Residential Community Association Policy - Starlight Mesastarlightmesa.org/Insurance.pdf ·...

10
A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS KSNbWAL UECLARATfUNH '9-9100 Named insured M-23-8370-FA2F F V ATI 002681 3126 STARLIGHT MESA HOA ATTN CARDINAL MGMT 1260 HUNTINGTON OR STE 104 S PASADENA CA 91030-4561 il>n «!l>||lli<>|llli-l|<l'"lil'l>li-l"|l>|t|l>ll>l>l"e Policy Numbsr 92-QH-1155-4 Policy Period Effective Date Expiration Date 12 Months JAN 30 2017 JATJ 30 2018 The policy period begins and ends at12:01 am standard time atfhe premisesTocatlon. Agent and Mailing Address JOHN R SINNER INS AGENCY INC 1230 E MAIN ST ALHAMBRA CA 91801-4113 PHONE: (626) 576-1078 (800) 516-1078 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 anc forms in effect for each succeeding policy period. If this policy Is terminated, we will give you and the Mortgagee/Lienhoider written notice in compliance with the policy provisions or as requiredfaylaw. Entity: PUD NOTICE: Information concerning changes In your policy language is inciuded. Please cail your agent If you have any questions. POLICY PREMIUM $ 3,314.00 Discounts Applied: Renewal Year Claim Record Prepared NOV 17 2016 © Copyright, State Farm Mutual AutomobilB InsuraicB Company,200a CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 016892 294 1 Continued on Reverse Side of Page Page 1 of 8 E 53a-68Ba.2 05-31-21H1 (oUS

Transcript of Residential Community Association Policy - Starlight Mesastarlightmesa.org/Insurance.pdf ·...

Page 1: Residential Community Association Policy - Starlight Mesastarlightmesa.org/Insurance.pdf · Residential Community Association Policy for STARLIGHT MESA HOA Policy Number 92-QH-1155-4

A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS K S N b W A L U E C L A R A T f U N H

'9-9100

Named insured M-23-8370-FA2F F V A T I

002681 3126 STARLIGHT MESA HOA ATTN CARDINAL MGMT 1260 HUNTINGTON OR STE 104 S PASADENA CA 91030-4561

il>n «!l>||lli<>|llli-l|<l'"lil'l>li-l"|l>|t|l>ll>l>l"e

Policy Numbsr 92-QH-1155-4

Policy Period Effective Date Expiration Date 12 Months JAN 30 2017 JATJ 30 2018 The policy period begins and ends at12:01 am standard time atfhe premisesTocatlon.

Agent and Mailing Address JOHN R SINNER INS AGENCY INC 1230 E MAIN ST ALHAMBRA CA 91801-4113

PHONE: (626) 576-1078 (800) 516-1078

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 anc forms in effect for each succeeding policy period. If this policy Is terminated, we will give you and the Mortgagee/Lienhoider written notice in compliance with the policy provisions or as required fay law.

Entity: PUD

N O T I C E : Information concerning changes In your policy language is inciuded. Please cail your agent If you have any questions.

POL ICY PREMIUM $ 3,314.00

Discounts Applied: Renewal Year Claim Record

Prepared NOV 17 2016 © Copyright, State Farm Mutual AutomobilB InsuraicB Company,200a CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission.

016892 294 1 Continued on Reverse Side of Page Page 1 of 8 E

53a-68Ba.2 05-31-21H1 (oUS

Page 2: Residential Community Association Policy - Starlight Mesastarlightmesa.org/Insurance.pdf · Residential Community Association Policy for STARLIGHT MESA HOA Policy Number 92-QH-1155-4

RENEWAL DECLARATIONS (CONTINUED)

Residential Community Association Policy for STARLIGHT MESA HOA Policy Number 92-QH-1155-4

SECTION 1 - P R O P E R T Y SCHEDULE

Location Number

Location of Described Premises

Limit of Insurance*

Coverage A -Buildings

Limit of Insurance*

Coverage B -Business Personal

Property

001 255 S T A R L I G H T C R E S T DR LA CANADA FLT CA 91011 -2838

No Coverage No Coverage

AUXILIARY S T R U C T U R E S

Location Number

Description Limit of Insurance*

Coverage A -Buildings

Limit of Insurance*

Coverage B -Business Personal

Property

001A 001B 001C

Driveway, sidewalk, etc. Pool Recreation Building

$ 169,400 $ 43,400 $ 55,600

See Prop Sch See Prep Sch

$ 6,000

* 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 INDEXfESf

Inflation Coverage Index: ' 182.3

Prepared NOV 17 2016 ® CoPViglit State Farm Mutual Automobile Insurance Company,Z003 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission.

016892 Continued on Next Page Page 2 of 8

Page 3: Residential Community Association Policy - Starlight Mesastarlightmesa.org/Insurance.pdf · Residential Community Association Policy for STARLIGHT MESA HOA Policy Number 92-QH-1155-4

RENEWAL DECLARATIONS (CONTINUED)

Residential Community Association Policy for STARLIGHT MESA HOA Policy Number 92-QH-1155-4

S5

SECTION I - DEDUCTIBLES

Basic Deductible $1,000

Special Deductibles:

Money and Securities $250 Employee Dishonesty $250 Equipment Breakdown $1,000

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, please refer to that policy 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 Fersonal Froperty (applies only if this policy provides Coverage B - Business Fersonal Froperty)

Newly Acquired Or Constructed Buildings (applies only if this policy provides Coverage A - Buildings)

LIMIT OF INSURANCE

Included

Coverage B Limit

2 5 % of covered loss

Included

$5,000

$5,000

included

10%

$100,000

$250,000

Prepared NOV 17 201 6 © Copyright, State Farm Mutual Automobile insurance Company, 2008 CMF-4000 inclutles copyrighted material of Insurance Services Office, inc., with its permission.

016893 294 Continued OH Reverse Side of Fags Fage 3 of 8 E

Page 4: Residential Community Association Policy - Starlight Mesastarlightmesa.org/Insurance.pdf · Residential Community Association Policy for STARLIGHT MESA HOA Policy Number 92-QH-1155-4

RENEWAL DECLARATIONS (CONTINUED)

Residential Community Association Policy for STARLIGHT MESA HOA Policy Number 92-QH-1155-4

Ordinance Or Law - Equipment Coverage Included

Preservatlcn Of Property 30 Days

Water Damage, Other Liquids, Powder Or Molten Material Damage Included

SECTION i - EXTENSIONS OF C O V E R A G E - LIMIT OF INSURANCE - EACH COMPLEX

The coverages and corresponding limits shown below apply separately to each complex as described in the policy.

LIMIT OF C O V E R A G E INSURANCE

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 Froperty)

Fersonal 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

$50,000 $15,000

$5,000

$10,000

$5,000

$10,000

$1,000

$5,000

$2,500

Prepared NOV 17 2016 ©Copyright, State Farm Mutual Automobilalnsuranae Company, ZDD3 CMP-4000 includes copyrighted material of Insurance Services Office, Inc., with its permission.

016893 Continued on Next Page Page 4 of 8

Page 5: Residential Community Association Policy - Starlight Mesastarlightmesa.org/Insurance.pdf · Residential Community Association Policy for STARLIGHT MESA HOA Policy Number 92-QH-1155-4

RENEWAL DECLARATIONS (CONTINUED)

Residential Community Association Policy for STARLIGHT MESA HOA Policy Number 92-QH-1155-4

SECTION I - EXTENSIONS O F C O V E R A G E - LIMIT OF INSURANCE - P E R 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

Included

$50,000

Actual Loss Sustained -12 Months

SECTION 11 - LIABILITY

LIMIT OF

COVERAGE INSURANCE

Coverage L - Business Liability $2,000,000

Coverage M - Medical Expenses (Any One Person) $5,000

Damage To Premises Rented To You $300,000

Directors And Officers Liability $2,000,000

LIMIT OF

A G G R E G A T E LIMITS INSURANCE

Products/Completed Operations Aggregate $4,000,000

General Aggregate $4,000,000 Directors and Officers Aggregate $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.

Prepared NOV 17 2016 ® Copyright, State Farm Mutual Automobile Insurance Company,2D0S CMP-4000 Includes oopyrighted material of Insurance Services Office, Inc., with its permission.

016894 294 Continued 0 0 Reverse Side of Page Page 5 of 8 E

Page 6: Residential Community Association Policy - Starlight Mesastarlightmesa.org/Insurance.pdf · Residential Community Association Policy for STARLIGHT MESA HOA Policy Number 92-QH-1155-4

RENEWAL DECLARATIONS (CONTINUED)

Residential Community Association Policy for STARLIGHT MESA HOA Policy Number 92-QH-1155-4

Your policy consists of these Declarations, the B U S I N E S S O W N E R S C O V E R A G E FORM shown below, and any other forms and endorsements that apply. Including those shown below a s well as those Issued subsequent to the issuance of this policy.

FORMS AND ENDORSEMENTS

CMP-4101 Businessowners Coverage Form FE-6999.2 *Terrorlsm Insurance Cov Notice CMP-4814 Directors & Officers Liability CMP-4795.1 Add! insd Designated Premises CMP-4696 Residential Community Assoc CMP-4746.1 Hired Auto Liability CMP-4710 Employee Dishonesty CMP-4508 Money and Securities CMP-4705.1 Loss of Income & Extra Expnse FD-6007 Inland Marine Attach Dec

* New Form Attached

S C H E D U L E OF ADDITIONAL INTERESTS

Interest Type: Addl Insured-Section 11 Endorsement #: CMP47951 Loan Number: N/A

CARDINAL MGMT 1260 HUNTINGTON DR S T E 104 S PASADENA CA 910304561

Prepared NOV 17 2016 ® •'"Pyhsht State Farm Mutual Automobile Insurance Company, 2DD3 CMP-4000 Includes copyrighted material of Insurance Services Office, Inc., with its permission.

016894 Continued on Next Page Page 6 of 8

Page 7: Residential Community Association Policy - Starlight Mesastarlightmesa.org/Insurance.pdf · Residential Community Association Policy for STARLIGHT MESA HOA Policy Number 92-QH-1155-4

RENEWAL DECLARATIONS (CONTINUED)

Residential Community Association Policy for STARLIGHT MESA HOA Policy Number 92-QH-1155-4

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 a s 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

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. 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. Please forward such complaints to: California Department of Insurance

Consumer Services Division 300 South Spring Street Los Angeles, CA 90013 Or call toll free: 1-800-927-HELP

Prepared NOV 17 2016 ©Copyright, Stats Farm Mutual Automobile Insurance Company,ZODB CMP-4000 Includes copyrighted material oflnsurance Services Office, Inc., with its permission.

016895 294 Continued on Reverse Side of Page Page 7 of E

Page 8: Residential Community Association Policy - Starlight Mesastarlightmesa.org/Insurance.pdf · Residential Community Association Policy for STARLIGHT MESA HOA Policy Number 92-QH-1155-4

RENEWAL DECLARATIONS (CONTINUED)

Residential Community Association Policy for STARLIGHT MESA HOA Policy Number 92-QH-1155-4

NOTICE TO POLICYHOLDER: For a comprehensivs descriptjon of coverages and forms, please refer to your policy. Policy changes requested before Itie "Date Prepared", which appear on this notice, are effective on the Renewal Date of tf policy unless otherwise indicated by a separate endorsefnent, binder, or amended declarations. Any coverage forms attach* 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 a s an amended declarations or as an endorsement 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 an questions about your insurance coverage, contact your State Farm agent. Please keep this with your policy.

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 lin equal to the estimated replacement cost of your structure. Replacement cost estimates are available from building contracto and replacement cost appraisers, or, your agent can provide an estimate from Xactware, lnc.®using information you provic about your sft-ucture. We *^n accept the type of estimate you choose a s long as it provides a reasonable level of detail abo your structure. State Farm does not guarantee that any estimate will be the actual future cost to rebuild your structure. High limits are available at higher premiums. Lower limits are also available, as long as the amount of coverage meets o underwriting requirements. We encourage you to periodically review your coverages and Jimils with your agent and to notify i of any changes or additions to your structure.

Prepared NOV 17 2016 CMP-4000

© Copyright State Farm Mutual Automobile Insurance Company, 2008 Incluiies copyrighted material of Insurance Services Office, Inc., with its permission.

016895 294 E

Page 8 of 8

Page 9: Residential Community Association Policy - Starlight Mesastarlightmesa.org/Insurance.pdf · Residential Community Association Policy for STARLIGHT MESA HOA Policy Number 92-QH-1155-4

8

A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS INLAND MARINE ATTACHING DECLARATIONS

^Da9fa§jFmP9-9100

M-23-8370-FA2F F V

Named Insured

STARLIGHT MESA HOA ATTN CARDINAL MGMT 1260 HUNTINGTON DR STE 104 S PASADENA CA 91030-4561

ATTACHING INLAND MARINE

Policy Number 92-QH-1155-4

Policy Period Effective Date Expiration Date 12 Months JAN 30 2017 JAT I30 201B The policy period begins and ends at 12:01 am standard time atthe premisesTocatlon.

Automafjc Renewal - if the paltcy period is shown as 12 months, this policy will be renewed automatically subjectto the premiums, rules anc forms in effect for each succeeding policy period. If this policy is terminated, we will give you and the Mortgagee/Lienhoider 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 subsequenttothe issuance of this policy.

Forms, Options, and Endorsenionts

FE-8739 Inland Marine Conditions FE-6271 Amendatory Endorsement FE-8745 Inland Marine Computer Frop

See Reverse for Schedule Page with Limits

Prepared

NOV 17 2016 © Copyright State Farm Mutual Automobile Insurance Company, 2008 FD-6007 includes copyrighted material of insurance Services Office, Inc., with its permission.

016896 53a-6863.2 D5-31-Z[m (oll3

Page 10: Residential Community Association Policy - Starlight Mesastarlightmesa.org/Insurance.pdf · Residential Community Association Policy for STARLIGHT MESA HOA Policy Number 92-QH-1155-4

AmCHING INLAND MARINE SCHEDULE PAGE

ATTACHING INLAND MARINE

ENDORSEMENT NUMBER COVERAGE

LIMIT OF INSURANCE

DEDUCTIBLE AMOUNT

ANNUAL PREMIUM

FE-8745 Inland Marine Computer Prop L o s s of Income and Extra Expense

10,000 10 ,000

500 I n c l u d e d I n c l u d e d

OTHER LIMITS AND EXCLUSIONS MAY APPLY - REFER TO YOUR POLICY-Prepared NOV 17 2016 • ©CopyrightState Farm Mutual Automobile insurance Company, 2DDa FD-60D7 Includes oopyrighted material oflnsurance Services Office, inc., with its permission,

016896