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HomeMy WebLinkAboutFrench Concrete Inc - Insurance Certificate StateFarm STATE FARM FIRE AND CASUALTY COMPANY ❑ A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS DECLARATIONS — •�s Boomingtton IL 6 1 702-29 15 Policy Number 96-E5-W461-8 Replaces Number 96-EU-W227-0 Addl Insured-Section I) Only Policy Period Effective Date Expiration Date M-20-2455-FAF1 F E 1 Year APR 3 2025 APR 3 2026 001849 3123 The poly period be?ins and ends at 12:01 am standard CITY OF FORT COLLINS time at a premises 0cation. 281 N COLLEGE AVE FORT COLLINS CO 80524-2404 Named Insured r FRENCH CONCRETE INC g 0 0 40 �o Artisan And Service Contractor 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: Corporation Total Estimated Claim Record Premium $ 2,597.00 Disaster Mitigation $ 2.00 Audit Period: Annual Total Estimated Amt $ 2,599.00 Discounts Applied: Renewal Year Years in Business Prepared FEB 26 2025 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP-4000 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 013281 290 Al Continued on Reverse Side of Page Page 1 of 6 N DECLARATIONS(CONTINUED) Artisan And Service Contractor Policy for CITY OF FORT COLLINS Policy Number 96-E5-W461-8 -SECTION I - PROPERTY SCHEDULE 11 !Pi 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 3579 S COUNTY ROAD 5 No Coverage $ 8,800 25% LOVELAND CO 80537-3804 * 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 INDEWESS) , f Cov A - Inflation Coverage Index: N/A Cov B - Consumer Price Index: 317.7 SECTION I - DEDUCTIBLES Basic Deductible $1,000 Special Deductibles: Equipment Breakdown $1,000 Other deductibles may apply - refer to policy. Prepared FEB 26 2025 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP-4000 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 013281 Continued on Next Page Page 2 of 6 StateFarm • ••. DECLARATIONS (CONTINUED) Artisan And Service Contractor Policy for CITY OF FORT COLLINS Policy Number 96-E5-W461-8 a SECTION I - EXTENSIONS OF COVERAGE - LIMIT OF INSURANCE- EACH DESCRIBED PREMISES 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, �N but has "Included" indicated, please refer to that policy provision for an explanation of that coverage. �o LIMIT OF COVERAGE INSURANCE Accounts Receivable On Premises $10,000 Off Premises $5,000 Arson Reward $5,000 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 $2,500 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 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 Prepared FEB 26 2025 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP-4000 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 013282 290 Continued on Reverse Side of Page Page 3 of 6 N DECLARATIONS(CONTINUED) Artisan And Service Contractor Policy for CITY OF FORT COLLINS Policy Number 96-E5-W461-8 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 On Premises $10,000 Off Premises $5,000 Water Damage, Other Liquids, Powder Or Molten Material Damage Included SECTION II- DEDUCTIBLES Business Liability - Property Damage $1,000 Other deductibles may apply - refer to policy. SECTION II - LIABILITY LIMIT OF COVERAGE INSURANCE Coverage L - Business Liability $5,000,000 Coverage M - Medical Expenses (Any One Person) $5,000 Damage To Premises Rented To You $100,000 LIMIT OF AGGREGATE LIMITS INSURANCE Products/Completed Operations Aggregate $10,000,000 Prepared FEB 2 2025 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP-4000 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 013282 Continued on Next Page Page 4 of 6 StateFarm • ••- DECLARATIONS(CONTINUED) Artisan And Service Contractor Policy for CITY OF FORT COLLINS Policy Number 96-E5-W461-8 General Aggregate $10,000,000 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. 0 0 0 0 F-M (n O 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-4561.5 *Policy Endorsement CMP-4532 *Exclusion Cyber Incident CMP-4785.1 *Addl Ins Owners Lessee Blkt FE-1401 *Exclusion Cyber Incident FE-6999.3 *Terrorism Insurance Cov Notice CMP-4536 *Addl Insd Owners Lessee Sched CMP-4787 *Waiver of Trans Rgt of Recov CMP-4600 Artisan and Service Contractor CMP-4206.2 Amendatory Endorsement FE-3650 Actual Cash Value Endorsement FD-6007 Inland Marine Attach Dec NOTICE: INFORMATION CONCERNING CHANGES IN YOUR POLICY LANGUAGE IS INCLUDED. PLEASE CALL YOUR AGENT IF YOU HAVE ANY QUESTIONS. * New Form Attached Prepared FEB 26 2025 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP-4000 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 013283 290 Continued on Reverse Side of Page Page 5 of 6 N DECLARATIONS(CONTINUED) Artisan And Service Contractor Policy for CITY OF FORT COLLINS Policy Number 96-E5-W461-8 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 FEB 26 2025 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP-4000 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 013283 290 Page 6 of 6 N StateFarm STATE FARM FIRE AND CASUALTY COMPANY LJ A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS INLAND MARINE ATTACHING DECLARATIONS •ems P BoX 2915om�ngtonIL 6 1 702-29 15 Policy Number 96-E5-W461-8 B�o Replaces Number 96-EU-W227-0 Named Insured Policy Period Effective Date Ex *ration Date M-20-2455-FAF1 F E 1 Year APR 3 2025 Af�R 3 2026 The poll y period begins and ends at 12:01 am standard FRENCH CONCRETE INC time ate premises location. s 0 0 v, 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 $ 562.00 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 FE-8756.1 Installation Endorsement FE-8760 Mobile Equipment Form See Reverse for Schedule Page with Limits Prepared FEB 26 2025 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 FD-6007 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 013284 530-666 a.2 05 31-2011 IoH3232c1 yd t5 w4bi-� 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 5 25,000 $ 500 Included FE-8760 Mobile Equipment Form S 70 ,000 S 1 , 000 $ 562 . 0( FE-8756.1 Installation Endorsement S 51000 $ 500 Included Property in Transit S 51000 Number of Job-Sites: 1 OTHER LIMITS AND EXCLUSIONS MAY APPLY- REFER TO YOUR POLICY Prepared FEB 26 2025 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 FD-6007 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 013284 530 686 e.2 05-31-2011 Io113233( StateFarm 96-E5-W461-8 013285 � CMP-4536 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY CMP4536 ADDITIONAL INSURED — OWNERS, LESSEES, OR CONTRACTORS (Scheduled) _ This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM 0 SCHEDULE Policy Number: 96-E5-W461-8 Named Insured: FRENCH CONCRETE INC Name And Address Of Additional Insured Person Or Organization: CITY OF FORT COLLINS 281 N COLLEGE AVE FORT COLLINS CO 80524-2404 1. SECTION 11 — WHO IS AN INSURED of SECTION II — LIABILITY is amended to include, as an additional insured, any person or organization shown in the Schedule, but only with respect to liability for "bodily injury", "property damage", or "personal and advertising injury" caused, in whole or in part, by: a. Ongoing Operations (1) Your acts or omissions, or (2) The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for that additional insured; or b. Products-Completed Operations "Your work" performed for that additional insured and included in the "products-completed opera- tions hazard". 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 afforded the additional insured shall be primary insurance. Any insurance carried by the additional insured shall be noncontributory with respect to coverage provided by you. All other policy provisions apply. CMP-4536 ©,Copyright,State Farm Mutual Automobile Insurance Company, 2018 Includes copyrighted material of Insurance Services Office, Inc., with its permission.