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HomeMy WebLinkAboutFront Range Electric LLC - Insurance Certificate StateFarm STATE FARM FIRE AND CASUALTY COMPANY U A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS DECLARATIONS BFoomay 291 IL 61702 2915 Policy Number 96-E5-W401-2 Replaces Number 96-E0-A133-7 Addi Insured-Section II Only Policy Period Effective Date Expiration Date M-20-3F6D-FAF1 F E 1 Year APR 20 2025 APR 20 2026 001923 3123 The poll y period begins and ends at 12:01 am standard CITY OF FORT COLLINS ITS time a4e premises location. OFFICERS, AGENTS AND PO PBOXE580 Named Insured f £a: FORT COLLINS CO 80522-0580 FRONT RANGE ELECTRIC LLC 8 0 0 �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 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 Total Estimated Claim Record Premium $ 803.00 Disaster Mitigation $ 2.00 Audit Period: Annual Total Estimated Amt $ 805.00 Discounts Applied: Renewal Year Years in Business Prepared FEB 20 2025 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP-4000 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 014670 290 Al Continued on Reverse Side of Page Page 1 of 6 N San 686RI 115-11 Nnn WM73i'. DECLARATIONS(CONTINUED) Artisan And Service Contractor Policy for CITY OF FORT COLLINS ITS Policy Number 96-E5-W401-2 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 1878 NATURITA ST No Coverage $ 1,400 25% LOVELAND CO 80538-1010 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 $1,000 Special Deductibles: Equipment Breakdown $1,000 Other deductibles may apply- refer to policy. Prepared FEB 20 2025 Q Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP-4000 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 014670 Continued on Next Page Page 2 of 6 StateFarm • ❑ •W DECLARATIONS(CONTINUED) Artisan And Service Contractor Policy for CITY OF FORT COLLINS ITS Policy Number 96-E5-W401-2 H 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 0 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 OF 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 20 2025 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP-4000 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 014671 290 Continued on Reverse Side of Page N Page 3 of 6 DECLARATIONS(CONTINUED) Artisan And Service Contractor Policy for CITY OF FORT COLLINS ITS Policy Number 96-E5-W401-2 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 SECTION II- DEDUCTIBLES - Business Liability- Property Damage $500 Other deductibles may apply - refer to policy. SECTION II- LIABILITY LIMIT OF COVERAGE INSURANCE Coverage L - Business Liability $1,000,000 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 $2,000,000 Prepared © 20 2025 Copyright,State Farm Mutual Automobile Insurance Company,2008 FEB FEB 20 00 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 01CM Continued on Next Page Page 4 of 6 StateFarm [_j • ••. DECLARATIONS (CONTINUED) Artisan And Service Contractor Policy for CITY OF FORT COLLINS ITS Policy Number 96-E5-W401-2 General Aggregate $2,000,000 .y 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. S 0 0 �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 FE-6999.3 `Terrorism Insurance Cov Notice FE-1401 `Exclusion Cyber Incident 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 20 2025 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP-4000 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 014672 290 Continued on Reverse Side of Page Page 5 of 6 N DECLARATIONS(CONTINUED) Artisan And Service Contractor Policy for CITY OF FORT COLLINS ITS Policy Number 96-E5-W401-2 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. c � Secretary President Prepared FEB 20 2025 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 CMP-4000 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 014672 290 Page 6 of 6 N StateFarm STATE FARM FIRE AND CASUALTY COMPANY 11 Q A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS INLAND MARINE ATTACHING DECLARATIONS e�oom°ingror 5lL 6 1 702-29 1 5 FThe y Number 96-E5-W401-2 Named Insured ces Number 96-EO-A133-1 y Period Effective Date Expiration Date M-20-3F6D-FAF1 F E ar APR 20 2025 APR 20 2026 FRONT RANGE ELECTRIC LLC oll y period be?ins and ends at 12:01 am standard time at a premises ocatlon. 8 0 0 �o 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 bylaw. 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 FE-8756.1 Installation Endorsement FE-8760 Mobile Equipment Form See Reverse for Schedule Page with Limits Prepared FEB 20 2025 ©Copyright,State Farm Mutual Automobile Insurance Company,2008 FD-6007 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 014673 96-E5-W401-2 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 $ 500 Included FE-8760 Mobile Equipment Form S 10 , 000 $ 500 Included FE-8756.1 Installation Endorsement 5 5,000 S 500 Included Property in Transit 5 51000 Number of Job-Sites: 1 OTHER LIMITS AND EXCLUSIONS MAY APPLY-REFER TO YOUR POLICY Prepared © EB 20 2025 Copyright,Mate Farm Mutual Automobile Insurance Company,2008 F FEB 07 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 014673 530 686 a.2 05-31-1011 101132 StateFarm 96-E5-W401-2 014674 CMP-4536 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY. CMP-4536 ADDITIONAL INSURED — OWNERS, LESSEES, OR CONTRACTORS (Scheduled) This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM SCHEDULE s Policy Number: 96-E5-W401-2 �o Named Insured: FRONT RANGE ELECTRIC LLC Name And Address Of Additional Insured Person Or Organization: CITY OF FORT COLLINS ITS OFFICERS AGENTS AND EMPLOYES PO BOX 580 FORT COLLINS CO 80522-0580 1. SECTION II — 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 Cffice, Inc.,with its permission. StateFarm 96-E5-W401-2 014675 A. CMP-4787 THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY. Page 1 of 1 CMP-4787 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM 0 SCHEDULE Cb Policy Number: 96-E5-W401-2 Named Insured: FRONT RANGE ELECTRIC LLC Name And Address Of Person Or Organization: CITY OF FORT COLLINS ITS OFFICERS GENTS AND EMPLOY&PO BOX 580 FORT COLLINS CO 80522-0580 The following is added to Paragraph 10.b. of SECTION I AND SECTION II — COMMON POLICY CONDITIONS: We waive any right of recovery we may have against the person or organization shown in the Schedule because of payments we make for injury or damage arising out of: a. Your ongoing operations; or b. "Your work" done under contract with that person or organization and included in the "products- completed operations hazard". This waiver applies only to the person or organization shown in the Schedule. All other policy provisions apply. CMP-4787 ©, Copyright, State Farm Mutual Automobile Insurance Company,2008 Includes copyrighted material of Insurance Services Office, Inc., with its permission.