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HomeMy WebLinkAbout233831 FOSTER VALUATION CO LLC - INSURANCE CERTIFICATESTATE FARM FIRE AND CASUALTY COMPANY ASTOCK COMPANY WITH HOME OFFICES INBLOOMINGTON.ILLINOIS RENEWAL DECLARATIONS StateFarm • • • 2702 Ireland Grove Road Bloomington, IL 61709-0001 Addl Insured -Section II Only AT2 T-20-2456-FAF1 F U 002171 3125 CITY OF FORT COLLINS PURCHASING DIVSION PO BOX 580 FORT COLLINS CO 80522-0580 LI'III'Illlll'Ill ll'I1111111111111111111111J1111111J11"I'Illll Office Policy Policy Number 96-17-9762-0 Policy Period Effective Date Expiration Date 12 Months MAR 16 2015 MAR 16 2016 The poly period be?ins and ends at 12:01 am standard time at a premises ocation. Named Insured D �1 FOSTER VALUATION CO LLC 910 54TH AVE STE 210 GREELEY CO 80634-4456 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: LLC NOTICE: Information concerning changes in your policy language is included. Please call your agent if you have any questions. POLICY PREMIUM Discounts Applied: Renewal Year Years in Business Enclosed Building Claim Record Prepared MAR 17 2015 CMP-4000 $ 588.00 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 013247 294 Al N Continued on Reverse Side of Page Page 1 of 7 530 586 a.2 05 31 2011 toIQ231cI RENEWAL DECLARATIONS (CONTINUED) Office Policy for CITY OF FORT COLLINS Policy Number 96-17-9762-0 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 001 910 54TH AVE STE 210 No Coverage $ 59,400 25% GREELEY CO 80634-4456 * 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 INDEX(ES) Cov A - Inflation Coverage Index. Cov B - Consumer Price Index: SECTION I - DEDUCTIBLES NIA 2383 Basic Deductible $500 Special Deductibles: Money and Securities $250 Employee Dishonesty $250 Equipment Breakdown $500 Other deductibles may apply - refer to policy. Prepared MAR 17 2015 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 013247 Continued on Next Page Page 2 of 7 = RENEWAL DECLARATIONS (CONTINUED) Office Policy for CITY OF FORT COLLINS Policy Number 96-17-9762-0 SECTION I - EXTENSIONS OF COVERAGE - LIMIT OF INSURANCE - EACH DESCRIBED PREMISES 0 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, 0 but has "Included" indicated, please refer to that policy provision for an explanation of that coverage. LIMIT OF COVERAGE INSURANCE Accounts Receivable On Premises Off Premises Arson Reward Back -Up Of Sewer Or Drain Collapse Damage To Non -Owned Buildings From Theft, Burglary Or Robbery Debris Removal Equipment Breakdown Fire Department Service Charge Fire Extinguisher Systems Recharge Expense Forgery Or Alteration Glass Expenses Increased Cost Of Construction And Demolition Costs (applies only when buildings are insured on a replacement cost basis) Money And Securities (Off Premises) Money And Securities (On Premises) Money Orders And Counterfeit Money Newly Acquired Business Personal Property (applies only if this policy provides Coverage B - Business Personal Property) Newly Acquired Or Constructed Buildings (applies only if this policy provides Coverage A - Buildings) Prepared MAR 17 2015 CMP-4000 013248 294 N © Copyright, State Farm Mutual Automobile Insurance Company, 2008 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Continued on Reverse Side of Page $50,000 $15,000 $5,000 $15,000 Included Coverage B Limit 25% of covered loss Included $5,000 $5,000 $10,000 Included 100/0 $5,000 $10,000 $1,000 $100,000 $250,000 Page 3 of 7 RENEWAL DECLARATIONS (CONTINUED) Office Policy for CITY OF FORT COLLINS Policy Number 96-17-9762-0 Ordinance Or Law - Equipment Coverage Included Outdoor Property $5,000 Personal Effects (applies only to those premises provided Coverage B - Business $5,000 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 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 Dependent Property - Loss Of Income Employee Dishonesty Utility Interruption - Loss Of Income Loss Of Income And Extra Expense LIMIT OF INSURANCE $5,000 $10,000 $10,000 Actual Loss Sustained - 12 Months Prepared MAR 17 2015 © Copyright State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 013248 Continued on Next Page Page 4 of 7 StateFarm • • RENEWAL DECLARATIONS (CONTINUED) Office Policy for CITY OF FORT COLLINS Policy Number 96-17-9762-0 SECTION II - LIABILITY 0 S LIMIT OF COVERAGE INSURANCE R Coverage L - Business Liability $1,000,000 Coverage M - Medical Expenses (Any One Person) $5,000 Damage To Premises Rented To You $300,000 LIMIT OF AGGREGATE LIMITS INSURANCE Products/Completed Operations Aggregate $2,000,000 General Aggregate $2,000,000 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. 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 FE-6999.2 *Terrorism Insurance Cov Notice CMP-4206.1 Amendatory Endorsement CMP-4791 Addl Insd State Political Perm CMP-4786 Addl Insd Owners Lessee Sched CMP-4819.1 Unauthorized Business Card Use CMP-4706 Back -Up of Sewer or Drain CMP-4704 Dependent Prop Loss of Income CMP-4710 Employee Dishonesty CMP-4709 Money and Securities CMP-4703 Utility Interruption Loss Incm CMP-4705 Loss of Income & Extra Expnse CMP-4785 Addl Ins Owners Lessee Blkt Prepared MAR 17 2015 © Copyright, State Farm Mutual Automobile Insurance Company, 2D08 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 013249 294 Continued on Reverse Side of Page N Page 5 of 7 RENEWAL DECLARATIONS (CONTINUED) Office Policy for CITY OF FORT COLLINS Policy Number 96-17-9762-0 FD-6007 Inland Marine Attach Dec " New Form Attached 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 MAR 17 2015 © Copyright State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 013249 Continued on Next Page Page 6 of 7 StateFarm • •• RENEWAL DECLARATIONS (CONTINUED) Office Policy for CITY OF FORT COLLINS Policy Number 96-17-9762-0 M NOTICE TO POLICYHOLDER: For a comprehensive description of coverages 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 us 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. Prepared MAR 17 2015 CMP-4000 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 013250 294 N Page 7 of 7 STATE FARM FIRE AND CASUALTY COMPANY A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS INLAND MARINE ATTACHING DECLARATIONS State Farm • • • 702Ireland Grove RoaO Bloomington. IL 61 09-0001 T-20-2456-FAF1 F U Named Insured FOSTER VALUATION CO LLC 910 54TH AVE STE 210 GREELEY CO 80634-4456 ATTACHING INLAND MARINE Policy Number 96-17-9762-0 Policy Period Effective Date Expiration Date 12 Months MAR 16 2015 MAR 16 2016 The policy period beg9ins and ends at 12:01 am standard time attfle premisesTocatlon. 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 effectfor each succeeding policy period. If this policy is terminated, we will give you and the Mortgagee/Lien holder written notice in compliance with the policy provisions or as required by law. Annual Policy Premium Included The above Premium Amountis 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 Inland Marine Computer Prop See Reverse for Schedule Page with Limits Prepared MAR 17 2015 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 FD-6007 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 013251 530-686 a.2 85-31-2811 ATTACHING INLAND MARINE SCHEDULE PAGE ATTACHING INLAND MARINE ENDORSEMENT LIMIT OF DEDUCTIBLE ANNUAL NUMBER COVERAGE INSURANCE AMOUNT PREMIUM FE-8743 Inland Marine Computer Prop S 25,000 S 500 Included Loss of Income and Extra Expense S 25,000 Included Prepared MAR 17 2015 FD-6007 OTHER LIMITS AND EXCLUSIONS MAY APPLY - REFER TO YOUR POLICY © Copyright State Farm Mutual Automobile Insurance Company, 2008 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 013251 530-666 a.2 05-31 2011 lot t3233c1