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Insurance Policy - 2337 Greenvale Rd, Cleveland, OH 44121.pdf

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Tue Sep 21 15:31:49 CDT 2021 Shelter Mutual Insurance Company 1817 W Broadway Columbia, MO 65218 1-800-SHELTER (743-5837) Dwelling Insurance Policy Evidence Of Insurance As Of 09/21/2021 Named Insured: LOFTY HOLDING 2337 GREENVALE ROAD LLC 11718 FOLKSTONE LN LOS ANGELES, CA 90077-1310 Policy Number: Effective Date: Expiration Date: Agent: 34-73-10784513-6 09/20/2021 (1:15 PM CST) 09/20/2022 (12:01 AM CST) LUKE ROTH 34-AB19-85 2245 W DUBLIN GRANVILLE RD WORTHINGTON, OH 43085-3336 (614) 832-7949 P

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Tue Sep 21 15:31:49 CDT 2021
Shelter Mutual Insurance Company
1817 W Broadway
Columbia, MO 65218
1-800-SHELTER (743-5837)

Dwelling Insurance Policy
Evidence Of Insurance
As Of 09/21/2021
Named Insured:
LOFTY HOLDING 2337 GREENVALE ROAD LLC
11718 FOLKSTONE LN
LOS ANGELES, CA 90077-1310

Policy Number:
Effective Date:
Expiration Date:
Agent:

34-73-10784513-6
09/20/2021 (1:15 PM CST)
09/20/2022 (12:01 AM CST)
LUKE ROTH
34-AB19-85
2245 W DUBLIN GRANVILLE RD
WORTHINGTON, OH 43085-3336
(614) 832-7949

Policy Deductible
$1,000
Described Premises
2337 GREENVALE RD CLEVELAND, OH 44121

Description
FRAME, NON-OWNER, 1 FAMILY DWELLING

Coverages

Limits

Dwelling
Additional Living Expense
Drainage System Endorsement ($38.00)
Addition of the Peril of Vandalism
Loss of Rents

Endorsement
Number

$115,000
$11,500
$10,000

$545.00
B-102.7-B
B-847.2-B

$11,500
$597.00

Total for Term (This is Not a Bill):
Policy forms and additional endorsements attached to this policy
Additional Living Expense
Landlord Liability Coverage and Medical Payments Coverage
1000
Loss of Rents
Policy Term: 12 months
Zone Code: 002

Premium

Number
ADDEXP
B-454.12-B
RENTLOSS

Protection Class: 2

Secretary

President and CEO
End of Evidence Of Insurance

B-750.1-B

Page 1 of 1

Tue Sep 21 15:31:49 CDT 2021

SHELTER INSURANCE COMPANIES
1817 WEST BROADWAY, COLUMBIA, MISSOURI 65218-0001
ShelterInsurance.com
Phone:1-800-SHELTER
Federal Tax ID: 43-0613000
Cardholder

Payment Amount

LOFTY HOLDING 2337 GREENVALE ROAD LLC

597.00

Card Number

Transaction Number

Agent Number

Date Payment Received

************0081

1679

34-AB19-85

09/21/2021

Authorization Code
A490AD

Transaction Payment Type
MasterCard

Credit

Transaction Type

Card Transaction ID Number

Purchase

15019110

Risk Description

Payment Amount

Payment Detail
Policy Number
34-73-10784513-6

Insured Name
NB

LOFTY HOLDING 2337 GREENVALE ROAD LLC 2337 GREENVALE RD

Total Payment Received:
For policy details or payment questions, please contact your agent or call 1-800-SHELTER (1-800-743-5837).

M-1408.2-M

Receipt

597.00

597.00