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HomeMy WebLinkAboutCity Visions - Insurance Certificate 2025 State Farm Insurance PO Box 2915 Bloomington, IL 61702-2915 c.�StateFarw AT2 000971 1200 01 State Farm Fire and Casualty Company y CITY OF FORT COLLINS A stock company with home offices in Bloomington, Illinois 580 PO BOX FORT COLLINS CO 80522-0580 Sa o� �� �� �1111�'�1111 ��1�1'III'�I�II�IIII��I�IIII�III'�"�I�III O N fnO CNf Renewal Declarations Policy number:96-AP-D417-4 Effective date:May 4, 2025 Policy period: 12 months Expiration date:May 4, 2026 The policy period begins and ends at 12:01 am standard time at the premises location. OFFICE POLICY Automatic renewal -If the State Farm°policy period is shown as 12 months, this policy will be renewed automatically subject to the premiums, rules and forms in effect for each succeeding policy period. If this policy is terminated, we will give you and the MortgageelLienholder written notice in compliance with the policy provisions or as required by law. NAMEDINSURED WOODS, KATHERINE DBA CITY VISI ENTITY Sole Proprietorship-Individual POLICY PREMIUM This is not a bill.If an amount is due, then a separate statement will be sent prior to the due date. The premium(s)shown below is the 12 months premium(s)for the characteristics of the policy as described in this Declarations. Premium: $249.00 Disaster Mitigation: $2,00 Total Premium: $251.00 Discounts applied: Business Experience Rating Renewal Discount Years in Business Business in Residence Premises IMPORTANTMESSAGE(S) Notice - Information concerning changes in your policy language is included. Please call your agent if you have any questions. Policy number:96-AP-D417-4 Page 1 of 5 ©Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP Dec 3P CO.1 CMP-4000 1009482 2012 153090 212 11-16.2024 Prepared:February 24,2025 wwStatekrm SECTION I-PROPERTY SCHEDULE Location Location of described premises Limit of Insurance* Limit of Insurance* Seasonal Increase- number Coverage A- Coverage B-Business Business Personal Property Buildings Personal Property 001 315 S SHERWOOD ST No Coverage $15,800 25% FORT COLLINS CO 80521-2635 *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: 315.7 SECTION I—DEDUCTIBLES BASIC DEDUCTIBLE $500 SPECIAL DEDUCTIBLES: Employee Dishonesty: $250 Equipment Breakdown: $500 Money and Securities: $250 Other deductibles may apply-refer to policy. 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, but has "Included" indicated, refer to that policy provision for an explanation of that coverage. Coverage Limit of Insurance 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 Debris Removal 25%of covered loss Equipment Breakdown Included 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 insured on a 10% replacement cost basis) Policy number:96-AP-0417-4 Page 2 of 5 ©Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 c Statefarm" Coverage Limit of Insurance Money Orders and Counterfeit Money $1,000 Money and Securities On Premises $10,000 8a S Off Premises $5,000 U, NewlyAcquired Business Personal Property(applies only If this policy provides Coverage B-Business $100,000 q P h'( PP Y P YP 9 Personal Property) Newly Acquired or Constructed Buildings(applies only if this policy provides Coverage A-Buildings) $250,000 Ordinance or Law-Equipment Coverage Included Outdoor Property $5,000 Personal Effects(applies only to those premises provided Coverage B-Business Personal Property) $5,000 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 Personal $2,500 Property) Signs $2,500 Unauthorized Business Card Use $5,000 Valuable Papers and Records On Premises $50,000 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. Coverage Limit of Insurance Dependent Property-Loss of Income $5,000 Employee Dishonesty $10,000 Loss of Income and Extra Expense 12 Months Actual Loss Sustained Utility Interruption-Loss of Income $10,000 Policy number:96-AP-D417-4 Page 3 of 5 ©Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 &StateFarm- SECTION II -LOCATION SCHEDULE Location Location of described premises number 001 315 S SHERWOOD ST FORT COLLINS CO 80521-2635 SECTION II-LIABILITY Coverage Limit of Insurance Coverage L-Business Liability Per Occurrence $1,000,000 Coverage M-Medical Expenses $5,000 Any One Person Damage to Premises Rented to You $300,000 Aggregate Limits Limit of Insurance General Aggregate $2,000,000 Products/Completed Operations Liability-Annual Aggregate Excluded 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-4206.2 Amendatory Endorsement(Colorado) • CMP-4532 Exclusion-Cyber Incident • CMP-4536 Additional Insured-Owners,Lessees or Contractors(Scheduled) • CMP-4561.5 Policy Endorsement CMP-4703.1 Utility Interruption-Loss of Income CMP-4704.1 Dependent Property-Loss of Income CMP-4705.2 Loss of Income and Extra Expense CMP-4706 Back-up of Sewer or Drain CMP-4709 Money and Securities CMP-4710 Employee Dishonesty k CMP-4785.1 Additional Insured-Owners,Lessees or Contractors(Blanket) CMP-4819.1 Unauthorized Business Card Use CMP-4845 Exclusion-Products-Completed Operations Hazard FD-6007 Inland Marine Attaching Declarations FE-3650 Actual Cash Value Endorsement FE-6999.3 Policyholder Disclosure Notice of Terrorism Insurance Coverage *New Form Attached SCHEDULE OF ADDITIONAL INTEREST(S) Interest type: Owners,Lessees, or Contractors(Schedul Endorsement number: CMP-4536 Loan number: N/A CITY OF FORT COLLINS 580 Po Box Fort Collins CO 80522-0580 Policy number:96-AP-D417-4 Page 4 of 5 ©Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 &Statefarm, FULL NAMED INSURED 1•• L Named Insured: WOODS, KATHERINE DBA CITY VISIONS This policy is issued by the State Farm Fire and Casualty Company. PARTICIPATING POLICY so You are entitled to participate in a distribution of the earnings of the company as determined by our Board of Directors in accordance owith 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. President Secretary OTHER MESSAGE(S) NOTICE TO POLICYHOLDER: For a comprehensive description of coverage 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. Your coverage amount.... It is up to you to choose the coverage and limits that meet your needs. We recommend that you purchase a coverage limit equal to the estimated replacement cost of your structure, Replacement cost estimates are available from building contractors and replacement cost appraisers, or, your agent can provide an estimate from Xactware, Inc, using information you provide about your structure. State Farm does not guarantee that any estimate will be the actual future cost to rebuild your structure. Higher limits are available at higher premiums. Lower limits are also available, as long as the amount of coverage meets our underwriting requirements, We encourage you to periodically review your coverages and limits with your agent and to notify us of any changes or additions to your structure. Policy number:96-AP-D417-4 Page 5 of 5 ©Copyright, State Farm Mutual Automobile Insurance Company, 2008 GMP-4000 State Farm Insurance PO Box 2915 Bloomington, IL 61702-2915 StateFarm- State Farm Fire and Casualty Company CITY OF FORT COLLINS A stock company with home offices in Bloomington, Illinois 580 PO BOX FORT COLLINS CO 80522-0580 8a 00 o� H S N Inland Marine Attaching Declarations Policy number: 96-AP-D417-4 Effective date: May 4, 2025 Policy period: 12 months Expiration date: May 4, 2026 The policy period begins and ends at 12:01 am standard time at the premises location. ATTACHING INLAND MARINE Automatic renewal -If the State Farm'policy period is shown as 12 months, this policy will be renewed automatically subject to 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. FULL NAMED INSURED Named Insured: WOODS, KATHERINE DBA CITY VISIONS 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 subsequent to the issuance of this policy. FORMS,OPTIONS AND ENDORSEMENTS FE-1401 Exclusion-Cyber Incident FE-8739 Inland Marine Conditions FE-8743.1 Inland Marine Computer Property Form *New Form Attached See below for schedule page with limits ATTACHING INLAND MARINE SCHEDULE PAGE Endorsement Coverage Limit of insurance Deductible amount Annual premium number FE-8743.1 Inland Marine Computer Property Form $25,000 $500 Included Policy number:96-AP-D417-4 —-------_-- -----_--© Page t of 2 Copyright, State Farm Mutual Automobile Insurance Company, 2008 CAM Att Doc 3P CO.1 F0-0007 1009481 2002 153089 202 03-08-2021 AStatefarm- Endorsement Coverage Limit of insurance Deductible amount Annual premium number Loss of Income and Extra Expense $25,000 Included Other limits and exclusions may apply - refer to your policy. Policy number:96-AP-D417-4 Page 2 of 2 ©Copyright, state Farm Mutual Automobile Insurance Company, 2008 FD-6007 CMP-4536 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY, 1•• L -1 ADDITIONAL INSURED —OWNERS, LESSEES, OR CONTRACTORS (Scheduled) This endorsement modifies insurance provided under the following: s^ BUSINESSOWNERS COVERAGE FORM o� " U)oNM SCHEDULE Policy Number: 96-AP-D417-4 Named Insured: WOODS, KATHERINE DBA CITY VISIONS Name And Address Of Additional Insured Person Or Organization: CITY OF FORT COLLINS 580 Po Box Fort Collins CO 80522-0580 1. SECTION II —WHO IS AN INSURED of SECTION II — b. Products-Completed Operations LIABILITY is amended to include, as an additional "Your work" performed for that additional insured and insured, any person or organization shown in the included in the "products-completed operations Schedule, but only with respect to liability for "bodily hazard". injury", "property damage", or "personal and advertising injury" caused, in whole or in part, by: 2. Any insurance provided to the additional insured shall only apply with respect to a claim made or a "suit" brought for a. Ongoing Operations damages for which you are provided coverage. (1) Your acts or omissions; or 3. Primary Insurance, The insurance afforded the additional (2) The acts or omissions of those acting on your insured shall be primary insurance, Any insurance carried behalf; by the additional insured shall be noncontributory with in the performance of your ongoing operations for respect to coverage provided by you. that additional insured; or All other policy provisions apply. CMP-4536 154972 03-20-2019 ©, Copyright, State Farm Mutual Automobile Insurance Company, 2018 Includes copyrighted material of Insurance Services Office, Inc.,with its permission.