POLICY PREMIUM $ 27, RECEIVED

Similar documents
A P.O. Box v~ o. Residential Community Association Policy $

Residential Community Association Policy

Residential Community Association Policy

l»'l'l">l'>ll I'll Il l l'l>"ll«l -I>l>

100 * 000. RENEWAL DECLARATIONS Policy Number 97-BY-X604-7

Prepared. Copyright, State Farm Mutual Automobile Insurance Company, 2008

$ i1li i llilli Ii IlIli III lull tilli lliii COMMERCIAL LIABILITY UMBRELLA POLICY Automatic Renewal $ 1,000,000

forms in effect for each succeeding policy period. If this policy is terminated, we will give you and the Mortgagee/Lienholder written notice in

PHONE: (435) Residential Community Association Policy

!illlill iii!i! Insurance Support Center > TIERRA GOLINAS HOMEOWNERS ASSOCIATION

Prepared. Copyright, State Farm Mutual Automobile Insurance Company, 2008

Wflfl Named Insured. REChIVhU SEP Residential Corn mu nhty Associatiøn Policy

~~I~b~rh~Od 5~8Nt11;~i~~- ~i!~r3tio2;j~~~" The polihcy period begins and ends at 12:01 am standard time at t e premises Iocanon.

F^esidentlal Community Association Poiicy

Rates Effective 4/2/12

Attachment C Expiring Policy ITB W Contractors Equipment Insurance

Commercial Insurance Proposal

Underwriting Bulletin

A MUST-HAVE GUIDE TO OUR SPECTRUM COVERAGES AND LIMITS.

EXCESS FIDUCIARY LIABILITY INSURANCE FOLLOWING FORM POLICY CERTIFICATE

Business Owner s Policy Broadening Endorsements

SEPTIC INSPECTORS APPLICATION General & Professional Liability Claims-Made Form. 1. Proposed insured: Mailing address: City, State, Zip: County:

e-clas Banner Page Environment:

BULLETIN All Property and Casualty Insurers Writing Commercial Lines Insurance Products

Businessowners Policy. The right coverage for your business

Arkansas Insurance Department

February 15, 2008 BUREAU CIRCULAR NO. 1543

Dovetail Managing General Agency Corp 1333 Main Street Suite 600 Columbia, SC City Variety Store 1312 Saint Nicholas Ave New York, NY

COMPREHENSIVE COMMERCIAL PACKAGE SMALL AND MEDIUM ENTERPRISE. rsabroker.ca

Application for Claims-Made Coverage Watershed District Public Official Liability Insurance. 1. Name of Watershed District: 2.

Bind Instructions & EFT Authorization Form - Sutter Business Auto

UNIVERSAL UNDERWRITERS INSURANCE COMPANY 7045 COLLEGE BOULEVARD OVERLAND PARK, KANSAS A Stock Insurance Company

OREGON MUTUAL INSURANCE COMPANY DIVISION FIVE FIRE AND ALLIED LINES EXCEPTION PAGES

BINDER BILL-EOC ALL TERMS, PROVISIONS, CLAUSES AND EXCLUSIONS OF THE POLICY NOTED ABOVE ARE AS EXPIRING UNLESS OTHERWISE INDICATED.

COMMERCIAL PACKAGE POLICY COVERAGES WITH CONTRACTOR SHIELDSM

COMMISSION FOR THIS PROGRAM IS 15%

Insurance Summary

Day Care Insurance Application and Rate Sheet California

R-T SPECIALTY, LLC Transit Road Depew, NY (716) ext. Ext 4837 Fax: (716)

MOBDEC BOP /17/ MARK CPP * N 41THOM MARKET STREET PO BOX 4021 CHATTANOOGA, TN CHATTANOOGA, TN 37405

NONPROFIT & HUMAN SERVICES

K 12 EDUCATION INSTITUTIONS

Insurance Summary

EVIDENCE OF PROPERTY INSURANCE

SENIOR LIVING COMMUNITIES

Terrorism Risk Insurance Program Reauthorization Act Endorsements

COMMERCIAL CONDOMINIUM PAC

BUSINESS KEY POLICY PROTECTING YOUR DREAMS

APPENDIX B WASHINGTON SUBURBAN SANITARY COMMISSION PROCUREMENT OFFICE INSURANCE AND BONDING CONTRACT NO.

Rail Owner Controlled Insurance Program Manual

Insurance Handbook for VHFA-financed rental housing contains the following: 1) Insurance coverages and limits that are required by VHFA;

STATEMENT. o New Business o Reinstatement o Change Of Coverage oadded Coverage ~ FARMERS INSURANCE. This Statement Reflects:

September 23, Special Liability Insurance Program (SLIP) Allied World National Assurance Company September 29, 2008 to September 29, 2009

Indiana Conference of The United Methodist Church Coverage Limits Recommendations. Property Coverage Guidelines

Mobile homes are eligible if they are permanently located, but may only be covered by the Basic Form. Coverage may not include an attached carport.

Enclosed you will find an annual non-admitted Commercial Liability quote for Sartins Seafood, Inc. The quote number is MGL012C83J4.

TEXAS INSURANCE PROPERTY AND CASUALTY - GENERAL KNOWLEDGE CONTENT OUTLINE

EXCESS INSURANCE POLICY

BLOOMSBURG AREA SCHOOL DISTRICT 728 East Fifth Street Bloomsburg, PA P: F:

FILED: NEW YORK COUNTY CLERK 12/22/ :58 AM INDEX NO /2013 NYSCEF DOC. NO. 95 RECEIVED NYSCEF: 12/22/2017

Enclosed you will find an admitted Commercial Liability quote for Medshare International, Inc.. The quote number is MSE017J3971 Version 8.

PINEWOOD LAKE OWNERS ASSOCIATION

2010 INSURANCE MANUAL

BULLETIN. Number 06-B-02

UTICA FIRST INSURANCE COMPANY ARTISANS PROGRAM NEW JERSEY

CLIENT / AGENT COVERAGE AGREEMENT

APPLICATION FOR EMPLOYMENT PRACTICES LIABILITY INSURANCE

The BOP...We All Sell It, But How Well Do We Really Know It?! SPONSORED BY

Minnesota Property and Casualty Insurance Producer Cross Reference Study Guide

Commercial Coverage For

5. OPTIONAL SECTION I - COVERAGES & ENDORSEMENTS: 5-c BUILDING ADDITIONS AND ALTERATIONS - (ML-51)

Table of Contents. Introduction: The Building and Personal Property Coverage Form CP

Insurance Proposal for Bronze Leaf Condominium Association

/ / / / / / / / / / / / /06

GUIDELINES FOR PURCHASING INSURANCE ELCA LEADERS

Community Association Underwriters of America, Inc.

Table of Contents. Underwriting Property Risks...4 The National Underwriter Company Coverage Guides...6

BUSINESSOWNERS EXTENSION ENDORSEMENT

NEW CASTLE COUNTY Purchasing Section New Castle County Government Center 87 Read s Way New Castle, DE (302)

Commercial Risk Summary Casual & Artisan Contractors

Alabama Manufactured Home Program Manual

DICE / ANNUAL PRODUCTIONS APPLICATION

COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS

COUNTRY Mutual Insurance Company

Georgia Dwelling Program Manual

The Martin Agency Church Coverage

Your Exam Content Outline

APPLICATION FOR EMPLOYMENT PRACTICES LIABILITY INSURANCE

Your Exam Content Outline

AMERICAN INTERNATIONAL SPECIALTY LINES INSURANCE COMPANY 175 Water Street Group, Inc. New York, NY 10038

HOMEOWNER HOMEOWNER. Call for the right answers from a real person. Visit: for more information or a no-obligation quote.

Summary of Coverage Diocesan Property & Casualty Program

BOARD OF SUPERVISORS BUSINESS MEETING ACTION ITEM

Additional Insured Lessor PP Assisted Living Care Coverage DP

THE BOP VS THE CPP... THE BATTLE OF THE CENTURY! SPONSORED BY

REQUEST FOR PROPOSAL FOR PROPERTY AND LIABILITY, AUTO, INLAND MARINE, COMPUTER, LEO AND ELECTED OFFICIAL, FLOOD INSURANCES

Key Facts About Your Policy

DECEMBER 28, 2007 ANNOUNCEMENT MO Missouri Item 06 MO 2007 Terrorism Risk Insurance Program Reauthorization Act of 2007

Aspen Specialty Insurance Company

No. of Years. M: manufacturer W: wholesaler R: retailer I: importer MR: manufacturer s rep. C: consumer direct O: other (describe)

Transcription:

StateFarm STATE FARM GENERAL INSURANCE COMPANY ^. «.». <m A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS RENEWAL DECLARATIONS \a?dson?t% 75085-3925 Named Insured Policy Period Effective Date Expiration Date AT2 M-12-0404-FA98 F V 12 Months SEP 9 2018 SEP 9 2019 ooo653 3125 The policy period begins a.nd ends at 12:01 am standard MEADOWRIDGE HOMEOWNERS time attne premises location. ASSOCIATION PD BOX 5038-5038 Jcjent ^S^RBY 9 Address PO BOX 2369-2369 PHONE: (760) 934-7575 Residential Community Association Policy 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: HOMEOWNERS ASSOCIATION Earthquake premium of $8,345.00 is included in your annual premium. NOTICE: Information concerning changes in your policy language is included. Please call your agent if you have any questions. POLICY PREMIUM $ 27,231.00 RECEIVED Discounts Applied: Renewal Year JUL 03 2018 Multiple Unit ClaimReCOrd BUTNERHOA SERVICES JUN 26 2018 Copyright, State Farm Mutual Automobile Insurance Company, 2DD8 003768 294 I Continued on Reverse Side of Page Page 1 of 11 N n COP n n rif ii nmi I inm-

M 3768 SECTION I - PROPERTY BLANKET Coverage A - Buildings Coverage B - Business Personal Property Location Number Limit of Insurance* $ 14,607,300 $ 51,400 Location of Described Premises 001 STE 1-2 002 STE 3-4 003 STE 5-6 004 STE 7-8 005 STE 9-10 006 007 008 STE 11-12 STE 13-14 STE 15-16 003768 Copyright StatB Farm Mutual Automobile Insurance Company, 2008 Continued on Next Page Page 2 of 11

StateFarm M 3768 D f>o Residential Community Association Policy for IUIEADOWRIDGE HOMEOWNERS Location Number Location of Described Premises 009 010 011 012 013 014 015 016 017 018 STE 17-18 STE 19-20 STE 21-22 STE 23-24 STE 25-26 STE 27-28 STE 29-30 STE 31-32 STE 33-34 STE 35-36 003769 294 N Copyright, State Farm Mutual Automobile Insurance Company, 2008 Includes copyrighted material of Insurance Services Dffice, Inc., with its permission. Continued on Reverse Side of Page Page 3 of 11

M 3768 Location Number Location of Described Premises 019 020 021 022 023 024 025 026 STE 37-38 STE 39-40 STE 41-42 STE 43-44 STE 45-46 STE 47-48 STE 49-50 STE 51-52 AUXILIARY STRUCTURES 003769 Copyright State Farm Mutual Automobile Insurance Company, 2008 Continued on Next Page Page 4 of 11

State Farm M 3768 D S>o Location Number 001A 001B Description Recreation Building Garage or Carport * As of the effective date of this policy, the Limit of Insurance as shown includes any increase in the limit due to Inflation Coverage. SECTION I - INFLATION COVERAGE INDEX(ES) Inflation Coverage Index: 177.1 SECTION I - DEDUCTIBLES Basic Deductible $50,000 Special Deductibles: Earthquake Employee Dishonesty 20% $250 Money and Securities Equipment Breakdown $250 $2,500 Other deductibles may apply - refer to policy. 003770 294 N Copyright State Farm Mutual Automobile Insurance Company, 2008 Continued on Reverse Side of Page Page 5 of 11

M 3768 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 "" indicated, please refer to that policy provision for an explanation of that coverage. COVERAGE LIMIT OF INSURANCE Collapse Damage To Non-Owned Buildings From Theft, Burglary Or Robbery Debris Removal Equipment Breakdown Fire Department Service Charge Fire Extinguisher Systems Recharge Expense Glass Expenses Increased Cost Of Construction And Demolition Costs (applies only when buildings are insured on a replacement cost basis) Newly Acquired Business Personal Property (applies only if this policy provides Coverage B - Business Personal Property) Newly Acquired Or Constructed Buildings (applies only if this policy provides Coverage A - Buildings) Ordinance Or Law - Equipment Coverage Preservation Of Property Water Damage, Other Liquids, Powder Or Molten Material Damage Coverage B Limit 25% of covered loss $5,000 $5,000 10% $100,000 $250,000 30 Days 003770 Copyright State Farm Mutual Automobile Insurance Company, ZDD8 Continued on Next Page Page 6 of 11

StateFarm M 3768 d <S O SECTION I - EXTENSIONS OF COVERAGE - LIMIT OF INSURANCE - EACH COMPLEX The coverages and corresponding limits shown below apply separately to each complex as described in the policy. COVERAGE LIMIT OF INSURANCE Accounts Receivable On Premises $50,000 Off Premises $15,000 Arson Reward $5,000 Forgery Or Alteration $10,000 Money And Securities (Off Premises) $5,000 Money And Securities (On Premises) $10,000 Money Orders And Counterfeit Money $1,000 Outdoor Property $5,000 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 Property Of Others (applies only to those premises provided Coverage B - Business $2,500 Personal Property) Signs $2,500 Valuable Papers And Records On Premises $10,000 Off Premises $5,000 JUN 26 2018 Copyright, State Farm Mutual Automobile Insurance Company, 2008 003771 294 Continued on Reverse Side of Page Page 7 of 11 N

M 3768 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 Back-Up of Sewer or Drain Employee Dishonesty Loss Of Income And Extra Expense LIMIT OF INSURANCE $25,000 Actual Loss Sustained -12 Months SECTION II - LIABILITY COVERAGE Coverage L - Business Liability Coverage M - Medical Expenses (Any One Person) Damage To Premises Rented To You Directors And Officers Liability AGGREGATE LIMITS Products/Completed Operations Aggregate General Aggregate Directors and Officers Aggregate LIMIT OF INSURANCE $2,000,000 $5,000 $300,000 $2,000,000 LIMIT OF INSURANCE $4,000,000 $4,000,000 $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. 003771 Copyright State Farm Mutual Automobile Insurance Company, 2008 Continued on Next Page Page 8 of 11

State Farm M 3768 D * 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-4101 FE-6999.2 CMP-4705.1 CMP-4814 CMP-4719.1 CMP-4828 CMP-4864 CMP-4696 CMP-4746.1 CMP-4710 CMP-4508 FD-6007 Businessowners Coverage Form *Terrorism Insurance Cov Notice Loss of Income & Extra Expense Directors & Officers Liability Earthquake Volcanic Eruption Extra Replacement Cost Building Ordinance or Law Cov Residential Community Assoc Hired Auto Liability Employee Dishonesty Money and Securities Inland Marine Attach Dec * New Form Attached This policy is issued by the State Farm General Insurance 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 General Insurance Company has caused this policy to be signed by its President and Secretary at Bloomington, Illinois. Secretary President 003772 294 N 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 9 of 11

M 3768 IMPORTANT NOTICE: California law requires us to provide you with Information for filing complaints with the State Insurance Department regarding the coverage and service provided under this policy. Your agent's name and contact information are provided on the front of this document. Another option is to reach out by mail or phone directly to: State Farm Executive Customer Service PO Box 2320 BloomingtonIL 61702 Phone # 1-800-ST ATE FARM (1-800-782-8332) Department of Insurance complaints should be filed only after you and State Farm or your agent or other company representative have failed to reach a satisfactory agreement on a problem. California Department of Insurance Consumer Services Division 300 South Spring Street Los Angeles, CA 90013 Phone # 1-800-927-HELP (4357) or visit www.insurance.ca.qov/oi-consumers NOTICE TO POLICYHOLDER: For a comprehensive description of coverages and forms, please refer to your policy. Policy changes requested before the "Date ", which appear on this notice, are effective on the Renewal Date of this policy unless otherwise indicated by a separate endorsement, binder, or amended declarations. Any coverage forms attached to this notice are also effective on the Renewal Date of this policy. Policy changes requested after the "Date " will be sent to you as an amended declarations or as an endorsement to your policy. Billing for any additional premium for such changes will be mailed at a later date. If, during the past year, you've acquired any valuable property items, made any improvements to insured property, or have any questions about your insurance coverage, contact your State Farm agent. Please keep this with your policy. JUN 26 2018 Copyright, State Farm Mutual Automobile Insurance Company, 2008 Includes copyrighted material of Insurance Services Office, Inc., with its permission 003772 Continued on Next Page Page 10 of 11

StateFarm M 3768 D @>o Your coverage amount... It is up to you to choose the coverage and limits that meet your needs. We recommend that you purchase a coverage limit equal to the estimated replacement cost of your structure. Replacement cost estimates are available from building contractors and replacement cost appraisers, or, your agent can provide an estimate from Xactware, lnc. using information you provide about your structure. We can accept the type of estimate you choose as long as it provides a reasonable level of detail about your structure. State Farm does not guarantee that any estimate will be the actual future cost to rebuild your structure. Higher limits are available at higher premiums. Lower limits are also available, as long as the amount of coverage meets our underwriting requirements. We encourage you to periodically review your coverages and limits with your agent and to notify us of any changes or additions to your structure. JUN 26 2018 Copyright State Farm Mutual Automobile Insurance Company, 2008 003773 294 Page 11 of 11 N

StateFarm STATE FARM GENERAL INSURANCE COMPANY A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS Po Box 853925 Rictiardson, TX 75085-3925 INLAND MARINE ATTACHING DECLARATIONS^ Named Insured M-12-0404-FA98 F V Policy Period Effective Date Expiration Date 12 Months SEP 9 2018 SEP 9 2019 The policy period begins and ends at 12:01 am standard time atthe premises location. MEADOWRIDGE HOMEOWNERS ASSOCIATION PO BOX 5038-5038 A ATTACHING INLAND MARINE 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. Annual Policy Premium 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 FE-6271 FE-8745 Inland Marine Conditions Amendatory Endorsement Inland Marine Computer Prop See Reverse for Schedule Page with Limits FD-6007 Copyright State Farm Mutual Automobile Insurance Company, 2008 003774 530-686o2 05 31-2011 lo1f3z32c

90-33-1354-9 M 3768 ATTACHING INLAND MARINE SCHEDULE PAGE ATTACHING INLAND MARINE ENDORSEMENT NUMBER COVERAGE LIMIT OF INSURANCE DEDUCTIBLE AMOUNT ANNUAL PREMIUM FE-8745 Inland Marine Computer Prop Loss of Income and Extra Expense 10,000 10,000 500 FD-6007 003774 OTHER LIMITS AND EXCLUSIONS MAY APPLY - REFER TO YOUR POLICY- Copyright State Farm Mutual Automobile Insurance Company, 2DD8 Includes copyrighted materiai of Insurance Services Office, Inc., with its permission 530-686B2 05-31-ZOlt (oi(3233c)

StateFarm 90-33-1354-9 003775 FE-6999 2 Page 1 of 1 In accordance with the Terrorism Risk Insurance Act of 2002 as amended and extended by the Terrorism Risk Insurance Program Reauthorization Act of 2015, this disclosure is part of your policy. FE-6999.2 POLICYHOLDER DISCLOSURE NOTICE OF TERRORISM INSURANCE COVERAGE Coverage for acts of terrorism is not excluded from your current policy. However your policy does contain other exclusions which may be applicable, such as an exclusion for nuclear hazard. You are hereby notified that under the Terrorism Risk Insurance Act, as amended in 2015, the definition of act of terrorism has changed. As defined in Section 102(1) of the Act: The term "act of terrorism" means any act that is certified by the Secretary of the Treasury in consultation with the Secretary of Homeland Security, and the Attorney General of the United States to be an act of terrorism; to be a violent act or an act that is dangerous to human life, property, or infrastructure; to have resulted in damage within the United States, or outside the United States in the case of certain air carriers or vessels or the premises of a United States mission; and to have been committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. Under this policy, any covered losses resulting from certified acts of terrorism may be partially reimbursed by the United States Government under a formula established by the Terrorism Risk Insurance Act, as amended. Under the formula, the United States Government generally reimburses 85% through 2015; 84% beginning on January 1, 2016; 83% beginning on FE-6999.2, Copyright State Farm Mutual Automobile Insurance Company, 2015 January 1, 2017; 82% beginning on January 1, 2018; 81% beginning on January 1, 2019; and 80% beginning on January 1, 2020 of covered terrorism losses exceeding the statutorily established deductible paid by the insurance company providing the coverage. The Terrorism Risk Insurance Act, as amended, contains a $100 billion cap that limits U.S. Government reimbursement as well as insurers' liability for losses resulting from certified acts of terrorism when the amount of such losses exceeds $100 billion in any one calendar year. If the aggregate insured losses for all insurers exceed $100 billion, your coverage may be reduced. There is no separate premium charged to cover insured losses caused by terrorism. Your insurance policy establishes the coverage that exists for insured losses This notice does not expand coverage beyond that described in your policy. THIS IS YOUR NOTIFICATION THAT UNDER THE TERRORISM RISK INSURANCE ACT, AS AMENDED, ANY LOSSES RESULTING FROM CERTIFIED ACTS OF TERRORISM UNDER YOUR POLICY MAY BE PARTIALLY REIM- BURSED BY THE UNITED STATES GOVERN- MENT AND MAY BE SUBJECT TO A $100 BILLION CAP THAT MAY REDUCE YOUR COV- ERAGE.