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Insurance Policy - 918 Frederick Blvd, Akron, OH 44320.pdf

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Wed Jun 01 16:14:32 CDT 2022 Shelter Mutual Insurance Company 1817 W Broadway Columbia, MO 65218 1-800-SHELTER (743-5837) Dwelling Insurance Policy Evidence Of Insurance As Of 06/01/2022 Policy Number: Effective Date: Expiration Date: Named Insured: LOFTY HOLDING 918 FREDERICK BOULEVARD LLC 66 W FLAGLER ST 900 MIAMI, FL 33130-1807 Agent: 34-73-10784513-96 06/01/2022 (3:38 PM CST) 06/01/2023 (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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Wed Jun 01 16:14:32 CDT 2022
Shelter Mutual Insurance Company
1817 W Broadway
Columbia, MO 65218
1-800-SHELTER (743-5837)

Dwelling Insurance Policy
Evidence Of Insurance
As Of 06/01/2022
Policy Number:
Effective Date:
Expiration Date:

Named Insured:
LOFTY HOLDING 918 FREDERICK
BOULEVARD LLC
66 W FLAGLER ST 900
MIAMI, FL 33130-1807

Agent:

34-73-10784513-96
06/01/2022 (3:38 PM CST)
06/01/2023 (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
918 FREDERICK BLVD AKRON, OH 44320

Description
FRAME, NON-OWNER, 1 FAMILY DWELLING

Coverages

Limits

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

Endorsement
Number

$135,000
$4,000
$13,500
$10,000

Premium
$658.00
$42.00

B-102.7-B
B-544.11-B

$13,500
$790.00

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
DTS PROPERTY MANAGEMENT
29115 ANDERSON RD
WICKLIFFE, OH 44092-2357
Policy Term: 12 months
Zone Code: 002

Protection Class: 2

Secretary

President and CEO
End of Evidence Of Insurance

B-750.1-B

Page 1 of 1

Wed Jun 01 16:14:32 CDT 2022

SHELTER INSURANCE COMPANIES
1817 WEST BROADWAY, COLUMBIA, MISSOURI 65218-0001
ShelterInsurance.com
Phone:1-800-SHELTER
Federal Tax ID: 43-0613000
Payor Name / Cardholder
FREDERICK BOULEVARD LLC, LOFTY HOLDING 918 / FREDERICK BOULEVARD LLC, LOFTY
HOLDING 918
Type
Number
Amount
Transaction Number
Agent Number
Card

MC *7006

$790.00

2482

Payment Amount
790.00
Date Payment Received

34-AB19-85

06/01/2022

Risk Description

Payment Amount

Payment Detail
Policy Number
34-73-10784513-96

Insured Name
NB

LOFTY HOLDING 918 FREDERICK BOULEVARD
918 FREDERICK BLVD
LLC

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

790.00

790.00