Attachment_C_-_Current_Policy.pdf
PDF 142 KB Posted
- Attached to
- Insurance, Property
- Solicitation number
- EVT0009965
- Issued by
- Sedgwick County, Wathena City, Kansas
About this file
This document contains the Commercial Property Coverage Declarations and an endorsement for a state and local government insurance policy issued by Auto-Owners Insurance Company for the State of Kansas Department of Labor and Commerce. The policy provides coverage for 8 government office buildings located in Topeka, Dodge City, Hays, Salina, and Olathe, Kansas, covering a total blanket building limit of $20,944,900. The policy term is from December 1, 2023 to December 1, 2024. The policy includes coverage for building, personal property, and additional coverages such as ordinance or law and terrorism. The endorsement notes that the Terrorism Risk Insurance Act will expire on December 31, 2027 and explains the potential impact and changes to the terrorism coverage depending on whether the Act is extended, revised, or replaced.
The policy premium is $43,651 with a paid-in-full discount of $4,453, resulting in a total policy premium of $39,198. The policy contains detailed information on the coverages, limits, deductibles, and premiums for each of the insured locations. There is no mention of any set-asides, incumbents, funding sources, or other salient business information.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| EVT0009965_-_Insurance,_Property.pdf | ||
| Attachment_A_-_Property_Data.xls | XLS spreadsheet | |
| Attachment_B_-_Loss_Run.pdf | ||
| Insurance,_Property.pdf |
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Text version
59511 (6-22)
13-0065-00
Agency phone:
Auto-Owners Insurance Company
STATE OF KANSAS
DEPARTMENT OF LABOR AND COMMERCE
800 SW JACKSON ST STE 600
TOPEKA KS 66612-1216
A G INSURANCE
PO BOX 817
PERRY KS 66073-0817
10-06-2023
785-597-2444 www.auto-owners.com
You can view your policy or change your paperless options at any time online at .
RE: Policy
Thank you for selecting Auto-Owners Insurance Group to serve your insurance needs! Feel free to contact your independent Auto-Owners agent with questions you may have. If you have questions your agent is unable to answer, please contact us at 517.323.1200.
Auto-Owners and its affiliate companies offer a full complement of policies, each of which has its own eligibility requirements, coverages and rates. Please take this opportunity to review your insurance needs with your Auto-Owners agent, and discuss which company and program may be most appropriate for you.
Auto-Owners Insurance Company was formed in 1916. Our A++ (Superior) rating by A.M. Best Company signifies that we have the financial strength to provide the insurance protection you need. The Auto-Owners Insurance Group is comprised of six property and casualty companies and a life insurance company.
125013-75347927-23
Serving Our Policyholders and Agents Since 1916
Agency Code Policy Number13-0065-00 125013-75347927
What We Do To Protect Your Privacy
At Auto-Owners Insurance Group*, we value your business and we want to retain your trust. In the course of providing products and services, we may obtain nonpublic personal information about you. We assure you that such information is used only for the purpose of providing our products and services to you.
Protecting Confidentiality
Our agents and Company associates may have access to nonpublic personal information only for the purpose of providing our products or services to you. We maintain physical, electronic and procedural safeguards against unauthorized use of your nonpublic personal information.
Information We Obtain
To assist in underwriting and servicing your policy, we may obtain nonpublic personal information about you. For example, we routinely obtain information through applications, forms related to our products or services, from visiting www.auto-owners.com, and your transactions with us. We may obtain such information from our affiliates, independent insurance agents, governmental agencies, third parties, or consumer reporting agencies.
The type of information that we collect depends on the product or service requested, but may include your name, address, contact information, social security number, credit history, claims history, information to properly investigate and resolve any claims, or billing information. We may obtain your medical history with your permission. The nature and extent of the information we obtain varies based on the nature of the products and services you receive.
The Internet and Your Information
If you would like to learn about how we gather and protect your information over the Internet, please see our online privacy statement at www.auto-owners.com/privacy.
Generally, Auto-Owners may use cookies, analytics, and other technologies to help us provide users with better service and a more customized web experience. Our business partners may use tracking services, analytics, and other technologies to monitor visits to www.auto-owners.com. The website may use web beacons in addition to cookies. You may choose to not accept cookies by changing the settings in your web browser.
Information obtained on our websites may include IP address, browser and platform types, domain names, access times, referral data, and your activity while using our site; who should use our web site; the security of information over the Internet; and links and co-branded sites.
Limited Disclosure
Auto-Owners Insurance Group companies do not disclose any nonpublic personal information about their customers or former customers except as permitted by law. We do not sell your personal information to anyone. We do not offer an opportunity for you to prevent or "opt out of" information sharing since we only share personal information with others as allowed by law.
When sharing information with third parties to help us conduct our business, we require them to protect your personal information. We do not permit them to use or share your personal information for any purpose other than the work they are doing on our behalf or as required by law.
59325 (12-19) Page 1 of 2
NOTICE OF PRIVACY PRACTICES
59325 (12-19)
The types of information disclosed may include personal information we collect as necessary to service your policy or account, investigate and pay claims, comply with state and federal regulatory requests or demands, and process other transactions that you request. Third parties that receive disclosures may include your independent agent, regulators, reinsurance companies, fraud prevention agencies, or insurance adjusters.
How Long We Retain Your Information
We generally retain your information as long as reasonably necessary to provide you services or to comply with applicable law and in accordance with our document retention policy. We may retain copies of information about you and any transactions or services you have used for a period of time that is consistent with applicable law, applicable statute of limitations or as we believe is reasonably necessary to comply with applicable law, regulation, legal process or governmental request, to detect or prevent fraud, to collect fees owed, to resolve disputes, to address problems with our services, to assist with investigations, to enforce other applicable agreements or policies or to take any other actions consistent with applicable law.
In some circumstances we may anonymize your personal information (so that it can no longer be associated with you) for research or statistical purposes, in which case we may use this information indefinitely without further notice to you. This allows the specific information collected (name, email, address, phone number, etc.) to become anonymous, but allows Auto-Owners to keep the transaction or engagement data.
Changes to the Privacy Policy
We will provide a notice of our privacy policy as required by law. This policy may change from time to time, but you can always review our current policy by visiting our website at www.auto-owners.com/privacy or by contacting us.
Contact Us
Auto-Owners Insurance Company Phone: 844-359-4595 (toll free) Email: privacyrequest@aoins.com
*Auto-Owners Insurance Group includes, Auto-Owners Insurance Company, Auto-Owners Life Insurance Company, Home-Owners Insurance Company, Owners Insurance Company, Property-Owners Insurance Company and Southern-Owners Insurance Company.
59325 (12-19) Page 2 of 2
59390 (11-20)
Dear Policyholder:
The Terrorism Risk Insurance Act (including ensuing Congressional actions pursuant to the Act) will expire on December 31, 2027 unless the Federal government extends the Act. What this means to you is the following:
1. Subject to policy terms and conditions, the enclosed policy will provide insurance coverage for certified acts of ter-rorism as defined in the Act only until December 31, 2027.
2. A conditional endorsement entitled, Conditional Exclusion Of Terrorism Involving Nuclear, Biological Or Chemical Terrorism (Relating To Disposition Of Federal Terrorism Risk Insurance Act) is enclosed. This conditional endorse-ment will only apply if the Act is not extended or if the Act is revised to increase statutory deductibles, decrease the federal government's share in potential losses above the statutory deductibles, change the levels, terms or conditions of coverage and we are no longer required to make terrorism coverage available and elect not to do so. It will not apply if the Act is simply extended.
3. The conditional endorsement will provide coverage for an incident of terrorism pursuant to the terms and conditions of the policy only if the incident does not involve nuclear, biological or chemical material.
4. A premium charge for the conditional endorsement will be applied effective January 1, 2028. The premium will be pro rated for the remainder of the policy term and is one-half of the current premium charge appearing in the Declara-tions for TERRORISM - CERTIFIED ACTS. However, it will only be made if the Terrorism Risk Insurance Act (includ-ing ensuing Congressional actions pursuant to the Act) is not extend. Revised Declarations will be mailed to you after January 1, 2028.
5. If the Act is extended without any revision, the enclosed policy will continue to provide coverage for certified acts of terrorism. The conditional endorsement will not be activated and the changes in coverage or premium referenced above will not apply.
6. If the Act is extended with revisions or is replaced, and we are required or elect to continue to offer coverage for certi-fied acts of terrorism, we may amend this policy in accordance with the provisions of the revised Act or its replace-ment.
This notice is for informational purposes only.
If you have any questions concerning your policy or this notice, please contact your Auto-Owners agency.
NOTIFICATION OF POSSIBLE CHANGES
IN COVERAGE FOR TERRORISM
59390 (11-20) Page 1 of 1
64360 (8-21)
NOTICE OF CHANGE IN POLICY TERMS
CHANGES - EXCLUSION FOR INSECTS, BIRDS, RODENTS OR OTHER ANIMALS
Dear Policyholder, Your policy is amended by the enclosed endorsement entitled CHANGES - EXCLUSION FOR INSECTS, BIRDS, RODENTS OR OTHER ANIMALS 64352 (12-20). The endorsement provides that your property exclusion for "Insects, birds, rodents or other animals" is now limited to losses involving "Nesting or Infestation, or discharge or release of waste products or secretions".
This notice is for informational purposes only. Your policy contains the specific terms and conditions of coverage.
If you have any questions regarding your policy or this notice, please contact your Auto-Owners agency.
64360 (8-21) Page 1 of 1
ADDRESS
POLICY NUMBER
INSURED
to
AGENCY
Issued
In consideration of payment of the premium shown below, this policy is renewed. Please attach this Declarations and attachments to your policy. If you have any questions, please consult with your agent.
125013-75347927-23
A G INSURANCE
785-597-244413-0065-00
6101 ANACAPRI BLVD., LANSING, MI 48917-3999
INSURANCE COMPANY
STATE OF KANSAS
DEPARTMENT OF LABOR AND COMMERCE
800 SW JACKSON ST STE 600
TOPEKA KS 66612-1216
Bill Company
75-50-KS-1212Company Use
10-06-2023
Policy Term
12-01-2023
12:01 a.m.
12-01-2024
12:01 a.m.
TAILORED PROTECTION POLICY DECLARATIONS
MKT TERR 118
12-01-2023EffectiveRenewal
COMMON POLICY INFORMATION
55039 (11-87)
Business Description:
Entity:
Govt Office Bldgs
Governmental
THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE PART(S): PREMIUM
COMMERCIAL PROPERTY COVERAGE $43,651.00
TOTAL $43,651.00
PAID IN FULL DISCOUNT $4,453.00
TOTAL POLICY PREMIUM IF PAID IN FULL $39,198.00
THIS PREMIUM MAY BE SUBJECT TO ADJUSTMENT.
The Paid in Full Discount does not apply to fixed fees, statutory charges or minimum premiums.
Forms that apply to all coverage part(s) shown above (except garage liability, dealer's blanket, commercial automobile, if applicable):
55000 (07-12) 55056 (07-87) 59390 (11-20)
Countersigned By: ________________________________________
Term
AGENCY POLICY NUMBER
INSURED to
Issued
125013-75347927-23A G INSURANCE
13-0065-00
Auto-Owners Ins. Co.
STATE OF KANSAS
Company Bill 75-50-KS-1212
10-06-2023
12-01-2023 12-01-2024
MKT TERR 118
COMMERCIAL PROPERTY COVERAGE
54104 (07-87)
Coverages Provided
Insurance at the described premises applies only for coverages for which a limit of insurance is shown.
LOCATION 0001 - BUILDING 0001
Location: 401 Sw Topeka Blvd, Topeka, KS 66603-3102
Occupied As: Offices
Secured Interested Parties: None
Rating Information
Construction: Fire Resist
Class Code: 0701
Protection Class: 02
Specific Rate - Building: 0.018
Territory: 446 County: Shawnee
COVERAGE COINSURANCE DEDUCTIBLE RATE PREMIUMLIMIT
BUILDING $4,575,900
(BLANKET)
Causes of Loss
Basic Group I 100% $5,000 0.019 $869.00
Basic Group II 100% $5,000 0.067 $3,066.00
Windstorm/Hail 100% 1% Included
Special 100% $5,000 0.031 $1,419.00
Theft 100% $5,000 Included
OPTIONAL COVERAGE
Inflation Guard Factor Building 1.003
Replacement Cost
Equipment Breakdown Excluded
ORDINANCE OR LAW
Coverage A-Undamaged Portion $5,000 Incl in Bldg Limit Included
Coverage B-Demolition $5,000 $10,000 Included
Coverage C-Increased Cost $5,000 $10,000 Included
Forms that apply to this building:
54835 (07-08) IL0017 (11-85) IL0261 (12-89) IL0003 (07-02) 59350 (01-15)
IL0160 (01-16) 64224 (01-16) 54753 (03-19) 59325 (12-19) 64329 (07-19)
CP0090 (07-88) 64000 (12-10) 64013 (12-10) 64010 (12-10) 64020 (12-10)
54585 (12-10) 64352 (12-20) 59390 (11-20)
PREMIUMCOMMERCIAL PROPERTY COVERAGE - LOCATION 0001 SUMMARY
TERRORISM - CERTIFIED ACTS SEE FORM: 59350, 54835, 59390 $54.00
LOCATION 0001 $5,408.00
AGENCY POLICY NUMBER
INSURED to
Issued
125013-75347927-23A G INSURANCE
13-0065-00
Auto-Owners Ins. Co.
STATE OF KANSAS
Company Bill 75-50-KS-1212
10-06-2023
12-01-2023 12-01-2024
MKT TERR 118
LOCATION 0003 - BUILDING 0001
Location: 1309 Sw Topeka Blvd, Topeka, KS 66612-1816
Occupied As: Offices-Governmental
Secured Interested Parties: None
Rating Information
Construction: Mas N-C
Class Code: 0702
Protection Class: 02
Specific Rate - Building: 0.024
Territory: 446 County: Shawnee
COVERAGE COINSURANCE DEDUCTIBLE RATE PREMIUMLIMIT
BUILDING $4,141,400
(BLANKET)
Causes of Loss
Basic Group I 100% $5,000 0.019 $787.00
Basic Group II 100% $5,000 0.067 $2,775.00
Windstorm/Hail 100% 1% Included
Special 100% $5,000 0.031 $1,284.00
Theft 100% $5,000 Included
OPTIONAL COVERAGE
Inflation Guard Factor Building 1.003
Replacement Cost
Equipment Breakdown Excluded
ORDINANCE OR LAW
Coverage A-Undamaged Portion $5,000 Incl in Bldg Limit Included
Coverage B-Demolition $5,000 $10,000 Included
Coverage C-Increased Cost $5,000 $10,000 Included
Forms that apply to this building:
54835 (07-08) IL0017 (11-85) IL0261 (12-89) IL0003 (07-02) 59350 (01-15)
IL0160 (01-16) 64224 (01-16) 54753 (03-19) 59325 (12-19) 64329 (07-19)
CP0090 (07-88) 64000 (12-10) 64013 (12-10) 64010 (12-10) 64020 (12-10)
54585 (12-10) 64352 (12-20) 59390 (11-20)
PREMIUMCOMMERCIAL PROPERTY COVERAGE - LOCATION 0003 SUMMARY
TERRORISM - CERTIFIED ACTS SEE FORM: 59350, 54835, 59390 $48.00
LOCATION 0003 $4,894.00
LOCATION 0006 - BUILDING 0001
Location: 417 Sw Jackson St, Topeka, KS 66603-3327
Occupied As: Offices-Governmental
AGENCY POLICY NUMBER
INSURED to
Issued
125013-75347927-23A G INSURANCE
13-0065-00
Auto-Owners Ins. Co.
STATE OF KANSAS
Company Bill 75-50-KS-1212
10-06-2023
12-01-2023 12-01-2024
MKT TERR 118
Secured Interested Parties: None
Rating Information
Construction: Masonry
Class Code: 0701
Protection Class: 02
Class Rate - Building: 0.176
Territory: 446 County: Shawnee
COVERAGE COINSURANCE DEDUCTIBLE RATE PREMIUMLIMIT
BUILDING $806,500
(BLANKET)
Causes of Loss
Basic Group I 100% $5,000 0.018 $145.00
Basic Group II 100% $5,000 0.098 $790.00
Windstorm/Hail 100% 1% Included
Special 100% $5,000 0.027 $218.00
Theft 100% $5,000 Included
OPTIONAL COVERAGE
Inflation Guard Factor Building 1.003
Replacement Cost
Equipment Breakdown Excluded
ORDINANCE OR LAW
Coverage A-Undamaged Portion $5,000 Incl in Bldg Limit Included
Coverage B-Demolition $5,000 $10,000 Included
Coverage C-Increased Cost $5,000 $10,000 Included
Forms that apply to this building:
54835 (07-08) IL0017 (11-85) IL0261 (12-89) IL0003 (07-02) 59350 (01-15)
IL0160 (01-16) 64224 (01-16) 54753 (03-19) 59325 (12-19) 64329 (07-19)
CP0090 (07-88) 64000 (12-10) 64013 (12-10) 64010 (12-10) 64020 (12-10)
54585 (12-10) 64352 (12-20) 59390 (11-20)
PREMIUMCOMMERCIAL PROPERTY COVERAGE - LOCATION 0006 SUMMARY
TERRORISM - CERTIFIED ACTS SEE FORM: 59350, 54835, 59390 $12.00
LOCATION 0006 $1,165.00
LOCATION 0007 - BUILDING 0001
Location: 2650 Sw East Circle Dr S, Topeka, KS 66606-2411
Occupied As: Offices-Governmental
Secured Interested Parties: None
Rating Information
Construction: Fire Resist
Class Code: 0701
Protection Class: 02
Specific Rate - Building: 0.016
Territory: 446 County: Shawnee
AGENCY POLICY NUMBER
INSURED to
Issued
125013-75347927-23A G INSURANCE
13-0065-00
Auto-Owners Ins. Co.
STATE OF KANSAS
Company Bill 75-50-KS-1212
10-06-2023
12-01-2023 12-01-2024
MKT TERR 118
COVERAGE COINSURANCE DEDUCTIBLE RATE PREMIUMLIMIT
BUILDING $4,212,100
(BLANKET)
Causes of Loss
Basic Group I 100% $5,000 0.019 $800.00
Basic Group II 100% $5,000 0.067 $2,822.00
Windstorm/Hail 100% 1% Included
Special 100% $5,000 0.031 $1,306.00
Theft 100% $5,000 Included
OPTIONAL COVERAGE
Inflation Guard Factor Building 1.003
Replacement Cost
Equipment Breakdown Excluded
ORDINANCE OR LAW
Coverage A-Undamaged Portion $5,000 Incl in Bldg Limit Included
Coverage B-Demolition $5,000 $10,000 Included
Coverage C-Increased Cost $5,000 $10,000 Included
Forms that apply to this building:
54835 (07-08) IL0017 (11-85) IL0261 (12-89) IL0003 (07-02) 59350 (01-15)
IL0160 (01-16) 64224 (01-16) 54753 (03-19) 59325 (12-19) 64329 (07-19)
CP0090 (07-88) 64000 (12-10) 64013 (12-10) 64010 (12-10) 64020 (12-10)
54585 (12-10) 64352 (12-20) 59390 (11-20)
PREMIUMCOMMERCIAL PROPERTY COVERAGE - LOCATION 0007 SUMMARY
TERRORISM - CERTIFIED ACTS SEE FORM: 59350, 54835, 59390 $49.00
LOCATION 0007 $4,977.00
LOCATION 0009 - BUILDING 0001
Location: 2308 1St Ave, Dodge City, KS 67801-2560
Occupied As: Offices-Governmental
Secured Interested Parties: None
Rating Information
Construction: Mas N-C
Class Code: 0701
Protection Class: 03
Class Rate - Building: 0.127
Territory: 145 County: Ford
AGENCY POLICY NUMBER
INSURED to
Issued
125013-75347927-23A G INSURANCE
13-0065-00
Auto-Owners Ins. Co.
STATE OF KANSAS
Company Bill 75-50-KS-1212
10-06-2023
12-01-2023 12-01-2024
MKT TERR 118
COVERAGE COINSURANCE DEDUCTIBLE RATE PREMIUMLIMIT
BUILDING $513,700
(BLANKET)
Causes of Loss
Basic Group I 100% $5,000 0.018 $92.00
Basic Group II 100% $5,000 0.098 $503.00
Windstorm/Hail 100% 1% Included
Special 100% $5,000 0.027 $139.00
Theft 100% $5,000 Included
OPTIONAL COVERAGE
Inflation Guard Factor Building 1.000
Replacement Cost
Equipment Breakdown Excluded
ORDINANCE OR LAW
Coverage A-Undamaged Portion $5,000 Incl in Bldg Limit Included
Coverage B-Demolition $5,000 $10,000 Included
Coverage C-Increased Cost $5,000 $10,000 Included
Forms that apply to this building:
54835 (07-08) IL0017 (11-85) IL0261 (12-89) IL0003 (07-02) 59350 (01-15)
IL0160 (01-16) 64224 (01-16) 54753 (03-19) 59325 (12-19) 64329 (07-19)
CP0090 (07-88) 64000 (12-10) 64013 (12-10) 64010 (12-10) 64020 (12-10)
54585 (12-10) 64352 (12-20) 59390 (11-20)
PREMIUMCOMMERCIAL PROPERTY COVERAGE - LOCATION 0009 SUMMARY
TERRORISM - CERTIFIED ACTS SEE FORM: 59350, 54835, 59390 $7.00
LOCATION 0009 $741.00
LOCATION 0011 - BUILDING 0001
Location: 107 E Spruce St, Garden City, KS 67846-5446
Occupied As: Offices-Governmental
Secured Interested Parties: None
Rating Information
Construction: Mas N-C
Class Code: 0701
Protection Class: 02
Territory: 140 County: Finney
AGENCY POLICY NUMBER
INSURED to
Issued
125013-75347927-23A G INSURANCE
13-0065-00
Auto-Owners Ins. Co.
STATE OF KANSAS
Company Bill 75-50-KS-1212
10-06-2023
12-01-2023 12-01-2024
MKT TERR 118
COVERAGE COINSURANCE DEDUCTIBLE RATE PREMIUMLIMIT
BUILDING $357,400
(BLANKET)
Causes of Loss
Basic Group I 100% $5,000 0.017 $61.00
Basic Group II 100% $5,000 0.095 $340.00
Windstorm/Hail 100% 1% Included
Special 100% $5,000 0.026 $93.00
Theft 100% $5,000 Included
OPTIONAL COVERAGE
Inflation Guard Factor Building 1.000
Replacement Cost
Equipment Breakdown Excluded
ORDINANCE OR LAW
Coverage A-Undamaged Portion $5,000 Incl in Bldg Limit Included
Coverage B-Demolition $5,000 $10,000 Included
Coverage C-Increased Cost $5,000 $10,000 Included
Forms that apply to this building:
54835 (07-08) IL0017 (11-85) IL0261 (12-89) IL0003 (07-02) 59350 (01-15)
IL0160 (01-16) 64224 (01-16) 54753 (03-19) 59325 (12-19) 64329 (07-19)
CP0090 (07-88) 64000 (12-10) 64013 (12-10) 64010 (12-10) 64020 (12-10)
54585 (12-10) 64352 (12-20) 59390 (11-20)
PREMIUMCOMMERCIAL PROPERTY COVERAGE - LOCATION 0011 SUMMARY
TERRORISM - CERTIFIED ACTS SEE FORM: 59350, 54835, 59390 $5.00
LOCATION 0011 $499.00
LOCATION 0012 - BUILDING 0001
Location: 332 E 8Th St, Hays, KS 67601-4145
Occupied As: Offices-Governmental
Secured Interested Parties: None
Rating Information
Construction: Mas N-C
Class Code: 0701
Protection Class: 02
Specific Rate - Building: 0.043
Territory: 130 County: Ellis
AGENCY POLICY NUMBER
INSURED to
Issued
125013-75347927-23A G INSURANCE
13-0065-00
Auto-Owners Ins. Co.
STATE OF KANSAS
Company Bill 75-50-KS-1212
10-06-2023
12-01-2023 12-01-2024
MKT TERR 118
COVERAGE COINSURANCE DEDUCTIBLE RATE PREMIUMLIMIT
BUILDING $821,900
(BLANKET)
Causes of Loss
Basic Group I 100% $5,000 0.018 $148.00
Basic Group II 100% $5,000 0.098 $805.00
Windstorm/Hail 100% 1% Included
Special 100% $5,000 0.027 $222.00
Theft 100% $5,000 Included
OPTIONAL COVERAGE
Inflation Guard Factor Building 1.000
Replacement Cost
Equipment Breakdown Excluded
ORDINANCE OR LAW
Coverage A-Undamaged Portion $5,000 Incl in Bldg Limit Included
Coverage B-Demolition $5,000 $10,000 Included
Coverage C-Increased Cost $5,000 $10,000 Included
Forms that apply to this building:
54835 (07-08) IL0017 (11-85) IL0261 (12-89) IL0003 (07-02) 59350 (01-15)
IL0160 (01-16) 64224 (01-16) 54753 (03-19) 59325 (12-19) 64329 (07-19)
CP0090 (07-88) 64000 (12-10) 64013 (12-10) 64010 (12-10) 64020 (12-10)
54585 (12-10) 64352 (12-20) 59390 (11-20)
PREMIUMCOMMERCIAL PROPERTY COVERAGE - LOCATION 0012 SUMMARY
TERRORISM - CERTIFIED ACTS SEE FORM: 59350, 54835, 59390 $12.00
LOCATION 0012 $1,187.00
LOCATION 0014 - BUILDING 0001
Location: 203 N 10Th St # Th, Salina, KS 67401-2115
Occupied As: Offices-Governmental
Secured Interested Parties: None
Rating Information
Construction: Mas N-C
Class Code: 0701
Protection Class: 02
Territory: 425 County: Saline
AGENCY POLICY NUMBER
INSURED to
Issued
125013-75347927-23A G INSURANCE
13-0065-00
Auto-Owners Ins. Co.
STATE OF KANSAS
Company Bill 75-50-KS-1212
10-06-2023
12-01-2023 12-01-2024
MKT TERR 118
COVERAGE COINSURANCE DEDUCTIBLE RATE PREMIUMLIMIT
BUILDING $758,200
(BLANKET)
Causes of Loss
Basic Group I 100% $5,000 0.018 $136.00
Basic Group II 100% $5,000 0.098 $743.00
Windstorm/Hail 100% 1% Included
Special 100% $5,000 0.027 $205.00
Theft 100% $5,000 Included
OPTIONAL COVERAGE
Inflation Guard Factor Building 1.002
Replacement Cost
Equipment Breakdown Excluded
ORDINANCE OR LAW
Coverage A-Undamaged Portion $5,000 Incl in Bldg Limit Included
Coverage B-Demolition $5,000 $10,000 Included
Coverage C-Increased Cost $5,000 $10,000 Included
Forms that apply to this building:
54835 (07-08) IL0017 (11-85) IL0261 (12-89) IL0003 (07-02) 59350 (01-15)
IL0160 (01-16) 64224 (01-16) 54753 (03-19) 59325 (12-19) 64329 (07-19)
CP0090 (07-88) 64000 (12-10) 64013 (12-10) 64010 (12-10) 64020 (12-10)
54585 (12-10) 64352 (12-20) 59390 (11-20)
PREMIUMCOMMERCIAL PROPERTY COVERAGE - LOCATION 0014 SUMMARY
TERRORISM - CERTIFIED ACTS SEE FORM: 59350, 54835, 59390 $11.00
LOCATION 0014 $1,095.00
LOCATION 0016 - BUILDING 0001
Location: 1430 Sw Topeka Blvd, Topeka, KS 66612-1945
Occupied As: Offices-Governmental
Secured Interested Parties: None
Rating Information
Construction: Fire Resist
Class Code: 0701
Protection Class: 02
Specific Rate - Building: 0.016
AGENCY POLICY NUMBER
INSURED to
Issued
125013-75347927-23A G INSURANCE
13-0065-00
Auto-Owners Ins. Co.
STATE OF KANSAS
Company Bill 75-50-KS-1212
10-06-2023
12-01-2023 12-01-2024
MKT TERR 118
COVERAGE COINSURANCE DEDUCTIBLE RATE PREMIUMLIMIT
BUILDING $5,331,800
(BLANKET)
Causes of Loss
Basic Group I 100% $5,000 0.019 $1,013.00
Basic Group II 100% $5,000 0.067 $3,572.00
Windstorm/Hail 100% 1% Included
Special 100% $5,000 0.031 $1,653.00
Theft 100% $5,000 Included
OPTIONAL COVERAGE
Inflation Guard Factor Building 1.003
Replacement Cost
Equipment Breakdown Excluded
ORDINANCE OR LAW
Coverage A-Undamaged Portion $5,000 Incl in Bldg Limit Included
Coverage B-Demolition $5,000 $10,000 Included
Coverage C-Increased Cost $5,000 $10,000 Included
Forms that apply to this building:
54835 (07-08) IL0017 (11-85) IL0261 (12-89) IL0003 (07-02) 59350 (01-15)
IL0160 (01-16) 64224 (01-16) 54753 (03-19) 59325 (12-19) 64329 (07-19)
CP0090 (07-88) 64000 (12-10) 64013 (12-10) 64010 (12-10) 64020 (12-10)
54585 (12-10) 64352 (12-20) 59390 (11-20)
PREMIUMCOMMERCIAL PROPERTY COVERAGE - LOCATION 0016 SUMMARY
TERRORISM - CERTIFIED ACTS SEE FORM: 59350, 54835, 59390 $62.00
LOCATION 0016 $6,300.00
LOCATION 0017 - BUILDING 0001
Location: 427 Sw Topeka Blvd, Topeka, KS 66603-3151
Secured Interested Parties: None
Rating Information
Construction: Masonry
Class Code: 1070
Protection Class: 02
Class Rate - Building: 0.219
AGENCY POLICY NUMBER
INSURED to
Issued
125013-75347927-23A G INSURANCE
13-0065-00
Auto-Owners Ins. Co.
STATE OF KANSAS
Company Bill 75-50-KS-1212
10-06-2023
12-01-2023 12-01-2024
MKT TERR 118
COVERAGE COINSURANCE DEDUCTIBLE RATE PREMIUMLIMIT
BUILDING $697,900
(BLANKET)
Causes of Loss
Basic Group I 100% $5,000 0.018 $126.00
Basic Group II 100% $5,000 0.098 $684.00
Windstorm/Hail 100% 1% Included
Special 100% $5,000 0.027 $188.00
Theft 100% $5,000 Included
OPTIONAL COVERAGE
Inflation Guard Factor Building 1.003
Replacement Cost
Equipment Breakdown Excluded
ORDINANCE OR LAW
Coverage A-Undamaged Portion $5,000 Incl in Bldg Limit Included
Coverage B-Demolition $5,000 $10,000 Included
Coverage C-Increased Cost $5,000 $10,000 Included
Forms that apply to this building:
59350 (01-15) 54835 (07-08) IL0017 (11-85) IL0003 (07-02) IL0160 (01-16)
IL0261 (12-89) 64224 (01-16) 54753 (03-19) 59325 (12-19) 64329 (07-19)
CP0090 (07-88) 64000 (12-10) 64013 (12-10) 64010 (12-10) 64020 (12-10)
54585 (12-10) 64352 (12-20) 59390 (11-20)
PREMIUMCOMMERCIAL PROPERTY COVERAGE - LOCATION 0017 SUMMARY
TERRORISM - CERTIFIED ACTS SEE FORM: 59350, 54835, 59390 $10.00
LOCATION 0017 $1,008.00
LOCATION 0018 - BUILDING 0001
Location: 10900 S Clay Blair Blvd, Olathe, KS 66061-1301
Occupied As: Human/Animal R&D Fac
Secured Interested Parties: None
Rating Information
Construction: Non-Comb
Class Code: 0702
Class Rate - Building: 0.218
Protection Class: 01
Rated As Sprinklered
Territory: 230 County: Johnson
AGENCY POLICY NUMBER
INSURED to
Issued
125013-75347927-23A G INSURANCE
13-0065-00
Auto-Owners Ins. Co.
STATE OF KANSAS
Company Bill 75-50-KS-1212
10-06-2023
12-01-2023 12-01-2024
MKT TERR 118
COVERAGE COINSURANCE DEDUCTIBLE RATE PREMIUMLIMIT
BUILDING $13,859,000
(BLANKET)
Causes of Loss
Basic Group I 100% $5,000 0.019 $2,633.00
Basic Group II 100% $5,000 0.067 $9,286.00
Windstorm/Hail 100% 1% Included
Special 100% $5,000 0.031 $4,296.00
Theft 100% $5,000 Included
OPTIONAL COVERAGE
Inflation Guard Factor Building 1.000
Replacement Cost
Equipment Breakdown Excluded
ORDINANCE OR LAW
Coverage A-Undamaged Portion $5,000 Incl in Bldg Limit Included
Coverage B-Demolition $5,000 $10,000 Included
Coverage C-Increased Cost $5,000 $10,000 Included
Forms that apply to this building:
59350 (01-15) 54835 (07-08) IL0017 (11-85) IL0003 (07-02) IL0160 (01-16)
IL0261 (12-89) 64224 (01-16) 54753 (03-19) 59325 (12-19) 64329 (07-19)
CP0090 (07-88) 64000 (12-10) 64013 (12-10) 64010 (12-10) 64020 (12-10)
54585 (12-10) 64352 (12-20) 59390 (11-20)
PREMIUMCOMMERCIAL PROPERTY COVERAGE - LOCATION 0018 SUMMARY
TERRORISM - CERTIFIED ACTS SEE FORM: 59350, 54835, 59390 $162.00
LOCATION 0018 $16,377.00
AGENCY POLICY NUMBER
INSURED to
Issued
125013-75347927-23A G INSURANCE
13-0065-00
Auto-Owners Ins. Co.
STATE OF KANSAS
Company Bill 75-50-KS-1212
10-06-2023
12-01-2023 12-01-2024
MKT TERR 118
55056 (07-87)
SUPPLEMENTAL DECLARATIONS
BLANKET BLDG INSURANE LIMIT: $36,075,800
54585 (12-10)
This endorsement modifies insurance provided under the following:
BUILDING AND PERSONAL PROPERTY COVERAGE FORM
BUILDERS RISK COVERAGE FORM
CONDOMINIUM ASSOCIATION COVERAGE FORM
CONDOMINIUM COMMERCIAL UNIT-OWNERS COVERAGE FORM
The Windstorm or Hail Deductible, as shown in the Declarations and set forth in this endorsement, applies to covered loss or damage caused directly or indirectly by Windstorm or Hail. This Deductible applies to each occurrence of Windstorm or Hail.
Nothing in this endorsement implies or affords cover-age for any loss or damage that is excluded elsewhere in this policy. If you have a flood insurance policy, a separate Flood Deductible applies to loss or damage attributable to Flood, in accordance with the terms of that policy.
As used in this endorsement, the terms "specific in-surance" and "blanket insurance" have the following meanings:
a. Specific insurance covers each item of insurance (for example, each building or personal property in a building) under a separate Limit of Insurance.
b. Blanket insurance covers two or more items of in-surance (for example, a building and personal property in that building, or two buildings) under a single Limit of Insurance.
Items of insurance and corresponding Limit(s) of In-surance are shown in the Declarations.
WINDSTORM OR HAIL DEDUCTIBLE
CALCULATIONS
A. Calculation Of The Deductible - All Policies
1. A deductible is calculated separately for, and applies separately to:
a. Each building that sustains covered loss or damage;
b. Personal Property in or on the building or in the open (or in a vehicle) within 1,000 feet of the described premises that sustains covered loss or damage; and
c. Other Covered Property:
(1) That is scheduled in the Declarations;
and
(2) Sustains loss or damage.
If there is damage to both a building and per-sonal property as described in a. and b. above, separate deductibles apply to the building and to the personal property.
2. We will not pay for loss or damage until the amount of covered loss or damage exceeds the applicable Deductible. We will then pay the amount of covered loss or damage in excess of that Deductible, up to the applicable Limit of Insurance, after any reduction by any of the following:
a. Coinsurance Condition;
b. Agreed Value Optional Coverage; or
c. Any provision in a Value Reporting Form relating to full reporting or failure to submit reports.
3. When property is covered under Coverage Extension for Newly Acquired or Constructed Property: In determining the amount, if any, that we will pay for covered loss or damage, we will deduct an amount equal to a percentage of the value(s) of the property at time of loss. The applicable percentage for Newly Acquired or Constructed Property is the highest percentage shown in the Declarations for any described premises.
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
54585 (12-10) Copyright ISO Properties, Inc., 2006 Page 1 of 2
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WINDSTORM OR HAIL PERCENTAGE DEDUCTIBLE
B. Calculation Of The Deductible - Specific Insurance Other Than Builders' Risk
1. Property Not Subject To Value Reporting Forms
In determining the amount, if any, that we will pay for covered loss or damage, we will deduct an amount equal to the percentage (as shown in the Declarations) of the Limit(s) of Insurance applicable to the property that has sustained covered loss or damage.
2. Property Subject To Value Reporting Forms
In determining the amount, if any, that we will pay for covered loss or damage, we will deduct an amount equal to the percentage (as shown in the Declarations) of the value(s) of the property that has sustained covered loss or damage. The value(s) to be used are the latest value(s) shown in the most recent Report of Values on file with us.
However:
a. If the most recent Report of Values shows less than the full value(s) of the property on the report dates, we will determine the deductible amount as a percentage of the full value(s) as of the report dates.
b. If the first Report of Values is not filed with us prior to loss or damage, we will deter-mine the deductible amount as a percent-age of the applicable Limit(s) of Insurance.
C. Calculation Of The Deductible - Blanket Insurance Other Than Builders' Risk
1. Property Not Subject To Value Reporting Forms
In determining the amount, if any, that we will pay for covered loss or damage, we will deduct an amount equal to the percentage (as shown in the Declarations) of the value(s) of the property that has sustained covered loss or damage.
The value(s) to be used are those shown in the most recent Statement of Values on file with us.
2. Property Subject To Value Reporting Forms
In determining the amount, if any, that we will pay for property that has sustained covered loss or damage, we will deduct an amount equal to the percentage (as shown in the Declarations) of the value(s) of that property as of the time of covered loss or damage.
D. Calculation Of The Deductible - Builders' Risk In-surance
1. Builders' Risk Other Than Reporting Form
In determining the amount, if any, that we will pay for loss or damage, we will deduct an amount equal to the percentage (as shown in the Declarations) of the actual cash value(s) of that property as of the time of covered loss or damage.
2. Builders' Risk Reporting Form
In determining the amount, if any, that we will pay for covered loss or damage, we will deduct an amount equal to the percentage (as shown in the Declarations) of the value(s) of the property that has sustained covered loss or damage.
The value(s) to be used are the actual cash value(s) shown in the most recent Report of Values on file with us.
However:
a. If the most recent Report of Values shows less than the actual cash value(s) of the property on the report date, we will deter-mine the deductible amount as a percent-age of the actual cash value(s) as of the report date.
b. If the first Report of Values is not filed with us prior to covered loss or damage, we will determine the deductible amount as a percentage of the actual cash value(s) of the property as of the time of covered loss or damage.
All other policy terms and conditions apply.
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
54585 (12-10) Copyright ISO Properties, Inc., 2006 Page 2 of 2
54835 (7-08)
This endorsement modifies insurance provided under the following:
COMMERCIAL PROPERTY COVERAGE PART
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
54835 (7-08) Copyright ISO Properties, Inc., 2004 Page 1 of 2
A. Applicability Of This Endorsement
1. The provisions of this endorsement will apply if and when one of the following situations occurs:
a. The federal Terrorism Risk Insurance Program ("Program"), established by the Terrorism Risk Insurance Act of 2002 (in-cluding ensuing Congressional actions pursuant to the Act), terminates; or
b. The Program is renewed, extended or otherwise continued in effect:
(1) With revisions that increase insurers' statutory percentage deductible or decrease the federal government's statutory percentage share in poten-tial terrorism losses above such de-ductible, or that results in a change in the level or terms or conditions of coverage; and
(2) We are not required by the Program to make terrorism coverage available to you and elect not to do so.
2. When this endorsement becomes applicable in accordance with the terms of A.1.a. or A.1.b., above, it supersedes any terrorism endorsement already endorsed to this policy that addresses "certified acts of terrorism".
3. If this endorsement does NOT become appli-cable, then any terrorism endorsement al-ready endorsed to this policy, that addresses "certified acts of terrorism", will remain in effect. However, if the Program is renewed, extended or otherwise continued in effect with revisions that change the level or terms or conditions of coverage, and we are re-quired to offer you the revised coverage or to provide the revised coverage to those who previously accepted coverage under the Program, then we will take the appropriate steps in response to the federal require-ments.
B. The following definition is added and applies under this endorsement wherever the term terrorism is enclosed in quotation marks.
"Terrorism" means activities against persons, or-ganizations or property of any nature:
1. That involve the following or preparation for the following:
a. Use or threat of force or violence; or
b. Commission or threat of a dangerous act; or
c. Commission or threat of an act that inter-feres with or disrupts an electronic, com-munication, information, or mechanical system; and
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CONDITIONAL EXCLUSION OF TERRORISM
INVOLVING NUCLEAR, BIOLOGICAL OR CHEMICAL
TERRORISM (RELATING TO DISPOSITION OF FEDERAL
TERRORISM RISK INSURANCE ACT)
2. When one or both of the following applies:
a. The effect is to intimidate or coerce a gov-ernment or the civilian population or any segments thereof, or to disrupt any segment of the economy; or
b. It appears that the intent is to intimidate or coerce a government or the civilian popu-lation or to further political, ideological, religious, social or economic objectives or to express (or express opposition to) a philos-ophy or ideology.
C. The following exclusion is added:
Exclusion Of "Terrorism"
We will not pay for loss or damage caused directly or indirectly by "terrorism", including action in hinder-ing or defending against an actual or expected incident of "terrorism". Such loss or damage is ex-cluded regardless of any other cause or event that contributes concurrently or in any sequence to the loss. This exclusion applies only when one or more of the following are attributed to an incident of "terrorism":
1. The "terrorism" is carried out by means of the dispersal or application of radioactive material, or through the use of a nuclear weapon or device that involves or produces a nuclear reaction, nuclear radiation or radioactive contamination;
2. Radioactive material is released, and it appears that one purpose of the "terrorism" was to re-lease such material;
3. The "terrorism" is carried out by means of the dispersal or application of pathogenic or poisonous biological or chemical materials; or
4. Pathogenic or poisonous biological or chemical materials are released, and it appears that one purpose of the "terrorism" was to release such materials.
Multiple incidents of "terrorism" which occur within a 72-hour period and appear to be carried out in concert or to have a related purpose or common leadership will be deemed to be one incident, regardless of whether this endorsement was in effect during the entirety of that time period or not.
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
54835 (7-08) Copyright ISO Properties, Inc., 2004 Page 2 of 2
64329 (7-19)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CHANGES – DEPRECIATION
This endorsement modifies insurance provided under the following:
COMMERCIAL PROPERTY COVERAGE PART
Wherever it appears in this Coverage Part and any endorsement attached to this Coverage Part, depreciation means a decrease in value because of age, wear, obsolescence or market value and includes:
1. The cost of materials, labor and services;
2. Any applicable taxes; and
3. Profit and overhead necessary to repair, rebuild or replace lost or damaged property.
The meaning of depreciation in this endorsement supersedes any provision in this Coverage Part and any endorsement attached to this Coverage Part to the contrary.
All other policy terms and conditions apply.
64329 (7-19) Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1
64352 (12-20)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CHANGES - EXCLUSION FOR INSECTS, BIRDS,
RODENTS OR OTHER ANIMALS
This endorsement modifies insurance provided under the following:
CAUSES OF LOSS - SPECIAL FORM
B. EXCLUSIONS, 2.d.(5) is deleted and replaced by the following exclusion.
(5) Nesting or infestation, or discharge or release of waste products or secretions, by insects, birds, rodents or other animals.
All other policy terms and conditions apply.
64352 (12-20) Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1
59350 (1-15)
It is agreed:
1. With respect to any one or more certified acts of terrorism, we will not pay any amounts for which we are not respon-sible because of the application of any provision which results in a cap on our liability for payments for terrorism losses in accordance with the terms of the federal Terrorism Risk Insurance Act of 2002 (including ensuing Congres-sional actions pursuant to the Act).
2. Certified act of terrorism means any act certified by the Secretary of the Treasury, in consultation with:
a. the Secretary of Homeland Security; and
b. the Attorney General of the United States to be an act of terrorism as defined and in accordance with the federal Terrorism Risk Insurance Act of 2002 (includ-ing ensuing Congressional actions pursuant to the Act).
3. Under the federal Terrorism Risk Act of 2002 (including ensuing Congressional actions pursuant to the Act) a terrorist act may be certified:
a. if the aggregate covered commercial property and casualty insurance losses resulting from the terrorist act ex-ceed $5 million; and
b. (1) if the act of terrorism is:
a) a violent act; or
b) an act that is dangerous to human life, property or infrastructure; and
(2) if the act is committed:
a) by an individual or individuals as part of an effort to coerce the civilian population of the United States; or
b) to influence the policy or affect the conduct of the United States government by coercion.
All other policy terms and conditions apply.
CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM
AND
IMPORTANT INFORMATION REGARDING TERRORISM RISK
INSURANCE COVERAGE
59350 (1-15) Page 1 of 2
The Terrorism Risk Insurance Act of 2002 was signed into law on November 26, 2002. The Act (including ensuing Con-gressional actions pursuant to the Act) defines an act of terrorism, to mean any act that is certified by the Secretary of the Treasury, in consultation with the Secretary of Homeland Security and the Attorney General of the United States to be (i) an act of terrorism; (ii) to be a violent act or an act that is dangerous to human life, property or infrastructure; (iii) to have resulted in damage within the United States or outside the United States in the case of certain air carriers or vessels or the premises of a United States mission; and (iv) to have been committed by an individual or individuals as part of an ef-fort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States government by coercion.
Subject to the policy terms and conditions, this policy provides insurance coverage for acts of terrorism as defined in the Act.
Any coverage for certain commercial lines of property and casualty insurance provided by your policy for losses caused by certified acts of terrorism are partially paid by the federal government under a formula established by federal law. Un-der this formula, the government will reimburse us for 85% of such covered losses that exceed the statutory deductible paid by us. However, beginning January 1, 2016 the share will decrease 1% per calendar year until it equals 80%. You should also know that in the event aggregate insured losses exceed $100 billion during any year the Act is in ef-fect, then the federal government and participating United States insurers that have met their insurer deductible shall not be liable for the payment of any portion of that amount of the loss that exceeds $100 billion. In the event that aggregate insured losses exceed $100 billion annually, no additional claims will be paid by the federal gov-ernment or insurers. This formula is currently effective through December 31, 2020 unless extended.
The premium charge, if any, for this coverage is shown separately on the attached Declarations page. In the event of a certified act of terrorism, future policies also may include a government assessed terrorism loss risk-spreading premium in accordance with the provisions of the Act.
Please contact us if you would like to reject coverage for certified acts of terrorism.
59350 (1-15) Page 2 of 2
IMPORTANT INFORMATION REGARDING TERRORISM RISK
INSURANCE COVERAGE
59511 (6-22)
13-0065-00
Agency phone:
Auto-Owners Insurance Company
STATE OF KANSAS
DEPARTMENT OF LABOR AND COMMERCE
800 SW JACKSON ST STE 600
TOPEKA KS 66612-1216
A G INSURANCE
PO BOX 817
PERRY KS 66073-0817
10-11-2023
785-597-2444 www.auto-owners.com
You can view your policy or change your paperless options at any time online at .
RE: Policy
Thank you for selecting Auto-Owners Insurance Group to serve your insurance needs! Feel free to contact your independent Auto-Owners agent with questions you may have. If you have questions your agent is unable to answer, please contact us at 517.323.1200.
Auto-Owners and its affiliate companies offer a full complement of policies, each of which has its own eligibility requirements, coverages and rates. Please take this opportunity to review your insurance needs with your Auto-Owners agent, and discuss which company and program may be most appropriate for you.
Auto-Owners Insurance Company was formed in 1916. Our A++ (Superior) rating by A.M. Best Company signifies that we have the financial strength to provide the insurance protection you need. The Auto-Owners Insurance Group is comprised of six property and casualty companies and a life insurance company.
Serving Our Policyholders and Agents Since 1916
ADDRESS
POLICY NUMBER
INSURED
to
AGENCY
Issued
A G INSURANCE
785-597-244413-0065-00
6101 ANACAPRI BLVD., LANSING, MI 48917-3999
INSURANCE COMPANY
STATE OF KANSAS
DEPARTMENT OF LABOR AND COMMERCE
800 SW JACKSON ST STE 600
TOPEKA KS 66612-1216
Bill Company
75-50-KS-1212Company Use
10-11-2023
Policy Term
12-01-2023
12:01 a.m.
12-01-2024
12:01 a.m.
TAILORED PROTECTION POLICY DECLARATIONS
MKT TERR 118
12-01-2023EffectiveChange Endorsement
Description of Change
ALL COVERAGES FOR LOCATION 9 AT 2308 FIRST AVE, DODGE CITY, KS; HAS
BEEN DELETED.
ALL COVERAGES FOR LOCATION 14 AT 203 N 10TH ST, SALINA, KS; HAS BEEN
DELETED.
ALL COVERAGES FOR LOCATION 18 AT 10900 S CLAY BLAIR BLVD, OLATHE, KS
HAS BEEN DELETED.
Transaction Number: 002
Endorsement Premium: $14,305.00
RETURNED
AGENCY POLICY NUMBER
INSURED to
Issued
125013-75347927-23A G INSURANCE
13-0065-00
Auto-Owners Ins. Co.
STATE OF KANSAS
Company Bill 75-50-KS-1212
10-11-2023
12-01-2023 12-01-2024
MKT TERR 118
55056 (07-87)
SUPPLEMENTAL DECLARATIONS
BLANKET BLDG INSURANCE LIMIT: $20,944,900
| State of Kansas Dept. of Labor and Commer - policy Dec. 1 2023-2024.pdf |
| State of Kansas Dept. of Labor and Commer - policy endorsment.pdf |
File details come from the government source that posted it. Updated .