HomeMy WebLinkAboutCOI - Agustin Lara Chavez - Expires 2023-10-15State Farm General Insurance Company
A Stock Company With Home Offices in Bloomington, Illinois
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PO Box 853907
Richardson, TX 75085-3907
AT1 002554 32-02-34A4-FAD9 F H 6
CITY OF GILROY HCD
7351 ROSANNA ST
GILROY CA 95020-6141
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GILROY CITY CLERKS OFFICE
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Location of Residence Premises
7610 GENNARO WAY
GILROY CA 95020-5278
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RENEWAL DECLARATIONS
AMOUNT DUE: None
Payment k (Iwo by PAID BY SPECIFIED PARTY
Policy Number: 05-B8-N714-8
Policy Period: 12 Months
Effective Dates: OCT 15 2022 to OCT 15 2023
The policy period begins and ends at 12:01 am standard
time atthe residence premises.
Your State Farm Agent
A ANDERSON INS AND FIN SVC IN
980 EL CAMINO REAL STE 350
SANTA CLARA CA 95050-4290
Phone: (408) 244-4400
Construction: Frame
Year Built: 2013
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 $8,300. Refer to the Important Notice for
possible terms, limits, conditions, or restrictions.
PRE ,:UUM
Annual Premium
Intervenor Fees
Your premium has already been adjusted by the following:
Home Alert Discount Sprinkler Discount
Home/Auto Discount Claim Record Discount
$437.00
.38
Total Premium
$437.38
Prepared AUG 18 2022
HO-2000
017388 920
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StateFarm°
NAMED INSURED
MORTGAGEE AND ADDITIONAL INTERESTS
LARA CHAVEZ, AGUSTIN
3rd Mortgagee
SOUTH COUNTY HOUSING Loan Number:
PO BOX 4112 N/A
SAN JOSE CA 95150-4112
SECTION I - PROPERTY COVERAGES AND LIMI d'S
GUILgag
MORTGAGE COMPANY LLC
I SAOA/ATI MA
PO BOX 818009
CLEVELAND OH 44181-8009
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CITY OF GaIEROY HCD
7351 ROSANNA ST
GILROY A 95020-6141
Loan Number:
826-1017206
Loan BEGIN Number
:
Coverage
A Building Property
B Personal Property
C Loss of Use
D Loss Assessment
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
SECTION II - LIABILITY COVERAGES AND LIMITS
Limit of Liability
$ 83,000
$ 54,400
$ 38,080
$ 10,000
$1,000
$1,000
Additional 5% available/$1,000 tree debris
$500 per occurrence
$10,000
$1,000
5% of Coverage B 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
$ 1,000
Inflation Coverage Index: 296.3
DEDUCTIBLES
Section I Deductible
All Losses
LOSS SETTLEMENT PROVISIONS
Deductible Amount
$ 1,000
Replacement Cost - Similar Construction - Coverage A
B1 Limited Replacement Cost - Coverage B
HD-2000
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05-B8-N714-8
StateFarm.
Eniall s, o NI (3, E 0, Jla'ENITS
H6-2105 Condominium Unitowners Policy
HO-2408 Building Ordinance or Law
HO-2832 Back -Up Of Sewer Or Drain -
15% of Coverage B/$ 8,160
HO-2420 Form 438bfu NS Lndr Loss Pay
HO-2362 State of Emergency Amendatory
HO-2214 Amendatory Endorsement
ADDITIONAL MESSAGES
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 Condominium Unitowners 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.
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Secretary President
Prepared AUG 18 2022
H 0-2000
017389 920
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