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HomeMy WebLinkAboutWEKAN LIABILITY CERTIFICATION FOR 2018-2019 13-01627-20 SHEPHERD INSURANCE LLC Grange Mutual Casualty Company 111 CONGRESSIONAL BLVD P.O. Box 1218 CARMEL,IN Grange Columbus, Ohio 43216-1218 46032 Insurance® ABC (317)846-5554 Agent No. 13-01627-20 nknies@shepherdins.com www.shepherdins.com Named Insured and Address BusinessAssuresM Policy Type:Contractors&Tradesmen Reason Issued: Renewal WEKAN LLC Policy Number: CT 2656466-03 R I CK LOVAN Issue Date: 06/22/18 2107 SAINT ANDREWS RD Acct. No: 0000223610 JEFFERSONV I LLE I N 47130 From: 08/07/18 To: 08/07/19 12:01 a.m. standard time at the address of the named insured as shown above. These declarations together with the applications, common policy conditions, coverage part declarations, coverage part coverage form(s) and forms and endorsements, if any, issued to form a part thereof, complete the above numbered policy. In return for the payment of the premium, and subject to all the terms of this policy, we agree with you to provide the insurance as stated in this policy. Policy Declarations Business Description HANDYMAN Legal Entity LIMITED LIABILITY CO. This policy consists of the following coverage parts for which a premium is indicated.This advance premium may be subject to adjustment. Coverage(s) Advance Premium Businessowners Coverage $535.00 Certified Acts of Terrorism Excluded per signed rejection on file . Your Estimated Total Policy Premium Is $535.00 Premium does not include service charges. THIS IS NOT A BILL.Any outstanding balance due will be billed at a later date. INSURED COPY M3Y Page 1 BOP241(10-2012) noonr,n • Grange Mutual Casualty Company Policy Schedule Described Premises Location Premises: Building 2107 MINT ::BREWS RD 0001 001 jEFFERSONVILLE IN 47130 ;6754 Coverages Applying to This Business Location Coverages Limits of Insurance Advance Premium No Location Specific Coverage Applies . Refer to: "Coverages Applying to All Business Locations" on preceding page . Named Insured: WEKANLLC Policy Number: CT 2656466 INSURED COPY Page 3 BP241(10-2004) 1 Policy Forms Inventory Endorsement BP 00 03 (01/10) Businessowners Coverage Form BP 01 35 (11/17) * Indiana Changes BP 05 01 (07/02) Calculation of Premium BP 14 45 (12/10) Indiana Workers ' Compensation Exclusion BP 158 (05/11) Medical Expenses and Common Policy Conditions Changes CG 09 (01/05) Asbestos, Silica OR Mixed Dust Exclusion IL 15 (06/97) Lead Exclusion IL 33 (09/12) Indiana Changes - Pollutants BP 04 17 (01/10) Employment-Related Practices Exclusion BP 04 48 (01/06) Additional Insured - Designated Person or Organizatio. . . BP 04 51 (01/06) Additional Insured - Owners, Lessees or Contractors - . . . BP 05 24 (01/15) Exclusion of Certified Acts of Terrorism BP 05 77 (01/06) Fungi or Bacteria Exclusion (Liability) BP 07 02 (07/02) Amendment - Aggregate Limits of Insurance (Per Project) BP 124 (10/06) Lawn Care Services Coverage BP 14 08 (01/10) Exclusion - Exterior Insulation and Finish Systems BP 14 19 (01/10) Exclusion - Damage To Work Performed By Subcontractor . . . BP 149 (05/10) Exclusion - Tainted Drywall Material * Indicates an Added or Changed Form Page 5 BP241(10-2004) FIPPM G e BUSINESSOWNERS BP 01 35 11 17 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. INDIANA CHANGES This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM A. Section II - Liability is amended as follows: (2) 20 days before the effective date of 1. The following is added to Paragraph E.2. cancellation if you have perpetrated Duties In The Event Of Occurrence, a fraud or material misrepresentation Offense, Claim Or Suit Liability And Medical on us; or Expenses General Condition: (3) 45 days before the effective date of e. Notice given by or on behalf of the insured cancellation if: to any of our authorized agents in Indiana, (a) There has been a substantial with particulars sufficient to identify the change in the scale of risk insured, shall be considered to be notice to covered by this policy; us. (b) Reinsurance of the risk B. Section III - Common Policy Conditions is associated with this policy has amended as follows: been cancelled; or 1. Paragraph A.2. Cancellation is replaced by (c) You have failed to comply with the following: reasonable safety recommenda- 2. Cancellation Of Policies In Effect tions. a. 90 Days Or Less 2. Paragraph C. Concealment, Misrepre- sentation Or Fraud is replaced by the If this policy has been in effect for 90 following: days or less, we may cancel this policy by mailing or delivering to the first C. Concealment, Misrepresentation Or Named Insured written notice of Fraud cancellation at least: We will not pay for any loss or damage in (1) 10 days before the effective date of any case of: cancellation if we cancel for 1. Concealment or misrepresentation of a nonpayment of premium; material fact; or (2) 20 days before the effective date of 2. Fraud cancellation if you have perpetrated committed by an insured at any time and a fraud or material misrepresentation relating to a claim under this policy. on us; or (3) 30 days before the effective date of 3. Paragraph 2. does not apply when a claim is made by an "innocent coinsured" for coverage cancellation if we cancel for any for property loss or damage, provided: other reason. a. The property loss or damage occurs to the b. More Than 90 Days primary residence of the "innocent coinsured" If this policy has been in effect for more as covered under the policy; and than 90 days, or is a renewal of a policy b. The "final settlement" for the property loss we issued, we may cancel this policy, or damage is at least 60% of available only for one or more of the reasons insurance proceeds under the policy. listed below, by mailing or delivering to the first Named Insured written notice of cancellation at least: (1) 10 days before the effective date of cancellation if we cancel for nonpayment of premium; BP 01 35 11 17 © Insurance Services Office, Inc., 2017 Page 1 of 3 The person or organization to or for whom 8. The following paragraph is added and we make payment must do everything supersedes any provision to the contrary. necessary to secure our rights and must do M. Nonrenewal nothing after loss to impair them. But you may waive your rights against another party 1. If we elect not to renew this policy, we in writing: will mail or deliver to the first Named Insured written notice of nonrenewal at a. Prior to a loss to your Covered Property. least 45 days before: b. After a loss to your Covered Property a. The expiration date of this policy, if only if, at time of loss, that party is one the policy is written for a term of one of the following: year or less; or (1) Someone insured by this insurance; b. The anniversary date of this policy, if (2) A business firm: the policy is written for a term of (a) Owned or controlled by you; or more than one year. (b) That owns or controls you; or 2. We will mail or deliver our notice to the first Named Insured's last mailing (3) Your tenant. address known to us. If notice is mailed, You may also accept the usual bills of proof of mailing will be sufficient proof lading or shipping receipts limiting the of notice. liability of carriers. This will not restrict your insurance. BP 01 35 11 17 © Insurance Services Office, Inc., 2017 Page 3 of 3 Grange Insurance Important Information: Your Policy May Need to be Audited The insurance premium shown on your policy may be an estimate if it was calculated using variable exposures such as payroll or sales. To determine the correct exposure or premium base for your policy,we may need to complete a premium audit. Audits are necessary on policies with a variable premium base(such as payroll or sales) so that the correct exposures are used to calculate the premium on your policy.By reviewing your operations, records and accounting books,we can determine the actual insurance exposure for the coverage provided. If your exposure estimates are too high,we will return the excess premium to you. If the actual exposures are higher than initially estimated,additional premium may be due. Properly Maintained Records Help Ensure Accurate Audit Depending on your business operations, premiums can be based on:payroll,sales,number of employees,and/or contract costs.By properly maintaining your records,you can help ensure our premium auditors complete a thorough and accurate audit. Our auditors typically review journals,ledgers,tax reports,individual earning cards,vehicle titles,registrations and ownership tax receipts. Generally,two of these records provide the information our auditors need to complete the audit.The Premium Auditor will ask you questions about your operations and may observe the premises to verify that the actual operations match the classification used to rate your policy. All information obtained during the audit process is treated confidentially and used to calculate your final premiums. How Records Are Kept May Benefit You Payroll is defined as total remuneration for services performed by an employee and includes the following: • Wages • Value of Board &Lodging • Vacation Pay • Store Certificates • Sick Pay • Other$Substitutes • Holiday Pay • Statutory Payments • Overtime • Payment for Piece Work • Tool Allowances • Bonuses I0246(02-2006) Continued... Grange Mutual Casualty Company P.O. Box 1218 Columbus, Ohio 4321 6-1 21 8 Policy Number: CT 2656466 Mutual Conditions Notice of Policyholders Annual Meetings By acceptance of this policy and payment of the You,by virtue of this policy, are a member of Grange premium,you become a member of Grange Mutual Mutual Casualty Company while this policy is in Casualty Company,and shall be entitled to vote at force and are entitled to one vote at all meetings of all meetings of the Company,but upon cancellation the members.The annual meeting of the members is or other termination of this policy you shall cease to held at 10:00 A.M. on the fourth Thursday of be a member. February of each year at our Home Office, Columbus, Ohio, for the election of directors, and for Policy Non-Assessable the transaction of such other business as may properly come before the meeting. This policy is non-assessable. IN WITNESS WHEREOF,we,have caused this policy to be signed by our President and attested by our Secretary, and, if required by state law, this policy shall not be binding upon us unless countersigned by our authorized representative. LaVawn D. Coleman John Ammendola Secretary President AJ226(06-2015) • 13-01627-20 SHEPHERD INSURANCE LLC Grange Mutual Casualty Company 111 CONGRESSIONAL BLVD P.O. Box 1218 CARMEL,IN Columbus, Ohio 43216-1218 46032 ABC (317)846-5554 Agent No. 13-01627-20 nknies@shepherdins.com www.shepherdins.com Named Insured and Address BusinessAssuresM Policy Type:Contractors&Tradesmen WEKAN LLC Policy Number: CT 2656466-03 R I CK LOVAN Issue Date: 06/22/18 2107 SAINT ANDREWS RD Acct. No: 0000223610 JEFFERSONV I LLE I N 47130 From:08/07/18 To: 08/07/19 12:01 a.m. standard time. POLICY PREMIUM RECAP STATEMENT Line of Business/Coverages Policy Premium Commission Totals .................................................... . . ....................... . .. ....... Businessowners - Contractor $41400 15% Addl Insd - OLC - Auto Status S97.O0. 15% Addl Insured Designated Person or Organization $24. 00` 15% ......................................... .......................................... ......................................... Your Total Policy Premium Is $53500 THIS IS NOT A BILL.Any outstanding balance due will be billed at a later date. AKK204(10-2012) AGENT COPY 1 S-U1ti1!-11.1 SHEPHERD INSURANCE LLC Grange Mutual Casualty Company 111 CONGRESSIONAL BLVD P.O. Box 1218 CARMEL,IN Columbus, Ohio 43216-1218 46032 ABC (317)846-5554 Agent No. 13-01627-20 nknies@shepherdins.com www.shepherdins.com Named Insured and Address BusinessAssuresM Policy Type:Contractors&Tradesmen Reason Issued: Renewal WEKAN LLC Policy Number: CT 2656466-03 R I CK LOVAN Issue Date: 06/22/18 2107 SAINT ANDREWS RD Acct. No: 0000223610 JEFFERSONV I LLE I N 47130 From: 08/07/18 To: 08/07/19 12:01 a.m. standard time at the address of the named insured as shown above. These declarations together with the applications, common policy conditions, coverage part declarations, coverage part coverage form(s) and forms and endorsements, if any, issued to form a part thereof, complete the above numbered policy. In return for the payment of the premium, and subject to all the terms of this policy, we agree with you to provide the insurance as stated in this policy. Policy Declarations Business Description HANDYMAN Legal Entity LIMITED LIABILITY CO. This policy consists of the following coverage parts for which a premium is indicated.This advance premium may be subject to adjustment. Coverage(s) Advance Premium Businessowners Coverage $535.013' Certified Acts of Terrorism Excluded per signed rejection on file . ........................................... .... ............................ .. Your Estimated Total Policy Premium Is $535.00 Premium does not include service charges. THIS IS NOT A BILL.Any outstanding balance due will be billed at a later date. AGENT COPY M3Y Page 1 1101,241 n n-7(1171 RPanT i n • Grange Mutual Casualty Company Policy Schedule Described Premises Location Premises: Building 2�;0 MINT t NDREWS 0001 001 j1r1 NV1L1v IN 47.130 654 Coverages Applying to This Business Location Coverages Limits of Insurance Advance Premium No Location Specific Coverage Applies . Refer to: "Coverages Applying to All Business Locations" on preceding page. 3 Named Insured: WEKANLLC Policy Number: CT 2656466 AGENT COPY Page RPM 11 fl_7lf161 RPPOL3R Policy Forms Inventory Endorsement BP 00 03 (01/10) Businessowners Coverage Form BP 01 35 (11/17) * Indiana Changes BP 05 01 (07/02) Calculation of Premium BP 14 45 (12/10) Indiana Workers ' Compensation Exclusion BP 158 (05/11) Medical Expenses and Common Policy Conditions Changes CG 09 (01/05) Asbestos , Silica OR Mixed Dust Exclusion IL 15 (06/97) Lead Exclusion IL 33 (09/12) Indiana Changes - Pollutants BP 04 17 (01/10) Employment-Related Practices Exclusion BP 04 48 (01/06) Additional Insured - Designated Person or Organizatio. . . BP 04 51 (01/06) Additional Insured - Owners , Lessees or Contractors - . . . BP 05 24 (01/15) Exclusion of Certified Acts of Terrorism BP 05 77 (01/06) Fungi or Bacteria Exclusion (Liability) BP 07 02 (07/02) Amendment - Aggregate Limits of Insurance (Per Project) BP 124 (10/06) Lawn Care Services Coverage BP 14 08 (01/10) Exclusion - Exterior Insulation and Finish Systems BP 14 19 (01/10) Exclusion - Damage To Work Performed By Subcontractor . . . BP 149 (05/10) Exclusion - Tainted Drywall Material * Indicates an Added or Changed Form Page 5 nwa+nn_gnu% BPPOL5A BUSINESSOWNERS BP 01 35 11 17 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. INDIANA CHANGES This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM A. Section II - Liability is amended as follows: (2) 20 days before the effective date of 1. The following is added to Paragraph E.2. cancellation if you have perpetrated Duties In The Event Of Occurrence, a fraud or material misrepresentation Offense, Claim Or Suit Liability And Medical on us; or Expenses General Condition: (3) 45 days before the effective date of e. Notice given by or on behalf of the insured cancellation if: to any of our authorized agents in Indiana, (a) There has been a substantial with particulars sufficient to identify the change in the scale of risk insured, shall be considered to be notice to covered by this policy; us. (b) Reinsurance of the risk B. Section III - Common Policy Conditions is associated with this policy has amended as follows: been cancelled; or 1. Paragraph A.2. Cancellation is replaced by (c) You have failed to comply with the following: reasonable safety recommenda- 2. Cancellation Of Policies In Effect tions. a. 90 Days Or Less 2. Paragraph C. Concealment, Misrepre- sentation Or Fraud is replaced by the If this policy has been in effect for 90 following: days or less, we may cancel this policy by mailing or delivering to the first C. Concealment, Misrepresentation Or Named Insured written notice of Fraud cancellation at least: We will not pay for any loss or damage in (1) 10 days before the effective date of any case of: cancellation if we cancel for 1. Concealment or misrepresentation of a nonpayment of premium; material fact; or (2) 20 days before the effective date of 2. Fraud cancellation if you have perpetrated committed by an insured at any time and a fraud or material misrepresentation relating to a claim under this policy. on us; or (3) 30 days before the effective date of 3. Paragraph 2. does not apply when a claim is made by an "innocent coinsured" for coverage cancellation if we cancel for any for property loss or damage, provided: other reason. a. The property loss or damage occurs to the b. More Than 90 Days primary residence of the "innocent coinsured" If this policy has been in effect for more as covered under the policy; and than 90 days, or is a renewal of a policy b. The "final settlement" for the property loss we issued, we may cancel this policy, or damage is at least 60% of available only for one or more of the reasons insurance proceeds under the policy. listed below, by mailing or delivering to the first Named Insured written notice of cancellation at least: (1) 10 days before the effective date of cancellation if we cancel for nonpayment of premium; BP 01 35 11 17 © Insurance Services Office, Inc., 2017 Page 1 of 3 The person or organization to or for whom 8. The following paragraph is added and we make payment must do everything supersedes any provision to the contrary. necessary to secure our rights and must do M. Nonrenewal nothing after loss to impair them. But you may waive your rights against another party 1. If we elect not to renew this policy, we in writing: will mail or deliver to the first Named Insured written notice of nonrenewal at a. Prior to a loss to your Covered Property. least 45 days before: b. After a loss to your Covered Property a. The expiration date of this policy, if only if, at time of loss, that party is one the policy is written for a term of one of the following: year or less; or (1) Someone insured by this insurance; b. The anniversary date of this policy, if (2) A business firm: the policy is written for a term of (a) Owned or controlled by you; or more than one year. (b) That owns or controls you; or 2. We will mail or deliver our notice to the first Named Insured's last mailing (3) Your tenant. address known to us. If notice is mailed, You may also accept the usual bills of proof of mailing will be sufficient proof lading or shipping receipts limiting the of notice. liability of carriers. This will not restrict your insurance. BP 01 35 11 17 © Insurance Services Office, Inc., 2017 Page 3 of 3 M 1J Grange Insurance Important Information: Your Policy May Need to be Audited The insurance premium shown on your policy may be an estimate if it was calculated using variable exposures such as payroll or sales. To determine the correct exposure or premium base for your policy,we may need to complete a premium audit. Audits are necessary on policies with a variable premium base(such as payroll or sales)so that the correct exposures are used to calculate the premium on your policy.By reviewing your operations, records and accounting books, we can determine the actual insurance exposure for the coverage provided. If your exposure estimates are too high,we will return the excess premium to you. If the actual exposures are higher than initially estimated,additional premium may be due. Properly Maintained Records Help Ensure Accurate Audit Depending on your business operations,premiums can be based on:payroll,sales,number of employees,and/or contract costs.By properly maintaining your records,you can help ensure our premium auditors complete a thorough and accurate audit. Our auditors typically review journals, ledgers,tax reports, individual earning cards,vehicle titles,registrations and ownership tax receipts. Generally,two of these records provide the information our auditors need to complete the audit.The Premium Auditor will ask you questions about your operations and may observe the premises to verify that the actual operations match the classification used to rate your policy. All information obtained during the audit process is treated confidentially and used to calculate your final premiums. How Records Are Kept May Benefit You Payroll is defined as total remuneration for services performed by an employee and includes the following. • Wages • Value of Board&Lodging • Vacation Pay • Store Certificates • Sick Pay • Other$Substitutes • Holiday Pay • Statutory Payments • Overtime • Payment for Piece Work • Tool Allowances • Bonuses I0246(02-2006) Continued...