HomeMy WebLinkAbout292606 STILO ENTERPRISES - INSURANCE CERTIFICATE (11)Policy Number
9643ic-7080-6
DECLARATIONS PAGE AMENDED JAN 19 2006 a
STATE FARM FIRE AND CASUALTY COMPANY ., ,•ems
1555 PROMONTORY CIRCLE, GREELEY CO 80638-0001
A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS
20-2015-F625 T 2
BUSINESS POLICY - SPECIAL FORM 3
Named Insured and Mailing Address
STILO, ROBERT J JR
DBA STILO ENTERPRISES
PO BOX 358
LOVELAND CO 80539-0358
Cov A - Inflation Coverage Index: N/A
Cov B - Consumer Price -index: 191.8
AUTOMATIC RENEWAL - If the POLICY PERIOD is shown as 12 MONTHS, this policy will be renewed automatically
subject to the premiums, rules and forms in effect for each succeedin policy period. If this policy is terminated, we will
give you and the Mortgagee/Lienholder written notice in compliance winh the policy provisions or as required by law.
Policy Period: 12 Months The policy period begins and ends at 12:01 am standard time at the
Effective Date: APR 25 2005 premises location.
Expiration Date: APR 25 2006
Location of Covered Premises:
435 E 11 TH ST
LOVELAND CO 80537-4827
Coverages & Property
Section 1
A Buildings
B Business Personal Property
C Loss of Income - 12 Months
Section II
L Business Liability
M Medical Payments
Products -Completed Operations
(PCO) Aggregate
General Aggregate (Other
Than PCO)
Forms, Options, and Endorsements
Special Form 3
*Section II Additional Insured
Amendatory Endorsement
Tree Debris Removal
Business Policy Endorsement
Glass Deductible Deletion
Fungus (Including Mold) Excl
* New Form Attached
Limits of Insurance
Excluded
1,400
Actual Loss
1,000,000
5,000
2,000,000
$ 2,0005000
FP-6103
FE-6609
FE-6206.1
FE-6451
FE-6464
FE-6538.1
FE-6566
Your policy is amended JAN 19 2006
ENDORSEMENT FE-6324 DELETED
ENDORSEMENT FE-6309 DELETED
ENDORSEMENT FE-6609 ADDED
Deductibles - Section I
$ 500 Basic
In case of loss under this policy, the deductible will be
applied to each occurrence and will be deducted from the
amount of the loss. Other deductibles may apply - refer to
Endorsement Premium None
Discounts Applied:
Claim Record
Continued on Reverse Side of Page I
OTHER LIMITS AND EXCLUSIONS MAY APPi Y -
Prepared
JAN 27 2006
Cc
FP-8030.2C AFM5
By
0611993
ED
Your policy consists of this page, any endorsements
(97
and the policy form. PLEASE KEEP THESE TOGETHER.
TO YOU
(0 2172b)
Policy Number
96-GK-7080-6
CONTINUED FROM FRONT SIDE
BUSINESS POLICY - SPECIAL FORM 3
Prepared
JAN 27 2006
(012VU)
-TCH Policy No. 96-GK-7060-6 EFF DATE JAN 19 2006 2015-F625 FE-6609
!a[l[ IIM
SECTION II ADDITIONAL INSURED ENDORSEMENT
IN[YIYNt�
P011cy No.: 96-GK-7080-6
Named Insured: STILO, ROBERT J JR
DBA STILO ENTERPRISES
Additional Insured (include address):
CITY OF FORT COLLINS
C/O PURCHASING DEPT
PO BOX 580
FORT COLLINS CO 80522-0580
WHO IS AN INSURED, under SECTION II DESIGNATION OF INSURED, is amended to include as an insured the
Additional Insured shown above, but only to the extent that liability is imposed on that Additional Insured solely
because of your work performed for that Additional Insured shown above.
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.
The Primary Insurance coverage below applies only when there is an "X" in the box.
❑ Primary Insurance. The insurance provided to the Additional Insured shown above shall be primary
insurance. Any insurance carried by the Additional Insured shall be noncontributory with respect to
coverage provided to you.
All other policy provisions apply.
FE-6609 Printed in U.S.A.