Loading...
HomeMy WebLinkAbout6286 - COI_AESCS Inc._2StateFarm • • • STATE FARM FIRE AND CASUALTY COMPANY A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS DECLARATIONS AMENDED AUG 10 2022 P BoX 2915 3 oommgton IL 61702-2915 Policy Number 98=CD-W066=6 Addl Insured -Section II Only 001082 3123 CITY OF BREMERTON 345 6TH ST STE 100 BREMERTON WA 98337-1891 M-15-2761-FBBC F N Policy Period Effective Data Expiration Date 12 Months AUG 5 2022 AUG 5 2023 The poll y period beggins and ends at 12:01 am standard time at e premises iocatlon. Named Insured AE;CS INC Businessowners Policy Automatic Renewal - If the policy period is shown as 12 months, this policy will be renewed automatically subject to 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: Corporation Reason for Declarations: Your policy is amended AUG 10 2022 ADDITIONAL INSURED ADDED PREMIUM ADJUSTMENT FORM CMP-4786 ADDED Endorsement Premium None Discounts Applied: Renewal Year Years in Business Claim Record Prepared SEP 23 2022 CMP-4000 009714 290 Al N RECEIVED JCT 0 4 702I City of Bremerton Attorneys QMCe O Copyright, State Farm Mutual Automobile Insurance Company, 2DD8 Includes copyrighted material of Insurance Services Offioe, Ina, with its permission. Continued on Reverse Side of Page Page 1 of 6 IIWaRrA lIN M' R 11 R FUTVA ki IF F M11• s Y 001 3472 NW LOWELL SILVERDALE WA 98383-9120 * As of the effective date of this policy, the Limit of Insurance as shown Cov A -Inflation Coverage Index: Cov R - Consumer Price Index: PA + , r:+ R • I �overage : «^ R iness Personal M r R Y R 4 R R x eludes any increase $ 134,300 � 25% mit due to Basic Deductible $1 0 Earthquake 10% Equipment Breakdown $1,000 Other deductibles may apply - refer to policy. Prepared SEP 23 2022 CMP-4000 Money and Securities c� Copyright, State Farm Mutual Automobile hisurance Company, ZD08 Includes copyrighted material of Insurance Services Office, hie„with its permission. $250 009714 Continued on Next Page Page 2 of 6 Ai ROW ik I I Wmr LIMIT OF COVERAGE INSURANCE Accounts Receivable On Premises $105000 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) $55000 Money Orders And Counterfeit Money $19000 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 $2509000 Coverage A -Buildings) Prepared SEP 23 2022 ©Copyright, State Farm Mutual Automobile Insurance Company, 200s C1V1P-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 009715 290 Continued on Reverse Side of Page Page 3 of 6 N • ■ - AL* PolicyNumber 98 1 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 4 ,A Loss Of Income And Extra Expense Caverage L -Business Liability Pref�ared SAP �0 2022 CMP-4000 Included +11 $15,000 $10,000 30 Days $2,500 $10,000 $5,000 Included Actual Loss Sustained - 12 Months © Copyright, State Farm Mutual Automobile Insurance Company, 2008 Includes copyrighted material of Insurance Services Office, Inc., with its permission. $1,000,000 oo971:; Continued on Next Page Page 4 of 6 �� • • •\ Policy Number 98wCDwW066w6 Coverage M - Medical Expenses (Any One Person) $10,000 Damage To Premises Rented To You $3005000 LIMIT OF AGGREGATE LIMITS INSURANCE a Products/Completed Operations Aggregate $2,000,000 �o General Aggregate $23000,000 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. CMP-4102 Businessowners Coverage Form CMP-4786 *Addl Insd Owners Lessee Sched CMP-4787 *Waiver of Trans Rgt of Recov CMP-4247.1 Amendatory Endorsement CMP-4720.1 Earthquake Volcanic Eruption FE-6999.3 Terrorism Insurance Cov Notice CMP-4709 Money and Securities CMP-4705.2 Loss of Income & Extra Expnse CMP-4785 Addl Ins Owners Lessee Blkt CMP-4859 Al Engineer Architect Survey FE-3650 Actual Cash Value Endorsement CMP-4779 Employers Liability CMP-4572 Amendment of Premium Cond CMP4561 A Policy Endorsement CMP-4870 Addl Insd Primary Non Contrib CMP-4860 Al Design Person Org 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 Prepared SEP 23 2022 O Copyright, State Farm Mutual Automohile Insurance Company, 2DD8 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 009716 290 Continued on Reverse Side of Page Page 5 of 6 N go umugmyw +� i This policy is issued by the State Farm Fire and Casualty Company. Participating Policy You are entitled to partioipate in a ctistributian of the earnings of the company as determined by our Board of ®irectors in accordance with the Company's Articles of Incorporation, as amended. In Witness Whereof, the State Farm Fire arrd Casualty Company has caused this policy to be signed by its President and Secretary at Bloomington, Illinois. Secretary President Prepared SEP 23 2022 CMP-4000 009716 290 N c� Copyright, State Faun Mutual Automohile Insurance Company, 2DD8 Inrludes oopyrighted material of Insurance Services Office, Inc., with its permission. Page 6 of 6 STATE FARM FIRE AND CASUALTY COMPANY I I A STOCK COMPANY WITH HOME OFFICES IN BLOOMWGTON, ILLINOIS INLAND MARINE ATTACHING DECLARATIONS P BoX 2915 eoomIngton IL 61702-2915 Named Insured M-15-2761-FBBC F N AESCS INC ATTACHING INLAND MARINE Policy Number 98-CD=WO66-6 Policy Period Effective Date Expiration Date 12 Months AUG 5 2022 AUG 5 2023 The poll y period be ins and ends at 12:01 am standard time at ie premises�ocatlon. 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. Annual Policy Premium $ 1,540.00 The above Premium Amountis 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 vuell as those issued aubsequentto the issuance of this policy. Forms, Options, and Endorsements FE-8724 Inland Marine Conditions FE-8744.1 Inland Marine Com uter Prop FE-8760 Mobile Equipment Form See Reverse for Schedule Page with Limits RECEIVED OCT 04 2022 City of Bremerton City Attorneys Office Prepared SEP 23 2022 ©Copyright, State Farm Mutual Automohile Insurance Company, 2008 FD-6007 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 009717 53U 5Bti a.2 05 31 2011 10113233c1 i .fill,. . ENDORSEMENT LIMIT OF DEDUCTIBLE ANNUAL NUMBER COVERAGE INSURANCE AMOUNT PREMIUM F&B744.1 Inland Marine Computer Prop $ 2 5, 0 0® 500 Included Loss of Income and Extra Expense 2 5 , 000 Included FE-8760 Mobile Equipment Form 14 4, 0 0 0 S 11000 125 4 0. 0 C OTHER LIMITS AND EXCLUSIONS MAY APPLY - REFER TO YOUR POLICY Prepared SEP �6 202� ©Copyright, State Fenn Mutual Automobile Insurance Company, 2008 FD-6007 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 009717 530 UUU u.'l U5 31 'lUt i luil3'138c �rE1C�t�,tt'tlt STATE FARM FIRE AND CASUALTY COMPANY A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS DECLARATIONS AMENDED OCT 20 2022 P Box 2915 B�oomfngton IL 61702-2915 Policy Number 98=CD=WO66=6 E Wo Addl Insured -Section II Only 001346 3123 M-15-2761-FBBC F N CITY OF BREMERTON 345 6TH ST STE 100 $REMERTON WA 98337-1891 'I111l1111III1111IIIIII'11ll'I1111I1II1IIII1,I1IIIIII,IIII1IIII Policy Period Effective Date Expiration Date 12 Months AUG 5 2022 AUG 5 2023 The policy period be ins and ends at 12:01 am standard time atthe premises�ocatlon. Named Insured AESCS INC Businessowners Policy Automatic Renewal -If the policy period is shown as 12 months, this policy will be renewed automatically subject to 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: Corporation Reason for Declarations: Your policy is amended OCT 20 2022 ADDITIONAL INSURED ADDED PREMIUM ADJUSTMENT FORM CMP4786 ADDED Endorsement Premium Discounts Applied: Renewal Year Years in Business Claim Record Prepared NOV 10 2022 CMP-4000 010163 290 Al N None O Copyright, State Farm Mutual Automohile Insurance Company, 2DOU Includes copyrighted material of Insurance Services Office, Inc., with its permission. Continued on Reverse Side of Page Page 1 of 6 536 686 0.2 65-31 2611 (o1f3231c1 !•OM M 1 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 3472 NW LOWELL $ 614,100 $ 134,300 25% SILVERDALE WA 98383-9120 of the effective date of this policy, the Limit of Insurance as shown includes any increase in the limit due to Inflation Coverage Gov A 4. Inflation Coverage Index: 239.6 Cov S " Consumer Price Index: 289.1 �M r - KIM0 111 Earthquake 10% Money and Securities $250 Ec�uiprnent Rrealcdown $1,000 Okher doductibles may apply - refer to policy. ©Copyright, State Farm Mutual Automobile Insurance Company, 2008 Includes copyrighted material of Insurance Services Dffice, Inc., with its permission, ci0i63 Continued on Next Page Page 2 of 6 111141 1 i Lii oil LIMIT OF COVERAGE INSURANCE Accounts Receivable On Premises $10,000 Off Premises $55000 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 $2503000 Coverage A -Buildings) Prepared NOV 10 2022 O Copyritiht, State Farm Mutual Automobile Insurance Comptjny, 2008 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 010164 290 Continued on Reverse Side of Page Page 3 of 6 N oil 41iX IL k . o f Ordinance Or Law - Equipment Coverage Outdoor Property Personal Effects (applies anly to those premises provided Coverage B -Business Personal Property) Personal Property Off Premises Pollutant Clean Up And Removal Preservation Of Praperty 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, Pawder Or Molten Material Damage Loss Of Income And Extra Expense Coverage L -Business Liability Prepared NOV 10 2022 CMP-4000 Included $5,000 $2,500 $15,000 $10,000 so Days $2,500 $10,000 $5,000 Included Actual Loss Sustained - 12 Months n CopyrighT, State farm Mutual Automobile Insurance Company, 7.008 Includes copyrighted material of Insurance Services Office, Inc., with its permission. A $1,O009000 010164 Continued on Next Page Page 4 of 6 ,,-, mg 6TU010A MMM Coverage M - Medical Expenses (Any One Person) Damage To Premises Rented To YdU t, 0 a Products/Completed Operations Aggregate General Aggregate Each paid claim for Liability Caverage 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. $10,000 $300,000 $2,000,000 $2,000,000 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. CMP-4102 Businessowners Coverage Form CMP-4786 *Add, Insd Owners Lessee Sched CMP-4787 *Waiver of Trans Rgt of Recov CMP-4247.1 Amendatory Endorsement CMP-4720A Earthquake Volcanic Eruption FE-6999.3 Terrorism Insurance Cov Notice CMP-4709 Money and Securities CMP-4705.2 Loss of Income & Extra Expnse CMP4785 Addl Ins Owners Lessee Blkt CMP-4859 Al Engineer Architect Survey FE-3650 Actual Cash Value Endorsement CMP-4779 Employers Liability CMP-4572 Amendment of Premium Cond CMP-4561.1 Policy Endorsement CMP4870 Addl Insd Primary Non Contrib CMP-4860 Al Design Person Org 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 Prepared NOV 10 2022 ©Copyright, State Farm Mutual Automobile Insurance Company, 20DE; CMP-4000 hicludes copyrighted material of Insurance Services Office, lnc., with its permission. 010165 290 Continued on Reverse Side of Page Page 5 of 6 N This policy is issued by the Mate Farrrt 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 Directars 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 Prepar�ti NG�V 1 g �g2� GMP"4000 J1U165 200 ©Copyright, State Farm Mutual Automohile Insurance Company, 20D6 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 6 of 6 TATE FARM FIRE AND CASUALTY COMPANY F-1 A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS INLAND MARINE ATTACHING DECLARATIONS P BOX 2915 e0omington IL 61702-2915 Named Insured M-15-2761-FBBC F N AESCS INC Policy Poriod Effective Dato Expiration Dato 12 Months AUG 5 2022 AUG 5 2023 The poli y period begins and ends at 12:01 am standard time atte premises locabon. Automatic Renewal - If the policy period is shown as 12 rmonths , 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. Annual Policy Premium $ 1,540.00 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 tiIose issued subsequentto the issuance of this policy. Forms, Options, and Endorsements FE-8724 Inland Marine Conditions FE-8744.1 Inland Marine Computer Prop FE-8760 Mobile Equipment Form See Reverse for Schedule Page with Limits Prepared NOV 10 2022 n Copyright, State Farm Mutual Automobile Insurance Company, 20D© FD-6007 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 010166 530-ae6a.2 o531-2011 lo1f3232c1 _. �. . 1' A ' ti;11, 1,. x ENDORSEMENT NUMBER COVERAGE FE-8I44.1 Inland Marine Computer Prop Loss of Income and Extra Expense F&8760 Mobile Equipment Form Prepared NOV 10 2022 FD-6007 010166 LIMIT OF DEDUCTIBLE INSURANCE AMOUNT S 25g000 $ 500 S 25,000 S 144,000 $ 1,000 OTHER LIMITS AND EXCLUSIONS MAY APPLY - REFER TO YOUR POLICY n Copyright, State Farm Mutual Automobile Insurance Company, )008 Includes copyrighted material of Insurance Services Office, hic., with its permission. ANNUAL PREMIUM aau-ser,�a n�ai-2nt� ionaz�a�i