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HomeMy WebLinkAbout233831 FOSTER VALUATION COMPANY LLC - INSURANCE CERTIFICATE (5)StateFarm • STATE FARM FIRE AND CASUALTY COMPANY A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS DECLARATIONS 3 Ravin" pnv Atlanta �A 3346-2117 E M-20-2456-FAF1 F U 003530 3123 Addl Insured -Section II Only CITY OF FORT COLLINS PURCHASING DIVSION PO BOX 580 FORT COLLINS CO 80522-0580 Office Policy Policy Number 96-17-9762-0 Policy Period Effective Date Expiration Date 12 Months MAR 16 2018 MAR 16 2019 The policy period begins and ends at 12:01 am standard time at the premisesTocation. Named Insured 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: 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 Enclosed Building Claim Record $ 622.00 Prepared DEC 04 2017 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 041220 290 AI Continued on Reverse Side of Page Page 1 of 6 N 5an.aua nw ai ni i..i 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 $ 61,700 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 aue to Innanon coverage. SECTION I - INFLATION COVERAGE INDEXES) Cov A - Inflation Coverage Index: Cov B - Consumer Price Index: SECTION I - DEDUCTIBLES N/A 246.8 Basic Deductible $500 Special Deductibles: Money and Securities $250 Employee Dishonesty $250 Equipment Breakdown $500 Other deductibles may apply - refer to policy. Prepared DEC 04 2017 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 041220 Continued on Next Page Page 2 of 6 StateFarm • • •" 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 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. LIMIT OF COVERAGE INSURANCE Accounts Receivable On Premises $50,000 Off Premises $15,000 Arson Reward $5,000 Back -Up Of Sewer Or Drain $15,000 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 $5,000 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) $5,000 Money And Securities (On Premises) $10,000 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 DEC 04 2017 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 041221 290 Continued on Reverse Side of Page Page 3 of 6 N 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 DEC 04 2017 (D Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 041221 Continued on Next Page Page 4 of 6 StateFarm • •• DECLARATIONS (CONTINUED) Office Policy for CITY OF FORT COLLINS Policy Number 96-17-9762-0 SECTION II - LIABILITY LIMIT OF COVERAGE INSURANCE 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 CMP-4561.1 CMP-4705.2 CMP-4704.1 CMP-4703.1 FE-6999.2 CMP-4206.1 CMP-4791 CMP-4786 CMP-4819.1 CMP-4706 CMP-4710 CMP-4709 Prepared DEC 04 2017 CMP-4000 Businessowners Coverage Form *Policy Endorsement *Loss of Income & Extra Expnse *Dependent Prop Loss of Income *Utility Interruption Loss Incm *Terrorism Insurance Cov Notice Amendatory Endorsement Addl Insd State Political Perm Addl Insd Owners Lessee Sched Unauthorized Business Card Use Back -Up of Sewer or Drain Employee Dishonesty Money and Securities © Copyright, State Farm Mutual Automobile Insurance Company, 2008 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 041222 290 N Continued on Reverse Side of Page Page 5 of 6 DECLARATIONS (CONTINUED) Office Policy for CITY OF FORT COLLINS Policy Number 96-17-9762-0 CMP-4785 Addl Ins Owners Lessee Blkt FE-3650 Actual Cash Value Endorsement CMP-4787 Waiver of Trans Rgt of Recov FD-6007 Inland Marine Attach Dec 6E-8743.1 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 DEC 04 2017 CMP-4000 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 041222 290 N Page 6 of 6