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L. STATEMENT OF VALUES Font,MLB-2k4
ty�tygy��...6 (FOR USE WITH INSTITUTIONAL PROGRAM) (Ed.5-69)
Page No 1
Board of County Commissioners
Policy Number Issued To of the County of Weld i____
r sr.
By Date 5/31/79 y, .
Name of Company .J*..
IMIIIIIIIIIR
Item DESCRIPTION AND LOCATION VALUES
T
No. OF PROPERTY Replacement Cost Organization Rating
Use
Specify A-Building B-Personal Property Actual Cash Value When Applicable
1 On a to Court House, 911 9th Ave. 3,047,000
2 On contents of Item #1 60,500
3 On a 1B-D Library, 227 23rd Ave,Sur # 29 425,250
4 On Contents of Item #3 60,500 At i ;f. .
5 On a 1E-D County Garage, 1500 2nd St. , 4;#'-‘-:‘,."-!,=.44,... .
Sur. #475
315,700
6 On contents of Item # 5 60,500
7 On a 1S Metal Shop & Shed, 1500 2nd S . ,
Sur. #475 42,350
8 On Contents of Item #7 30,250
9 On the 1D Oil Warehouse, 1420 2nd St. ,
Sur. #476 4,840 L .
10 On Contents of Item #9 9,075
11 On the 1B Driver's License Bureau. _ -4
Island Grove Sur. #501 30,250 pilmommom
12 On Contents of Item #11 12,100
13 On the 1BX Animal Bldg. , Island Grove
Sur. #501 12,100
14 On the 10 Poultry Exchange Bldg. 14,520
15 On Contents of Item #15 6;050
16- On the 10 Rabbit Exhibit 12,100
17 On the is Crop Bldg. 18,150 ' .'X^ rr
`
INSTRUCTIONS:
1. The values shown should reflect the basis of coverage (ACV or Replacement Cost) for each item and for either Coverage A -
— Buildings, Coverage B — Personal Property or both.
2. Include in building values '
a. building service and maintenance equipment owned by the insured, pp� "
b. floor coverings fastened to floors or walls, fixed seats and desks, fixed tables, railings, altars, clocks, bells, fire curtains, IKi�' s`4
and stained glass windows,
c. all permanent fixtures (including organ(s)) being a permanent part of the building,
d. mirrors, air conditioners, domestic appliances, fire extinguishing equipment, outdoor equipment. Ciac.:....»4a'?-4-.
3. Include in personal property values, personal property, including the legal liability of the insured for similar property belong- rrr:es.,Z.,:tra'-...v.'
ing in whole or in part to others and held by the insured, in each building which is not otherwise a part of building values.
4. The following are not covered and their value should not be included in values shown: p..
a. brick, stone or concrete foundations which are below the undersurface of the lowest basement floor, or where there is no
basement, which are below the surface of the ground inside the foundation walls of the building,
b. foundations of machinery or boilers and engines which are below the surface of the ground,
c. pilings, piers, pipes, flues, wiring and drains which are underground,
d. those portions of walks, roadways and other paved surfaces which are outside of buildings, - '
e. land values, cost of excavations, grading or filing, - -
f. lawns, trees, shrubs, plants, growing crops,
g. motor boats, sail boats, aircraft, automobiles and self-propelled vehicles or machines except motorized equipment not ...... .
licensed for us on public thoroughfares and operated principally on the premises,
h. animals and pets, """"agar..`
i. household furniture in apartments occupied by the insured,any officer,director, stockholder or partner of the insured or any
relative of the foregoing. NAM +r..
5. Nothing contained in these instructions shall be construed as changing in any manner the conditions of the policy. rte. .•
Form MLB-24(Ed.5-69) �.,y._ (OVER) Page 1 of 2 I'''''''''""•
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4.
STATEMENT OF VALUES Form MLB-24
(Ed.5-69)
• t (FOR USE WITH INSTITUTIONAL PROGRAM)
Page No 2
Board of County Commissioners
Policy Number Issued To of the County of Weld ._.
By Date 5/31/79
Name of Company
DESCRIPTION AND LOCATION VALUES
Item OF PROPERTY This Space for Rating
No. Replacement Specify A-Building B-Personal Property Actual Cash Value When h Applicable
Cost Organization Use
cable
18 On the 1B 4H and Home Dem. Bldg. ,
Island Grove 382,800
19 On Contents of Item #18 15,000 '�--�-
20 On the 1S Livestock Exhibit, Island j ...'
Grove 157,300 ,:. ,3/4"
21 On the 1D South Barn, Island Grove 12,100
22 On the 1O North Barn (Stable) Island
Grove 12,100
23 On the 1S Seed Bldg. , Island Grove 12,100
24 On the Contents of Item #23 6,050
25 On the 1S Storage Bldg. , Galeton 6,050
26 On the Contents of Item #25 2,000 ------
27 On the 1D Dwelling, Grover, CO 12,100
28 On the 1D Dwelling, Stoneham, CO 18,150
29 On the 1D Garage Buckingham, CO 6,050
30 On the Contents of Item #29 3,025
31 On a ISIC Garage, Briggsdale, CO 12,100
32 On Contents of Item #31 3,025
33 On a 1DX Dwelling, Briggsdale, CO 18,150
34 On a 1DX-D Garage, Windsor, CO 18,150
35- On a 1LC Garage & Equip. Repair Bldg. ,
Dacona, CO 12,100
INSTRUCTIONS:
1. The values shown should reflect the basis of coverage (ACV or Replacement Cost) for each item and for either Coverage A 1. ...="P"'"="m
— Buildings, Coverage B — Personal Property or both.
2. Include in building values
a. building service and maintenance equipment owned by the insured,
b. floor coverings fastened to floors or walls, fixed seats and desks, fixed tables, railings, altars, clocks, bells, fire curtains, t¢^e h - 404
and stained glass windows,
c. all permanent fixtures (including organ(s)) being a permanent part of the building,
d. mirrors, air conditioners, domestic appliances, fire extinguishing equipment, outdoor equipment. ► i Alto!tio nfi
3. Include in personal property values, personal property, including the legal liability of the insured for similar property belong- �65p,."h.,..„4 -,,
ing in whole or in part to others and held by the insured, in each building which is not otherwise a part of building values.
4. The following are not covered and their value should not be included in values shown:
a. brick, stone or concrete foundations which are below the undersurface of the lowest basement floor, or where there is no -
basement, which are below the surface of the ground inside the foundation walls of the building,
b. foundations of machinery or boilers and engines which are below the surface of the ground,
c. pilings, piers, pipes, flues, wiring and drains which are underground,
d. those portions of walks, roadways and other paved surfaces which are outside of buildings,
e. land values, cost of excavations, grading or filing,
f. lawns,trees, shrubs, plants, growing crops, .- -
g. motor boats, sail boats, aircraft, automobiles and self-propelled vehicles or machines except motorized equipment not
licensed for us on public thoroughfares and operated principally on the premises,
h. animals and pets,
i. household furniture in apartments occupied by the insured,any officer,director,stockholder orpartner of the insured or any
relative of the foregoing.
5. Nothing contained in these instructions shall be construed as changing in any manner the conditions of the policy. -•i •- `
Form MLB-24(Ed.5-69) (OVER) Page 1 of 2 ^�
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�'•. STATEMENT OF VALUES Form M sB-24
(EdIlk (FOR USE WITH INSTITUTIONAL PROGRAM)
Page No 3 -
Board of County Commissioners
Policy Number Issued to of the County of Weld
By Date 5/31/79 'T. 71t. u'r,•;tj.
,IbName of Company jJ it!.. '
BEM
Item DESCRIPTION AND LOCATION VALUES -.
No. OF PROPERTY This Space for Rating
Specify A-Building B-Personal Property Actual Cash Value Replacement Cost Organization Use
When Applicable
36 On a 1LC Garage & Storage Bldg. ,
Mead, CO 6,050
37 On a is Maintenance Garage, Johnstown 42,350
38 On Contents of Item #37 12,100
gBldg. , Johnstown, CO 18,150 s+
39 On a 1S Bridge .:
t
40 On Contents of Item #39 12,100
41 On a 1LC Truck & Equip. Garage, riamem �
Johnstown, CO 36,300
42 On Contents of Item #41 14,520 t
43 On a 1LC Garage, LaSalle, CO 24,200 I
44 On Contents of Item #43 12,100 .
45 On a 1S Garage & Shop, LaSalle 18,150
46 On Contents of Item #45 15,125
47 On a 1S Office & Shop, LaSalle, CO 30,250 A-4. t �,
48 On contents of Item #47 12,100
49 On a 1D Garage, Kersey, CO 6,050 mowilma*..
50 On a 1LC Garage, Platteville, CO 12,100
51 On a is Garage, Gill, CO 6,050
52 On a 1D Garage, Gill, CO 3,630
53 On a 1D Dwelling, Kiowa, CO 18,150
54_ On a 1S Garage, Kiowa, CO 2,420 k_
55 On a 1S Garage, Hudson, CO 3,620 a ,i"°'-s.
INSTRUCTIONS: MI , -
'w
I. The values shown should reflect the basis of coverage (ACV' or Replacement Cost) for each item and for either Coverage A ! 's 'amiews'a
— Buildings, Coverage B — Personal Property or both.
2. Include in building values
a. building service and maintenance equipment owned by the insured,
b. floor coverings fastened to floors or walls, fixed seats and desks, fixed tables, railings, altars, clocks, bells, fire curtains,
and stained glass windows, . -<y .
c. all permanent fixtures - y�
(including organ(s)) being a permanent part of the building, � -
d. mirrors, air conditioners, domestic appliances, fire extinguishing equipment, outdoor equipment. -t`S'4'42 *•;,
3. Include in personal property values, personal property, including the legal liability of the insured for similar property belong- i...--.
ing in whole or in part to others and held by the insured, in each building which is not otherwise a part of building values.
4. The following are not covered and their value should not be included in values shown: i .
a. brick, stone or concrete foundations which arc below the undersurface of the lowest basement floor, or where there is no
basement, which are below the surface of the ground inside the foundation walls of the building,
b. foundations of machinery or boilers and engines which are below the surface of the ground,
c. pilings, piers, pipes, flues, wiring and drains which are underground, f -
d. those portions of walks, roadways and other paved surfaces which are outside of buildings, i.
e. land values, cost of excavations, grading or filing,
f. lawns, trees, shrubs, plants, growing crops, i
g. motor boats, sail boats, aircraft, automobiles and self-propelled ve hides or machines except motorized equipment not L.
licensed for us on public thoroughfares and operated principally on the premises,
h. animals and pets,
i. household furniture in apartments occupied by the insured, any officer,director, stockholder or partner of the insured or any relative of the foregoing. ty,�
5. Nothing contained in these instructions shall be construed as changing in any manner the conditions of the policy. .,�•
Form MLB-24(Ed.5-69) (OVER) Page 1 of 2 sa
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STATEMENT OF VALUES Form MLB-24 " ''' .re a" ''
•.It e (FOR USE WITH INSTITUTIONAL PROGRAM) (Ed.5-69)
Page No 4
Board of County Commissioners
l.
Policy Number Issued To of the County of Weld
By Date 5/31/79 tsn u -
'• •,'r,
Name of CompanyIIIIIIIIIIIMIIIIIIIIIIIIII
•.,riot
VALUES
Item DESCRIPTION AND LOCATION ,-
No. OF PROPERTY This Space for Rating
Specify A-Building B-Personal Property Actual Cash Value Replacement Cost Organization Use
When Applicable
56 On a 1S Garage, Gilcrest, CO 6,050
57 On a 15 Garage, Ft. Lupton, CO 4,840
58 On a 1S Garage, Keenesburg, CO 4,840
59 On a 1BD Repair Shop, Ault, CO 12,100 •
60 On Contents of Item #59 12,100 ' , : r
61 On a 1D Oil Warehouse, Ault, CO 3,630
62 On Contents of Item #61 4,840 r...........—.
63 On a lD Car Garage, Ault, CO 3,630
64 On a 13 Machine Shed, Ault, CO 36,300
65 On a 1S Machine Shed, Ault, CO 42,350
66 On Contents of Item #65 6,050
67 On a 11C Warehouse & Garage, Ault, CO 18,150
68 On Contents of Item #67 18,150
69 On a 1D Garage at Ault, CO 18,150 ','r
70 On Contents of Item #69 2,420
71 On a 11C Garage, Nunn, CO 7,260 PEIMPIIIIIIIMIIIIMPIP
72 On Contents of Item #71 2,420
73 On a 11C Garage, Hereford, CO 4,840
74 On the 1S Garage, Hereford, CO 9,680
75 On Contents of Item #74 2,420
76_ On a 1DX Dwelling, Hereford, CO 12,100 •
77 On a 1D Garage, Grover, CO 7,260 '
,, .,. w .a
INSTRUCTIONS:
1. The values shown should reflect the basis of coverage (ACV or Replacement Cost) for each item and for either Coverage A
— Buildings, Coverage B — Personal Property or both.
2. Include in building values y,
a. building service and maintenance equipment owned by the insured,
b. floor coverings fastened to floors or walls, fixed seats and desks, fixed tables, railings, altars, clocks, bells, fire curtains, ;:y av y„s.,
and stained glass windows,
1,-.44 -J elf'
c. all permanent fixtures (including organ(s)) being a permanent part of the building, ... :-
d. mirrors, air conditioners, domestic appliances, fire extinguishing equipment, outdoor equipment.
3. Include in personal property values, personal property, including the legal liability of the insured for similar property belong- ,
ing in whole or in part to others and held by the insured, in each building which is not otherwise a part of building values. tiv2 soisvza2CY.:'L
4. The following are not covered and their value should not be included in values shown: -
a. brick, stone or concrete foundations which are below the undersurface of the lowest basement floor, or where there is no p.
basement, which are below the surface of the groun ci inside the foundation walls of the building,
b. foundations of machinery or boilers and engines which arc below the surface of the ground,
c. pilings, piers, pipes, flues, wiring and drains which are underground, `' '" `
d. those portions of walks, roadways and other paved surfaces which arc outside of buildings, P-'
e. land values, cost of excavations, grading or filing, %
f. lawns, trees, shrubs, plants, growing crops,
g. motor boats, sail boats, aircraft, automobiles and self-propelled vehicles or machines except motorized equipment not
licensed for us on public thoroughfares and operated principally on the premises, -
h. animals and pets, _
L household furniture in apartments occupied by the insured, any officer, director, stockholder or partner of the insured or any �a
relative of the foregoing.S. Nothing contained in these instructions shall be construed as changing in any manner the conditions of the policy. `..3�'`o ht f,.
Form MLB-24(Ed.5-69) (OVER) Page 1 of 2
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