HomeMy WebLinkAboutBrian ReberryPO Box 2915
Bloomington, IL 61702-2915
& Stat Farm
AT1 000396 1200 01
CITY OF CALDWELL
KM 411 BLAINE ST
CALDWELL ID 83605-3619
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Renewal Declarations
Policy number; 93-AJ-0569-9
Policy period: 12 months
The policy period begins and ends at 12:01 am standard time at the premises location.
State Farm Fire and Casualty Company
A stock company with home offices in Bloomington, Illinois
RECEIVED BY
CALDWELL CITY CLERK
NOV 0 5 2024
Effective date: December 21, 2024
Expiration date: December 21, 2025
BUSINESSOWNERS POLICY
Automatic renewal - If the State Farme 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
MortgageelLienholder written notice in compliance with the policy provisions or as required by law.
NAMEDINSURED
REBERRY, BRIAN
ENTITY
Sole Proprietorship -Individual
POLICY PREMIUM
This is not a bill, If an amount is due, then a separate statement will be sent prior to the due date. The premium(s) shown below is the 12 months
premium(s) for the characteristics of the policy as described in this Declarations,
Premium: $1,856.00
Total Premium: $1,856.00
Discounts applied:
Business Experience Rating Renewal Discount
Years in Business Age of Building
IMPORTANTMESSAGE(S)
Notice - Information concerning changes in your policy language is included. Please call your agent if you have any questions.
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Policy number 93•AJ-0569-9 Page t of 5
® Copyr.ght State Farm Mutual Automobile Insurance Company, 2008
CMP Dec 3P ID
CMP-40M 1D09462 2011 153090 211 05.18.2024
Prepared October 28, 2024
�StateFarm°
SECTION I - PROPERTY SCHEDULE
Location Location of described premises Limit of insurance*
Limit of Insurance" Seasonal Increase -
number Coverage A -
Coverage B - Business Business Personal Property
Buildings
Personal Property
001 6125 AIRPORT WAY $227,300
$255,600 25%
HANGER 833
CALDWELL ID 83605
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)
Cov A - Inflation Coverage Index: 249-3
Cov B - Consumer Price Index: 314.E
SECTION I — DEDUCTIBLES
BASIC DEDUCTIBLE $500
SPECIAL DEDUCTIBLES:
Equipment Breakdown: $500
Money and Securities: $250
Other deductibles may apply - refer to policy.
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,
refer to that policy provision for an explanation of that coverage.
Coverage
Limit of Insurance
Accounts Receivable
On Premises
$10.000
Off Premises
$5,000
Arson Reward
$5,000
Back-up of Sewer or Drain
$40,000
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 insured on a 10%
replacement cost basis)
Policy number 93-AA559.9 Page 2 of 5
® Copyright State Farm Mutual Automobile Insurance Company, 2008
CMP-40o0