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Home My WebLink About111 N COLLEGE LLC - INSURANCE CERTIFICATEStateFarm • • STATE FARM FIRE AND CASUALTY COMPANY A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS RENEWAL DECLARATIONS 3 RavinntaVr30346-2117 Atla Loss Payee AT1 M-20-2359-FAF1 F Z 004656 3125 THE CITY OF FORT COLLINS PO BOX 580 FORT COLLINS CO 80522-0580 II IIII'Il'Illll"'I'Il'I I'1'Illlll'Il'Illlllllllllllll'Ill'Illl11 Businessowners Policy Policy Number 96-J9-2084-8 Policy Period Effective Date Expiration Date 12 Months JUN 15 2019 JUN 152020 The policy period beggins and ends at 12:01 am standard time atthe premises Tocatlon. Named Insured 111 N COLLEGE LLC 111 N COLLEGE AVE FORT COLLINS CO 80524-2443 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: Limited Liability Company 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 Claim Record $ 3,533.00 Prepared MAR 04 2019 @1 Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 DEC PAGE ONLY Includes copyrighted material of Insurance Services Office, Inc., with its permission. 031843 294 Al Continued on Reverse Side of Page Page 1 of 6 N 530 HRR a.7 05 31 71111 1.1 RENEWAL DECLARATIONS (CONTINUED) Businessowners Policy for THE CITY OF FORT COLLINS Policy Number 96-J9-2084-8 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 001 111 N COLLEGE AVE $ 1,678,800 No Coverage N/A FORT COLLINS CO 80524-2443 * 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: Cov B - Consumer Price Index: SECTION I - DEDUCTIBLES 185.2 N/A Basic Deductible $5,000 Special Deductibles: Money and Securities $250 Equipment Breakdown $2,500 Other deductibles may apply - refer to policy. Prepared MAR 04 2019 Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 031843 Continued on Next Page Page 2 of 6 StateFarm • • • RENEWAL DECLARATIONS (CONTINUED) Businessowners Policy for THE CITY OF FORT COLLINS Policy Number 96-J9-2084-8 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, N but has "Included" indicated, please refer to that policy provision for an explanation of that coverage. LIMIT OF COVERAGE 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 And Securities (Off Premises) $2,000 Money And Securities (On Premises) $5,000 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) Prepared MAR 04 2019 Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 031844 294 Continued on Reverse Side of Page Page 3 of 6 N RENEWAL DECLARATIONS (CONTINUED) Businessowners Policy for THE CITY OF FORT COLLINS Policy Number 96-J9-2084-8 Ordinance Or Law - Equipment Coverage Outdoor Property Personal Effects (applies only to those premises provided Coverage B - Business Personal Property) Personal Property Off Premises Pollutant Clean Up And Removal Preservation Of Property Property Of Others (applies only to those premises provided Coverage B - Business Personal Property) Signs Valuable Papers And Records On Premises Off Premises Water Damage, Other Liquids, Powder Or Molten Material Damage SECTION I - EXTENSIONS OF COVERAGE - LIMIT OF INSURANCE - PER POLICY Included $5,000 $2,500 $15,000 $10,000 30 Days $2,500 $2,500 $10,000 $5,000 Included 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 Loss Of Income And Extra Expense LIMIT OF INSURANCE Actual Loss Sustained - 12 Months SECTION II - LIABILITY LIMIT OF COVERAGE INSURANCE Coverage L - Business Liability $2,000,000 Prepared MAR 04 2019 Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 031844 Continued on Next Page Page 4 of 6 StateFarm • •• RENEWAL DECLARATIONS (CONTINUED) Businessowners Policy for THE CITY OF FORT COLLINS Policy Number 96-J9-2084-8 Coverage M - Medical Expenses (Any One Person) Damage To Premises Rented To You Ila AGGREGATE LIMITS Products/Completed Operations Aggregate General Aggregate $5,000 $300,000 LIMIT OF INSURANCE $4,000,000 $4,000,000 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-4839 Loss Payable CMP-4709 Money and Securities CMP-4705.2 Loss of Income & Extra Expnse FE-3650 Actual Cash Value Endorsement CMP-4561.1 Policy Endorsement FD-6007 Inland Marine Attach Dec New Form Attached Prepared MAR 04 2019 (c) Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 031845 294 Continued on Reverse Side of Page Page 5 of 6 N RENEWAL DECLARATIONS (CONTINUED) Businessowners Policy for THE CITY OF FORT COLLINS Policy Number 96-J9-2084-8 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 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 thi: policy unless otherwise indicated by a separate endorsement, binder, or amended declarations. Any coverage forms attache( 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 t( 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 04 2019 CMP-4000 @' Copyright, State Farm Mutual Automobile Insurance Company, 2008 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 031845 294 N Page 6 of 6