HomeMy WebLinkAboutDeed 2007-09-12 (150 Chapel Drive, MV)
New Business
Declarations
Aa..
TRAVELERSJ
HOMESAVER POLICY
Named Insured
Your Agency's Name and Address
JOSH SALE
2372 VISTA DEL MAR
TIBURON CA 94920-1208
GROSSLIGHT INS INC
PO BOX 24946
LOS ANGELES CA 90024
Your Policy Number:
932523730 663 1
For Policy Service Call: (310) 473-9611
For Claim Service Call: 1-800-CLAIM33
Policy Period
FROM: 09-12-07 To: 09-12-08 12:01 A.M.
STANDARD TIME AT THE RESIDENCE PREMISES
Location of Residence Premises
150 CHAPEL DR
MILL VALLEY, CA 949413100
Section I - Property Coverages
Limits of
Liability
Premium
A - Dwelling
B - Other Structures
C - Household Furnishings
D - Loss of Use
$1,800,000
180,000
2,000
180,000
$ 3,788.00
INCL
INCL
INCL
Section II - Liability Coverages
E - Premises Liability
F - Medical Payments
$ 500,000
5,000
$
27.00
INCL
Policy Forms and Endorsements
HS 663 09 99 Rental Dwelling Form
HS 01 04 07 06 Special Provisions - California
HS 04 16 09 99 Premises Alarm Or Fire Protection
System
HS 80 91 07 02 Limited Fungi, Other Microbes
or Rot Remediation
HS 04 95 12 00 Water Back Up And Sump Overflow
HS 00 03 10 05 Special Coverage
Maximum Additional Amount
of Insurance - 25%
$ 5,000
$ 75.00
Total Premium
$ 3,890.00
Your Premium Reflects the Following Credits or State Surcharges
Premises Alarm System-Fire
8.0%
Continued on next page
PL-8653 1-97 476/0HE950
Mortgagee Copy
004504/01722 F3115MMD 6489 11/28/07
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Policy Deductible: $ 2,500.00 All perils insured against
In case of loss under section I, only that part of the loss over the stated
deductible is covered.
First Mortgagee
Second Mortgagee
BANK OF AMERICA, 133
ITS SUCCESSORS AND/OR ASSIGNS
PO BOX 1675
CORAOPOLIS, PA 15108
LOAN NUMBER: 6765465155
TOWN OF TIBURON
1505 TIBURON BLVD.
TIBURON, CA 94920
Your Insurer: Travelers Property Casualty Insurance Company
One of The Travelers Property Casualty Companies
One Tower Square, Hartford, CT 06183
For Your Information
The State of California requires that we share this message with you:
WHENEVER THIS COMPANY OR ITS AGENT HAS BEEN UNABLE TO RESOLVE A CONSUMER
COMPLAINT AFFECTING THIS POLICY, THE FOLLOWING STATE AGENCY MAY BE
CONTACTED TO ASSIST THE POLICYHOLDER:
CALIFORNIA DEPARTMENT OF INSURANCE
CONSUMER SERVICE DIVISION
300 SOUTH SPRING ST
LOS ANGELES, CALIFORNIA 90013
TOLL FREE NUMBER: 800-927-4357
Earthquake coverage is not included in this policy.
The limit of liability for this structure (Coverage A) is based on an estimate of
the cost to rebuild your home, including an approximate cost of the labor and materials
in your area, and specific information that you have provided about your home.
Thank you for insuring with Travelers. We appreciate your business. If you
have any questions about your insurance, please contact your agent or
representative.
For information about how Travelers compensates independent agents and
brokers, please visit www.Travelers~com or call our toll free telephone
number 1-866-904-8348. You may also request a written copy from Marketing
at One Tower Square, 2GSA, Hartford, Connecticut 06183.
These declarations are part of your Homesaver Insurance Policy, Rental
Dwelling Form 663. If a change number and effective date appear at the top
of this page, these Declarations replace any previous Declarations on that date.
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