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HomeMy WebLinkAboutLos Altos Hills Newcomers Club 05.17.2024StateFarm • • •® IN- 0 0 0 0 STATE FARM GENERAL INSURANCE COMPANY A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS RENEWAL DECLARATIONS P? BoX 2915 B oomington IL 61702-2915 Addl Insured -Section II Only AT2 000830 3125M-02-324E-FB80 F N THE TOWN OF LOS ALTOS HILLS, ITS ELECTIVE AND APPOINTED OFFICERS, EMPLOYEES, AND VOLUNTEERS 26379 W FREMONT RD LOS ALTOS HLS CA 94022-2624 'I�I'I�I'�11�111111�111'�'IIII'I'Illlll��ll�"1111111111x1 Businessowners Policy DI Policy Number 97 -EA -D221-9 Policy Period Effective Date Expiration Date 12 Months MAY 17 2024 MAY 17 2025 The policy period begins and ends at 12:01 am standard tame at the premises location. Named Insured LOS ALTOS, LOS ALTOS HILLS NEWCOMERS CLUB 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. Entity: NOT FOR PROFIT 501(C)(7) NOTICE: Information concerning changes in your policy language is included. Please call your agent if you have any questions. POLICY PREMIUM Minimum Premium Discounts Applied: Renewal Year Years in Business Claim Record $ 500.00 Prepared MAR 04 2024 © Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP -4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 005349 294 Al Continued on Reverse Side of Page N Page 1 of 7 5311 686 a.2 05-31-2011 (o1f323%) RENEWAL DECLARATIONS. (00,NTINUED) Businessow' ' r " 11 for THS TOWN : F. 1 S PolicyNumber.'2• I SECTI N. I Location c c M c .'� i r ce M� a r c Seas'd nal, Number r crr beiIncreasew P rid CoBusinvera ri yq� Pis ��s� Y@�Y�ga P rsoav- - .. .� ntl°J4�° Propertysonal : Property 001 • 372 D l �.�00 /L�y.lsj - LOS ALTOS l LS CA 940222639 � I i � this I IYY I It lnsur n in r ` rn r .� �n 1pr � t l'r�fl ,tin r Y policy.11h I FL IN -COMER E Ccs A - Inflation Coverage I n Y I/ C v C n rn r. ri l.n Y 3. Prepared 1 2024 Gopyright, State Farm Mutua,lAutorno it I'n��p s .. of anY, 2008 i�� l nigh ' d rnoteriai of Insuranc i e' CMP -4000 r � � ' ins itl its p r��niin. nln n'; Page f. 7 00534 ;� StateFarm • • •® RENEWAL DECLARATIONS (CONTINUED) Businessowners Policy for THE TOWN OF LOS ALTOS HILLS, Policy Number 97 -EA -D221-9 J &` 1, SECTION I - EXTENSIONS OF COVERAGE - LI_OF INSURANCE - EACH DESCRIBED PREMISES No MMI 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. COVERAGE Accounts Receivable On Premises Off Premises Arson Reward Collapse Damage To Non -Owned Buildings From Theft, Burglary Or Robbery Debris Removal Equipment Breakdown Fire Department Service Charge Fire Extinguisher Systems Recharge Expense Forgery Or Alteration Glass Expenses Increased Cost Of Construction And Demolition Costs (applies only when buildings are insured on a replacement cost basis) Money And Securities (Off Premises) Money And Securities (On Premises) Money Orders And Counterfeit Money 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) Prepared MAR 04 2024 CMP -4000 005350 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 LIMIT OF INSURANCE $10,000 $5,000 $5,000 Included Coverage B Limit 25% of covered loss Included $2,500 $5,000 $10,000 Included 10% $2,000 $5,000 $1,000 $100,000 $250,000 Page 3 of 7 RENEWAL DECLARATION(CONTINUED) ,Policy for, THE TOWN OF LOS $ WILL 1 Businessownersr Policy r r ' w 221" Ordinance r Law - E� i r t C + r Included $5,000 Outdoor Property I. Personal Eft.. ;�,. l"N� rr� rddausir� Personal r ,r ) Persona I Pro r re ses "ellrr6n d re , $ 0 1 .30 Days Property Ier(Applieson,l' those rrn��� Provided r e - Business $2,500.. err�C rer SIr� "Valuable papers And Rec6rds.$10,1000m.-I On +is '$5,,00 'off re' i SQCTION I EXIEN 2 L0, N S COVERAG E Lj MIT, OF.1 N -SU RA I' : y below are the most we �� r rdlets the number of Th cover � and 1� M � i"r so C OW De' lar ons. LIMIT. f ]NSURAN e l Le Less f 'income And Extra t l r d `1 nths, T Nl ,� LIa !L1 LIMIT OF :CE COV'E , , [�+�yy� / �+9Y�! �tM�g �Mp±� R•{'�.�q� 'M�y a Liability 8 tS prye' gg Coverage iNMI :'4ld" �L MeN' W r W!�' .labili Re $49000900,0, Prepared opyrlg7tr State, Fgrmut.al ttoniobile Insuraalre ompanyr 00 • MAR 202 4," l d co yrighted Material r n tr t r�►i + i Inc.,i l� i rmi ion. CMP -400 00,5350Continued. ,etPage P 4.0 StateFarm • ••®' RENEWAL DECLARATIONS (CONTINUED) Businessowners Policy for THE TOWN OF LOS ALTOS HILLS, Policy Number 97 -EA -D221-9 Coverage M - Medical Expenses (Any One Person) Damage To Premises Rented To You AGGREGATE LIMITS 0 Products/Completed Operations Aggregate 0 O General Aggregate $5,000 $300,000 LIMIT OF INSURANCE $8,000,000 $8,000,000 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 -4101 Businessowners Coverage Form FE -6999.3 *Terrorism Insurance Cov Notice CMP -4260.1 Amendatory Endorsement -CA CMP -4705.2 Loss of Income & Extra Expense CMP -4709 Money and Securities CMP -4804 Addl Insd Club Members CMP -4261 Amendatory Endorsement CMP -4860.1 Al Design Person Org FD -6007 Inland Marine Attach Dec * New Form Attached Prepared MAR 04 2024 O Copyright, State Farm Mutual Automobile Insurance Company, 2008 CMP -4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 005351 294 Continued on Reverse Side of Page N Page 5 of 7 X UED) E TIONS �:,1T'1 ,i�u;�l� Prepared Copyright, State Farr�,Mutu i utor�oit Ill, ��r � oi�j�an M 008 MSR 202 CMP- Includes Copyrighted inateri l of insurance �rviuop %�I� i� permission. 4000 0051 Page 6 of 7 StateFarm A. RENEWAL DECLARATIONS (CONTINUED) Businessowners Policy for THE TOWN OF LOS ALTOS HILLS, Policy Number 97 -EA -D221-9 NO-., NOTICE TO POLICYHOLDER: For a comprehensive description of coverages and forms, please refer to your policy. Policy changes requested before the "Date Prepared", 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 LIS forms attached to this notice are also effective on the Renewal Date of this policy. Policy changes requested after the "Date Prepared" 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. Prepared MAR 04 2024 CMP -4000 005352 294 N 01 Copyright, State Farm Mutual Automobile Insurance Company, 2008 Includes copyrighted nnaterW of Insurance Services Office, Inc., with its permission. Page 7 of 7 StateFarm • • •® 0 0 0 0 0 0 STATE FARM GENERAL INSURANCE COMPANY 11 A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS INLAND MARINE ATTACHING DECLARATIONS Po Box 2915 B%omington IL 61702-2915 Named Insured M -02-32413-F1380 F N LOS ALTOS, LOS ALTOS HILLS NEWCOMERS CLUB ATTACHING INLAND MARINE Policy Number 97 -EA -D221-9 Policy Period Effective Date Expiration Date 12 Months MAY 17 2024 MAY 17 2025 The policy period begins and ends at 12:01 am standard time at the premises location. .....mom- numMell - n uie poncy perroa is snown as 1Z months , this policy will be renewed automatically subject -to 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 Included 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 Inland Marine Conditions FE -6271 Amendatory Endorsement FE -8745 Inland Marine Computer Prop See Reverse for Schedule Page with Limits Prepared MAR 04 2024 C Copyright, State Farm Mutual Automobile Insurance Company, 2008 FD -6007 Includes copyrighted material of Insurance Services off ire, Inc., with its permission. 005353 530-666 a.2 05.31.2611 (01W320