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HomeMy WebLinkAboutS & S PLUMBING INC - INSURANCE CERTIFICATEStateFarm STATE FARM FIRE AND CASUALTY COMPANY A A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS DECLARATIONS AMENDED JUL 1 2018 Atlanta EGA 30346-2117 M-20-2702-FA65 F E 002853 3123 Addl Insured -Section li Only CITY OF FORT COLLINS ATTN: BUILDING SERVICES 281 N COLLEGE AVE FORT COLLINS CO 80524-2404 Artisan And Service Contractor Policy Policy Number 96-CG-Q181-8 Replaces Number 96-CG-KO83-4 Policy Period 1 Year Effective Date Expiration Date JUL 1 2018 JUL 1 2019 The policy period be9ins and ends at 12:01 am standard time at the premisesTocatton. Named Insured S & S PLUMBING INC 5213 CRYSTAL LN LOVELAND CO 80538-1664 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 Reason for Declarations: Your policy is amended JUL 1 2018 This amendment declaration is a result of an audit. It contains updated coverage and exposure information. Endorsement Premium Decrease Audit Period: Annual Discounts Applied: Renewal Year Years in Business Claim Record $ 235.00 Prepared AUG 31 2018 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 026576 790 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-CG-0181-8 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 001 241 12TH ST SE No Coverage $ 9,000 25% LOVELAND CO 80537-6309 * As of the effective date of this policy, the Limit of Insurance as shown includes any increase in the Omit clue to innauon uoveraye. SECTION I - INFLATION C VERAGE INDEXES) Cov A - Inflation Coverage Index: Cov B - Consumer Price Index: SECTION I - DEDUCTIBLES Basic Deductible $1,000 Special Deductibles: Equipment Breakdown $1,000 Other deductibles may apply - refer to policy. N/A 249.6 Prepared AUG re 2018 © Copyright State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 026576 Continued on Next Page Page 2 of 6 StateFarm • • • DECLARATIONS (CONTINUED) Artisan And Service Contractor Policy for CITY OF FORT COLLINS Policy Number 96-CG-Q181-8 SECTION I - EXTENSIONS OF COVERAGE - LIMIT OF INSURANCE - EACH DESCRIBED PREMISES 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, but has "Included" indicated, please refer to that policy provision for an explanation of that coverage. COVERAGE Accounts Receivable On Premises Off Premises Arson Reward 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 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) Ordinance Or Law - Equipment Coverage Outdoor Property Prepared AUG 31 2018 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 026577 790 Continued on Reverse Side of Page N LIMIT OF INSURANCE $10,000 $5,000 $5,000 Included Coverage B Limit 25% of covered loss Included $2,500 $5,000 $10,000 Included 10% $1,000 $100,000 $250,000 Included $5,000 Page 3 of 6 DECLARATIONS (CONTINUED) Artisan And Service Contractor Policy for CITY OF FORT COLLINS Policy Number 96-CG-0181-8 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 $2,000 Other deductibles may apply - refer to policy. SECTION II - LIABILITY LIMIT OF COVERAGE INSURANCE Coverage L - Business Liability Coverage M - Medical Expenses (Any One Person) Damage To Premises Rented To You AGGREGATE LIMITS Products/Completed Operations Aggregate Prepared © AUG re 2018 Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 026577 Continued on Next Page $1,000,000 $5,000 $100,000 LIMIT OF INSURANCE $2,000,000 Page 4 of 6 StateFarm • ••, DECLARATIONS (CONTINUED) Artisan And Service Contractor Policy for CITY OF FORT COLLINS Policy Number 96-CG-Q181-8 General Aggregate 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. $2,000,000 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-4206.1 Amendatory Endorsement FE-6999.2 Terrorism Insurance Cov Notice CMP-4600 Artisan and Service Contractor CMP-4785 Addl Ins Owners Lessee Blkt CMP-4786 Addl Insd Owners Lessee Sched FE-3650 Actual Cash Value Endorsement CMP-4787 Waiver of Trans Rgt of Recov CMP-4561.1 Policy Endorsement FD-6007 Inland Marine Attach Dec Prepared AUG 31 2018 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 026578 790 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-CG-0181-8 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 e0 AUG re 2018 Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 026578 790 Page 6 of 6 N StateFarm STATE FARM FIRE AND CASUALTY COMPANY Al A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS INLAND MARINE ATTACHING DECLARATIONS 3 Ravini8 pn3v Atlanta GA 346-2117 M-20-2702-FA65 F E Named Insured S & S PLUMBING INC 5213 CRYSTAL LN LOVELAND CO 80538-1664 ATTACHING INLAND MARINE Policy Number 96-CG-Q181-8 Replaces Number 96-CG-KO83-4 Policy Period 1 Year Effective Date Expiration Date JUL 1 2018 JUL 1 2019 The policy period begins and ends at 12:01 am standard time atthe premises Tocation. 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 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-8760 Mobile Equipment Form FE-8743.1 Inland Marine Computer Prop FE-8756.1 Installation Endorsement See Reverse for Schedule Page with Limits Prepared AUG 31 2018 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 FD-6007 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 026579 96-CG-0181-8 ATTACHING INLAND MARINE SCHEDULE PAGE ATTACHING INLAND MARINE ENDORSEMENT LIMIT OF DEDUCTIBLE ANNUAL NUMBER COVERAGE INSURANCE AMOUNT PREMIUM FE-8760 Mobile Equipment Form $ 10 , 0 0 0 $ 500 Included FE-8743.1 Inland Marine Computer Prop $ 25,000 $ 500 Included FE-8756.1 Installation Endorsement $ 51000 $ 500 Included Property in Transit $ 51000 Number of Job -Sites: 1 Prepared AUG 31 2018 FD-6007 026579 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. 530 586 a.2 05 31 2011 loi f32330