Loading...
HomeMy WebLinkAboutFORT COLLINS CHILDREN'S THEATRE INC - INSURANCE CERTIFICATE (2)StateFarm • • • STATE FARM FIRE AND CASUALTY COMPANY A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS DECLARATIONS AMENDED APR 4 2019 a 8 t/aRavinnta GA 30ia rn10 346-2117 Addl Insured -Section II Only M-20-2359-FAF1 F N 002345 3123 THE CITY OF FORT COLLINS PO BOX 580 FORT COLLINS CO 80522-0580 I�1����I�IIIII�I�III�II��IIIII��III�II'IIII�I�I'Il�'I'Il�"I��I�1 Businessowners Policy Policy Number 96-BO-8754-5 Policy Period Effective Date Expiration Date 12 Months JUN 20 2019 JUN 202020 The policy period begins and ends at 12:01 am standard time at the premises location. Named Insured FORT COLLINS CHILDREN'S THEATRE INC PO BOX 442 FORT COLLINS CO 80522-0442 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 APR 4 2019 SECTION II COVERAGE LIMITS CHANGED Endorsement Premium Discounts Applied: Renewal Year Years in Business Protective Devices Claim Record Prepared MAY 07 2019 CMP-4000 022433 290 AI N Other items shown are effective with the policy's 2019 renewal None © 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 Page 1 of 6 530-Mal 05-31-2011 WQ2310 I DECLARATIONS (CONTINUED) Businessowners Policy for THE CITY OF FORT COLLINS Policy Number 96-BO-8754-5 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 001 725 E VINE DR No Coverage $ 46,300 25% FORT COLLINS CO 80524 * As of the effective date of this policy, the Limit of Insurance as shown inclucles any increase in the limit clue to Inuatlon Loverage. SECTION I - INFLATION COVERAGE INDEX(ES) Cov A - Inflation Coverage Index: Cov B - Consumer Price Index: SECTION I - DEDUCTIBLES N/A 254.2 Basic Deductible $500 Special Deductibles: Money and Securities $250 Equipment Breakdown $500 Other deductibles may apply - refer to policy. Prepared MAY 07 2019 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 022433 Continued on Next Page Page 2 of 6 StateFarm • • • DECLARATIONS (CONTINUED) Businessowners Policy for THE CITY OF FORT COLLINS Policy Number 96-BQ-8754-5 IN, SECTION I - EXTENSIONS OF COVERAGE - LIMIT OF INSURANCE - EACH DESCRIBED PREMISES s The coverages and corresponding limits shown below apply separately to each described premises shown in these $ Declarations unless indicated b "See Schedule." If a coverage does not have a corresponding limit shown below, "Included" Y 9 p 9 �N but has Included indicated, please refer to that policy provision for an explanation of that coverage. a 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 MAY 07 2019 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 022434 290 Continued on Reverse Side of Page Page 3 of 6 N DECLARATIONS (CONTINUED) Businessowners Policy for THE CITY OF FORT COLLINS Policy Number 96-BD-8754-5 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 1- 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 MAY 07 2019 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 022434 Continued on Next Page Page 4 of 6 SfatEFaf'.,!r, 4M DECLARATIONS (CONTINUED) Businessowners Policy for THE CITY OF FORT COLLINS Policy Number 96-BQ-8754-5 Coverage M - Medical Expenses (Any One Person) Damage To Premises Rented To You 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 CMP-4206.1 Amendatory Endorsement CMP-4766 Theft Deletion (Cov B Only) FE-6999.2 Terrorism Insurance Cov Notice CMP-4709 Money and Securities CMP-4705.2 Loss of Income & Extra Expnse CMP-4860 Al Design Person Org FE-3650 Actual Cash Value Endorsement CMP-4561.1 Policy Endorsement CMP-4788 Addl Insd Mgrs Lessor of Prem FD-6007 Inland Marine Attach Dec Prepared MAY 07 2019 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 022435 290 Continued on Reverse Side of Page Page 5 of 6 N DECLARATIONS (CONTINUED) Businessowners Policy for THE CITY OF FORT COLLINS Policy Number 96-BO-8754-5 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 MAY 07 2019 CMP-4000 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 022435 290 N Page 6 of 6 STATE FARM FIRE AND CASUALTY COMPANY A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS INLAND MARINE ATTACHING DECLARATIONS tanta & F r30346-2117 Policy Number 96-BO-8754-5 N 0 a Named Insured M-20-2359-FAF1 F N FORT COLLINS CHILDREN'S THEATRE INC PO BOX 442 FORT COLLINS CO 80522-0442 ATTACHING INLAND MARINE Policy Period Effective Date Expiration Date 12 Months JUN 20 2019 JUN 202020 The poll y period beggins and ends at 1201 am standard time at a premises Tocatlon. 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/Lien holder 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-8743.1 Inland Marine Computer Prop See Reverse for Schedule Page with Limits Prepared MAY 07 2019 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 FD-6007 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 022436 530-586 a.2 05-31-2011 lot 96-BQ-8754-5 ATTACHING INLAND MARINE SCHEDULE PAGE ATTACHING INLAND MARINE ENDORSEMENT LIMIT OF DEDUCTIBLE ANNUAL NUMBER COVERAGE INSURANCE AMOUNT PREMIUM FE-8743.1 Inland Marine Computer Prop S 25,000 S 500 Included Loss of Income and Extra Expense $ 25,000 Included Prepared MAY 07 2019 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. FD-6007 022436 530 686 a.2 05-31.2011 to IQ2330