HomeMy WebLinkAboutTHE ELLEN E WEBER TRUST - INSURANCE CERTIFICATEState Farm Fire and Casualty Company
1555 Promontory Circle
Greeley, CO 80638-0001
AT1 T-20- 2359-F913
m 002023
THE CITY OF FORT COLLINS
PO BOX 580
FORT COLLINS CO 80522-0580
Insured: 111 N COLLEGE LLC
Location: 111 N COLLEGE AVE
FORT COLLINS CO
80524-2443
Mortgagee: THE ELLEN E WEBER TRUST
Forms, Options, and Endorsements
Z 3 F
Special Form 3
FP-6103
Amendatory Endorsement
FE-6206. 1
Tree Debris Removal
FE-6451
Business Policy Endorsement
FE-6464
Glass Deductible Deletion
FE-6538. 1
Fungus (Including Mold) Excl
FE-6566
Terrorism Insurance Cov Notice
* FE-6999. 1
Policy Endorsement - Business
FE-6610
Inc Cost and Demolition Cov
FE-6587
Dist Mat Violat Statues Excl
FE-6655
Policy Endorsement
FE-6656
Loss Payable Endorsement
FE-6309
Continued on next page
*Effective: JUN 15 2009
RENEWAL CERTIFICATE
POLICY NUMBER s 96-J9-2084-8
Business Policy
JUN 15 2009 to JUN 15 2010
PAID BY SPECIFIED PARTY
Coverages and Limits
Section I
A Buildings
$1,031,100
B Business Personal Property
Excluded
C Loss of Income
Actual Loss
Deductibles - Section I
Basic
1,000
Other deductibles may
apply - refer to policy
Section 11
L Business Liability
$1,000,000
M Medical Payments
5,000
Gen Aggregate (Other than POO)
2,000 000
Products -Completed Operations
2, 000, 000
(POO Aggregate)
Annual Premium
$2,100.00
Bus Liability - Cov L
1,086.00
Total Amount
$3,186.00
Premium Reductions
Renewal Year Discount
Claim Record Discount
Cov. A - Inflation Index: 195.4
Cov. B - Consurner Price: N/A
a NOTICE: Information concerning changes in your policy language is included. Please call your agent if
you have any questions.
N
V
y7 p_ If you have moved, please contact your agent.
/ IUU(rC ' �pjyQctPS�I vQ c�Ct ... See reverse side for important information.
7784 v 401 Ki-v Agent BISCHOFF INS AGCY INC
N ` Telephone (970) 223-9400 REB Prepared APR 28 2009
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State Farm Fire and Casualty Company
1555 Promontory Circle
Greeley, CO 80638-0001
T-20- 2359-F913 Z 3 F
002023
THE CITY OF FORT COLLINS
PO BOX 580
FORT COLLINS CO 80522-0580
Forms, Options, and Endorsements
Policy Endorsement
Building Coverage for Tenants
"Effective: JUN 15 2009
FE-6851
* FE-6859
15 2009 to JUN 15 2010
7785 401 AIN Agent BISCHOFF INS AGCY INC
N " Telephone (970) 223-9400 AEB Prepared APR 28 2009