT YOUR MAILING ADDRESS SHOWN ABOVE. AGENT NAME AND ADDRESS SECURITY INSURANCE A JBL&K COMPANY 707 MURPHY RD MEDFORD, OR 97504 36-28302 (877) 538-1920 FORM OF BUSINESS: CORPORATION THE TOTAL PREMIUM DUE FOR THE POLICY TERM IS $816.00. YOU WILL BE BILLED THROUGH YOUR CUSTOMER ACCOUNT #020-0585-291-01. YOU NEED NOT PAY ANY PREMIUM AT THIS TIME. WE WILL SEND A BILLING STATEMENT IN A SEPARATE MAILING. IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. THIS RENEWAL SERVES THE SAME PURPOSE AS WRITING A NEW POLICY WITH THE SAME PROVISlONS, CONDITIONS AND INSURING AGREEMENTS. THE POLICY DECLARATIONS EXTENSION WHICH FOLLOWS, LISTS ALL OF THE FORMS THAT APPLY TO YOUR RENEWAL AND THOSE, IF ANY, WHICH NO LONGER APPLY. ONLY NEW OR REVISED FORMS ARE ATTACHED TO THIS RENEWAL. YOU MUST ADD THEM TO YOUR PRIOR POLICY. ADDITIONAL INSURED ADDITIONAL INSURED JACKSON COUNTY CITY OF ASHLAND PREMISES 001 HEALTH & HUMAN SERVICES DEPT. PREMISES 001 CITY HALL 1005 E MAIN ASHLAND, OR 97520 MEDFORD, OR 97504 - iiiiiii - - - - iiiiiii - - ~ - - - - - - - - - t/ /3/D& (DATE) BY ~~HORI~ - - === - - - - - - - 9-BP(11-91) COMPANY USE DNLY SafecoCil and the Safeco logo are trademarks of Safeco Corporation '-'r'lnTLJhlrCT 60 (ABBDEG) OTHER INTEREST COpy PREPARED 03-24-06 (AMYPAR) _ .... ..,. nnll.lTI"V'H ".,1::1 1YYl1_~ ~. rt\\J L ~ POLICY DECLARATIONS EXTENSION NAMED INSURED: CENTER FOR NON-PROFIT LEGAL POLICY NUMBER: 02-BO-437026-4 PREMISES 1 225 W MAIN ST BUILDING 1 MEDFORD, OR 97501 CONSTRUCTION: JOISTED MASONRY OCCUPANCY: OFFICE - ATTORNEYS APPLICABLE TO THESE PREMISES EXCEPT WHERE NOTED BELOW, A DEDUCTIBLE OF $ 250 APPLIES BUILDING - REPLACEMENT COST BUSINESS PERSONAL PROPERTY BUSINESS INCOME (NOT EXCEEDING 12 CONSECUTIVE MONTHS) DEDUCTIBLE: NONE TENANTS LIABILITY DEDUCTIBLE: NONE EQUIPMENT BREAKDOWN OUTDOOR SIGNS (DEDUCTIBLE: $ 250) MONEY AND SECURITIES (DEDUCTIBLE: $ 250): INSIDE THE PREMISES OUTSIDE THE PREMISES ACCOUNTS RECEIVABLE COMMERCIAL FINE ARTS VALUABLE PAPERS AND RECORDS MINI COMPUTER COVERAGE: EQUIPMENT ACTIVE DATA PROCESSING MEDIA EXTRA EXPENSE MINI COMPUTER MECHANICAL BREAKDOWN SEWER OR DRAIN BACK-UP ORDINANCE OR LAW LIMITS OF INSURANCE $ 340,000 $ 132,000 ACTUAL LOSS SUSTAINED $ 1,000,000 INCLUDED $ 7, 500 $ 10,000 $ 5,000 $ 25,000 $ 10,000 $ 50,000 INCLUDED INCLUDED INCLUDED INCLUDED $ 5,000 SEE ENDORSEMENT - ~ - - - == - - ~ - - - - - - - - - - = - - - - - - - - . -. -. .......,...^^~ ".,,.~ tvV'I':) t - T ---,-~._--.. ---.- L POLICY DECLARATIONS EXTENSION PAGE NAMED INSURED: CENTER FOR NON-PROFIT LEGAL POLICY NUMBER: 02-BO-437026-4 APPLICABLE TO ALL PREMISES YOU OWN, RENT OR OCCUpy LIMITS OF INSURANCE BUSINESS LIABILITY: LIABILITY AND MEDICAL EXPENSES $ 1,000,000 MEDICAL EXPENSES (ANY ONE PERSON) $ 10,000 AGGREGATE LIMITS $ 2,000,000 HIRED AUTO AND NON-OWNED AUTO LIABILITY SEE BUSINESS LIABILITY EMPLOYEE DISHONESTY (DEDUCTIBLE: NONE) $ 15,000 FORGERY OR ALTERATION (DEDUCTIBLE NONE) $ 25,000 EMPLOYMENT PRACTICES (DEDUCTIB~E: NONE): EACH INCIDENT LIMIT $ 5,000 AGGREGATE LIMIT $ 5,000 RETROACTIVE DATE OF 05/15/03 ~ ... ... ... PREMIUM FOR CERTIFIED ACTS OF TERRORISM TERM PREMIUM TOTAL TERM PREMIUM $ $ $ 3.00 813.00 816.00 - --- - iiiii - - --- - ~ - - - - - - - - - - === - - - - - - - POLICY DECLARATIONS EXTENSION NAMED INSURED: CENTER FOR NON-PROFIT LEGAL THE FOllOWING FORMS CURRENTLY APPLY TO THIS POLICY: BP0003(0702) BUSINESSOWNERS SPECIAL COVERAG BP7080(0702) ORDINANCE OR LAW COVERAGE BP1203(0702) LOSS PAYABLE PROVISIONS BP7059(0105) COMMERCIAL FINE ARTS COV FORM BP8136(0702) EQUIPMENT BREAKDOWN ENDORSEMEN C4359(0405) NOTICE TO POLICYHOLDERS BP8068(0702) EXCLUSION -ASBESTOS BP0455(0702) BUSINESS LIABILITY COV-TENANTS BP0441(0702) BUSINESS INCOME CHANGES BP0178(0106) OREGON CHANGES POLICY NUMBER: 02-BO-4 37026-4 BP7076(0105) ULTRA PLUS BP0404(0702) HIRED AUTO AND NON-OWNED A BP8094(0702) NON-OWNED AUTO LIAB. AMEND. EN BP0437(0702) EXCLUSION-PERSONAL & ADVERT. I BP0523(1102) CAP ON LOSSES CERTIFIED ACTS 0 IL7201(0392) COMPANY COMMON POL CONDITIONS BP8029(0702) AMENDMENT-AGGREGATE LIMITS OF BP0576(1102) FUNGI OR BACTERIA EXCLUSION (p BP0417(0702) EMPLOYMENT RELATED PRACT. EXCL BP8128(0502) EMPLOYMENT PRACTICES LIABILITY THE FOllOWING FORMS NO lONGER APPLY TO THIS COVERAGE: BP7076(1203) ULTRA-PLUS C4114(0603) ADVISORY NOTICE TO POLICYH BP0178(0702) OREGON CHANGES C4042(0702) POLICYHOLDER NOTICE ,.. nil I"j'" OCltJTM1 ''':It;.1...lVVl~F ~,-- POLICY DECLARATIONS EXTENSION NAMED INSURED: CENTER FOR NON-PROFIT LEGAL LOSS PAYEE AT&T CREDIT CORPORATION PREMISES 001 C/O LEASE INS. AGENCY SERVICES P.O. BOX 96064 BELLEVUE, WA 98009 16070W30321800011 - MERLIN II LOSS PAYEE COPELCO CREDIT CORP. PREMISES 001 15325 S.E. 30TH PLACE,ST. 100 BELLEVUE, WA 98007 ACCT# 1232350/SHARP COPIER LOSS PAYEE LUCENT TECHNOLOGIES PRODUCT PREMISES 001 FINANCE C/O ABIC-SPECIALTY SERVICES, 5TH FLOOR P.O. BOX 979220 MIAMI, OR 33197 W3032180003A L PAGE POLICY NUMBER: 02-BO-437026-4 MORTGAGE HOLDER JOHN FERRIS, WILLIAM FERGUSON, PREMISES 001 AND ROBERT GRANT C/O JOHN FERRIS, ATTY AT LAW 27 NORTH IVY MEDFORD, OR 97501 ADDITIONAL INSURED ROGUE VALLEY COUNCIL OF PREMISES 001 GOVERNMENTS AGING PROGRAM P.O. BOX 3275 CENTRAL POINT, OR 97502 )( ~