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HomeMy WebLinkAboutLord Elite Group - Insurance CertificateStateFam STATE FARM FIRE AND CASUALTY COMPANY A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS E?BPI n?n? Jf L u,, o, - r s, s Addl lnsured-Section ll Only M-20-2579-FA65 F E 002307 3123CITY OF FORT COLLINS28I N COLLEGE AVEFT coLLINs C0 4052.t-?404 tlrt,il, rl[,lllr, r, rlil Iil trl[, rtrl,,,l,ll,il,rll,,,,tlilrlrr Artisan And Service Contractor Policy DECLARATIONS AN,4ENDED DEC 27 2024 Policyl{umber 96-E$H335-2 Policv Pariod Etleclive Dale Exoiralion Oate 1 Year SEP I2024 SEP I2025 The polipy penod beoins and ends at l2:01 am standard !me at me premtses Iocaton. Named lnsured LORD EL ITE GROUP LLC DBA LIT ELECTRIC (-) C'I'J tr,,,-,ii H& 8 Aubmalic Benowal - lf he policy period is shown as 12 months , this policy will be renewed automatically subiectto the premiums, rules and forms in effect for each succeeding policy period. lf fiis policy is terminated, we will give you and t're Mortgagee/Lienholder written notice in compliance wifi the policy provisions or as re quired by law Entity: Limited Liability Company Reason tor Declarations: Your policy is amended DEC 27 2024 ADDITIONAL INSURED ADDED PREMIUM ADJUSTMENT FORIVI CMP.4793 ADDED Endorsement Premium Audit Period: Annual None Discounts Applied: Years in Business Protective Devices Prepared JAN 02 2025 cMP-4000 018408 290 Al N O Copyrigh! Stato F6rm Mutu!l Automobilo lnsur!ncs Compsny,20CE lncludBs copyrighted mate.i6l ol lnsur!nce Services 0flic€, lnc., with its psrmrsrion Continued on Reverse Side of Page Page 1 of 6 530 686i.2 05 31 20ll (oll373ld DECLARATIONS (CONTINUEO) Artlsan And Sorvice Contractor Policy lor CITY OF FORT COLLINS Pollcy Number 96-E9-H335-2 ' SECTION I- PHOPEBTY SCHEDULE Location Number Location of Described Premises Limit ol lnsurance* Covereoe A - Buildfngs Limit of lnsurance* Coveraoe B - Business Fersonal Property Seasonal lncrease- Business Personal Property 001 1255 S GRAPE ST DENVER CO 80246-3230 No Coverage $ 1o,7oo 25% - As of the ellective date of this policy, the imlt of lnsurance as shown n SECTION I - INFLATION COVERAGE INDEX(ES) any increase in the limit due to lnf lat ron erage Cov A - lnf lation Coverage lndex Cov B - Consumer Price lndex: N/A 314.2 SECTION I . DFDTICTIBLES Baslc Osducubte Sp€cial Deductibles: Equipment Breakdown $1,000 $1 ,000 Other deductibles may apply - refer to policy Prepared JAN 02 2025 cMP-4000 018408 @ Copyrigh! State Fsrm Mutuil Automobils lnsurance CompanY,2008 lnolud6s copyrighted mat€risl of lnru.ancB S0rvicss offics, lnc., with its pormission Continued on Next Page Page 2 of 6 StateFarm(-(!XD DECLABATIONS (CONTINUED) Artisan And S€rvice Contractor Policy lor CITY OF FORT COLLINS Policy Number 96-E9-H335-2 ffi 8 SECTION I . EXTENSIONS OF COVEBAGE - LIMIT OF INSU RANCE - EACH DESCRIBED PREMISES The covorages and corresponding limits shown below apply separately to each described pr,omises shown in these Declarations, unless indicated by "See Schedule." ll a coverage does not have a corresponding limit shown below, but has "lncluded" indicated, please reler to that policy provision for an explanation of thal coverage. COVEBAGE Accounts Receivable On Premises Otf Premises Arson Reward Collapse Damage To Non-Owned Buildings From Thefl, Burglary Or Bobbery Debris Flomoval Equipment Breakdown Fire Department Service Charge Fire Extinguisher Systems Recharge Expense Forgery Or Alteration Glass Expenses lncreascd Cost Of Construction And Demolition Costs (applies only when buildings are insured on a replac€ment cost basis) Money Orders And Counterteit Money Newly Acquired Business Personal Property (applies only if this policy provides Coverago B - Business Personal Property) Newly Acquired Or Constructed Buildings (applies only il this policy provides Coverage A - Buildings) Ordinance Or Law - Equipment Coverage Outdoor Property LIMIT OF INSURANCE $250,000 $10,000 $s,ooo $5,000 lncluded Coverage B Limit 25olo ol covered loss lncluded $2,soo $s,000 $10,000 lncluded 10% $1,000 $100,000 lncluded $5,000 Prepared JAN 02 2025 cMP-4000 01840S 290 N O Copyrish! SGIB F.rm Mutu0l Automobile lnsurance Comprny,2008 lncludes copyri0htsd mrterial of lnsur0nca Serurces offic0, lnc., with its permi.sion Continued on Reverse Side of Page Page 3 of 6 DECLARATIONS (CONTINUEO) Artisan And S€rvice Contractor Pollcy for CITY OF FORT COLLINS Policy Number 95-E9-H335-2 ' Personal Effects (applies only to those premises provided Coverage B - Business Personal Proporty) Personal Property Olf Pr6mis€s Pollutant Clean Up And Removal Preservation Of Property Property Ot Others (applies only to those premises provided Coverage B - Business Personal Propsrty) Signs Valuable Papers And R6cords On Premises Off Premises Waler Damage. Other Liquids, Powder Or Molten Material Damage qFa:Tr6N |l nFnt ra:llFlt Fs $2,500 $15,000 $10,000 30 Days $2,soo $2,s00 $10,000 $5,000 lncluded Business Liability - Property Damage $500 Other deductibles may apply - rel€r to policy. sFeTtoN - ItAE tTY COVERAGE Coverage L - Businsss Liability Coverage M - Medical Exponsas (Any One Person) Damage To Prsmises Rontod To You AGGREGATE LIMITS Products/Completod Oporations Aggregate LIMIT OF INSUHANCE $1,000,000 $5,000 $100,000 LIMIT OF INSURANCE $2,000.000 Prepared JAN 02 2025 cMP-4000 018409 C Copyri0ht, St.te FrIm Mutu!lAutomobilB lnsurancs Comp8ny,2008 lnrludB! copyriohied mrteri!l of lnsur0nce Services oflice, lnc., with its p9rmissior Continued on Next Page Page 4 ol 6 StateFarm l _o_(!x!' DECLARATIoNS (coNTtNUED) Artisan And Servlce Contractor Pollcv lor CITY OF FOBT COLLINS Policy Number 96-E9-Hgl5-2 ' General Aggregate Each paid claim for Liability Coverage reduces the amount of insurance we provide duri annual period. Please refer to Section ll - Liability in the Coverage Form and any attach $2,000,000 PJitB#ng ed the applicable endorsements 8 ;3 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. FOBMS ANO EN DORSEI\IIENTS cMP-4100 cMP-4793 cMP-4600 FE-6999.3 cMP-4206.2 FE-3650 cMP-4561.4 cMP-4786 cMP-4785 cMP-4791 FD-6007 Businessowners Coverage Form.Al State Political Perm Prem Artisan and Service Contractor Terrorism lnsurance Cov Notice Amendatory Endorsement Actual Cash Value Endorsement Policy Endorsement Addl lnsd Owners Lessee Sched Addl lns Owners Lessee Blkt Addl Insd State Political Perm lnland Marine Attach Dec " New Form Attached Prepared JAN 02 2025 cMP-4000 018410 290 N O Copyrioht, Stdte tarm Mufirrl Automobils lnsurance Company,2008 lncludes copyrighted material of lnsurance Servicss oflic€, lnc., with ils pBrmrssion Continued on Reverse Side of Page Page 5 of 6 DECLABATIONS (CONTINUED) Artisan And Service Contractor Policv tor CITY OF FOHT COLLINS Policy Number 96-E9-H3it5-2 ' This policy is issued by the State Farm Fire and Casualty Company, ParticiPating PolicY You are entilled to participate in a distribution of the earnings of the company as determined by our Board of Directors in accordance with the Company's Artlcles of lncorporation, as amended, ln Witness Whereof, he State Farm Fire and Casualty Company has caused this polioy to be signed by its President and Secr€tary at Bloomington, lllinols. ,Y1",i./L-t14a,,t;a .P/,1*Z'Secr€tary President Prepared JAN 02 2025 cMP-4000 018410 290 N O Copyri!h! State F6rm Mutunl Automobil€ lnsur€ncB Comprny,2008 lncludes copyri0hted material of lnsuranca SBrylcss otfico, lnc., with its permissron Page 6 of 6 StateFarm STATE FABM FIRE AND CASUALTY COMPANY A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS E?#9ln6ili L arzoe-zs,s Named lnsured M-20-2579-FA65 F E LORD ELITE GROUP LLC DIA LIT ELECTRIC ATTACHING INLAND MARINE INLAND MARINE ATTACHING DECLARATIONS Policyl{umber 96-E$,H335-2 Policv Period Elleclive Datr Exoiration Dais 1 Year SEP 9 2024 SEP 9 2025 Ihe polipy period begins qnd ends at 12:01 am standard tlme atne Premlses locaton L](-@ P.rl"#iEtr c Automalic Renewal ' lf the policy period is shown as 12 monlhs , tiris policy will be renewed automatically su bjectto tre premiums, rules and forms in effect for each suc ceeding policy period. lf tris policy is terminated, we will give you and the Mortgagee/Lienholder written notice in compliance witr the policy provisions or as required by law. Annual Pollcy Promium lncluded The above Premium Amountis included in $e Policy Premium shown on tre Declarations Your policy consists ofthese Declarations, $e INLAND MARINE C0NDITI0NS shown below, and any other forms and endorsemenb that apply, including fiose shown below as well as $ose issued subsequentto the issuance ofthis policy. Forms, 0plions, and Endorsamsltb FE.8 FE-8 FE-8 FE-8 739 lnland Marine Conditions lnland Marine Computer Prop lnstallation Endorsement l\ilobile Equipment Form 743.1 756.1 760 See Reverse for Schedule Page witr Limits Prepared JAN 02 2025 FD-6007 018411 O Copyrighl Stlte F€rm Mutu.l Automobilo lnsurcnc€ Comp.ny,2008 lncludes cogyrighted materiol of lnstranco S6rvic0t Oflice, lnc., with it, permission !fl,688s.? 05 31 ?011 lo1f32!2cl I 96-E9'H33s-2 ATTACHING It{LAIIID MARIiIE ATTACHING INLANO MARINE SCHEDUTE PAGE ENDORSEMENI NUMBER FE-8743.1 FE-8760 FE-8756.1 C OVERAGE Lil\4tT 0F INSURANC E DEDUCTIBLE AMOUNT ANNUAL PREI\4IUI\4 Inland Marine Computer Prop Mobile Eouiom6nt Form lnstallatioh Endorsement Proo€rlv in Transit Nurhbei ol Job-Sitos: 1 25,000 10r0005r0005,000 50 0 500 500 s $ s $ s s s Includod InctudedIncluded Prepared JAN 02 2025 FD-6007 0'18411 OTHER LIMITS AND EXCLUSIONS MAY APPLY . REFER TO YOUR PO O copyrigh! St0t6 tarm Nlutu 6l Automobile lnsurance Company, 2008 lncludes copyrighted material ol lnsuronce SetvicBs oflice, 1nc., with its permission. t30 606.2 05 3r lll lolllrll StateFarm 9&ElH335-2 018412 THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY ctvP-4793 Page 1 of I(-i@ &CMP4793 ADDIT]ONAL INSURED _ STATE OR POLITICAL SUBDIVISIONS (Permits Relating To Premises) EHitE blE 8 FC This endorsement modifies tnsurance provided under the following BUSINESSOWNERS COVERAGE FORIVI SCHEDULE Policy Number: 96-E9-H335-2 Named lnsured: LORD ELITE GROUP LLC Name And Address Of Additional lnsured Or Political Subdivision: CITY OF FOBT COLLINS 281 N COLLEGE AVE FT COLLINS CO 8[]524-2404 1. SECTION ll - WHO lS AN INSURED of SECTION ll - LIABILITY is amended to include, as an additional insured, any state or political subdivision shown in the Schedule, but only with respect to the following hazards for which the state or political subdivision has issued a permit in connection with premises you own, rent or control and to which this insurance applies: a. The existence, maintenance, repair, construction, erection or removal of advertising signs, awn- ings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away open- ings, sidewalk vaults, street banners or decorations and similar exposures; or b. The construction, erection or removal of elevators; or c. The ownership, maintenance or use of any elevators covered by this insurance. 2. Any insurance provided to the additional insured shall only apply with respect to a claim made or a "suit" brought for damages for which you are provided coverage. 3, Primary Insurance. The insurance afiorded the additional insured shall be primary insurance. Any insurance carried by the additional insured shall be noncontributory with respect to coverage pro- vided by you. All other policy provisions apply. cMP-4793 O, Copyright, State Farm Mutual Automobile lnsurance Company, 2008 lncludes copyrighted material of lnsuranoe SeNices Ofllce, lnc , with its permission