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Home My WebLink AboutCOI - City of Gilroy Planning Division - Expires 2022-12-15PO BOX 45126 POLICY NUMBER I JACKSONVILLE FL 32232-5126 NP3036613 STI LLWATE R For Service call 1-800-691-3817 HOMEOWNERS 6 UNIT OWNERS FORM (NSUKANCECOMPANY For Claims call 1-877-679-9835 Client ID 000006136686 SUMMARY OF THIS POLICY EXPIRES ON 12/15/2021 RENEWAL OFFER RENEWAL COVERAGES OFFERED YOUR POLICY WILL LAPSE IF PAYMENT IS NOT MADE BY 12/14/2021 MORTGAGEE INSURED CITY OF GILROY PLANNING DIVISO KOLUN WANG 7351 ROSANNA ST BO LI GILROY CA 95020-6141 261 LEWIS ST GILROY CA 95020-5211 EFFECTIVE 12/15/2021 TO 12/15/2022 LOCATION OF RESIDENCE PREMISES 261 LEWIS ST GILROY CA 95020-5211 EFFECTIVE TIME IS 12:01 A.M. STANDARD TIME AT YOUR RESIDENCE COVERAGE A COVERAGE B DWELLING OTHER STRUCTURES $ 55,000 SECTION I PROPERTY COVERAGES COVERAGE C COVERAGE D DEDUCTIBLE PERSONAL PROPERTY LOSS OF USE $ 250 $ 17,400 $6,480 SECTION 11 LIABILITY COVERAGES COVERAGE E - PERSONAL LIABILITY COVERAGE F - MED PAY TO OTHERS $ 300,000 EACH OCCURRENCE $ 2,000 EACH PERSON LIMIT PREMIUM/CREDIT COVERAGE A - DWELLING $55,000 $214.00 COVERAGE C - PERSONAL PROPERTY $17,400 $239.00 COVERAGE D - LOSS OF USE $6,480 $12.00 COV E - PERSONAL LIABILITY $300,000 $23.00 COV F - MED PAY TO OTHERS $2,000 $3.00 HOME ALERT PROTECTION REPLACEMENT COST - CONTENTS LOSS ASSESSMENTS BACK-UP OF SEWERS OR DRAINS DISCOUNTS: AGE OF INS (40-54) DSC, COMPANION DISCOUNT LOSS EXPERIENCE ADJ... $ 13.71- $48.00- $67.00 $10,000 $8.00 $5,000 $21.00 TOTAL POLICY PREMIUM $ 651.00 NO COVERAGE IS PROVIDED UNDER THIS POLICY FOR LOSS CAUSED BY EARTHQUAKE 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. Please refer to the Mortgagee, Additional Insured and Certifieateholder page located behind the Declarations Page when applicable. If you have any questions regarding this offer, please contact your agent. If you are unable to resolve the issue with your agent, you may contact us at 1-800-691-3817. SEE REVERSE SIDE FOR POLICY FORMS AND ENDORSEMENTS FAMILIES/ YEAR OF P/G FT MILES FIR APARTMENTS CONSTR CONSTR O/G TERR HYDRANT F. DEPT DISTRICT 2009 FRAME 03 *`r 727 < 1000 < 5 I1515H (08-03) MORTGAGEE CA 10/21/2021 H9X 002 IDY9499 COPY I OF 2 1 238000000000003661321295 00006 AMENDMENT PROVISION If the Declarations indicates your policy is amended, it will be effective on the date shown, and will provide the indicated insurance. Such amended Declarations replaces all prior Declarations. All other terms, conditions, agreements or limitations of the policy, other than contained on the Declarations shall remain the same. VESTING FORMS, ENDORSEMENTS AND NOTICES *This is a reprinted, new or revised document that changes your policy. Please read it carefully. HO 00 06 05 11 HOMEOWNERS 6 UNIT OWNERS FORM ANIMAL EXCL 0321 IMPORTANT NOTICE - EXCLUSION A6121 CA 0505 SATELLITE DISH EXCLUSION A6122 CA 0505 OCCUPANCY ENDORSEMENT A6125 CA 0505 MORTGAGE CLAUSE A6139 CA 0210 SECTION II -EARTH MOVEMENT EXCL A6142 CA 0419 PERS PROP REPL COST AMENDATORY A6145 CA 0321 AMENDATORY ENDORSEMENT A6154 SIC 0416 ANIMAL LIABILITY ENDORSEMENT A6156 CA 1006 COVERAGE C-INCR SPECIAL LIMITS FNIC DN CA 0106 CALIFORNIA DISCLOSURE NOTICE FN 1194 0505 IMPORTANT INFO - CA CIGA FN 1298 0505 CA RESIDENTIAL PROP INS DISCL FN 1472 1214 LIMITED WATER BACK UP AND SUMP FN 1686 04 12 LIMITED HOME DAY CARE COVERAGE HO 0104 0720 SPECIAL PROVISIONS-CALIFORNIA HO 04 07 0719 PERS PROP REPLACEMENT COST HO 04 16 1000 PREMISES ALARM/FIRE PROTECTION HO 04 28 05 11 LIMITED FUNGI, WET OR DRY ROT HO 04 35 0511 SUPPLEMENTAL LOSS ASSESSMENT HO 17 32 05 11 UNIT -OWNERS COV A SPECIAL COV HO 24 90 0801 WORKERS COMP RES EMPL - CA IL N 018 0903 CALIFORNIA FRAUD STATEMENT IL N 135 07 11 CA RESIDENTIAL PROP INS BILL PRIVACY POLICY 0120 PRIVACY POLICY SP1842 01 16 ADDITIONAL PERSON DESIGNATION SP2052 CA 0420 ADVISORY NOTICE -NEW COVERAGES 438BFU NS 0542 LENDERS LOSS PAYABLE DATE: COUNTERSIGNED BY Val 1 238000000000003661321295 00006 PO BOX 45126 POLICY NUMBER I JACKSONVILLE FL 32232-5126 NP3036613 STILLWATER For Service call 1-800-691-3817 HOMEOWNERS 6 UNIT OWNERS FORM I N S U RANC E COM PANY For Claims call 1-877-679-9835 Client ID 000006136686 SUMMARY OF THIS POLICY EXPIRES ON 12/15/2021 RENEWAL OFFER RENEWAL COVERAGES OFFERED YOUR POLICY WILL LAPSE IF PAYMENT IS NOT MADE BY 12/14/2021 MORTGAGEE INSURED CITY OF GILROY PLANNING DIVISO KOLUN WANG 7351 ROSANNA ST BO LI GILROY CA 95020-6141 261 LEWIS ST GILROY CA 95020-5211 EFFECTIVE 12/ 15/2021 TO 12/ 15/2022 LOCATION OF RESIDENCE PREMISES 261 LEWIS ST GILROY CA 95020-5211 EFFECTIVE TIME IS 12:01 A.M. STANDARD TIME AT YOUR RESIDENCE COVERAGE COVERAGEB DWELLING OTHER STRUCTURES $ 55,000 SECTION I PROPERTY COVERAGES COVERAGE C COVERAGE D DEDUCTIBLE PERSONAL PROPERTY LOSS OF USE $ 250 $ 17,400 $6,480 SECTION II LIABILITY COVERAGES COVERAGE E - PERSONAL LIABILITY COVERAGE F - MED PAY TO OTHERS $ 300,000 EACH OCCURRENCE $ 2,000 EACH PERSON LIMIT PREMIUM/CREDIT UNIT OWNERS BLDG SPCL COVERAGE $55.00 ANIMAL LIABILITY BUY BACK $300,000 $27.00 POLICY FEE - FULLY EARNED $30.00 DISCOUNTS: AGE OF INS (40-54) DSC, COMPANION DISCOUNT LOSS EXPERIENCE ADJ... $ 13.71- TOTAL POLICY PREMIUM $ 651.00 NO COVERAGE IS PROVIDED UNDER THIS POLICY FOR LOSS CAUSED BY EARTHQUAKE 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. Please refer to the Mortgagee, Additional Insured and Certifieateholder page located behind the Declarations Page when applicable. If you have any questions regarding this offer, please contact your agent. If you are unable to resolve the issue with your agent, you may contact us at 1-800-691-3817. SEE REVERSE SIDE FOR POLICY FORMS AND ENDORSEMENTS FAMILIES/ YEAR OF P/G FT MILES FIR APARTMENTS CONSTR CONSTR O/G TERR HYDRANT F. DEPT DISTRICT 2009 FRAME 03 ''" 727 < 1000 < 5 I1515H (08-03) MORTGAGEE CA 10/21/2021 H9X 002 IDY9499 COPY 2 OF 2 ,a 16 1 238000000000003661321295 00006 AMENDMENT PROVISION If the Declarations indicates your policy is amended, it will be effective on the date shown, and will provide the indicated insurance. Such amended Declarations replaces all prior Declarations. All other terms, conditions, agreements or limitations of the policy, other than contained on the Declarations shall remain the same. VESTING FORMS, ENDORSEMENTS AND NOTICES *This is a reprinted, new or revised document that changes your policy. Please read it carefully. DATE: COUNTERSIGNED BY 16 1 238000000000003661321295 00006 •fi 2 CC O LL CO CC `'.' z o000 Z Z co 0 N W U) N m W p T �z�w >- p F= U w Z CU w °LL mow w 0 J 0 w a t� w V G w GC N Z J Z 0 F- G G a co w H 0 O U) 0 > U) o O z 0 w CD U N o T z It Q IA. w x T T 0- I- o O0 .. .-. U)} W QQ CCD0 w (n cm 0Zrn w W 2 �-z 0ZpM0 m JZQ m C.'3�V 2 0 X z crU-0Oma z u- O >- z OoC� oFn<0< Z p z �MJ p Mm- W 01"o .A O O O O Allstate® Blake Ins Agcy Inc 449 Leavesley Rd C & Gilroy CA 95020-3634 nll�pl�l�gp�uhII1111illlluillpr��h�IrrlI11�11PPrllll PASCUAL G GASCA & HORTENCIA S GASCA H/W 419 MADISON CT GILROY CA 95020-3641 New coverage required by the state of California Information as of October 20, 2021 Policyholder(s) Page 1 of 1 Pascual G Gasca & Hortencia 5 Gasca H/W Po'icv number 0 99 889 899 Your Allstate agency is Blake Ins Agcy Inc (408) 848-3800 MikeBlake@allstate.com As of July 1, 2021, California law requires residential policies with dwelling Replacement Cost coverage to provide no less than 10% Building Codes Coverage. We have updated your policy with this mandatory Building Codes Coverage and enclosed an Amended Policy Declarations that reflects this change. We will not apply any additional premium to your policy during the current period, but we will apply the appropriate premium amount for any future renewal offer. In addition, if you have a covered loss on or after July 1, 2021, and your policy effective date is also on or after July 1, 2021, we will honor the new Building Codes Coverage. You can also contact your Allstate agency or representative if you had a covered loss fit this criteria, but you did not file a claim because your current Policy Declarations did not indicate 10% Building Codes Coverage. Thank you again for choosing Allstate. We appreciate your business. Have questions? Please contact us. If you have any questions regarding the information in this letter or your insurance coverage in general, please feel free to contact your Allstate agency or representative. Sincerely, Customer Service Department Y6CW 1-1 Amended Deluxe Homeowners Policy Declarations Your policy effective date is August 7, 2021 Total Premium for the Premium Period (Your bill will be mailed separately) Premium for property insured Page 1 of 3 Information as of October 20, 2021 $850.00 Summary Total $850.00 Your bill will be mailed separately. Before making a payment, please refer to your latest bill, which includes payment options and installment fee information. if you do not pay in full, you will be charged an installment fee(s). Discounts (included in your total premium) Protective Device $14.00 Claim Free $166.00 Home and Auto $91.00 Total discount savings $271.00 1 Location of property insured 419 Madison Ct, Gilroy, CA 95020-3641 Rating Information Please refer to the Important Notice (X73944) for additional coverage information, and estimated replacement costs for Coverage A and B. Please review and verify the information regarding your insured property. Contact us if you have any changes. The dwelling is of frame construction Dwelling Style: Built in 1988;1 family;1200 sq. ft. Fire protection details: Fire department subscription - no Wildfire Risk Group: 006 Mortgagee 2 miles to fire department SELECT PORTFOLIO SERVICING INC ITS SUCCESSORS &/OR ASSIGNS P O Box 7277, Springfield, OH 45501-7277 Loan number: 0025767583 Additional Interested Party: City of Gilroy 7351 Rosanna St, Gilroy, CA 95020-6141 Named Insured(s) Pascual G Gasca & Hortencia S Gasca H/W Mailing address 419 Madison Ct Gilroy CA 95020-3641 Policy number 099 889 899 Your policy provided by Allstate Insurance Company Policy period Begins on August 7, 2021 through August 7, 2022 at 12:01 a.m. Pacific Time, and continues until cancelled Premium period Beginning August 7, 2021 through August 7, 2022 at 12:01 a.m. Pacific Time Your policy change is effective August 7, 2021 Your Allstate agency is Blake Ins Agcy Inc 449 Leavesley Rd C & Gilroy CA 95020-3634 (408) 848-3800 MikeBlake@alistate.com Some or all of the information on your Policy Declarations is used in the rating of your policy or it could affect your eligibility for certain coverages. Please notify us immediately if you believe that any information on your Policy Declarations is incorrect. We will make corrections once you have notified us, and any resulting rate adjustments, will be made only for the current policy period or for future policy periods. Please also notify us immediately if you believe any coverages are not listed or are inaccurately listed. 0 0 O 0 N 0 0 0 0 0 Q 0 N C N O N O Nr a, N O O V m 000 0Na Amended Deluxe Homeowners Policy Declarations WAllstate. Policy number: 099 889 899 Page 2 of 3 Policy effective date: August 7, 2021 Coverage detail for the property insured Dwelling Protection - with Building $359,051 • $250 Wildfire Structure Reimbursement Extended • $250 All other perils Limits' *150% of the Limit of Liability applicable to the building structure(s) for Dwelling Protection Other Structures Protection $35,906 • $250 Wildfire • $250 All other perils Personal Property Protection - $251,336 • $250 Wildfire Reimbursement Provision • $250 All other perils Additional Living Expense Up to 24 months not to exceed $71,811 Family Liability Protection $100,000 each occurrence Guest Medical Protection $1,000 each person Building Codes $35,906 Workers' Compensation and Statutory/See Form Employers' Liability Coverage for Residence Employees No. Other Coverages Not Purchased: • Business Property Protection' • Business Pursuits' • Cellular Communication System' • Electronic Data Processing Equipment* • Extended Coverage on Cameras' • Extended Coverage on Jewelry, Watches and Furs" • Extended Coverage on Musical Instruments' • Extended Coverage on Sports Equipment' • Fire Department Charges' • Golf Cart* • Home Day Care" • Incidental Office, Private School Or Studio` * This coverage can provide you with valuable protection. To help you stay current with your Insurance needs, contact your agent to discuss available coverage options and other products and services that can help protect you. • Increased Coverage on Money' • Increased Coverage on Securities' • Increased Silverware Theft Limit* • Lock Replacement" • Loss Assessments* • Satellite Dish Antennas' The limit of liability for this structure (Coverage A -Dwelling Protection) 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. This policy does not cover earth movement including earthquake. You have elected not to purchase a CEA earthquake policy. Scheduled Personal Property Coverage Your policy does not include Scheduled Personal Property Coverage. This coverage can provide you with valuable protection. To help you stay current with your insurance needs, contact your agent to discuss available coverage options and other products and services that can help protect you. Amended Deluxe Homeowners Policy Declarations Policy number: 1099889 899 Policy effective date: August 7, 2021 Your policy documents Page 3 of 3 Your Homeowners policy consists of the Policy Declarations and the following documents. Please keep them together. • Deluxe Homeowners Policy - AP2 • California Deluxe Homeowners Amendatory Endorsement - AP2237 • Lender's Loss Payable Endorsement - AU319 • California Deluxe Plus And Deluxe Homeowners Policy Amendatory Endorsement - AP29-5 • Amendment of Policy Provisions - AP425 • California Deluxe Homeowners Amendatory Endorsement - AP4482-3 • California Standard Fire Policy Provisions - AP1862-2 • Building Structure Reimbursement Extended Limits Endorsement - AP445 • Additional Mortgagee Endorsement - AU273 • Wildfire Deductible Endorsement - AP4886 • Marijuana Amendatory Endorsement - AVP504 • California Workers' Compensation And Employers' Liability Coverage For Residence Employees Coverage Form - AP1127 Important payment and coverage information Here is some additional, helpful information related to your coverage and paying your bill: s The Property Insurance Adjustment condition applies using the Marshall Swift Boeckh Publications building cost index. Please note: This is not a request for payment. Any adjustments to your premium will be reflected on your next scheduled bill which will be mailed separately. In the meantime, if you have any outstanding or unpaid bills, please pay at least the minimum amount due to assure your policy continues in force. If you have any questions, please contact your agent. Allstate Insurance Company's Secretary and President have signed this policy with legal authority at Northbrook, Illinois. 4 � - A /2- e� — Thomas J. Wilson President Susan L. Lees Secretary 0 0 N