Loading...
HomeMy WebLinkAboutSTROMBERG CONSTRUCTION LLC - INSURANCE CERTIFICATEI StateFarm STATE FARM FIRE.AND CASUALTY At A STOCK COMPANY WITH HOME Of Atfanf l 3i%46-2117 Addl Insured -Section II Only 001585 3123 CITY OF FORT COLLINS PO BOX 580 Mai FORT COLLINS CO 80522-0580 mhll�llh�hllllllll�j14111h114�i��ll�ll�llljllll�� s C q ,�g 0o Artisan And Service Contractor Polic' BLOOMINGTON, ILLINOIS. DECLARATIONS AMENDED MAY 14 2020 Policy Number 96-C7-HS79-3 Policy Period Effective Date Expiration Date 59-FAF1 F E 1 Year SEP 19 2019 SEpP 19 2020 The polipv period begins and ends at 12:01 am standard Named Insured STRO,MBERG CONSTRUCTION LLC 2819 EASTBOROUGH DR FORT COLLINS CO $0525-2364 Itllytl 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' is policy is terminated, we will give you and the Mortgagee/Lienholderwritten notice in compliance with the policy provisions or as required by law. Entity: Limited Liability Company Reason for Declarations: Your policy is amended MAY 14 2020 ADDITIONAL INSURED ADDED FORM CMP-4766 ADDED FORM CMP-4785 ADDED Endorsement Premium Increase Audit Period: Annual Discounts Applied: Years in Business $ 83.00 Prepared JUN 15 2020 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material oflnsumnice SeNi6es Office, Inc., with its permission. 011374 290 Al Continued on Reverse Side of Page N Page 1 of 6 Un.nannn ne.vrgnii i„ 1eaxa DECLARATIONS (CONTINUED) Artisan. And Service Contractor Policy for CITY OF FORT COLLINS Policy Number 96-C7-1-1579-3 SECTION I_ PROPERTY BLANKET Coverage A: Buildings Coverage B - Business Personal Property Seasonal Increase - Business Personal Property 001 002 003 As of the effective Inflation Coverage. SECTION I - INFLAT ON COVERAGE INDEX(ES) Cov A - Inflation Coverage Index: Cov B - Consumer Price Index: SECTION I - DEDUCTIBLES Basic Deductible $1,000 Limit of Insurail NoCoverage 1 000 9% 2819 EASTBOROUGH DR FORT COLLINS CO 80525-2364 142 TIMBERLINE RD FORT COLLINS CO 80524-1402 2040_AIRWAY AVE. FORT COLLINS CO 80524-3699 N/A 256.8 Prepared JUN 15 2020 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 011374 Continued, on Next Page in the limit due to Page 2 of 6 StafeFarm • • •e DECLAF Artisan And Service Contractor.Policy for C Policy Number 96-C7-H579.3 Spec let Deductibles: M1 Equipment Breakdown $1,0( Other deductibles may apply - refer to policy. ONS (CONTINUED) OF FORT COLLINS SECTION 1- EXTENSIONS OF COVERAGE- LIMIT OF INSURANCE EACH DESCRIBED PREMISES I 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 tI o 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 Debris Removal Equipment Breakdown Fire Department Service. Charge Fire Extinguisher Systems Recharge Exl Forgery Or Alteration Glass Expenses Increased Cost Of Construction And insured on a replacement cost basis) Money Orders And Counterfeit Money Newly Acquired Business Personal Proper Coverage B - Business Personal Property) Newly Acquired Or Constructed Buildings I Coverage A - Buildings) Prepared JUN 15 2020 CMP-4000 011375 290 N Burglary Or Robbery Costs (applies only when buildings are (applies only if this policy provides only if this policy provides © 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 LIMIT OF :INSURANCE See Schedule See Schedule $5,000 Included Coverage B Limit 25% of covered loss Included $2,500 $5,000 $10,000 Included 10% $1,000 $100,000 $250,00b Page 3 of 6 DECLARATIONS (CONTINUED) Artisan And Service Contractor Policy for CITY OF FORT COLLINS Policy Number 96-C7-H579-3 Ordinance Or Law - Equipment Coverage . Included Outdoor Property See Schedule 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 See Schedule Personal Property) Signs See Schedule Valuable Papers And Records On Premises See Schedule Off Premises See Schedule Water Damage, Other Liquids, Powder Or Molten Material Damage Included SECTION I -EXTENSIONS OF COVERAGE - LIMIT OF INSURANCE - SCHEDULE The coverages and corresponding limits shown below apply only to the described premises as shown. LOCATION COVERAGE 0001 Signs Property Of Others (applies only to those premises provided Coverage B - Business Personal Property) Accounts Receivable (On Premises) Accounts Receivable (Off Premises). Outdoor Property Valuable Papers and Records (On Premises) Valuable Papers and Records (Off Premises) 0002 Signs Property Of Others (applies only to those premises provided Coverage B - Business Personal Property) Accounts Receivable (On Premises) Accounts Receivable (Off _Premises) Outdoor Property Valuable Papers and Records (On Premises) Prepared JUN 15 2020 M Copyright, State Farm Mutual Automobile Insurance Company,20.08 CMP 4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. LIMIT OF INSURANCE $2,500 $2,500 $1.0,000 $5,000 $5,000 $10,000 . $5,000 $2,500 $2,500 $10,000 $5,000 $5,000 $10,000 011375 Continued on Next Page Page 4 of 6 5tateFarm • • • ® DECLARATIONS (CONTINUED) l Artisan And Service Contractor Policy for CITY OF FORT COLLINS Policy Number 96-C7-N579-3 Valuable Papers and Recor 0003 Signs Property Of Others (applies Personal Property) Accounts Receivable (On P Accounts Receivable P (Off $ Outdoor Property UjoValuable Papers and Recor Valuable Papers and Recor (Off Premises) $5,000 $2,500 ly to those premises provided Coverage B - Business $2,500 nises 10,000 nises) $5,000 $5,000 (On Premises) $10,o00 (Off Premises) $5,000 Business Liability - Property Damage $500 Other deductibles may apply - refer to policy. COVERAGE Coverage L - Business Liability Coverage M - Medical Expenses (Any One Damage To Premises Rented To You AGGREGATE LIMITS Products/Completed Operations Ac General Aggregate Each paid claim for Liability Coverage rec annual period. Please refer to Section II - Prepared JUN 15 2020 CMP-4000 011376 290 N In Person) LIMIT OF INSURANCE $1,000,000 $5,000 $100,000 LIMIT OF INSURANCE $2,000,000 $2,000,000 the amount of.insurance we provide during the applicable. lity in the Coverage Form and any attached endorsements. ® Copyright, State Farm Mutual Automobile Insurance Company, 20D8 ides copyrighted material of Insurance Services Office, Inc., with its permission. Continued on Reverse Side of Page Page 5 of 6 DECLARATIONS (CONTINUED) Artisan And Service Contractor Policy for CITY OF FORT COLLINS Policy Number 96-C7-H579-3 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. UeeJ7LL-1AAL4 'A CMP-4100 Businessowners Coverage Form CMP-4785 *Addl Ins Owners Lessee Blkt CMP-4786 *Addl Insd Owners Lessee. Sched CMP-4787 *Waiver of Trans Rgf of Recov CMP-4600 Artisan and Service Contractor FE-6999.2 Terrorism Insurance Cov Notice CMP-4206.1 Amendatory Endorsement FE-3650 Actual Cash Value Endorsement CMP-4561.1 Policy Endorsement FD-6007 Inland Marine Attach Dec NOTICE: INFORMATION CONCERNING CHANGES IN YOUR POLICY LANGUAGE IS INCLUDED. PLEASE CALL YOUR AGENT IF YOU HAVE ANY QUESTIONS. * 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 JUN 15 2020 CMP-4000 © Copyright, State Form Mutual Automobile Insurance Company, 2008 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 011376 290 N Page 6 of 6