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

Transcription

1 0108-ST STATE FARM FIRE AND CASUALTY COMPANY A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS 3 Ravinia Drive Atlanta GA Named Insured AT ORCHARD VILLA TOWNHOME HOA PO BOX 1409 MOAB UT M FAD1 F V Residential Community Association Policy RENEWAL DECLARATIONS Policy Number 94-BD-S537-1 Policy Period Effective Date Expiration Date 12 Months DEC DEC The policy period begins and ends at 12:01 am standard time at the premises location. Agent and Mailing Address BRITTNEY MELTON 30 W CENTER ST MOAB UT PHONE: (435) 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: HOA NOTICE: Information concerning changes in your policy language is included. Please call your agent if you have any questions. POLICY PREMIUM $ 16, V Discounts Applied: Renewal Year Age of Building Multiple Unit Claim Record CMP N D2 I Continued on Reverse Side of Page Page 1 of a (o1f3231c)

2 M RENEWAL DECLARATIONS (CONTINUED) Residential Community Association Policy for ORCHARD VILLA TOWNHOME HOA Policy Number 94-BD-S537-1 SECTION I - PROPERTY BLANKET Coverage A - Buildings Coverage B - Business Personal Property Location Number Limit of Insurance* 001,047,21 $ egarevoc on Location of Described Premises W HALE MOAB UT W HALE MOAB UT W HALE MOAB UT W HALE MOAB UT ALBERTA CT MOAB UT ALBERTA CT MOAB UT ALBERTA CT MOAB UT ALBERTA CT MOAB UT CMP Continued on Next Page Page 2 of 10

3 M RENEWAL DECLARATIONS (CONTINUED) Residential Community Association Policy for ORCHARD VILLA TOWNHOME HOA Policy Number 94-BD-S ST Location Number Location of Described Premises W HALE MOAB UT W HALE MOAB UT W HALE MOAB UT W HALE MOAB UT N HALE MOAB UT N HALE MOAB UT N HALE MOAB UT W HALE MOAB UT W HALE MOAB UT AUXILIARY STRUCTURES CMP N Continued on Reverse Side of Page Page 3 of 10

4 M RENEWAL DECLARATIONS (CONTINUED) Residential Community Association Policy for ORCHARD VILLA TOWNHOME HOA Policy Number 94-BD-S537-1 Location Number 001A Description Recreation Building * 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: SECTION I - DEDUCTIBLES Basic Deductible Special Deductibles: Money and Securities Equipment Breakdown 000,01$ 005,2$ 052$ Employee Dishonesty 052$ Other deductibles may apply - refer to policy. CMP Continued on Next Page Page 4 of 10

5 M RENEWAL DECLARATIONS (CONTINUED) Residential Community Association Policy for ORCHARD VILLA TOWNHOME HOA Policy Number 94-BD-S ST 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, please refer to that po licy provision for an explanation of that coverage. COVERAGE 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 LIMIT OF INSURANCE dedulcni syad 03 dedulcni 000,052$ 000,001$ %01 dedulcni 000,5$ 000,5$ dedulcni ssol derevoc fo %52 timil B egarevoc dedulcni CMP N Continued on Reverse Side of Page Page 5 of 10

6 M RENEWAL DECLARATIONS (CONTINUED) Residential Community Association Policy for ORCHARD VILLA TOWNHOME HOA Policy Number 94-BD-S537-1 SECTION I - EXTENSIONS OF COVERAGE - LIMIT OF INSURANCE - EACH COMPLEX The coverages and corresponding limits shown below ap ply separately to each complex as described in the policy. COVERAGE Accounts Receivable On Premises Off Premises Arson Reward Forgery Or Alteration Money And Securities (Off Premises) Money And Securities (On Premises) Money Orders And Counterfeit Money Outdoor Property Personal Effects (applies only to those premises provided Coverage B - Business Personal Property) Personal Property Off Premises Pollutant Clean Up And Removal Property Of Others (applies only to those premises provided Coverage B - Business Personal Property) Signs Valuable Papers And Records On Premises Off Premises LIMIT OF INSURANCE 000,5$ 000,01$ 005,2$ 005,2$ 000,01$ 000,51$ 005,2$ 000,5$ 000,1$ 000,01$ 000,5$ 000,01$ 000,5$ 000,51$ 000,05$ CMP Continued on Next Page Page 6 of 10

7 M RENEWAL DECLARATIONS (CONTINUED) Residential Community Association Policy for ORCHARD VILLA TOWNHOME HOA Policy Number 94-BD-S ST 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 dedulcni 000,52$ 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 LIMIT OF INSURANCE 000,003$ 000,5$ 000,000,2$ 000,000,1$ LIMIT OF INSURANCE Products/Completed Operations Aggregate General Aggregate Directors and Officers Aggregate 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. 000,000,4$ 000,000,4$ 000,000,1$ CMP N Continued on Reverse Side of Page Page 7 of 10

8 M RENEWAL DECLARATIONS (CONTINUED) Residential Community Association Policy for ORCHARD VILLA TOWNHOME HOA Policy Number 94-BD-S537-1 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-4100 FE CMP-4814 CMP-4244 CMP-4829 CMP-4566 CMP-4746 CMP-4710 CMP-4508 CMP-4705 FD-6007 Businessowners Coverage Form *Terrorism Insurance Cov Notice Directors & Officers Liability Amendatory Endorsement Guaranteed Replacement Cost Residential Community Assoc Hired Auto Liability Employee Dishonesty Money and Securities Loss of Income & Extra Expnse Inland Marine Attach Dec * New Form Attached SCHEDULE OF ADDITIONAL INTERESTS Interest Type: Mortgagee Endorsement #: N/A Loan Number: EVERBANK A DIVISION OF EVERBANK ISAOA PO BOX DORAVILLE GA CMP Continued on Next Page Page 8 of 10

9 M RENEWAL DECLARATIONS (CONTINUED) Residential Community Association Policy for ORCHARD VILLA TOWNHOME HOA Policy Number 94-BD-S ST CMP N Continued on Reverse Side of Page Page 9 of 10

10 M RENEWAL DECLARATIONS (CONTINUED) Residential Community Association Policy for ORCHARD VILLA TOWNHOME HOA Policy Number 94-BD-S537-1 CMP N Page 10 of 10

11 STATE FARM FIRE AND CASUALTY COMPANY A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS INLAND MARINE ATTACHING DECLARATIONS 3 Ravinia Drive Atlanta GA Policy Number 94-BD-S537-1 Named Insured M FAD1 F V Policy Period Effective Date Expiration Date 12 Months DEC DEC The policy period begins and ends at 12:01 am standard time at the premises location ST ORCHARD VILLA TOWNHOME HOA PO BOX 1409 MOAB UT ATTACHING INLAND MARINE 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. 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 subsequent to the issuance of this policy. Forms, Options, and Endorsements FE-8739 FE-8743 Inland Marine Conditions Inland Marine Computer Prop See Reverse for Schedule Page with Limits FD a (o1f3232c)

12 94-BD-S537-1 M ATTACHING INLAND MARINE SCHEDULE PAGE ATTACHING INLAND MARINE ENDORSEMENT NUMBER COVERAGE LIMIT OF INSURANCE DEDUCTIBLE AMOUNT ANNUAL PREMIUM FE-8743 Inland Marine Computer Prop $ 10,000 $ 500 Included Loss of Income and Extra Expense $ 10,000 Included FD OTHER LIMITS AND EXCLUSIONS MAY APPLY - REFER TO YOUR POLICY a (o1f3233c)

13 94-BD-S ST--0001

14 94-BD-S M 27586

15 94-BD-S ST--0001

16 94-BD-S M 27586

17 ST State Farm Fire and Casualty Company A Stock Company With Home Offices in Bloomington, Illinois 3 Ravinia Drive Atlanta GA Named Insured AT ORCHARD VILLA TOWNHOME HOA PO BOX 1409 MOAB UT Entity: HOMEOWNERS ASSOCIATION 9M FAD1F M RENEWAL DECLARATIONS Policy Number 94-BE-P577-3 Policy Period Effective Date Expiration Date 12 Months DEC DEC The policy period begins and ends at 12:01 am standard time at your mailing address as shown. COMMERCIAL LIABILITY UMBRELLA POLICY Automatic Renewal - If the policy period is shown as 12 months, this policy will be renewed automatically upon payment of the renewal premium when due subject to the premiums, rules and forms in effect for each succeeding policy period. If this policy is terminated we will give you written notice in c ompliance with the policy provisions or as required by law. Coverage(s) Coverage L - Business Liability Coverage L - Business Liability (Each Occurrence) (Annual Aggregate) Limits of Insurance $ 2,000,000 $ 2,000,000 Business Liability Employers Non-Owned Auto Liability Self-Insured Retention Bodily Injury (Per Occurrence) Bodily Injury (Annual Aggregate) Property Damage (Per Occurrence and Annual Aggregate) --or-- Bodily Injury and Property Damage (Per Occurrence) Bodily Injury and Property Damage (Annual Aggregate) $ 10,000 $ 500,000 $ 1,000,000 $ 100,000 $ 500,000 $ 1,000,000 Bodily Injury and Property Damage (Each Occurrence) $ 500,000 Bodily Injury and Property Damage (Annual Aggregate) $ 1,000,000 --or-- Bodily Injury (Each Person/Each Accident) $ 500,000 / $ 500,000 Property Damage (Each Accident) $ 100,000 --or-- Bodily Injury and Property Damage (Each Accident) $ 500, BE-P M Forms & Endorsements Commercial Umb Coverage Form *Terrorism Insurance Cov Notice Exclusion - Total Pollution Amendatory Endorsement Exclusion - Lead Poisoning CU-2100 FE CU-2341 CU-2244 CU-2339 Policy Premium $ * New Form Attached Other limits and exclusions may apply - refer to your pol icy 75 CU I N Continued on Reverse BRITTNEY MELTON (435) (o1f2941c)

18 94-BE-P Continued from Front M 0923 Hired Auto Liability Bodily Injury and Property Damage (Each Occurrence) Bodily Injury and Property Damage (Annual Aggregate) --or-- Bodily Injury (Each Person/Each Accident) $ 500,000 / Property Damage (Each Accident) --or-- Bodily Injury and Property Damage (Each Accident) $ 500,000 $ 1,000,000 $ 500,000 $ 100,000 $ 500, (o1f2942c)

19 H 94-BE-P577-3 ( 0924) H ST BE-P M

20 H 94-BE-P M 0923 H