HomeMy WebLinkAboutPRYOR, ROBERT & DONNA - INSURANCE CERTIFICATEStateFarm State Farm Fire and Casualty Company RENEWAL CERTIFICATE ❑
P.O. Box82542 P6L�Yt9UM9ER 08-BL-3340.7
• Lincoln, NE 68501-2542
Fem/Pnnn6 PnLni
252014 to JUN 252015
NO
AT1
Y-20- 2544-FAFi
001923 0001
CITY OF FORT COLLINS
215 N MASON ST FL 2
FORT COLLINS CO 80524-4402
III III I11I11IIIII11III11II'I1illi1lll'1I1IIIIII1111iil1liiitIII II
Insured: PRYOR, ROBERT B & DONNA
Location
See schedule page(s) for location of premises
Loss Settlement Provisions (See Policy)
A2 Replacement Cost -Common Construction -Coverage A
Bt Limited Replacement Cost - Coverage B
Forms, Options, and Endorsements
Farm/Ranch Policy
FP-8105
Ordinance/Law 105/6/ $17,600
OPT OL
Special Limits - Money/Jf
FE-8689
Farm/Ranch Policy Endorsement
FE-1302
Fungus (Including Mold) Excl
FE-8728
Terrorism Insurance Cov Notice
FE-6999
Increase Dwlg up to $35,200
OPT ID
Policy Endorsement
FE-8733
Mandatory Reportng Endorsement
FE-5801
Additional Insured Endorsement
FE-8568
Civil Union Endorsement
FE-8790
Equipment Breakdown Coverage
FE-1320
I TO BE PAID BY INSURED I
Coverages and Limits
Section I
A Dwelling
B Personal Property
C Loss of Use
Deductibles - Section I
All Losses
$176000
132:000
Actual Loss
500
Section II
L Farm Liability
(each occurrence) 500,000
(annual aggregate) 1,000,000
M Medical Payments (each person) 1, 000
Annual Premium
Premium Reductions
Renewal Discount
Inflation Coverage Index:
228.4
EQUIPMENT BREAKDOWN is an optional endorsement added with this renewal. Any premium charged for this
coverage is displayed in the Basic Charges and Discounts section on this renewal certificate. Please
refer to the policy insert for coverage details and how to decline this endorsement and its premium.
Please help us update the data used to determine your premium. Contact your agent with the year each of
your home's utilities (heating/cooling, plumbing, or electrical) and roof were last updated.
$811.00
Moving? See your State Farm agent.
/ /uN'KS"�• uSSf'I`[�E 2/g CYte CttS Ar(eI"rn. P See reverse for important information.
9039 ao1 m At NA &aLEO GI SON Prepared
N
nip Telephone (970) 226-1200 11513 MAY 02 2014
StateFarm State Farm Fire and Casualty Company
® P.O. Bar 82542
Lincoln, NE 68501-2542
Y-20- 2544-FAF1 A F
001923 0001
CITY OF FORT COLLINS
215 N MASON ST FL 2
FORT COLLINS CO 80524-4402
LOCATION OF COVERED PREMISES
Loc
No of
Portion
No
Acres
of Section
Section Twnshp Range
01
19
Described on
file in the Regional Office.
02
5
Described on
file in the Regional Office.
County and State
9040 301 M Agent NAPOLEON GIBSON
N Telephone (970) 226-1200 FEB
1M
Prepared MAY 02 2014