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Home My WebLink AboutLE, LAM - INSURANCE CERTIFICATEStateFarm • • • STATE FAfiM FIRE ANb CASUALTY COMPANY A STOCK COMPANY kNITN NQME OFFlCES 1N BLC�OMlNGTd'N, JLLlNOIS DECLARATIONS AMENDEtI DEC 13 2023 P Box 2� 15 B�oomrng on IL 61702-28 i 5 Addl lnsured-Section !I Only M-20-182E-FAF1 F Z 002210 3123 CITY OF FORT COLLINS DEVELOPMENT REVIEW CENTER � 281 N COLLEGE AVE FORT COLLINS CO 80524-2404 I�I�illi�l�r�liiii�ii��i��i,iiiiili��ll��iili��ill�i�ili��it � �� o Policy Number 96-05-C417-3 L Policy Periad EHective Date Ex� piration Date 12 Months JUN 10 2023 JUN 10 2fl24 The poliGy perro� be ins and ends at 12:01 am standard time atthe premises�ocabon. Named Insured LE, LAM Hair Salon, Day Spa and Barber Policy Automatic Renewal - If the policy pe�iod ss shown as 12 months , tfns policy will be renewed automaUcally subjectto tfie premiums, rules anc forms in effect for each succeeding policy period. If ti�is policy �s terminated, we will glve you and the Mortgagee/Lienholder written natice in compltance with the policy provisions or as required by law. Entity: Individua! Reason for Declarations: Endorsement Premium Discaunts Applied: Renewaf Year Years in Business Protective Devices Sprinkler Claim Record Prepared JAN 16 2024 CMP-4000 Your policy is amended DEC 13 2023 ADDITIONAL INSURED ADDED FORM CMP-4791 ADDED FORM CMP-47$7 ADDED None '�J Copynght, State Farm Muival Automobile Insurence Compa�y, 2008 Includes eopynghted mater�al of Insurance Services Olf�ce, Ine., with its permission 018390 290 At Continued on Reverse Side of Page Page 1 of fi DECLARATEONS (CON7INUED) Hair 5alon, Day Spa and Barber Policy for CITY OF FORT COLLINS Policy Number 96-05-0017-3 � \ i � _ A 1 � " A: Location Locatfon of Limit of Insurance* Limit of Insurance* Seasonal Number Described Increase- Premises Coverage A- Coverage 8- Business Buildings Buslness Personal Personal Property Property OOi 3632 W 10TH ST STE A No Coverage $ 23,604 25% GREELEY CO 8Qfi34-1850 , of the effective date of this poiicy, the Limit of Insurance as shown includes any increase in the limit due to Inflaiion Coverage •� � � • _;_ r � Cov A- lnflakion Coverage Index: N/A Cov B- Consumer Price lndex: 299.2 SECTION I - D�UUC BLES Basic Deducttble Specfal Deductibles: Money and Securities Equipment Breakdown $50Q $250 Empioyee Dishonesty $50Q Oiher deductibles may apply - refer to policy. Prepared JAN 16 2Q24 CMP-4d00 C� Copynght. State farm Mutuel Automobde Insurence Compeny, 20D8 Includes copyr gh[ed mater{el of Insurance Services Office, Inc., with its permission. $250 018390 Continued on Next Page Page 2 af 6 StateFarm • • r►, DECLARATIONS (CONTINUED} Hair Salon, Day Spa and Barber Policy for CITY OF FORT COLLIN5 Policy Number 96-05-0017-3 �Y �� r �o SECTION I- EXTENSIONS OF COVERAGE - I,IMIT F fNSURANCE - 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." !f a coverage does not have a carresponding limit shown below, but has "Included" indicated, please refer to that policy provision for an explanation of that coverage. COVERAGE Accounts Receivable On Premises Off Premises Arson Reward Brands And Labels Collapse Damage To Non-Owned Buildings From The(t, Burglary Or Robbery Debris Removal Employee Equipment - Off Premises (applies only to thase premises provided Coverage B - Business Personal Property} Per Occurrence Per Employee Per Piece Employee Equipment - On Premises (applies only ta those premises provideci Coverage B - Business Personal Property} Per Occurrence Per Employee Per Piece Equipment Breakdown Fire Department Service Charge Fire Extinguishe� Systems Recharge Expense Forgery Or Alteration Glass Expenses Increased Cost Of Construction And Demolition Costs (applies only when buildings are insured on a replacement cost basis) Prepared JAN 16 2024 CMP-4000 (� Copyright State Farm Mutual Automobile Insurance Company, ZODB Includes copyriphted materiel of Insurance Services Office, Inc , with its permisston LIMIi' OF INSURANCE $10,000 $5,000 $5,000 $25,000 lncluded Coverage B �imit 25% of cavered loss $2,500 �� ,aoo $500 $5,000 $1,000 $500 Included $2,500 $5,000 $10,040 Included 10% 018391 290 Continued on Reverse Side of Page Page 3 of 6 ni DECLARAifONS (C4N71NUED} Halr Salon, Day Spa and Barber Poltcy for CITY OF FORT COLI.INS Poltcy Number 96-05-0017-3 Money And Securities (Off Premises} Money And Securities (On P�emises) Money Orders And Counterfeit Money Newly Acquired Business Personal Property (applies only if this policy ptovides Coverage B- Business Personal Property) Newly Acquired Or Constructed Buildings {applies only if this policy provldes Coverage A - Buildings) Ordinance Qr Law - Equipment Coverage Outdoor Property Personal Effects (applies only to those premises provided Coverage B-�usiness f'ersonal Property) Persanal Property Off Premises Poilu4ant Clean Up And Removal Preservation Of Property Praperty �f Others (applies only to ihose premises provided Caverage 6- Business Personal Property) Signs Valuable Papers And Records On Premises Off Premises Wa#er Damage, Other Liquids, Powder Or Molten Material Damage $5,000 $10,000 $1,004 $100,000 $250,004 Included $5,000 $2,5Q0 $t 5,004 $� a,000 30 Days $2,500 $2,500 $i o,aoo $5,000 Included SEC�,_, TION I- E�TEN,��Q�VS OF �OYERAGE - LIMIT Q� (�VSU ANC - P�R POLICY ihe coverages and corresponding limlts shown below are the most wa will pay regardless of the number of described premises shown in thsse Declarations. COV�RAGE Dependent Properiy - Loss Of Income Prepared JAIV 16 2024 � Copyright, State Farm Mutusl Automobile Insur��ce Company, 2008 CMP-4000 Includes copynghted matena! of nsurance Services Q(fjrg, Inc., with its permission. 01B391 Continued on Next Pag� LIMIT OF fiVSURANCE $5,040 Page 4 of 6