HomeMy WebLinkAboutFitch Family Trust
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State Farm Fire and Casualty Company
PO Box 5000
Dupont, WA 98327-5000
RENEW At CERTIFICATE
POLICY NUMBER 9H~Q-4552~3
Rental Dwelling Pol - Special Form
OCT 02 2007 to OCT 02 2008
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0-15- 93C3-F472F R
10467
CITY OF ASHLAND
BUILDING DEPT
20 E MAIN ST
ASHLAND OR 97520-1850
BILLED THROUGH SFPP
11.1..1...1.1.1...1.111......111..1..1.1.11...1.1..1.1...1.1.1
Coverages and Limits
Section I
A Dwelling
Dwelling Extension
B Personal Property
C Loss of Rents
See Schedule
See Schedule
See Schedule
Actual Loss
Deductibles - Section I
Basic
5,000
Insured: FITCH FAMILY TRUST
Locations: Refer to schedule page
SFPP No: 0024794815
Add Ins: CITY OF ASHLAND
BUILDING DEPT
Section II
L Business Liab (per occurrence)
(annual aggregate)
M Medical Payments to Others
(each person)
$1,000,000
2,000,000
5,000
Forms, Options, and Endorsements
Special Form 3
Modified Replacement Cost
Debris Removal Endorsement
Amendatory Endorsement
Additional Insured
Multiple Locations Endorsement
Amendatory Collapse
Fungus & Seepage or Leak Excl
FP-8129
FE-5768
FE-7540
FE-8237.2
OPT AI
FE-5781
FE-5782.1
FE-5827
Annual Premium
$2,012.00
Premium Reductions
See schedule page(s).
Inflation Coverage Index: 222.7
~ This policy does not provide earthquake coverage. If you are interested in obtaining earthquake coverage,
g please contact your State Farm agent for more information concerning the coverage and eligibility
~ criteria.
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10467 901 M Agent PAUL FINCH
N Telephone (541) 482-2461
If you have moved, please contact your agent.
See reverse side for important information.
REP
Prepared AUG 08 2007
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State Farm Fire and Casualty Company
PO Box 5000
Dupont, WA 98327-5000
RENEWAL CERTIFICATE SCHEDULE PAGE
POLICY NUMBER 97~BQ"4552..3
RENTAL DWELLING SCHEDULE PAGE
OCT 022007 to OCT 022008
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D-15-93C3-F472 FR
10468
CITY OF ASHLAND
BUILDING DEPT
20 E MAIN ST
ASHLAND OR 97520-1850
CONTINUED
11.1..1...1.1.1...1.111......111..1..1.1.11...1.1..1.1...1.1.1
Location
Number Location of Premises Coverages and Limits Discounts Applied Premium
1. 117 6TH ST Dwe11in~ $84,700 $296.00
ASHLAND OR Dwel Ex 8,470 Home Alert
97520-2017 Per Prop 4,235
2. 119 6TH ST Owe 11 i n~ $58,400 $234.00
ASHLAND OR Dwel Ex 5,840 Home Alert
97520-2017 Per Prop 2,920
3. 123 & 123 1/2 6TH ST Owe 11 i n~ $164,600 $498.00
ASHLAND OR Owe 1 Ex 16,460 Home Alert
97520 Per Prop 8,230
4. 127 6TH ST Dwe11in~ $59,900 $238.00
ASHLAND OR Dwel Ex 5,990 Home Alert
97520-2017 Per Prop 2,995
5. 549 FAIRVIEW Owe 11 i n~ $134,700 $423.00
ASHLAND OR Owe 1 Ex 13,470 Home Alert
97520-2977 Per Prop 6,735
6. 148 OHIO ST Dwe11in~ $95,700 $323.00
ASHLAND OR Dwel Ex 9,570 Home Alert
97520-1119 Per Prop 4,785
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10468
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Agent PAUL FINCH
Telephone (541) 482-2461
REP
Prepared AUG 08 2007