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Agmt25 Blacksmith (2048 Broadway)
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Agmt25 Blacksmith (2048 Broadway)
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Last modified
10/16/2025 4:03:19 PM
Creation date
10/16/2025 4:02:22 PM
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Agreement
PROJECT NAME
Outdoor Business Activity License Agreement_9.23.2025
RMP File Number
304.5
Date
9/23/2025
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PRODUCER <br />_ Bruce Lyons <br />3 Page Policy Summary (Declarations) Page LLC Pacific Insurance Marketing <br />THREE <br />BY BERKSHIRE HATHAWAY 77 Mark or #24 <br />San Rafael, CA, 94903 <br />Policy Number: PCA602577E Policy Period: 06/22/2025 to 06/22/2026 @12:01 AM <br />This Policy Issued By: Berkshire Hathaway Direct Insurance Company. A Nebraska Stock Insurance Company. <br />Named Insured (Your Business): Phone: (650) 365-3320 <br />Barrel Dog, Inc. dba Blacksmith Email: theblacksmithbar@gmail.com <br />138 Loma Vista Dr [Additional Insureds Listed on Extension] <br />Burlingame, CA 94010 <br />What's insured & for how much: <br />The table below shows the insured buildings, and the Deductible and Limit for each Coverage. We will pay <br />up to the Limit after a loss is more than the Deductible. If your business has more than one loss, it must pay <br />a separate Deductible for each loss. We will pay up to the Limit for each loss, except for Business Liability, <br />where there is a Maximum Limit. After we have paid the Maximum Limit, we will no longer pay any amounts <br />for Business Liability under this policy <br />I COVERAGE FOR LIMIT DEDUCTIBLE <br />Business Liability <br />Cyber Incident Response <br />All Other Property <br />Business Interruption (Net Income) <br />Earthquake Damage <br />Flood <br />$1,000,000 per occurrence, $0 <br />$3,000,000 Maximum <br />$250,000 <br />$154,875 <br />Up to 1 year, $557,550 <br />NOT PURCHASED <br />NO CHANGE <br />$0 <br />$2,500 <br />3 day waiting period <br />NO CHANGE <br />Estimated Premium: $29,364.15 (Subject to Audit When Permitted or Required by Law) <br />Cancellation: Your business may cancel for any reason by written request for a future date. We may only cancel <br />as allowed by California law, at least for 30 days before cancellation or 10 if for nonpayment of premium. We will <br />send a notice to the address above, and any additional interests requiring notice, that explains the cancellation <br />and the effective date. After cancellation, the premium will be adjusted proportionately based on the time the <br />policy was in effect. <br />Policy Forms & Endorsements: <br />3 Page Policy Form 3PG 00 00 - 06/24 <br />California Supplement 3PG CA 01 - 06/24 <br />3PG COVEX 01 - 11/22 <br />3PG EXWC 01 - 01/23 <br />- THREE To Report a Claim or For Questions: Call 1-800-507-4495 or Log On httos://threeinsurance.com/ <br />BY BERKSHIRE HATHAWAY 3PG 00 00 - 06/24 <br />ATTY/AGR.2025.229/Barrel Dog, Inc. dba Blacksmith (2048 Broadway - Blacksmith) (Page 28 of 44) <br />
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