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Insurance Policy - 3139 West Blvd, Cleveland, OH 44111.pdf

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Thu Feb 10 14:40:40 CST 2022 Shelter Mutual Insurance Company 1817 W Broadway Columbia, MO 65218 1-800-SHELTER (743-5837) Dwelling Insurance Policy Evidence Of Insurance As Of 02/10/2022 Policy Number: Effective Date: Expiration Date: Named Insured: LOFTY HOLDING 3139 WEST BOULEVARD LLC 11718 FOLKSTONE LN LOS ANGELES, CA 90077-1310 Agent: 34-73-10784513-63 02/10/2022 (2:24 PM CST) 02/10/2023 (12:01 AM CST) LUKE ROTH 34-AB19-85 2245 W DUBLIN GRANVI WORTHINGTON, OH 43085-3336 (614) 832-7949 Policy

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Thu Feb 10 14:40:40 CST 2022
Shelter Mutual Insurance Company
1817 W Broadway
Columbia, MO 65218
1-800-SHELTER (743-5837)

Dwelling Insurance Policy
Evidence Of Insurance
As Of 02/10/2022
Policy Number:
Effective Date:
Expiration Date:

Named Insured:
LOFTY HOLDING 3139 WEST
BOULEVARD LLC
11718 FOLKSTONE LN
LOS ANGELES, CA 90077-1310

Agent:

34-73-10784513-63
02/10/2022 (2:24 PM CST)
02/10/2023 (12:01 AM CST)
LUKE ROTH
34-AB19-85
2245 W DUBLIN GRANVI
WORTHINGTON, OH 43085-3336
(614) 832-7949

Policy Deductible
$1,000
Described Premises
3139 WEST BLVD CLEVELAND, OH 44111
Coverages

Description
FRAME, NON-OWNER, 2 FAMILY DWELLING
Limits

Dwelling
Frame
Additional Living Expense
Drainage System Endorsement ($50.00)
Addition of Broad Perils
Loss of Rents

Endorsement
Number

$172,500
$15,500
$17,250
$10,000

Premium
$803.00
$117.00

B-102.7-B
B-544.11-B

$17,250
$1,010.00

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
1000000/1000
Loss of Rents

Number
ADDEXP
B-454.12-B
RENTLOSS

ADDITIONAL INSURED
HAVEN REALTY INC
34050 SOLON RD STE 100
SOLON, OH
Policy Term: 12 months
Zone Code: 002

Protection Class: 1

Secretary

B-750.1-B

President and CEO

Page 1 of 2

Policy Number:

34-73-10784513-63

End of Evidence Of Insurance

B-750.1-B

Page 2 of 2