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HomeMy WebLinkAboutNewsummit LLC - Insurance Certificate 2024 Jra_ m STATE FARM FIRE AND CASUALTY COMPANY � A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON,ILLINOIS DECLARATIONS AMENDED DEC 18 2024 Boom/ng o1n IL 6 1 702-29 1 5 Policy Number 96-C7-H511-0 Addl Insured-Section II Only Policy Period Effective Date Expiration Date 002124 3123 M-20-215D-FB05 F N 12 Months SEP 18 2024 SEEP 18 2025 CITY OF FORT COLLINS The poll¢y period begins and ends at 12:01 am standard time atthe premises Tocataon. PURCHASING DIVISION PO BOX 580 FORT COLLINS CO 80522-0580 Named Insured NEWSUMMIT LLC i � llillllillll'llll"illlll'Illl"I'illl"IIIII'Ill'Ill'Illl'I'Il" g 0 0 �o Office 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 DEC 18 2024 ADDITIONAL INSURED DELETED PREMIUM ADJUSTMENT FORM CMP-4860 DELETED Endorsement Premium None Discounts Applied: Renewal Year Years in Business Sprinkler Claim Record Prepared JAN 09 2025 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP-4000 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 016043 290 Al Continued on Reverse Side of Page N Page 1 of 6 I DECLARATIONS(CONTINUED) Office Policy for CITY OF FORT COLLINS Policy Number 96-C7-H511-0 SECTION I - PROPERTY SCHEDULE Location Location of Limit of Insurance* Limit of Insurance* Seasonal Number Described Increase- Premises Coverage A- Coverage B - Business Buildings Business Personal Personal Property Property 001 5610 WARD RD STE 300 No Coverage $ 6,500 25% ARVADA CO 80002-1309 * 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 INDEXES) Cov A- Inflation Coverage Index: N/A Cov B - Consumer Price Index: 314.1 SECTION I - DEDUCTIBLES Basic Deductible $1,000 Special Deductibles: Money and Securities $250 Employee Dishonesty $250 Equipment Breakdown $1,000 Other deductibles may apply - refer to policy. Prepared 2025 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 JAN 09 JAN 09 00 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 01CM Continued on Next Page Page 2 of 6 SfafeFarm • �J •• DECLARATIONS(CONTINUED) Office Policy for CITY OF FORT COLLINS Policy Number 96-C7-H511-0 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, �o but has "Included" indicated, please refer to that policy provision for an explanation of that coverage. COVERAGE LIMIT OFINSURANCE 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 J Debris Removal 25%of covered loss t Equipment Breakdown Included s Fire Department Service Charge $5,000 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 And Securities (Off Premises) $5,000 Money And Securities (On Premises) $10,000 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) Prepared JAN 09 2025 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP-4000 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 016044 290 Continued on Reverse Side of Page Page 3 of 6 N DECLARATIONS(CONTINUED) Office Policy for CITY OF FORT COLLINS Policy Number 96-C7-H511-0 Ordinance Or Law- Equipment Coverage Included Outdoor Property $5,000 Personal Effects (applies only to those premises provided Coverage B - Business $5,000 Personal Property) 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 $2,500 Personal Property) Signs $2,500 Unauthorized Business Card Use $5,000 Valuable Papers And Records On Premises $ ,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. LIMIT OF COVERAGE INSURANCE Dependent Property- Loss Of Income $5,000 Employee Dishonesty $10,000 Utility Interruption - Loss Of Income $10,000 Loss Of Income And Extra Expense Actual Loss Sustained- 12 Months Prepared AN 09 2025 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 J AN 09 00 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. oiCM Continued on Next Page Page 4 of 6 3rarerarm • ••. DECLARATIONS (CONTINUED) Office Policy for CITY OF FORT COLLINS Policy Number 96-C7-H511-0 SECTION II- LIABILITY COVERAGE LIMIT OF �$ INSURANCE o0 Coverage L - Business Liability $2,000,000 Coverage M - Medical Expenses (Any One Person) $5,000 Damage To Premises Rented To You $300,000 AGGREGATE LIMITS LIMIT OF INSURANCE Products/Completed Operations Aggregate $4,000,000 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. 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-4819.1 Unauthorized Business Card Use FE-6999.3 Terrorism Insurance Cov Notice CMP-4206.2 Amendatory Endorsement FE-3650 Actual Cash Value Endorsement CMP-4561.4 Policy Endorsement CMP-4705.2 Loss of Income & Extra Expnse CMP-4710 Employee Dishonesty CMP-4709 Money and Securities CMP-4706 Back-Up of Sewer or Drain CMP-4704.1 Dependent Prop Loss of Income CMP-4703.1 Utility Interruption Loss Incm CMP-4713.1 Excl Testing Consulting E&O Prepared JAN 09 2025 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP-4000 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 016045 290 Continued on Reverse Side of Page Page 5 of 6 I N DECLARATIONS(CONTINUED) Office Policy for CITY OF FORT COLLINS Policy Number 96-C7-H511-0 CMP-4860 Al Design Person Org CMP-4787 Waiver of Trans Rgt of Recov CMP-4786 Addl Insd Owners Lessee Sched FD-6007 Inland Marine Attach Dec 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. 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. Secretary President Prepared © 2025 Copyright,State Farm Mutual Automobile Insurance Company,2008 JAN 09 JAN 09 00 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 6 of 6 016045 290 N StateFarnt STATE FARM FIRE AND CASUALTY COMPANY - A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS INLAND MARINE ATTACHING DECLARATIONS PO Box 2915 Bloomington IL 6 1 702-29 1 5 Policy Number 96-C7-H511-0 Named Insured Policy Period Effective Date Expiration Date M-20-215D-FB05 F N 12 Months SEP 18 2024 SEP 18 2025 NEWSUMMIT LLC The pollppy period beggins and ends at 12:01 am standard time atthe premisesTocabon. s 0 g WO 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/Lienholder 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. r 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-8743.1 Inland Marine Computer Prop See Reverse for Schedule Page with Limits Prepared JAN 09 2025 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 FD-6007 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 016046