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HomeMy WebLinkAboutPOLICY CONFLUENCE INC - INSURANCE CERTIFICATE 2020-2021StateFarm • • • �y � 0 �� �o STATE FARM FIFI£ AND CASUALTY COMPANY A STOCK COMF�ANY WlTN NOMF OFFlC�S 1N BLOOMINGTON, !LLlN015 DECLARATIONS AMENDED MAR 3 2fl20 Ateai7fa ciA r3o346-21 �7 Addl Insured-Sectian fl Only 001993 3123 CITY 0� FORT COLLINS 3000 LAPORTE AVE FORT COLLINS CO 80�21 Policy Number 96-CS-B39$-8 Policy Period Effective Date Expiration Da� M-20-2388-FA65 F U �2 Months MAY 1 2020 MAY 1 202� The poli y period begins and ends at 12:Oi am standar bme at�ie premises lacaUon. �Ililll������l��l�l�l�����`I����i�l�l�ll�llil�l������l��l���lF��I O#fice Policy Named Insured POLICY CONFLUENCE INC DBA NATIONAL RESEARCH 2955 VALMONT RD STE 300 BOULDER CO 803DI-1�b0 Automatic Renewaf - If the policy period is shown as 12 months , this polrcy will be renewed automatically subjectto the premiums, rules forms in effect for each succeeding pol�cy period. I€ this policy is terminated, we w�ll give you and the MortgageelLienholder written noticE compliance with the policy provisions or as required by law, Entity: Corporaiion Reason for Declarations: Your policy is amended MAR 3 2020 ADDiTIONAL INSURED ADDED PR�MIUM ADJUSTMENT FORM CMP-4786 ADD�D Other items shawn are effeCtive with the policy's 2020 renewal Endorsement Premium Discounts Appiied: Ye�rs in Business Enclosed Building Prepared MAR 25 2020 cMP-aooa a159as zso ,a� N None d Copyright, State Farm Mutual Automobde Insurance Compa�y, 2008 Incl�des capyrig�tted materiai of Insurance Services Office, 4nc., with its permission. Continued on Rsverse Side of Page Page 1 of 530 586 a.2 93 31 2011 DECLARATIONS (CONTINUED} Office Policy for CITY OF FORT COLLINS Pnlicy Number 96-05-6398-8 � • •-�• �i��«�L� _ - - " A: L.ocation Locatian af Limit of Insurance" Limit of fnsurance* Seaso�al Number Described increase- Premises Co�erage A- Coverage B- Business Buildings Busine5s Persona! Personal Property Property 001 2955 VALMONT RD S7E 300 Na Coverage $ 75,600 25% BOULQER CO 80301-1360 � of the effective date of this policy, the Limit af Ir�surance as shown includes any increase in the limit due to Inflation Coverage. �� + � ��i[d� _ : � � Cav A- Inflation Co�erage Ir�dex: N/A Cov B- Consumer Price Index: 257.3 SECTION 1- DEDUCTIBLES „__ ,,,,,,,___. , _ Basic Deductible Speclal Deductibles: Money and Securitiss Equipment Breakdown $i,000 $250 Employee Dishonesty $1,000 Other deducti#�les may apply - refer to policy. Prepared MAR 25 2o2a cnn�-aoao 015946 C� Cupynght, State Farm Mutual Ruromobile Insurance Company, 2008 'ncludes copyrFghted matenel of Insurance Serv�ces OEfica, Inc, with its permission, Continued on Next page $250 Page 2 of 6 StateFarm • • DECLARATIONS (CONTINUED) Office Policy for CI7Y OF fORT CQLLINS Policy Numher 96-05-B398-8 �� SECTION I-�XT�NSfONS OF �QVERAG�-1�U4�IIT OF INSURANCE - EACH DESCRIBED PREM�ES __ w R The coverages and corresponding limits shown below apply separately to each described premises shown in thes $ Declarations, unless indicated by "See Schedule." If a co�erage does not ha�e a corresponding �imit shawn belov �� but has "Included" incficated, please refer to that policy pro�ision iar an explanation of that coverage. �o COV�RAGE Accounts Receivable On Premtses Off Premises Arson Reward Back-iJp Of Sewer Or Drain Coilapse I]amage To Non��Owned Buiidmgs From Theft, Burglary Or Robbery Debris Removal Equipmeni Breakdown Fire Department 5ervice Charge Fire Extinguisher Systems Recharg� �xpense Forgery Or Alteration Glass Expenses Encreased Cost O# Construction And Demolition Costs (applies only when buildings are insured on a replacement cost basis) Money And Securities (Off Premises) Maney And Securities (On Prernises) Money Orders And Counterfeit Money Newly Acquired Busfness Personai Property (applies only if this policy �rovides Coverage B- Business Perso�al Property} Newly Acquired Or Consiructed Buildings (applies only if this policy provides Coverage A - Suildings} Prepared MAR �� 2o2a cnnP-aaoo 415947 290 N (� Copynght, State Farm Mutual Automohde Insurance Company, 20DB Incl�des copyrighted materisl of Insurance Services Office, Inc., with its permission. Continued an Reverse Side of �age LIMiT OF INSURANCE $50,QD0 $15,000 $5,000 $15,Q00 IncEuded Coverage B Ljmit 25% of covered loss lncEuded ��,aoo $�,aoo $10,000 Inciuded iQ% �5,aoo $1 o,aoo $� ,aoo $1 oo,oao $250,aao Page 3 of DECLARATIONS (CON7INUED) Office Policy for CITY OF FORT COLL.INS Palicy Number 96-05-8398-8 Ordinance �r Law - �qui}ament Covera�e OuEdoor Property Personal Effects (applies only to thase premises provided Coverage B- Business Personal Property) Personal Property Off Premises Pollutant CEean Up And Removal I'reservation Ot Property Praperty Of Dihers (applies oniy ta those premises pravided Caverage B- Business Personal Property) Signs l3nauthorized Business Card lJse Valuable �apers And Records On Premises O(4 Premises Water Damage, Other Liquids, Powder Qr Molten MaterFal Damage Inciuded $5,aQ0 $5,OOD $15,oaa $10,000 30 Days $2,500 $2, 50d $�,aoo $SQ,000 $� 5,000 Included SECTION I- EXTENSIONS OF COVERAGE - LIMIT QF INSURANC� - PER p�LICY The co�erages and oorresponding limits shown belaw are the most we will pay regardless of the number of described premises shown in these Declarations. COVERAGE Dependent PEoperty - Loss Of Income �mpfoyee Dishonesty Utility Interruption - i.oss Of Incom� Loss Of Income And Extra Expens� L,IMIT OF INSURANCE �5,000 $1 o,00a $10,oaa Actual Loss Sustained - 12 Months Prepared MAR 25 2020 0 Copyright, State Farm Mutual Aatamobile Insurance Company, 2�08 CMP-40da Includes sopyrighted msterial ofi Insurance Services OfEice, Inc., wath its permiss on. 015947 Continueci on Next Page Page 4 of 6 Sfate�arm • •• DECLARATIONS (CONTINUED) Office Policy for CITY OF FORT COLLlNS Policy Number 9G-05-B398-8 �� s t:. $ �o SE�TION II - LIA8ILITY ,. , COVERAGE Coverage L - Business Liability Coverage M- Medical Expenses (Any One Person) Damage To Premises f�ented Ta You AGGREGAT� LIMITS Products�Campleted Operatior�s Aggregate Generai Aggregate LIMIT OF INSURANCE �2,aao,00a $5,000 $300,000 L�MIT QF INSURANCE $a,000,00a $a,oao,aoo �ach paid clairr� #ar Liability Coverage reduces the amount of insurance we provide during the applicable annual period. Please refer to Sec#ion II - Liability in the Coverage Form ar�d any attachec! endorsements. Your poiicy consists of these Declarations, the BUSINESSOWNERS COVERAGE �ORM shown below, anci any other forms and Endarsements that apply, including t�ose shown below as well as those issued subsequent to the issuance of this policy. • � L �_� R� i l CMP-410Q CMP-4786 CMP-4819.1 FE-6999.2 CMP-4206.1 FE-3850 CMP-45fi1.1 CMP-4705.2 CMP-4710 CM�-4709 CM�'-4706 CMP-4704.1 CMP-4703.1 F'repared MAR 25 2020 CMP-4000 Businessowners Caverage Farm *Addl Insd Owners Lessee 5ched Unauthorized Business Card lise Terrorism Insurance Cov Notice Amendatory Endorserr�ent Actual Cash Value Endorsement Policy Endorsemer�t Loss ai Incame & Extra Expnse Emp�ayee Qisf�onesty Money and Securities Back-Up of Sewer or Drain Dependent Prop Loss of Incame Utility Interruption Loss Incm � Copyright, StaEe Farrn Mutual Autamobde I�s�rance Company, 2008 Includes copyrighted materrel of Insurance Services OEfice, Inc., with rts permission. 015848 2g0 Continued on Re�erse Side af Page Page 5 of N DECLARAtIONS (CONTINUED) Office Policy for CI"iY OF FORT COL�.INS Pol€cy NumFier 9B-05-B398-8 CMP-4785 CMP-4875 CMP-4787 FD-6007 Addl Ins �wners Lesses Blkt Loss Payable Waiver at Trans Rgt of Recov lnland Marine Attach Dec " New Form Attached This policy is issued by the State Farm Fire and Casualry Company. Participating Policy You are entitled to participate in a distribu#ion of the earnings of t#te campany as dete�mined by our Baard of Directors in accordance with fhe Company's Articles of Incorporation, as amended. In Witness W#�ereof, khe Sta#e �arm Fire and Casualty Company has causec� this policy to #�e signed by its President and Secretary at Bloomingtan, Iklinois. �' � �°�"'`�' '���� Secretary President Prepared MAR 25 2020 CMP-4000 015948 280 � 0 Copynght, SteEe Farm Muwel Automohile Insurance Company, 20Q8 Includes copynghted metenal of Insurance Services Office, Ine., w�th its permission. Page 6 of 6 SfateFarm • • • STATE FARM FIR� AND CASUALTY COMPANY ASTOCKC�MPANYWITNH(7MEt�FFlGE.� lNBLOG`MlNGTON,lLLlNdlS iNLAND MAI�IN� ATTACHING D�CLARATIONS �tanta �[�/i �3�346-21 i7 Named Insured POLICY CONFLUENCE iNC DBA NATIONAL RESEARCH 2955 VALMONT 12D STE 300 � BOULDER CO 80301-1360 8 0 0 ��� ATTACHING INLAN� MARINE Policy Period Effactive Date Expiratinn Da M-20-2388�FA65 F U 12 Months MAY 1 202Q MAY 1 2Q21 The poli y period be ins and ends at 12:Oi am standar t�me at�e premises�ocation. Ae�tomatic Renewal - If the policy period is shawn as 12 months , this policy will be renewed automatically subjecttn the premiums, rukes forms in effectfor each succeeding policy period. If this pol�cy is terminated, we will give you and the Mortgagee/Lienholder written nodc� compliance with tha palicy prnvisions or as required by law. Annual Poiicy Premium Included The above Premium Amount is included in the Policy Premium sl�own on tt�e peclarations. Your poiicy consists af these Declaratinns, tt�e INLAI�D MARIN� COI�DITIOIVS shown below, and any ot�er forms and endorsements that apply, including thase shown belnw as well as tt�ose issued subsequentto the issuance of ihis policy. Forms, Options, and Endorsement� FE-8739 Inland Marine Concfitions FE-87'43.1 Inland Marine Computer Prop See Reverse for Schedule Page witt� Limits Prepared MAFi 25 2020 Fo-saa� Policy Nurnber 96-05-B398-8 � Copynght, State farm Mutual Auromobile Insurance Company, 2068 Includes copyrighted material of Insurance Services Dffice, Inc., w+th its permission. Oi5949 �ao sese.z os a� :a�� 96-05-B398-8 ATTACHING INI.AN[1 MARINE SCNEDULE PAGE ATTACHING INLAND MARINE ENDORSEM�NT NUMBER FE-$743.1 COVERAGE Inland Marine Computer Prop Loss of Income and Extra Expense L{MI� OF INSURANGE DEOUCTIBI.E AMOUNT Prepared MAR 25 2020 Fo-soa7 25,fl00 25,000 OTH�R LIMITS AND EXCLUSIOf�S MAY APPLY - REFER TO YOUR PQLICY m Copyright, State Farm Mutuai Automobiie Insurence Campany, 2008 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 500 ANNUAL PREMIUM Included Included 015949 530 686 a.2 05 31 2011 �011323i