HomeMy WebLinkAboutInsurance Certificate: Fitch Family Trust
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State Farm Fire and Casualty Company
PO Box 5000
Dupont, WA 98327-5000
RENEWAL CERTIFICATE
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Rental Dwelling Pol - Special Form
OCT 02 2008 to OCT 02 2009
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11.1..1...1.1.1...1.111......111..1....11.1..1..1.111.11...111
BILLED THROUGH SFPP
Coverages and Limits
Section I
A Dwelling
Dwelling Extension
B Personal Property
C Loss of Rents
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0-15- 9303.F472
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003707
CITY OF ASHLAND
BUILDING DEPT
20 E MAIN S1
ASHLAND OR 97520-1814
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
Registered Domestic Partnrship
FP-8129
FE-57G8
FE-7540
FE-8237.2
OPT AI
FE-5781
FE-5782.1
FE-5827
FE-6858
Annual Premium
$1,702.00
Premium Reductions
See schedule page(s).
Inflation Coverage Index: 225.2
i This policy does not provide earthquake coverage. If you are interested in obtaining earthquake coverage,
~ please contact your State Farm agent for more information concerning the coverage and eligibility
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9041 901 M Agent PAUL FINCH
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If you have moved, please contact your agent.
See reverse side for important information.
REP
Prepared AUG 08 2008
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State Farm Fire and Casualty Company
PO Box 5000
Dupont, WA 98327-5000
RENEWAL CERTIFICATE
SCHEDULE PAGE
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0-15- 9303-F472 R F
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R ENTAL DWELLING SCH EDULE PAG E
OCT 02 2008 to OCT 02 2009
CONTIN U ED
003707
CITY OF ASHLAND
BUILDING DEPT
20 E MAIN ST
ASHLAND OR 97520-1814
11.1..1...1.1.1...1.111......111..1....11.1..1..1.111......111
Location
Number Location of Premises Coverages and Limits Discounts Applied Premium
1. 117 6TH ST Dwellin~ $85,700 $251.00
ASHLAND OR Owe 1 Ex 8,570 Home Alert
97520-2017 Per Prop 4,285
2. 119 6TH ST Dwellin~ $59,100 $200.00
ASHLAND OR Dwel Ex 5,910 Home Alert
97520-2017 Per Prop 2,955
3. 123 & 123 1/2 6TH ST Dwellin~ $166,500 $417.00
ASHLAND OR Dwel Ex 16,650 Home Alert
97520 Per Prop 8,325
4. 127 6TH ST Owellin~ $60,600 $203.00
ASHLAND OR Dwel Ex 6,060 Home Alert
97520-2017 Per Prop 3,030
5. 549 FAIRVIEW Owellin~ $136,200 $357.00
ASHLAND OR Owel Ex 13,620 Home Alert
97520-2977 Per Prop 6,810
6. 148 OHIO ST Dwellin~ $96,800 $274.00
ASHLAND OR Owel Ex 9,680 Home Alert
97520-1119 Per Prop 4,840
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Agent PAUL FINCH
Telephone (541) 482-2461 or (866) 482-2461
REP
Prepared AUG 08 2008
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