HomeMy WebLinkAbout102621 NEIGHBOR TO NEIGHBOR INC - INSURANCE CERTIFICATE (3)358 05X3505250 10 000 LGPO04
AMERICAN FAMILY MUTUAL INSURANCE COMPANY
MADISON, WISCONSIN 53783-0001
BUSINESSOWNERS POLICY
POLICY NUMBER
05X3505250
DECLARATIONS
NAMED NEIGHBOR TO NEIGHBOR INC
INSURED /L
MAILING 1550 BLUE SPRUCE DR
ADDRESS FT COLLINS, CO 80524-2015
POLICY PERIOD FROM 01-01-2015 TO 01-01-2016
12:01 A.M. Standard Time at your mailing address shown above.
FORM OF BUSINESS CORPORATION
CUSTOMER BILLING ACCOUNT
012-370-633 82
In return for the payment of the premium, and subject to all the terms of this policy, we agree with you to provide the insurance as stated in
this policy.
SECTION I PROPERTY
COVERAGE PROVIDED. BLANKET INSURANCE AT THE FOLLOWING DESCRIBED PREMISES ONLY FOR COVERAGES FOR WHICH A LIMIT
OF INSURANCE IS SHOWN UNLESS COVERAGE IS PROVIDED BY AN ENDORSEMENT.
DESCRIPTION OF PREMISES
PREMISES NO. 0003 BUILDING NO. 001
LOCATION 1620 AZALEA ST
FT COLLINS, CO 80524
BUILDING INTEREST LEASED TO OTHERS
PREDOMINANT OCCUPANCY APARTMENT BUILDING WITHOUT MERCANTILE
NUMBER OF UNITS 8
CONSTRUCTION FRAME
YEAR BUILT 1980
COMMERCIAL BUILDING CONSTRUCTION COST INDEX LEVEL 327
DESCRIPTION OF PREMISES
PREMISES NO. 0004 BUILDING NO. 001
LOCATION 713 AZTEC DR
FT COLLINS, CO 80521-1771
BUILDING INTEREST LEASED TO OTHERS
PREDOMINANT OCCUPANCY APARTMENT BUILDING WITHOUT MERCANTILE
NUMBER OF UNITS 4
CONSTRUCTION FRAME
YEAR BUILT 1982
COMMERCIAL BUILDING CONSTRUCTION COST INDEX LEVEL 327
AGENT 020-309
JENNIFER LAMB—SANTIAGO
301 W MAGNOLIA ST
FORT COLLINS, CO 80521-2804
PHONE
970-221-0897
PAGE 0001
BRANCH LGP004 REW
ENTRY DATE 10-07-2014
BP AF 01 07 09 MEMORANDUM
Stock No. 15141
Includes Coovriahted material of Insurance Services Office. Inc with its narmissinn
358
05X3505250 10 000 LGP004
AMERICAN
FAMILY MUTUAL INSURANCE COMPANY
MADISON, WISCONSIN 53783-0001
BUSINESSOWNERS POLICY
POLICY NUMBER
DECLARATIONS
CUSTOMER BILLING ACCOUNT
05X3505250
012-370-633 82
PREM 0027 BLDG 001
MEDICAL EXPENSES - ANY ONE PERSON
$5,000
PREM 0028 BLDG 001
MEDICAL EXPENSES - ANY ONE PERSON
$5, 000
LOCATION
PREMIUM BASIS RATE
ADVANCE PREMIUM
PREMISES NO.
0003
BUILDING NO.
001
8 UNITS
$37.00
PREMISES NO.
0004
BUILDING NO.
001
4 UNITS
$18.00
PREMISES NO.
0009
BUILDING NO.
001
8 UNITS
$37.00
PREMISES NO.
0010
BUILDING NO.
001
8 UNITS
$37.00
PREMISES NO.
0011
BUILDING NO.
001
8 UNITS
$37.00
PREMISES NO.
0012
BUILDING NO.
001
8 UNITS
$37.00
PREMISES NO.
0013
BUILDING NO.
001
6 UNITS
$27.00
PREMISES NO.
0014
BUILDING NO.
001
6 UNITS
$27.00
PREMISES NO.
0015
BUILDING NO.
001
6 UNITS
$27.00
PREMISES NO.
0016
BUILDING NO.
001
6 UNITS
$27.00
PREMISES NO.
0017
BUILDING NO.
001
6 UNITS
$27.00
PREMISES NO.
0018
BUILDING NO.
001
6 UNITS
$27.00
AGENT 020-309 PHONE PAGE 0010
JENNIFER LAMB-SANTIAGO 970-221-0897 BRANCH LGP004 REW
301 W MAGNOLIA ST ENTRY DATE 10-07-2014
FORT COLLINS, CO 80521-2804
BP AF 01 07 09 MEMORANDUM Stock No. 15141
Includes coovriahted material of Insurance Services Office. Inc. with its oermission
358
05%3505250 10 000 LGP004
AMERICAN
FAMILY MUTUAL INSURANCE COMPANY
MADISON, WISCONSIN 53783-0001
BUSINESSOWNERS POLICY
POLICY NUMBER
DECLARATIONS
CUSTOMER BILLING ACCOUNT
05X3505250
012-370-633 82
PREMISES NO.
0019
BUILDING NO.
001
4 UNITS
$18.00
PREMISES NO.
0020
BUILDING NO.
001
4 UNITS
$18.00
PREMISES NO.
0021
BUILDING NO.
001
11 UNITS
$50.00
PREMISES NO.
0022
BUILDING NO.
001
3 UNITS
$14.00
PREMISES NO.
0024
BUILDING NO.
001
4 UNITS
$18.00
PREMISES NO.
0025
BUILDING NO.
001
4 UNITS
$18.00
PREMISES NO. 0026 BUILDING NO. 001
8 UNITS $37.00
PREMISES NO. 0027 BUILDING NO. 001
8 UNITS $37.00
PREMISES NO. 0028 BUILDING NO. 001
3136 SQUARE FOOTAGE $86.00
APPLICABLE BUSINESS LIABILITY ENDORSEMENT CHARGES $274.00
TOTAL ADVANCE BUSINESS LIABILITY PREMIUM $935.00
Liability forms and endorsements applying to all premises and made part of this policy at time of issue:
Any endorsement
followed
by a state abbreviation will only apply to coverages within
this state.
BP 04
04
01
06
BP 04 09 01 06 BP 04 16
01 06 BP
04
17
07
02
BP 04
39
07
02
BP 04 48 01 06 BP 04 54
01 06 BP
04
93
01
06
BP 05
17
01
06
BP 05 77 01 06 BP 10 05
07 02 BP
14
60
06
10
BP 84
24
01
07
BP 85 04 07 10 BP 85 05
07 98CO BP
85
10
07
98
BP 85
12
01
06
IL 75 26 12 05
TOTAL ADVANCE BUSINESS PREMIUM
$28, 356.00
This premium may be subject to adjustment.
AGENT 020-309
JENNIFER LAMB—SANTIAGO
301 W MAGNOLIA ST
FORT COLLINS, CO 80521-2804
BP AF 01 07 09
Includes coovriah
PHONE
970-221-0897
MEMORANDUM
trance Services I
PAGE 0011
BRANCH LGP004 REW
ENTRY DATE 10-07-2014
Stock No. 15141
358 05X3505250 10 000 LGP004
AMERICAN FAMILY MUTUAL INSURANCE COMPANY
MADISON, WISCONSIN 53783-0001
BUSINESSOWNERS POLICY
POLICY NUMBER DECLARATIONS CUSTOMER BILLING ACCOUNT
05R3505250 012-370-633 82
Forms and endorsements applying to property and liability at all premises and made part of this policy at time of issue:
Any endorsement followed by a state abbreviation will only apply to coverages within this state.
BP IN 01 01 06 BP 00 03 01 06 BP 01 81 07 02 BP 05 01 07 02
BP 05 15 01 08 BP 05 24 01 08 BP 05 41 06 08 BP 05 64 01 07
BP 05 71 01 07 BP 80 01 01 07
AUTHORIZED
REPRESENTATIVE CLLYYY���.www1YY/ PPrreesideeif1—�5
AGENT 020-309
JENNIFER LAMB—SANTIAGO
301 W MAGNOLIA ST
FORT COLLINS, CO 80521-2804
8P AF 01 07 09
Includes coovrI&
C a'� COUNTERSIGNED
Secretary LICENSED RESIDENT AGENT
PHONE
970-221-0897
MEMORANDUM
urance Services t
PAGE 0012
BRANCH LGP004 REW
ENTRY DATE 10-07-2014
Stock No. 15141
358 05X3505250 10 000 LGP004 _
AMERICAN FAMILY MUTUAL INSURANCE COMPANY
MADISON, WISCONSIN 53783-0001
BUSINESSOWNERS POLICY
POLICY NUMBER DECLARATIONS CUSTOMER BILLING ACCOUNT
05X3505250 012-370-633 82
DESCRIPTION OF PREMISES
PREMISES NO. 0009 BUILDING NO. 001
LOCATION 1550 BLUE SPRUCE BLDG 1
FT COLLINS CO 80524
BUILDING INTEREST LEASED TO OTHERS
PREDOMINANT OCCUPANCY APARTMENT BUILDING WITHOUT MERCANTILE
NUMBER OF UNITS 8
CONSTRUCTION FRAME
YEAR BUILT 1984
COMMERCIAL BUILDING CONSTRUCTION COST INDEX LEVEL 327
DESCRIPTION OF PREMISES
PREMISES NO. 0010 BUILDING NO. 001
LOCATION 1550 BLUE SPRUCE BLDG 2
FT COLLINS CO 80524
BUILDING INTEREST LEASED TO OTHERS
PREDOMINANT OCCUPANCY APARTMENT BUILDING WITHOUT MERCANTILE
NUMBER OF UNITS 8
CONSTRUCTION FRAME
YEAR BUILT 1984
COMMERCIAL BUILDING CONSTRUCTION COST INDEX LEVEL 327
DESCRIPTION OF PREMISES
PREMISES NO. 0011 BUILDING NO. 001
LOCATION 1550 BLUE SPRUCE BLDG 3
FT COLLINS CO 80524
BUILDING INTEREST LEASED TO OTHERS
PREDOMINANT OCCUPANCY APARTMENT BUILDING WITHOUT MERCANTILE
NUMBER OF UNITS 8
CONSTRUCTION FRAME
YEAR BUILT 1984
COMMERCIAL BUILDING CONSTRUCTION COST INDEX LEVEL 327
DESCRIPTION OF PREMISES
PREMISES NO. 0012 BUILDING NO. 001
LOCATION 1550 BLUE SPRUCE BLDG 4
FT COLLINS CO 80524
AGENT 020-309 PHONE PAGE 0002
JENNIFER LAMB—SANTIAGO 970-221-0897 BRANCH LGP004 REW
301 W MAGNOLIA ST ENTRY DATE 10-07-2014
FORT COLLINS, CO 80521-2804
BP AF 01 07 09 MEMORANDUM Stack No. 15141
Includes copvriehted material of Insurance Services Office, Inc , with its permission
358 0SX3505250 10 000 LGP004
AMERICAN FAMILY MUTUAL INSURANCE COMPANY
MADISON, WISCONSIN 53783-0001
BUSINESSOWNERS POLICY
POLICY NUMBER DECLARATIONS CUSTOMER BILLING ACCOUNT
05X3505250 012-370-633 82
BUILDING INTEREST LEASED TO OTHERS
PREDOMINANT OCCUPANCY APARTMENT BUILDING WITHOUT MERCANTILE
NUMBER OF UNITS 8
CONSTRUCTION FRAME
YEAR BUILT 1984
COMMERCIAL BUILDING CONSTRUCTION COST INDEX LEVEL 327
DESCRIPTION OF PREMISES
PREMISES NO. 0013 BUILDING NO. 001
LOCATION 1550 BLUE SPRUCE BLDG 5
FT COLLINS CO 80524
BUILDING INTEREST LEASED TO OTHERS
PREDOMINANT OCCUPANCY APARTMENT BUILDING WITHOUT MERCANTILE
NUMBER OF UNITS 6
CONSTRUCTION FRAME
YEAR BUILT 1984
COMMERCIAL BUILDING CONSTRUCTION COST INDEX LEVEL 327
DESCRIPTION OF PREMISES
PREMISES NO. 0014 BUILDING NO. 001
LOCATION 1550 BLUE SPRUCE BLDG 6
FT COLLINS CO 80524
BUILDING INTEREST LEASED TO OTHERS
PREDOMINANT OCCUPANCY APARTMENT BUILDING WITHOUT MERCANTILE
NUMBER OF UNITS 6
CONSTRUCTION FRAME
YEAR BUILT 1984
COMMERCIAL BUILDING CONSTRUCTION COST INDEX LEVEL 327
DESCRIPTION OF PREMISES
PREMISES NO. 0015 BUILDING NO. 001
LOCATION 1550 BLUE SPRUCE BLDG 7
FT COLLINS CO 80524
BUILDING INTEREST LEASED TO OTHERS
PREDOMINANT OCCUPANCY APARTMENT BUILDING WITHOUT MERCANTILE
NUMBER OF UNITS 6
CONSTRUCTION FRAME
YEAR BUILT 1984
AGENT 020-309 PHONE PAGE 0003
JENNIFER LAMB—SANTIAGO 970-221-0897 BRANCH LGP004 REW
301 W MAGNOLIA ST ENTRY DATE 10-07-2014
FORT COLLINS, CO 80521-2804
BP AF 01 07 09 MEMORANDUM Stock No. 15141
Includes COovriahted material of Insurance Services Office. Inc. with its nermission
358 05X3505250 10 000 LGP004
AMERICAN FAMILY MUTUAL INSURANCE COMPANY
MADISON, WISCONSIN 53783-0001
BUSINESSOWNERS POLICY
POLICY NUMBER DECLARATIONS CUSTOMER BILLING ACCOUNT
05R3505250 012-370-633 82
COMMERCIAL BUILDING CONSTRUCTION COST INDEX LEVEL 327
DESCRIPTION OF PREMISES
PREMISES NO. 0016 BUILDING NO. 001
LOCATION 1550 BLUE SPRUCE BLDG 8
FT COLLINS CO 80524
BUILDING INTEREST LEASED TO OTHERS
PREDOMINANT OCCUPANCY APARTMENT BUILDING WITHOUT MERCANTILE
NUMBER OF UNITS 6
CONSTRUCTION FRAME
YEAR BUILT 1984
COMMERCIAL BUILDING CONSTRUCTION COST INDEX LEVEL 327
DESCRIPTION OF PREMISES
PREMISES NO. 0017 BUILDING NO. 001
LOCATION 1550 BLUE SPRINGS BLDG 9
FT COLLINS CO 80524
BUILDING INTEREST LEASED TO OTHERS
PREDOMINANT OCCUPANCY APARTMENT BUILDING WITHOUT MERCANTILE
NUMBER OF UNITS 6
CONSTRUCTION FRAME
YEAR BUILT 1984
COMMERCIAL BUILDING CONSTRUCTION COST INDEX LEVEL 327
DESCRIPTION OF PREMISES
PREMISES NO. 0018 BUILDING NO. 001
LOCATION 1550 BLUE SPRUCE BLDG 10
FT COLLINS CO 80524
BUILDING INTEREST LEASED TO OTHERS
PREDOMINANT OCCUPANCY APARTMENT BUILDING WITHOUT MERCANTILE
NUMBER OF UNITS 6
CONSTRUCTION FRAME
YEAR BUILT 1984
COMMERCIAL BUILDING CONSTRUCTION COST INDEX LEVEL 327
AGENT 020-309 PHONE PAGE 0004
JENNIFER LAMB—SANTIAGO 970-221-0897 BRANCH LGP004 REW
301 W MAGNOLIA ST ENTRY DATE 10-07-2014
FORT COLLINS, CO 80521-2804
BP AF 01 07 09 MEMORANDUM Stook No. 15141
Includes coovriahted material of Insurance Services Office, Inc , with its Permission
358 05X3505250 10 000 LGP004
AMERICAN FAMILY MUTUAL INSURANCE COMPANY
MADISON, WISCONSIN 53783-0001
BUSINESSOWNERS POLICY
POLICY NUMBER DECLARATIONS CUSTOMER BILLING ACCOUNT
05X3505250 012-370-633 82
DESCRIPTION OF PREMISES
PREMISES NO. 0019 BUILDING NO. 001
LOCATION 613 CONIFER ST
FT COLLINS, CO 80524-2149
BUILDING INTEREST LEASED TO OTHERS
PREDOMINANT OCCUPANCY APARTMENT BUILDING WITHOUT MERCANTILE
NUMBER OF UNITS 4
CONSTRUCTION FRAME
YEAR BUILT 1976
COMMERCIAL BUILDING CONSTRUCTION COST INDEX LEVEL 327
DESCRIPTION OF PREMISES
PREMISES NO. 0020 BUILDING NO. 001
LOCATION 619 CONIFER ST
FT COLLINS, CO 80524-2150
BUILDING INTEREST LEASED TO OTHERS
PREDOMINANT OCCUPANCY APARTMENT BUILDING WITHOUT MERCANTILE
NUMBER OF UNITS 4
CONSTRUCTION FRAME
YEAR BUILT 1976
COMMERCIAL BUILDING CONSTRUCTION COST INDEX LEVEL 327
DESCRIPTION OF PREMISES
PREMISES NO. 0021 BUILDING NO. 001
LOCATION 533 E 4TH ST
LOVELAND, CO 80537-5791
BUILDING INTEREST LEASED TO OTHERS
PREDOMINANT OCCUPANCY APARTMENT BUILDING WITHOUT MERCANTILE
NUMBER OF UNITS 11
CONSTRUCTION FRAME
YEAR BUILT 1965
COMMERCIAL BUILDING CONSTRUCTION COST INDEX LEVEL 327
DESCRIPTION OF PREMISES
PREMISES NO. 0022 BUILDING NO. 001
LOCATION 1051 1055 W 8TH ST
LOVELAND CO 80538
AGENT 020-309
JENNIFER LAMB—SANTIAGO
301 W MAGNOLIA ST
FORT COLLINS, CO 80521-2804
PHONE
970-221-0897
PAGE 0005
BRANCH LGP004 REW
ENTRY DATE 10-07-2014
BP AF 01 07 09 MEMORANDUM Stock No. 15141
Innlndos rnm,inhtnd mata,W of Incmunra Sondroc nffirc Inr ,.dth e�
358 0SX3505250 10 000 LGP004
AMERICAN FAMILY MUTUAL INSURANCE COMPANY
MADISON, WISCONSIN 53783-0001
BUSINESSOWNERS POLICY
DECLARATIONS
POLICY NUMBER CUSTOMER BILLING ACCOUNT
05X3505250 012-370-633 82
BUILDING INTEREST LEASED TO OTHERS
PREDOMINANT OCCUPANCY APARTMENT BUILDING WITHOUT MERCANTILE
NUMBER OF UNITS 3
CONSTRUCTION FRAME
YEAR BUILT 1970
COMMERCIAL BUILDING CONSTRUCTION COST INDEX LEVEL 327
DESCRIPTION OF PREMISES
PREMISES NO. 0024 BUILDING NO. 001
LOCATION 2405 CRABTREE DR
FT COLLINS, CO 80521-4165
BUILDING INTEREST LEASED TO OTHERS
PREDOMINANT OCCUPANCY APARTMENT BUILDING WITHOUT MERCANTILE
NUMBER OF UNITS 4
CONSTRUCTION FRAME
YEAR BUILT 1980
COMMERCIAL BUILDING CONSTRUCTION COST INDEX LEVEL 327
DESCRIPTION OF PREMISES
PREMISES NO. 0025 BUILDING NO. 001
LOCATION 2413 CRABTREE DR
FT COLLINS, CO 80521-4121
BUILDING INTEREST LEASED TO OTHERS
PREDOMINANT OCCUPANCY APARTMENT BUILDING WITHOUT MERCANTILE
NUMBER OF UNITS 4
CONSTRUCTION FRAME
YEAR BUILT 1980
COMMERCIAL BUILDING CONSTRUCTION COST INDEX LEVEL 327
DESCRIPTION OF PREMISES
PREMISES NO. 0026 BUILDING NO. 001
LOCATION 2404 CLEARVIEW AVE
FT COLLINS, CO 80521-4164
BUILDING INTEREST LEASED TO OTHERS
PREDOMINANT OCCUPANCY APARTMENT BUILDING WITHOUT MERCANTILE
NUMBER OF UNITS 8
CONSTRUCTION JOISTED MASONRY
YEAR BUILT 1960
AGENT 020-309
JENNIFER LAMB-SANTIAGO
301 W MAGNOLIA ST
FORT COLLINS, CO 80521-2804
PHONE
970-221-0897
PAGE 0006
BRANCH LGP004 REW
ENTRY DATE 10-07-2014
BP AF 01 07 09 MEMORANDUM Stock No. 15141
Inrhidne rnnvrinhfad material of Insurance Services Office Inc with its nermissinn
358 05X3505250 10 000 LGP004
AMERICAN FAMILY MUTUAL INSURANCE COMPANY
MADISON, WISCONSIN 53783-0001
BUSINESSOWNERS POLICY
POLICY NUMBER DECLARATIONS CUSTOMER BILLING ACCOUNT
05X3505250 012-370-633 82
COMMERCIAL BUILDING CONSTRUCTION COST INDEX LEVEL 327
DESCRIPTION OF PREMISES
PREMISES NO. 0027 BUILDING NO. 001
LOCATION 1041 PONDEROSA DR
FT COLLINS, CO 80521-4184
BUILDING INTEREST LEASED TO OTHERS
PREDOMINANT OCCUPANCY APARTMENT BUILDING WITHOUT MERCANTILE
NUMBER OF UNITS 8
CONSTRUCTION JOISTED MASONRY
YEAR BUILT 1967
COMMERCIAL BUILDING CONSTRUCTION COST INDEX LEVEL 327
DESCRIPTION OF PREMISES
PREMISES NO. 0028 BUILDING NO. 001
LOCATION 1550 BLUE SPRUCE DR
FORT COLLINS, CO 80524-2015
BUILDING INTEREST OWNER OCCUPIED
PREDOMINANT OCCUPANCY OFFICE — NOT OTHERWISE CLASSIFIED (NOC)
CONSTRUCTION FRAME
YEAR BUILT 1982
COMMERCIAL BUILDING CONSTRUCTION COST INDEX LEVEL 327
The Following Applies To All Premises Identified In This Declaration
PROPERTY DEDUCTIBLE $1,000
OTHER PROPERTY DEDUCTIBLE(S)
OPTIONAL COVERAGE/GLASS DEDUCTIBLE $500
SEWER BACKUP. AND SUMP OVERFLOW DEDUCTIBLE $500
COVERAGE LIMIT OF INSURANCE
BUILDING - Blanket $8, 406, 334
REPLACEMENT COST
AUXILIARY BUILDINGS/STRUCTURES - Blanket $324, 548
REPLACEMENT COST
BUSINESS PERSONAL PROPERTY - Blanket $142, 442
REPLACEMENT COST
AUTOMATIC INCREASE IN COVERAGE 4%
AGENT 020-309 PHONE
JENNIFER LAMB—SANTIAGO 970-221-0897
301 W MAGNOLIA ST
FORT COLLINS, CO 80521-2804
BP AF 01 07 09 MEMORANDUM
PREMIUM
$25,121.00
$631.00
$421.00
PAGE 0007
BRANCH LGP004 REW
ENTRY DATE 10-07-2014
Stock No. 15141
358 05X3505250 10 000 LGP004
AMERICAN FAMILY MUTUAL INSURANCE COMPANY
MADISON, WISCONSIN 53783-0001
BUSINESSOWNERS POLICY
POLICY NUMBER DECLARATIONS CUSTOMER BILLING ACCOUNT
05R3505250 012-370-633 82
ADDITIONAL COVERAGE LIMIT OF INSURANCE PREMIUM
BUSINESS INCOME ACTUAL LOSS SUSTAINED INCLUDED
OTHER COVERAGES OR OPTIONS LIMIT OF INSURANCE PREMIUM
WATER BACKUP AND SUMP OVERFLOW $5 , 000 $1, 092.00
ORDINANCE OR LAW COVERAGE SEE BP 04 46 $151.00
Property forms and endorsements applying to this premises and made part of this policy at time of issue
Any endorsement followed by a state abbreviation will only apply to coverages within this state.
BP 84 09 01 07 BP 84 11 07 98
BP 85 11 12
08
BP 12 03 01 06
BE, 84 10 07 98 BP 04 46 01 06
MORTGAGEHOLDER
PREMISE NO.
BUILDING NO.
PREMISE NO. BUILDING NO.
WELLS FARGO BANK MINNESOTA NA
0010
001
0011 001
ITS SUCCESSORS AND/OR ASSIGNS
0012
001
0013 001
INVESTMENT MANAGEMENT TRUST
0014
001
6TH & MARQUETTE
MINNEAPOLIS, MN 55479-0001
MORTGAGEHOLOER LOAN NO. 54113431 & 54113659
THE HOME STATE BANK
303 E MOUNTAIN AVE
FORT COLLINS, CO 80524-2913
MORTGAGEHOLDER LOAN NO. 2335
CENTENNIAL LENDING LLC
ITS SUCCESSORS AND/OR ASSIGNS
4112 KODIAK CT UNIT D
LONGMONT, CO 80504-3431
MORTGAGEHOLDER
HOUSING AUTHORITY FORT COLLINS
1715 W MOUNTAIN AVE
FT COLLINS, CO 80521-2359
AGENT 020-309
JENNIFER LAMB—SANTIAGO
301 W MAGNOLIA ST
FORT COLLINS, CO 80521-2804
PREMISE NO. BUILDING NO. PREMISE NO. BUILDING NO
0009
001
0010
001
0011
001
0012
001
0013
001
0014
001
0015
001
0016
001
0017
001
0018
001
PREMISE NO. BUILDING NO.
0027 001
PREMISE NO.
BUILDING NO.
PREMISE NO.
BUILDING NO.
0019
001
0020
001
0021
001
0022
001
0024
001
0025
001
PHONE
970-221-0897
PAGE 0008
BRANCH LGP004 REW
ENTRY DATE 10-07-2014
BP AF 01 07 09 MEMORANDUM Stock No. 15141
1—InAae rn—Anhtarl mnforinl of Ineumnro Sonnroe rlffiro Inr with ile nnrmiecinn
358 05X3505250 10 000 LGP004
AMERICAN FAMILY MUTUAL INSURANCE COMPANY
MADISON, WISCONSIN 53783-0001
BUSINESSOWNERS POLICY
POLICY NUMBER DECLARATIONS CUSTOMER BILLING ACCOUNT
05X3505250 012-370-633 82
MORTGAGEHOLDER
PREMISE NO.
BUILDING NO.
PREMISE NO.
BUILDING NO.
COMMUNITY HOUSING CAPITAL INCORPORATED
0009
001
0015
001
315 W PONCE DE LEON AVE STE 225
0016
001
0017
001
DECATUR, GA 30030-2494
0018
001
0026
001
APPLICABLE PROPERTY ENDORSEMENT CHARGES $5.00
TOTAL ADVANCE PROPERTY PREMIUM $27, 421 .00
Property forms and endorsements applying to all premises and made part of this policy at time of issue:
Any endorsement followed by a state abbreviation will only apply to coverages within this state.
BP 06 01 01 07 BP 83 01 07 98 BP 83 02 01 07 BP 84 04 01 07
SECTION II LIABILITY AND MEDICAL EXPENSES
Each paid claim for the following coverages reduces the amount of insurance we provide during the applicable annual period. Please
refer to Section II Liability in the BUSINESSOWNERS COVERAGE FORM and any attached endorsements.
COVERAGE
AGGREGATE
LIMIT
(OTHER
THAN PRODUCTS COMPLETED OPERATIONS)
PRODUCTS-COMPLETED,OPERATIONS.AGGREGATE
LIMIT
DAMAGE TO PREMISES
RENTED TO YOU
LIABILITY
AND MEDICAL EXPENSES
PREM
0003
BLDG
001
MEDICAL EXPENSES - ANY
ONE
PERSON
PREM
0004
BLDG
001
MEDICAL EXPENSES - ANY
ONE
PERSON
PREM
0009
BLDG
001
MEDICAL EXPENSES - ANY
ONE
PERSON
PREM
0010
BLDG
001
MEDICAL EXPENSES - ANY
ONE
PERSON
PREM
0011
BLDG
001
MEDICAL EXPENSES - ANY
ONE
PERSON
PREM
0012
BLDG
001
MEDICAL EXPENSES - ANY
ONE
PERSON
PREM
0013
BLDG
001
MEDICAL EXPENSES - ANY
ONE
PERSON
PREM
0014
BLDG
001
MEDICAL EXPENSES - ANY
ONE
PERSON
PREM
0015
BLDG
001
MEDICAL EXPENSES - ANY
ONE
PERSON
PREM
0016
BLDG
001
MEDICAL EXPENSES - ANY
ONE
PERSON
PREM
0017
BLDG
001
MEDICAL EXPENSES - ANY
ONE
PERSON
PREM
0018
BLDG
001
MEDICAL EXPENSES - ANY
ONE
PERSON
PREM
0019
BLDG
001
MEDICAL EXPENSES - ANY
ONE
PERSON
PREM
0020
BLDG
001
MEDICAL EXPENSES - ANY
ONE
PERSON
PREM
0021
BLDG
001
MEDICAL EXPENSES - ANY
ONE
PERSON
PREM
0022
BLDG
001
MEDICAL EXPENSES - ANY
ONE
PERSON
PREM
0024
BLDG
001
MEDICAL EXPENSES - ANY
ONE
PERSON
PREM
0025
BLDG
001
MEDICAL EXPENSES - ANY
ONE
PERSON
PREM
0026
BLDG
001
MEDICAL EXPENSES - ANY
ONE
PERSON
AGENT 020-309 PHONE
JENNIFER LAMB—SANTIAGO 970-221-0897
301 W MAGNOLIA ST
FORT COLLINS, CO 80521-2804
BP AF 01 07 09 MEMORANDUM
Includes convrinhted material of Insuranre Services Office Inc wil
LIMIT OF INSURANCE
$4,000,000
$4,000,000
$50,000
$2,000,000
$5,000
$5,000
$5,000
$5,000
$5,000
$5,000
$5,000
$5,000
$5,000
$5,000
$5,000
$5,000
$5,000
$5,000
$5,000
$5,000
$5,000
$5,000
$5,000
PAGE 0009
BRANCH LGP004 REW
ENTRY DATE 10-07-2014
Stack No. 15141