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HomeMy WebLinkAboutLloyd's Barber Shop LLC - Insurance Certificate 2025 StateFarm STATE FARM FIRE AND CASUALTY COMPANY [] A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS RENEWAL DECLARATIONS Boomrngtton IL 6 1 702-29 1 5 Policy Number 96-1318-1<105-4 Add[ Insured-Section it Only Policy Period Effective Date Expiration Date AT2 M-20-2644-FAF1 F Z 12 Months JAN 12 2025 JAN 12 2026 001958 3125 The policy period be ins and ends at 12:01 am standard CITY OF FORT COLLINS time atthe premises�ocation. PO BOX 580 FORT COLLINS CO 80522-0580 ' Named Insured LLOYDS BARBER SHOP LLC g 0 0 s Hair Salon, Day Spa and Barber 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 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. Entity: Limited Liability Company NOTICE: Information concerning changes in your policy language is included. Please call your agent if you have any questions. POLICY PREMIUM $ 552.00 Disaster Mitigation $ 2.00 Total Amount $ 554.00 Discounts Applied: Renewal Year Years in Business Claim Record Prepared SEP 30 2024 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP-4000 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 013820 294 Al Continued on Reverse Side of Page Page 1 of 7 N RENEWAL DECLARATIONS(CONTINUED) Hair Salon, Day Spa and Barber Policy for CITY OF FORT COLLINS Policy Number 96-BS-KlOS-4 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 001 226 S COLLEGE AVE No Coverage $ 31,300 25% FORT COLLINS CO 80524-2811 * 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 INDE ES Cov A- Inflation Coverage Index: N/A Cov B - Consumer Price Index: 314.8 SECTION I - DEDUCTIBLES Basic Deductible $500 Special Deductibles: Money and Securities $250 Employee Dishonesty $250 Equipment Breakdown $500 Other deductibles may apply - refer to policy. Prepared CP 30 2024 Copyright,State Farm Mutual Automobile Insurance Company,2008 SE SE Includes copyrighted material of Insurance Services Office,Inc.,with its permission. otCMP 020 Continued on Next Page Page 2 of 7 StateFarm • ••. RENEWAL DECLARATIONS(CONTINUED) Hair Salon, Day Spa and Barber Policy for CITY OF FORT COLLINS Policy Number 96-138-IC105-4 SECTION I- EXTENSIONS OF OVERAGE - LIMIT OF INSURANCE EACH DESCRIBED PREMISES 0 0 s 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, CY but has "Included" indicated, please refer to that policy provision for an explanation of that coverage. COVERAGE LIMIT OF INSURANCE Accounts Receivable On Premises $10,000 Off Premises $5,000 Arson Reward $5,000 Back-Up Of Sewer Or Drain $10,000 Brands And Labels $25,000 Collapse Included Damage To Non-Owned Buildings From Theft, Burglary Or Robbery Coverage B Limit Debris Removal 25%of covered loss Employee Equipment-Off Premises (applies only to those premises provided Coverage B - Business Personal Property) Per Occurrence $2,500 Per Employee $1, 00 Per Piece $500 Employee Equipment - On Premises (applies only to those premises provided Coverage B - Business Personal Property) Per Occurrence $5,000 Per Employee Per Piece $1,000 $500 Equipment Breakdown Included Fire Department Service Charge $2,500 Fire Extinguisher Systems Recharge Expense $5,000 Forgery Or Alteration $10,000 Glass Expenses Included Prepared SEP 30 2024 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP-4000 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 013821 294 Continued on Reverse Side of Page Page 3 of 7 N RENEWAL DECLARATIONS (CONTINUED) Hair Salon, Day Spa and Barber Policy for CITY OF FORT COLLINS Policy Number 96.68-1<105.4 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) Ordinance Or Law - Equipment Coverage Included Outdoor Property $5,000 Personal Effects (applies only to those premises provided Coverage B - Business $2,500 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 Valuable Papers And Records $10,000 On Premises $5,000 Off Premises Water Damage, Other Liquids, Powder Or Molten Material Damage Included Prepared © P 30 2024 Copyright,State Farm Mutual Automobile Insurance Company,2008 SE SE P Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 0 20 013821 Continued on Next Page Page 4 of 7 StateFarm U A. •• RENEWAL DECLARATIONS (CONTINUED) Hair Salon, Day Spa and Barber Policy for CITY OF FORT COLLINS Policy Number 96-1218-1<105-4 SECTION I- EXTENSIONS OF COVERAGE - LIMIT OF INSURANCE- PER POLICY 0 0 $ The coverages and corresponding limits shown below are the most we will pay regardless of the number of described premises shown in these Declarations. 0 0 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 SECTION II- LIABILITY OF COVERAGE LIMIT INSURANN CE Coverage L- Business Liability $1,000,000 Coverage M - Medical Expenses (Any One Person) $5,000 Barber And Cosmetologist Professional Liability $1,000,000 Damage To Premises Rented To You $300,000 LIMIT OF AGGREGATE LIMITS INSURANCE Products/Completed Operations Aggregate Excluded General Aggregate $2,000,000 Professional Aggregate $1,000,000 Prepared SEP 30 2024 (D Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP-4000 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 013822 294 Continued on Reverse Side of Page Page 5 of 7 N RENEWAL DECLARATIONS(CONTINUED) Hair Salon, Day Spa and Barber Policy for CITY OF FORT COLLINS Policy Number 96-B8-1<105.4 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 FE-6999.3 'Terrorism Insurance Cov Notice CMP-4826 Employee Equipment Coverage CMP-4825 Brands and Labels CMP-4206.2 Amendatory 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-4793 Al State Political Perm Prem CMP-4402.1 Barber Cosmetologist Prof Liab CMP-4845 Excl Product Comp Operatn Liab CMP-4787 Waiver of Trans Rgt of Recov CMP-4788 Addl Insd Mgrs Lessor of Prem FE-3650 Actual Cash Value Endorsement CMP-4561.4 Policy Endorsement FD-6007 Inland Marine Attach Dec * New Form Attached Prepared P 3 2024 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 SE SE P 020 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 013822 Continued on Next Page Page 6 of 7 StateFarm ••� RENEWAL DECLARATIONS(CONTINUED) Hair Salon, Day Spa and Barber Policy for CITY OF FORT COLLINS Policy Number 96-138-K105-4 This policy is issued by the State Farm Fire and Casualty Company. s 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. *K4'-?-rn, l , Secretary President NOTICE TO POLICYHOLDER: For a comprehensive description of coverages and forms, please refer to your policy. Policy changes requested before the "Date Prepared",which appear on this notice, are effective on the Renewal Date of this policy unless otherwise indicated by a separate endorsement, binder, or amended declarations. Any coverage forms attached to this notice are also effective on the Renewal Date of this policy. Policy changes requested after the "Date Prepared"will be sent to you as an amended declarations or as an endorsement to your policy. Billing for any additional premium for such changes will be mailed at a later date. If, during the past year, you've acquired any valuable property items, made any improvements to insured property, or have any questions about your insurance coverage, contact your State Farm agent. Please keep this with your policy. Colorado law requires that we provide the following information to you: In addition to other allowable reasons for which your policy premium may have been adjusted upward or downward from your prior renewal, your premium increased due to the following: An increase in the estimated cost of anticipated claims and expenses for State Farm's commercial multi-peril business in Colorado. Please contact your State Farm agent if you have any questions about your policy. Prepared SEP 30 2024 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP-4000 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 013823 294 N Page 7 of 7 Statefarm STATE FARM FIRE AND CASUALTY COMPANY ❑ A STOCK COMPANY WITH HOME OFFICES IN BLOOMING TON, ILLINOIS INLAND MARINE ATTACHING DECLARATIONS Po Box 2915omington IL 6 1 702-29 15 Y Polic Number 96-B8-K105-4 Blo Named Insured Policy Period Effective Date Expiration Date M-20-2644-FAF1 F Z 12 Months JAN 12 2025 JAN 122026 The policy period be9ins and ends at 12:01 am standard LLOYDS BARBER SHOP LLC time atthe premises location. 0 0 0 0 a 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 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. Annual Policy Premium Included 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-8743.1 Inland Marine Computer Prop See Reverse for Schedule Page with Limits Prepared SEP 30 2024 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 FD-6007 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 013824 I 530 666 a.2 05-31-2011 Io1W: 96-B8-K105-4 ATTACHING INLAND MARINE SCHEDULE PAGE ATTACHING INLAND MARINE ENDORSEMENT LIMIT OF DEDUCTIBLE ANNUAL NUMBER COVERAGE INSURANCE AMOUNT PREMIUM FE-8743.1 Inland Marine Computer Prop S 25 , 000 S 500 Included Loss of Income and Extra Expense S 25 , 000 Included OTHER LIMITS AND EXCLUSIONS MAY APPLY-REFER TO YOUR POLICY Prepared ©Copyright,State Farm Mutual Automobile Insurance Company,2008 SEP re SEP 307 2024 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. FD-013824 530-605 a.2 05-31 2011 103233c1