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Insurance Policy - 2022 - 9902 Garfield Ave, Cleveland, OH, 44108.pdf

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Wed May 25 13:02:32 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 05/25/2022 Policy Number: Effective Date: Expiration Date: Named Insured: LOFTY HOLDING 9902 GARFIELD AVENUE LLC 66 W FLAGGER ST 100 MIAMI, FL 33130 Agent: 34-73-10784513-89 05/25/2022 (12:46 PM CST) 05/25/2023 (12:01 AM CST) LUKE ROTH 34-AB19-85 2245 W DUBLIN GRANVI WORTHINGTON, OH 43085-3336 (614) 832-7949 Policy Deducti

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Wed May 25 13:02:32 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 05/25/2022
Policy Number:
Effective Date:
Expiration Date:

Named Insured:
LOFTY HOLDING 9902 GARFIELD
AVENUE LLC
66 W FLAGGER ST 100
MIAMI, FL 33130

Agent:

34-73-10784513-89
05/25/2022 (12:46 PM CST)
05/25/2023 (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
9902 GARFIELD AVE CLEVELAND, OH 44108

Description
FRAME, NON-OWNER, 1 FAMILY DWELLING

Coverages

Limits

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

Endorsement
Number

$147,500
$10,000
$14,750

$694.00
$80.00
B-544.11-B
B-102.7-B

$10,000
$14,750

$864.00

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

Premium

Number
ADDEXP
B-454.12-B
RENTLOSS

ADDITIONAL INSURED
B2B REALTY
4320 RIDGE RD
BROOKLYN, OH
Policy Term: 12 months
Zone Code: 002

Protection Class: 1

Secretary

President and CEO
End of Evidence Of Insurance

B-750.1-B

Page 1 of 1

Wed May 25 13:02:32 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
GARFIELD AVENUE LLC, LOFTY HOLDING 9902 / GARFIELD AVENUE LLC, LOFTY HOLDING
9902
Type
Number
Amount
Transaction Number
Agent Number
Card

MC *3152

$864.00

2459

Payment Amount
864.00
Date Payment Received

34-AB19-85

05/25/2022

Risk Description

Payment Amount

Payment Detail
Policy Number
34-73-10784513-89

Insured Name
NB

LOFTY HOLDING 9902 GARFIELD AVENUE LLC 9902 GARFIELD AVE

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

864.00

864.00