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Home My WebLink AboutCOI - Kevin & Elizabeth A Kostielney - Expires 2023-09-01State Farm General Insurance Company A Stock Company With Home Offices in Bloomington, Illinois PO Box 853907 Richardson, TX 75085-3907 AT1 009291 32 -02-1 CBE-FBFF F HW CITY OF GILROY HCD 7351 ROSANNA ST GILROY CA 95020-6141 IIII�I��IIIII�II��IIIIIII'IIIIuiuiItlIIIIIIIIIui1IIIIIIIIII'III' Fl t neownee* [ oliicy Location of Residence Premises 1514 ROSETTE WAY GILROY CA 95020-2619 Construction: Year Built: Frame 2003 R E@IMOdI-RDD JUL 18 2022 GILROY CITY CLERICS OFFICE RENEWAL DECLARATIONS AMOUNT DUE: None Payment is due by BILLED THROUGH SFPP Policy Number: 05-BW-W147-2 Policy Period: 12 Months Effective Dates: SEP 02 2022 to SEP 02 2023 The policy period begins and ends at 12:01 am standard time at the residence premises. Your State Farm Agent YAMA EBRAT 1276 LINCOLN AVE SAN JOSE CA 95125-3050 Phone: (408) 320-4165 Roof Material: Composition Shingle Roof Installation Year: 2003 Automatic Renewal If the POLICY PERIOD is shown as 12 MONTHS, this policy will be renewed automatically subject to the premiums, rules, and forms in effect for each succeeding policy period. If this policy is terminated, we will give you and the Mortgagee/Lien- holder written notice in compliance with the policy provisions or as required by law. IMPORTANT MESSAGES This policy includes building code upgrade coverage of $28,190. Refer to the Important Notice for possible terms, limits, conditions, or restrictions. 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. PN[<::9@lIUlei Annual Premium Intervenor Fees Your premium has already been adjusted by the following: Sprinkler Discount Home/Auto Discount Claim Record Discount $724.00 .38 Total Premium $724.38 Prepared JUL062022 HO-2000 062802 920 N 7 a && doe dZpueseetiera. 219 r e. tea,. ka�te rcoste re Page 1 of 3 101F10008) 04-04-2016 State Farm NAMED INSURED MORTGAGEE AND ADDITIONAL INTERESTS KOSTIELNEY, KEVIN & ELIZABETH A GUILD MORTGAGE COMPANY LLC I SAOA/ATI MA PO BOX 8180Q9 CLEVELAND OH 44181-8009 gagee CITY OF GII:ROY HCD 7351 ROSANNA ST G I LROY CA 95020-6141 SECTION I - PROPERTY COVERAGES AND LIMITS Loan Number: 8261005437 Loan Number: N/A Coverage A Dwelling Other Structures B Personal Property C Loss of Use Additional Coverages Arson Reward Credit Card, Bank Fund Transfer Card, Forgery, and Counterfeit Money Debris Removal Fire Department Service Charge Fuel Oil Release Locks and Remote Devices Trees, Shrubs, and Landscaping SUTRA II - Lli 3IILI Y COVERAGES AND 1.161G1ITS Limit of Liability $ 281,900 $ 28,190 $ 211,425 $ 84,570 $1,000 $1,000 Additional 5% available/$1,000 tree debris $500 per occurrence $10,000 $1,000 5% of Coverage A amount/$750 per item Coverage L Personal Liability (Each Occurrence) Damage to the Property of Others M Medical Payments to Others (Each Person) INFLATION Limit of Liability $ 100,000 $ 1,000 $ 10,000 Inflation Coverage Index: 407.0 DEDUCTIBLES Section I Deductible All Losses LOSS SETTLEMENT PROVISIONS Deductible Amount $ 1,000 Al Replacement Cost - Similar Construction B1 Limited Replacement Cost - Coverage B H 0-2000 Page 2 of 3 05-BW-W147-2 t StateFarm FORMS, OPTIONS, AND ENDORSEMENTS HW-2105 Option JF Option ID Option OL HO-2424 HO-2609 HO-2622.1 HO-2420 HO-2779 HO-2362 HO-2213 ADDITIONAL MESSAGES Homeowners Policy Jewelry and Furs $2,500 Each Article/$5,000 Aggregate Increase Dwlg up to $56,380 Ordinance/Law 10%/ $28,190 Nurses' Professional Liability Cyber/ID Restoration/Fraud Coy Back -Up Of Sewer Or Drain - 5% of Coverage A/$ 14,095 Form 438bfu NS Lndr Loss Pay Wildfire Response End State of Emergency Amendatory Amendatory Endorsement 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 for labor and materials in your area, and specific information that you have provided about your home. CALIFORNIA LAW REQUIRES US TO PROVIDE THE FOLLOWING NOTICE: Our records indicate that you have not purchased earthquake coverage. Other limits and exclusions may apply - refer to your policy Your policy consists of these Declarations, the Homeowners Policy shown above, and any other forms and endorsements that apply, including those shown above as well as those issued subsequent to the issuance of this policy. This policy is issued by the State Farm General Insurance Company. Participating Policy You are entitled to participate in a distribution of the earnings of the company as determined by our Board of Directors in accordance with the Company's Articles of Incorporation, as amended. In Witness Whereof, the State Farm General Insurance Company has caused this policy to be signed by its President and Secretary at Bloomington, Illinois. ./9-0,h.g., )11 4,„,,,k_ c.4, Secretary President Prepared JUL Ofi 2022 H 0-2000 062803 920 N Page 3 of 3